I am writing this from the pediatric ICU at Primary Children's hospital with a very grateful heart. It is been a dramatic couple of days but Michael is stabilized and doing well as he fights RSV and pneumonia. I have learned some vital principles about breathing and I wanted to share what I have learned so the mommies of little ones can better understand how to respond to future possibilities.
Our little number 9, Michael Stout Cooper, was born February 21st and all went well. He was strong and healthy and weighed in at 8 lbs, 1 ounce. He looks like all the other kids combined but we think he looks mostly like Joseph. He is a very content little one and even quite contemplative. He was eating well and sleeping well and gaining weight and we were all thrilled to finally have him in our arms.
Last Monday night he had a mild fever and seemed to be coming down with a bit of congestion. Some of us had been sick, including me. I had just had a bout with the flu the weekend before he was born and was coming down with a cold during his delivery. But I didn't worry because it couldn't be avoided. We had an appointment with his pediatrician for his 2 week PKU/Well-baby checkup on Tuesday morning. This is the only well-baby visit I take my babies to and that is because the state requires the PKU test--which I think is a good thing. But otherwise, why does a healthy baby need to see a doctor? At the appointment his temperature was normal and all looked great. He continued with a little congestion for a few days but was eating and sleeping well. His nose wasn't blocked so he didn't have any problems nursing but every now and again he would cough and I could tell his lungs were congested. Knowing it was RSV season and knowing that pneumonia could set in I put eucalyptus oil diluted with coconut oil on his chest. It would help loosen up the phlegm in his lungs and is also a mild antibiotic. But he was still doing well and didn't seem very bothered by the congestion. None of my other kids have ever had RSV so this would be our first experience with it.
Thursday night was a bit rough and Douglas convinced me to take him to the doctor Friday afternoon. My first nine years of mothering have given me an aversion to taking my kids to the doctor. Trips to the doctor are very expensive and they don't just cost money. They also cost a lot of time, energy, and hassle, and I have come to despise them. Visit after visit I was frustrated with the solutions they had to offer for the routine illnesses of childhood my children periodically suffered from. I started looking for natural remedies and found great success. I felt very empowered to have wonderful solutions to common maladies in my bathroom cupboard rather than having to go through the doctor and then the pharmacist. Don't get me wrong, I know that the medical community has a very important place in our society. There is no better system for an emergency and they are often able to work miracles. But when it comes to long- term health issues they often do more harm than good. The trick is to know when to seek their help. Prayer helps tremendously with this, but we must also study things out in our minds and seek an education that will help us understand our children's health issues, and then be willing to do what it takes to resolve them. Sick children will be sick adults and they will not be able to fulfill their earthly assignments and meet their full potential if they are sick and tired.
So for the second time in 9 years I took my sick child to the doctor. He was still eating well through Friday morning and the doctor listened to his lungs and they sounded good--no RSV and nothing to be concerned about yet. I asked him lots of questions to know what I should look for so that I could understand if and when to take him to the hospital. He explained that babies are "periodic breathers". A normal healthy baby has periods of irregular breathing. Every mother has hovered over her newborn while the baby is holding his breath and there are a few anxious moments until the baby breathes again. This is normal. There is a difference, however, between periodic breathing and "labored breathing". Labored breathing happens when something is interfering with a baby's ability to get in enough oxygen. The signals that they are laboring to breathe are that they breathe quickly by taking short quick breaths, or they have to work really hard to get a breath in and you can see their chest and stomach straining to do so. Their color changes with labored breathing because their heart rate slows, so they become pale or gray. Periodic breathing doesn't affect their heart rate so they remain rosy and pink. The doctor explained that labored breathing is the sign to watch out for with RSV--but a few minutes of it isn't enough to take him to the hospital. If he recovers afterwards then there is nothing they can do at the hospital for him. But if he has this labored breathing for 45 minutes or an hour, then that is when to be concerned.
