Two days After a Good Day

Last night we turned a corner... and got mugged.

Micah had a good day yesterday. Her numbers were good for the second day in a row. Olivia got to Kangaroo Care. Micah was eating well, with very little residual (food not digested within the first three hours). Things were pretty nice.

Then, . . . Then, Micah's oxygen saturation (o2 sats) started to drop, and drop, and drop, which has happened before, only normally they raise back up in between. This time, they weren't rising, just dropping. We sent out a call for help and within minutes dozens of people were praying. Within an hour, hundreds of God's children were interceeding for our daughter.

The x-ray of her lungs from yesterday morning looked bad, that is cloudy, evidencing a lot of open airways and capacity. The big trigger for all the changes however happened last night after her o2 sats started dropping. They did a blood gas (to measure her CO2 and the Ph level that results from the interaction between the CO2 and the O2): not good. In fact, very bad! Micah's blood CO2 was at 100%! The situation quickly became critical. If we hadn't already been there,we would likely not have been allowed to be present.

They gave her pain meds to help her relax and endure the procedures to come, switched her to a new ventilator (the Oscillator she was on last week when she was sick), and spent almost half an hour trying in vain to get a line in so they could run the proper labs, etc. Micah did not appreciate all of the attention, and her numbers got into scary territory more than once. Her blood pressure and heart rate both dropped very low in teh process. After several hours, they found a place where they could compromise with Micah's needs and try to let her rest. They took another x=ray and her lungs looked picture perfect. The problem was the amount of effort they were having to go through to make them look that way. Their goal was to slowly back off the support over night, because too much support could eventually cause future support to be less effective and because the unavoidable trauma that support causes to Micah's lungs to outpace the healing and growth she is doing.

They felt ok backing off on the treatment because Micah's blood gases quickly swung the other way: they were "too good". That is, the support was drawing too much CO2 out of her body. We are designed to have a certain amount of CO2 in our blood because that is how our lungs know they need to breathe. The ideal target in 35-45%, but up to 55% is acceptable. Micah got as low as 22%. A culture was also drawn to check for signs of infection. Eventually Olivia and I left and we all got a little restless sleep last night, and Micah was holding her own when we checked on her every couple of hours.

That is, until 8AM this morning, when Micah's CO2 shot back up and her O2 dropped back down. The small sacks in her lungs have not stayed open as they have tried to decrease support. More support. More ventilator. More Oxygen in the air she is breathing (which they say could cause more damage). This time they added surfactant to open her lungs and after a few hours, Micah had another swing in her CO2 back to "too good" from "way too bad". And, lots more prayer! Let me break it down and walk you through today:

Every few minutes this morning, we would find out more, and little enough of it was any comfort: CO2 is maxed out, but they don't know why; New x-ray looks much worse than last night but not as bad as yesterday morning; Trying surfactant, which may work, may hurt, or may do nothing; Feel led of the Lord to ask for prayers specifically in the context of praise and worship (God has said He inhabits the praises of His people); We replace the battery in Micah's MP3 player so she can hear the soft praise music she heard regularly in Olivia's womb; At this point, her CO2 swings to "too good" but O2 is still bad; Feeding has been stopped since before we arrived and she misses her second or third meal since this started so IV nutrition is begun; More changes are made to her ventilator in order to address the two issues of oxygenation (O2 in blood) and ventilation (CO2 levels, either high or low). They begin to ween Micah off of the O2 supplied by the machine, because they have apparently re-opened her lungs back up with the high pressure and surfactant they had to use earlier, decide to restart feeding, and find a comfortable place for her to rest. The process involves multiple blood gases (which means lots of needle sticks sicne they couldn't get the pickline in) and lots of fine tuning (down on one factor, which requires going up on another, etc.)

The danger is that this cycle will continue: with increasing effort and decreasing results. Micah needs time to grow, and time to heal from the damage she has already suffered as a necessary consequence of the efforts that are keeping her alive. This is a race between nutrition and healing growth in one lane, and lung injury in the other. The goal is to support Micah as she grows while trying to keep the scale tipped in the right direction. Every traumatic intervention (like these two) is a momentary tip of the scale the wrong way. Even the normal support of ventilation can irritate and damage her fragile lung tissues.

We did have a good visit with the doctor on duty late his morning, and he seemed positive about the immediate outlook (there could be issues in the future related to lung injury and difficulty getting off of the ventilator in the future). The biggest issue for us is that Micah's lungs need healing. God has given young babies a natural capacity for this, but she needs time without lots of intervention. Of course, God can heal her regardless of these things, which would be fine, but this is what we know to ask for.

