Praying for a Better Day

Cute this direction...

...and cute this direction!

Micah is ok, but last night was rough. 

I remember the first time I was brave enough to ride the Shock Wave at Six Flags Over Texas. I wasn't much taller than the finger on the sign announcing only people of a certain stature (42") were permitted to ride that particular roller coaster. It was the first looping roller coaster I'd ever ride. (The first of many.) They'd strap you into this chain of carts, haul you 12 stories into the air, and let you slide into a gentle turn to the right. Then, before you are quite ready for it, you feel a pull forward as the first car slides down the ramp. Suddenly you're racing at 55 miles per hour straight down, and just when you catch your breath and realize you are screaming at the top of your lungs you're into the first loop and your stomach squashes down into your toes. Then, your head inexplicably fills with blood and for a brief moment you wonder, "What exactly is it that keeps this thing attached to the track when its unpide down?" and then back down you go. Your stomach bounces back from your throat to the seat of your pants with enough force to remind of that soda you drank in line and maybe you get a little light headed as all of the blood that just rushed into your brain dumps back down the other way. It's a little like being in a washing machine, kind of like a first date, and a lot like catching a fastball in the gut.

Last night was sort of like that. Sort of. Last night was harder, the drop more unexpected (despite all of the warnings) and the ride a lot longer than 2 minutes and 40 seconds. Also, I'm taller now. (Not much, but give a guy some credit!)



 Yesterday, I mentioned the "something big" we felt coming with Micah. Well, it came. Her tube came out while we were in the other room pumping after we returned to the hospital after dinner. We walked back into her room to the top up on Micah's incubator (though we couldn't actually see the incubator through all of the nurses and technicians). Micah's tube had slipped out (it was unclear to me whether she pulled it or not) during a normal attempt to reposition it on her "Logan's bow" (the little piece of metal that keeps her breathing and feeding tubes stationary). Since this was not a planned extraction, her situation was "emergent" (a term that sounds strange at first just means "an emergency" without sounding so panicky).

The doctor on duty re-intubated her, but was not able to use a larger tube. He determined that Micah's vocal chords and airway were still too small to increase her tube size. Doing so by force would likely have caused permanent damage, so we've decided to be ok with the fact that the new tube leaks almost as badly as the old one (though they don't know why since it is still a tight fit).

In one way, we weren't that surprised, because she had been irritated all day. But, we were unprepared for the way it happened and for the difficulties Micah had last night (most of which had nothing to do with the tube change).  (((No, I don't know why I am using so many parentheses.)))

Her oxygen levels were bouncing up and down as she struggled between settling down and letting her ventilator help her breathe and fighting it by clamping down in her chest. When she let the machine's work, they worked great; but when she fought them, her numbers would drop suddenly. Even today, I watched as her oxygen bounced back and forth from two low to too high and back in just seconds. She looked pale, and her red blood cell count was almost (but not quite) to the level the doctor had decided would require a transfusion. This was hard for us, because Olivia and I both felt that her levels were dropping too fast to wait and retest them on Friday before intervening, but the nurses couldn't retest without a specific order. She eventually settled a little bit, but still looked extremely pale when we finally left late last night, and all we could do was pray for protection.

Paleness was the only indication she gave last time to it being way past the point of needing blood, and the doctor said he would have transfused earlier if he had known how low she was. We felt like the situation looked the same, and were frustrated by our lack of ability to "make them" do something. All we could do was wait through the night and address the issue with the doctor in the morning. We knew her red blood count wasn't all that was going on, but it was something to start working with. So, while we believe God is in control and using Ahava's doctors and nurses as He assigns them, we still hardly slept.

Overnight, Micah continued to struggle with her settings and her levels. The less invasive meds they were trying were ineffective, and they had to give her stronger (harder hitting and shorter lasting) medicine. These make her much less responsive to us, and while they help in some ways they are obviously something Micah doesn't like. She wears herself outfighting their effects until they overcome her.

Early this morning, the Nurse Practitioner decided that Micah looked bad enough to order a transfusion even without a test to see how low her red blood count was. We are thankful for this decision. We wish it had happened earlier, but the multitude of factors just makes us glad it didn't take until Friday. (Again, this is only a starting point.) Micah is still deciding just how she will respond. She had a very bad blood gas this morning (which contributed to the transfusion decision), and had to have her machines turned up. She was irritated by the changes, and restless despite the medicines, but her blood gases did begin to improve by about 1PM.

Now, we are waiting for her new blood to oxygenate so they can begin the slow process of weening her off of the extra support.

We are praying for strength, comfort, and peace. We are praying for continued growth, and limited damage from the extensive interventions she required over the last 18 hours.We are praying for God's protection and presence. We are praying for a better day.

Dear Jesus, I need your touch.