PICU – Drains out

Saturdays in the Paediatric Intensive Care Unit felt different from weekdays. The doctors and nurses seemed more relaxed. The place felt quieter. Like going shopping on a Sunday, it’s still busy but not as much as the rest of the week. I liked the more relaxed vibe. I chatted to our nurse for the day and found out a little about her. Every day is a new nurse and it was always nice to get to know them a little bit. They would be with me for their whole 12 hour shift pretty much, which can be an intense time span to be close to each other and not talking. It also helped pass the time. I found out that on the weekends, unless an emergency, no surgery took place. Also, no meetings happened. The weekends were for maintenance, observing and recovery. The real business happened during the week and that’s why it all felt smoother. I was surprised to learn that Zach would be having his drain out and later would probably be coming off his ventilator.

First the doctors’ rounds had to happen. Then the individual doctors would come back to check what would be needed. So it was lunch time before it was confirmed. Doctor Jeff came to remove his drain. Dr Jeff is the Shoreditch of the PICU doctors. A very cool cucumber indeed. He came over to explain to me that they would give Zach ketamine to give him a nice sedation in order to take the drain out from his chest. I made some silly jokes about ketamine and to my surprise was greeted by laughs! Yes, Dr Jeff found me funny. Some of the doctors were all very serious which sometimes made more nervous, like being back at school as a student. I hovered by Zach’s bed as they started the procedure, but I couldn’t hang around and watch. It is a thick tube that was being pulled out and I really didn’t fancy seeing the hole it left behind. So I went and sat in the parents room for a few minutes whilst they finished.

When I came back it was all done. Dr Jeff was sat back at the middle station that was central to all of the beds. I went over and said thank you to him directly. Myself and Emmanuel always found it surprising how few people say thank you to the doctors and nurses. I know it’s their job but I was thankful to him, so why not say it!

I went over to Zach who was now very, very out of it thanks to the ketamine. I joked with the nurse about him hopefully having a nice little high. I really should stop making drug jokes to the nurse and doctors or they were going to start thinking I was going to try and sneak some home with me or something. Zach was high as a kite and I was glad. He deserved to not feel pain right now. They told me that it would be a few hours before he came round enough to take the ventilator out, but five hours later he was still very high. He was twitching and wiggling around every now and again, but he wasn’t aware enough to be able to take his own breaths and so it stayed in for now.

It wasn’t until 6pm that night that the ventilator finally came out. He hated having all the hands on him, but he was happy when it was gone. He loved sucking on his dummy again afterwards. It was nice to see him without the tube in. He was super sleepy afterwards and so I just sat holding his hand again. I didn’t stroke his head too much as it made him wiggle around, which I think must have hurt him. So, I just sat and stayed there. I am sure he knew I was there. It was a big day for him. Emmanuel was gutted that he had missed this. He had been sorting things out at home for us. I messaged him all the updates but it’s not the same as being there. All that mattered was that Zach was ok, but we like to do things together when we can. He was so happy to see him when he arrived later that day. It was really sweet to watch him. “Hello Son,” he sang over our sleepy baby. He warmed my heart.

That evening we headed back to Ronald McDonald House feeling positive. He’d had the surgery. He was through the worst part of the recovery process, right? Well that’s what we thought.

PICU – Day two -Holding Hands.

Myself and Emmanuel Arrived at the PICU early. We were told that everything with Zach looked good overnight. Nothing unexpected had happened. It was so reassuring to hear that. I really felt like we were through the hardest parts. It was just a case of time now.

I remember feeling that I didn’t know how to be. The PICU was new to us. I was used to my own space with my bags and snacks around me. In the intensive care unit the level of cleanliness was high. They was nothing there except the patient and all the machines. It was empty so that it could easily be kept clean. Of course, for good reason. Most children there had a lot of tubes going in and out of the body. Zach had drains and his ventilator as well as the central and ‘art lines’. All infection risks. It made perfect sense. I didn’t know where his nappies were. Or what I was allowed to touch. So, I sat still on my chair with a few bits next to me. My breast pump, a bottle of water and my phone. I wasn’t sure how close I could get, if I was in the way or not. I was like an awkward odd button that had been sewn on when the original had fallen off. Myself and Emmanuel sat quietly together by Zach’s bedside, both feeling like odd buttons. We messaged our families to let them know Zach had done well over night. Then we just sat some more. There really wasn’t much to do but sit and wait around.

Emmanuel had a DJ job that night, so he left in the afternoon to go back home in order to get his equipment ready. So I stayed by Zach’s bedside and held his little hand. I couldn’t think of much else to do but that. I stroked his head and whispered to him that I was there for him. He twitched a little bit as if to say ‘I know mummy.’ He hadn’t changed much from the day before. His drain had stopped producing so much liquid. His urine pot was filling up nicely so his kidneys were clearly fine. He was just doing well. That was it. I longed to hold him again. To let him know that he was safe. To feel his warm little body snuggled into mine. It was possible to hold him with the ventilator in, but moving him with the drains and everything else would probably have been painful for him. So, I sat and stayed nearby. 