When we finally felt released by the Lord to leave for lunch and a rest a little while ago, Micah's numbers were relatively impressive. They aren't where we want them to be, but they are better and generally headed in the right direction. Again, this is a race. We need to be both going in the right direction, and getting there quickly enough to outrun the lung injury. We went back after lunch and sent Mama's extra milk (extra for now that is) home to our deep freeze with some sweet friends headed back to Abilene. We just ate diner and will go see Micah again tonight. We are praying for a good visit and a good day in a day or two so we can recover,

So, that's what this all looks like in the physical, but of course, if you know me at all you understand that we understand the Bible to teach us that the physical is only part of the picture, and often not the most important part.

 Put on the full armor of God, so that you will be able to stand firm against the schemes of the devil. For our struggle is not against  flesh and blood, but against the rulers, against the powers, against the world forces of this darkness, against the spiritual forces of wickedness in the heavenly places. Therefore, take up the full armor of God, so that you will be able to resist in the evil day, and having done everything, to stand firm. ---Ephesians 6:11-13

There has been more going on than just Micah's physical struggle. Our world is in the midst of a great conflict between the prince of darkness and the God of Light. Everything (repeat, EVERYTHING) that happens in our lives is impacted by this reality. We are both the battlefield and the combatants in this conflict. There are two camps, and everyone you know is in one camp or the other. Of course, the problem is that we start off in the wrong camp. We don't know it, and often don't believe it, but we all begin as God's enemies.

Yet, even while we are God's enemies, He loves us (Roman 5:10) and creates a plan for us (2 Peter 3:9). Most of us have seemingly (though not truly) unimpressive roles to play in God's plan. Some of us are intended for specific purposes in his plan. Some people don't think this is fair, but if God were merely fair, we would all of us be without hope because fair is sinful mankind seprated forevr from a holy God. This is why Romans 9:20-21 says, "On the contrary, who are you, O man, who answers back to God? The thing molded will not say to the molder, “Why did you make me like this,” will it? Or does not the potter have a right over the clay, to make from the same lump one vessel for honorable use and another for common use?"

So, in reality (whether we like it or not) God intends to use some of us to bring Him glory in great ways and some in small. My ways of bringing God glory (despite all of my years of striving) will likely be small, and I find comfort in the fact that I do in fact have a role to play, and have been given the opportunity (again despite all of my years of striving) to spend the rest of my life doing it. I believe I am probably a vessel of relatively common use. I may be wrong, and God may have some "great" thing for me to do, but it mostly doesn't matter to me anymore, and to the degree that it does matter I consider myself proud and thus disqualified. [But,who am I to even know what sort of vessel I might be, I'm just trying to explain the idea, and I am not the point. What fickle distraction!!]

However, I do not believe this is the case with Micah. I believe (as much on the testimony of others as my personal feeling, though I am fine with her being completely ordinary if that is God's design for her) that this little girl has an anointing. She has a special purpose on her life, a calling, as do many other children of her generation. I cannot say more than I know, but I believe the enemy knows what anointing looks like, and he hates it, attacks it, and tries to confuse or destroy it. Sometimes I imagine he even succeeds. Not so here. Here, we are fighting for Micah, God's child, on loan to us from His hand, in order to protect and raise her up to know and serve Jesus in some particular way.

Now, I'm not trying to pick a fight. I am just telling you what the Holy Spirit has revealed about what is happening: real Frank Peretti style spiritual warfare, complete with scheming demons and warrior angels. After all, this is the sort of world Jesus is described as living in, not because "they didn't know any better" but because they didn't assume that they DID know better, as perhaps many today do. You can believe me and pray with me, or disbelieve me and pray for me. Neither one will offend me.

Micah was under attack last night. Somehow, a plan was laid against her, and for a while evil seemed to have the upper hand. But God is not without His resources, and as we prayed together from all over this nation, darkness was pushed back. The plan was confounded and peace was restored to our little girl. So, why the relapse this morning? How am I supposed to know? But we prayed and battled again, and Micah is doing better, again. We will always pray because we believe prayer changes things. {Thanks to my dad for helping me think some of these things out in the midst of distraction and refocusing.}

Certainly, you may believe that Micah's recovery is due solely to the skill and knowledge of her doctors and nurses, but I should tell you that we haven't met any doctors or nurses so far who would agree with you.

Some boast in chariots and some in horses,

But we will boast in the name of the Lord, our God.

Psalm 20:7