Not a Moment too Soon

I walked into the ward last night with my mind prepared for hearing the breathing struggles of a small boy my screening friends had told me about days earlier.

On Patient Selection day there had been an EMT call to the pre-screeners at the very front of the line, for a small boy who had an airway obstruction. He had by-passed registration and histories, where I was stationed, but I heard about it through the radio conversations. I also heard later that he’d been scheduled for surgery in the first week of the hospital being opened.

Yesterday when I walked into the ward, he was sitting in bed 1. When my ears heard the struggle of air passing through his airway, my eyes saw the retractions of his muscles, the tension in his neck, the waving of his hands as he struggled to gasp in the air that his body so desperately needed, my heart lurched and I swallowed back the lump in my throat and blinked back the tears that threatened to roll down my face. At that moment, although he was acutely distressed, he’d been in this position for four months, there was nothing I could immediately do to relieve his stress.

When he was awake it was only for small periods of time because his body was so exhausted from the struggle to get oxygen. When he fell asleep it was only for seconds because he would stop breathing and his body would wake him up to breathe. Over and over and over again, he’d wake up, fling his arms around in frustration and flop back into a restless, teasing sleep.

Today he got his surgery. As I was preparing to head to work I could hardly wait to hear how it had gone. I bumped into his surgeon in the hallway, who quickly filled me in. The tumour was out, he didn’t need a tracheostomy and he’d been extubated about 20 minutes ago.

He stayed in the recovery room for some hours as they woke him up slowly preparing for worst case scenario. He recovered well and so they brought him around to the ward, to the nurse in my team. Once he was settled in his bed, we monitored everything very closely, rejoicing in the sound of his much quieter breathing.

The doctors popped in and out, backing us up by being close by if we were concerned about anything. As time passed by, his oxygen saturation dropped lower and repositioning him didn’t help. His heart rate and respiratory rate increased and so we called the team back for help.

After discussion between doctors and with the mama, they took him back to the OR to intubate him and sedate him for a couple of days to let his body rest.

An hour later he arrived back from the OR. We settled him into the new intensive care bed, on the ventilator, letting his body catch up on the last four months of missed sleep. His little body lay there, the machine doing the work of breathing for him, his chest moving up and down, muscles completely relaxed, so peaceful and comfortable.

In the following days he will come off the ventilator and we will see him breathe on his own, healthy and strong. I can’t wait to see him walk and play and smile.

This is our little boy, days before his surgery. Strangely enough when you look at him here, you could never known how desperately he was trying to breathe before and after this photo was taken.