The nurse who was with us that day started to chatting with me about lots of different things. What job I do. What job Emmanuel does. Where did we live. All of the normal small talk type questions. I found myself in a conversation that was getting me through the minutes. The walls of the ward that had already started to close in were now backing off. The beeping of the monitors that starts to scratch at your brain had eased. Another nurse who was with another little baby in the opposite bay started talking with us as well. Soon we were in a full-blown chat about hen parties, wedding dresses and the TV program ‘Say Yes To The Dress.’ Before I knew it two hours had passed.

I am sure that nurses are trained to do this. Every nurse I met had a way to take my mind off things or supported me when I most needed it. I am sure that they were looking after me just as much as Zach. Those conversations about normal things kept my mind from drifting away into dark places. When I was sat watching Zach take each breath after another and silently praying for him to just take the next one, just keep going. A chat about a hen party takes you away for a few moments. It lifts you into something that resembles your old self again. Making you whole again. Giving you strength. That day I sat by Zach’s side for fourteen hours. The Nurse that switched over on shift change, kindly suggested that I might need to get some sleep. The senior nurse came over and had a chat with me that evening as well. I am sure she was told ‘you better check on that mum, she hasn’t moved in hours.’ Like a little whisper. We have a code purple. The mum wont leave!! I just didn’t want Zach to feel alone. Maybe I felt alone without him. We had just spent nine months together, for us to be apart was unnatural.

I read him the first few pages of the ‘Velveteen Rabbit’ before I left for the evening. I also gave him a fabric square that smelt of me. When I was pregnant, we had attended a class for parents who were going to have a baby that would be staying in hospital. In that class they gave us all a knitted square to take home so that when we were in hospital we could leave it with each of our children, post-surgery, and they would have our smell when we weren’t there. It was brilliant. I had knitted squares, cloths and blankets that I would rotate. This little square smelt of me. I had been wearing it in my bra all day. I placed it by Zach’s head, so he could easily catch a familiar scent. I tucked a freshly washed one underneath him so that when I needed to express milk away from him I had something that smelt of him. I started to do the same with blankets, I would sleep with one in my bed and bring it to him the next day. I have no idea if it worked but it made me feel like I was doing something at least. I kissed his head gently without disturbing him too much and left.

I cried the whole walk back to Ronald McDonald House. I was lonely by myself. I hate not having Emmanuel around me, I always miss him. This was just awful. I was alone. He was alone. Zach was alone. I made it past reception with my head down, hiding my red face and scurried to our room. I sat on the end of the bed and howled. Big screams, along with streams of tears, and got it all out. I needed to release it all and I did. I had some food and a shower and managed to express breast milk again before laying down to sleep. I had my alarm set for 3am (to express) and 6am ready to go back again in the morning. Tomorrow was a big day; he would be having his drains and ventilator out hopefully, I had to be there with him. It was hard closing my eyes that night, but soon exhaustion took over and I finally allowed sleep to take me.

Savannah Part two – Tea and Toast angels

Savannah ward became my home for the next six days until Zach would have his first surgery. We had no idea it would take that long before his operation but he was a tricky little critter and so posed a conundrum for the doctors. For six days I stayed on the Savannah ward with Zach day and night.

The first two nights I had the hospital bed that sat upright in the bay next to Zach’s. The nurses pulled the curtains around to make us one giant bay together. The first two nights I managed at least two hours of comfortable sleep. The third night the ward was full so I had to sleep on the pull-down bed next to Zach’s cot. That night I remember so distinctly. I was laying on the bed shivering and shaking from the urinary tract infection I had. I was wrapped up in two hospital blankets, but I was still icy cold. I had an upset stomach and kept getting up to have to go to the toilet as everything was simply passing through me. (TMI.) And Zach was not feeding very well. He was feeding constantly or just sleeping for too long and his blood sugar would then drop. By the time the morning arrived I was a wreck. Then an angel nurse came in and saw me crying over Zach’s cot at the start of her shift. He was sound asleep and I was drowning him in my tears. She promptly pulled the curtains around us and stated ‘I am getting you some tea and toast.’ I nodded unable to speak. I leant back over his cot again and continued to cry. She reappeared later with the tea and toast.

“I’m sorry” I mumbled. Wiping snot from my nose.

“I haven’t slept and I am ill and I have a bad stomach and I can’t help myself I just keep crying.” I blurted out all at once. Angel nurse stood calmly and listened to me as I droned on about my poor self and how much I felt like I couldn’t look after Zach. I thought He was upset all the time. That I didn’t know if we were doing the right things for him. She listened and listened as I cried my way through an onslaught of emotions. I finally managed to pause and drink some tea.

