Backstory, part four

My friend C just had a baby, and I went to the hospital to visit her Sunday afternoon. I packed a little picnic--biscuits and honey, with two travel mugs of hot tea, since you can’t get properly made tea in a hospital--and we sat and had a nice visit while she nursed her son. I enjoyed our visit, and it was fun to see the newly built hospital: clean and big and beautiful, more like a fancy hotel than a hospital.

But though my mind was happy enough, the rest of me didn’t feel so hot. I parked and walked up to the hospital, through the lobby to the elevator, past the gift shop to the “family birth center,” past the nurses’ station to the right room, all with my heartbeat and breathing quickening, my stomach queasy with adrenaline.

I had the same sort of “mini-anxiety-attack” a little over a year ago when Dan and I went to visit my brother- and sister-in-law and their new son in a different hospital. After talking to S about it for awhile tonight, I decided that hospitals, and especially the labor and delivery floor, take me back to the first six weeks of Elijah’s life.

Thinking back, the physical misery of those first weeks stands out in my mind. We lived an hour from the hospital, so the nurses took pity on us and let Dan and me stay in an unused room. First we were across the hall from the NICU, then down the hall, then in the other wing of the hospital in a tiny little room where the thermostat didn’t work. I was pumping for Elijah every two hours around the clock. I would wake up drenched in sweat and shivering, and even bundled in my warmest coat I was shaking so hard I could hardly put the pump pieces together. My skin hurt like I had the flu. By the time I finished pumping, I had about an hour and fifteen minutes until I had to get up and do it again. I spent the days sitting by Elijah’s bed pumping—and, once a day or so, holding him.

My milk came in great. I could have been supplying half the NICU, if that sort of thing weren’t against the law. At least I had the consolation that all that pumping was good for something. But Elijah couldn’t handle much volume in his tiny stomach, and he was barely gaining weight, even with my breast-milk supplemented to make it higher calorie. At the rate he was going, I was starting to feel like he was going to hit the eight pounds needed for surgery around the time he was six.

The doctors extubated Elijah four or five days into our stay, and it quickly became evident that he couldn’t breathe without assistance for any length of time. They placed an oral pharyngeal airway for about twenty-four hours, but it made the entire roof of Elijah’s mouth one big sore, so they replaced it with a nasal pharyngeal airway, or nasal trumpet.

The basic idea of an airway is that the plastic tube slides through the nose or mouth down behind the patient’s tongue and keeps a little space open for air to pass. For Elijah, this only worked so-so. His body recognized the airway--and the NG tube in the other nostril--as a foreign object, and was constantly producing mucus to try to get rid of it. The mucus clogged the airway, stopping his breathing, and sending his heart rate and blood-oxygen saturation (sats) dangerously low. The nurses were constantly suctioning out his airway, which irritated the area more and caused more mucus build-up. Sometimes, even when the tube was clear, he would desat, and his resting heart rate was always forty to sixty bpm higher than it should have been, just because breathing was so much work. (Hence his failure to gain weight.)