At this point, I didn't understand that there are two critical parts to the process of breathing. The first is to take in enough oxygen and the second is to expel the carbon dioxide from the lungs. Labored breathing interferes with both of these processes. Apparently, the carbon dioxide, unless properly expelled, builds up in the blood. High enough levels of it act as a sedative like morphine. It also induces apnea. The infant becomes very lethargic and will eventually stop breathing altogether. I didn't know this until we were in the emergency room. By Friday night Michael was experiencing labored breathing but after a few minutes would seem to recover. We knew enough to be concerned and Douglas and I decided to take shifts with him through the night so that one of us was always awake and watching him. At midnight he stopped breathing altogether and turned an ashen gray. I started walking around with him, jostling him and talking to him but got no response. Dallin was still awake and after about a minute I sent Dallin in to wake up Douglas. I took the baby into the bedroom and gave him to Douglas. He was still not breathing and was totally limp and lifeless. After a few more moments I called 911 and Douglas started mouth-to-mouth. It was about two full minutes before Michael took a breath. I was still on the line with 911 when he gasped and started screaming at the top of his lungs. It was the most beautiful sound I have ever heard. His color immediately returned to a beautiful pink and he cried for several seconds. Dallin was watching the front for the paramedics and they were on the street a few seconds after Michael started breathing again. We gave them the baby when they came in and a few moments later Michael crashed again. He stopped breathing and went completely limp. He started breathing again but very shallow and ineffective. They rushed the baby and me in the ambulance to the new hospital in Riverton a few minutes away. They checked his blood as soon as we got there and the carbon dioxide levels were very high. They can check oxygen saturation rates with a little sensor on the finger but they need a blood test to find out the levels of CO2. They put him on oxygen that they called "highflow". The oxygen is blown into their lungs with a bit of pressure and that seems to help the babies breathe more effectively. They saw from his levels of CO2 that he needed to be up at Primary Children's Hospital as soon as possible. They called the Lifeflight team to come and get him and were discussing whether to put him on a ventilator or not. By the time Lifeflight arrived Michael had stabilized enough with a higher dose of highflow that he didn't need a ventilator. He could have been transported in an ambulance but the Lifeflight team brought a helicopter so they loaded him up and flew him away. Douglas and I went back home to grab a few things before heading up to the hospital. By the time we arrived, Michael was all settled in and seemed stable. But within a few hours they had to put him on a ventilator because his breathing was too erratic and ineffective. The doctor explained that babies don't die of RSV itself. It is the secondary infections that set in like pneumonia, or an underlying health problem like heart disease, that cause the mortality risk with RSV. Michael started to develop pneumonia, but that doesn't seem to have progressed far and he is on antibiotics for it. They have cultured the bacteria to know for sure that it is the kind that will respond to the antibiotic he is on.
At this point, he remains stable and they have tried to wean him off the ventilator. By yesterday they had reduced it by almost half and he can breathe over it but not well enough yet to reduce it any further. He is still struggling with the apnea. They will try again tomorrow to reduce it further. Douglas was allowed to give him a wonderful blessing and we both feel we will be able to take him home with us eventually. Sierra taught us that babies have a choice in this too and that worried me. Who wouldn't choose heaven and exaltation over the challenges and rigors of this life if they are given a choice? But Michael gave Douglas the assurance yesterday that he was fighting this and would try to overcome it, so we have high hopes. For the most part he is calmly handling all the tubes and the pains that come with them. He has not been sedated since they put in the ventilator and for the most part is handling it all with great patience. There are times when he is wide awake and we can interact with him a little, and there are moments of stress and discomfort, but he tends to calm down quickly and he sleeps most of the time.
We have insurance that seems to be a good plan so hopefully all will go well in that regard. We are hoping not to have to pay more than a few thousand. Because he was more than 2 weeks old he was sent to the pediatric ICU rather than the newborn ICU and he is a few beds down from where Sierra was.
This is all new to me and we are very grateful that we didn't have to pay for this knowlege with our baby's life. My heart goes out to you, Heidi and Monterey, once again as I contemplate your experiences in this same place.