“It’s a really good tea. Thank you” I told her.

“The trick is to use two tea bags.” She smiled at me and somehow, I felt better. Her kindness and the tea had brought back some sense of logic.

“Can you watch him whilst I have a shower?” I asked her. And of course, she did.

The angel nurse that day took care of me just as much as she did Zach. We started talking about many things and somehow my day lifted. It took me away from what was happening in front of me. I will be forever grateful to her.

Some of the nurses on Savannah were the kindest people I have ever met. I honestly don’t know how they did it. How they keep their patience. How they deal with seeing sick babies’ day after day. The Savannah ward is a unique place. A sort of microcosm. An ecosystem all of its own. It became my whole world and the nurses, my friends. Myself and Emmanuel had nick-names for some of them as we couldn’t remember all of their names. One was ‘Team leader.’ As she seemed to be the one that everybody was friends with. She was the Queen bee of the group when she was in. There was ‘Social Media’ who was often on her phone. We overheard her once asking a colleague what emoji she should send to a guy she was talking to. Each nurse had their own way of doing things as well. It was a game during shift changeovers to see which nurse we would get. I loved messaging Emmanuel and saying, ‘Today is going to be a good day, we have one of our favourites again’. At night If I had a nurse that I trusted (which was most of them) I would ask them to do one of Zach’s feeds for me if I was asleep so that I could get at least four hours sleep. They would often sneak into the bay and do just that. Letting me get some much-needed rest. They would say ‘well we have to be awake so we might as well do it. But you need some sleep.’ 

As the days on Savannah wore on, my time there started to get to me. I was going back to Ronald MacDonald House (our accommodation) in the afternoon and getting a two-hour nap. Then about four hours at night if I was lucky. Which sounds great for a new mum, but I wasn’t at home. I couldn’t lounge on the sofa all day, or call my mum or mother in law to come and help me. I had to sit and wait for the doctor’s rounds. I had to try and take in the information they gave. I watched Zach’s machines as they beeped away all day. I kept track in my head the of all the numbers. I was constantly on high alert. I think my cortisol stress hormone levels were probably through the roof! Plus, I was recovering from my own surgery. Every time I lifted Zach out of his cot, I could feel my wound pull. I would wince with pain as I pulled myself up from the low-down beds to stand up. My feet were swollen and puffy. My body ached for a proper bed and I cried constantly. I was a mess. But I looked around and every other parent there was in the same position as me.

All the parents dealt with things differently. Some would keep to themselves and watch their phones all day long. Others would chat to everybody they could. Some started to take it out on each other. I heard one distinctive argument from a couple that I will never forget. I wish I hadn’t have overheard it, but we all deal with things differently and I guess that was their way. One night on a ward together and you know the sound of every body’s snores, their babies cry and each person’s toilet habits during the night. You get very comfortable very quickly. Let’s face it they all saw me wandering around with a bra and maternity pjs on all day. I was constantly breastfeeding and had no care for covering up. So, they probably thought of me as the crazy, breastfeeding, crying woman.

There is a parent’s room at the end of the ward on Savannah. A haven for parents to step away from the bay when needed. To make a cup of tea or to store food. To be honest It wasn’t the nicest room in the world. It did have a lovely big open window that looked across to St Thomas’ Hospital building which is quite beautiful. I stood by that window and cried when Zach had his blood tests done. I stood by that window when I just needed to breathe after another day with no news. I stood by that window listening to hear if Zach had woken up. It was a good window.

The parent’s room also became the place of small talk. ‘How was your night?’ ‘Are the stitches out yet?’ and ‘ah fantastic she had her feeding tube out.’ Were common conversational topics. At first, it was really scary to talk to other parents. I felt as though I wasn’t qualified to be there. But I soon realised nobody was. We were all new to this. Or most of us were. Most babies on this ward were cardiac babies, all under a month old. Some were older. But I only saw one child who was older than five and she was only in for the day. That’s the nature of the ward and the specialism in the hospital. It all happens when babies are firstborn. So, unless someone had an older child then we were all very new to this. The nurses knew more than us. Heck, even the kids knew what was going on more than we did. It is scary being a first-time parent, then being a first-time parent to a cardiac baby.

Soon those small conversations became mood lifters. A little chat about progress during the time the kettle boiled could lift a whole morning. Often, I would feel as though Zach wasn’t like the others and as he hadn’t come in and then gone for surgery. But as I got talking, I realised it was common for babies to take longer, or to come back later. It made me feel better to know it wasn’t just us. The same for when I was feeling as though Zach was doing really well. Another parent would need me to reassure them. I Would tell them that we had been here a week and that it does get easier. We were all in the same boat, floating down the Savanah River.