27 May 2009

PICU 2

We finally got home at about 11pm on Monday night after Cathal's surgery, after seeing him safely and comfortably settled in ICU. I think we might have phoned them to check on him before going to sleep, and again during the night, and the following morning as soon as we got up. The advantage of buying our house where we did, is that we are only 5 minutes away from the hospital. A stroke of luck. We never felt the need to book into parents accommodation, and I am so grateful that we were able to sleep in our own bed. And sleep we did, exhausted from the previous days events.

We got in to see Cathal early the next day, and he was stable. His nurse catered to everything, constantly checking his drugs, taking observations every 30 minutes. She told us that he was doing well, and she was not concerned about him. But during the day, his health started to deteriorate, slowly, so slowly we did not see it.
Paediatric Intensive Care is an intense place. It is a large open room with 6 beds, and two isolation rooms just off the main ward. Each patient has their own nurse. There is always a couple of nurses that run errands. If a nurse has a patient, they are not aloud leave until the end of their shift for infection control. There is a team of registrars, at least two that are constantly doing rounds. Then there is also the aesthetic team, renal, repository and cardiac teams to name but a few. All in all, with all the traffic, it is actually a quiet and peaceful place, even the alarms don't sound urgent. Each one is slightly different, and none of the staff jump when they go off. There is a sense of calm professionalism that surrounds each person which I found very reassuring. They also enforce "Quiet Times" between 7.30am-8.30am, 1pm-3pm and 7.30pm-8.30pm. No parents aloud in PICU during these times. We always took the opportunity to go home, sit for awhile and rest.

On Tuesday the 10th of March (Cathal's first birthday, we got back to ICU at 8.30pm, after the change of shift and hand over. We will never forget his nurse that night. She is the only person we met there who did not radiate that sense of calm. As soon as we reached his bed side after washing our hands and putting on our aprons, she told us she was very worried, he was very sick. There were several doctors close to him, discussing him. Cathal had forgotten to turn his kidneys back on after the surgery, and he was swollen from head to toe with excess fluid. All this extra fluid was then putting pressure on his fragile heart, which in turn was causing hit to work harder, which made it tense up, which in turn would cause his kidneys to shut down. A catch 22. The surgeon was phoned, the cardeologist was called, several options put forward, several drugs administered to get things going. But nothing was working. After several phone consultations with the surgeon, a plan of action was decided upon. But in the mean time, Cathal's nurse kept repeating "I'm very, very worried about him". Maybe she thought she was preparing us, but all it did was give us a sence of foreboding and extreme worry that was not in anyway helpful.

We were kicked out at 10.30pm, not knowing if we would see him alive again.

The renal team were called to put a catheter straight into his bladder. The plan was to kick start his kidneys by pumping fluid into his bladder, and then removing it the same way it went in, which should, in theory start his kidneys working again. His IV fluids were also reduced, every millilitre was counted to make sure that more fluid was coming out than going in.

In the meantime, we sat and waited in the ICU waiting room, exhausted, shattered and petrified. All I could think was that it was not possible for us to loose him, we had committed too much to Cathal, we had put everything into him, all our hopes, love and devotion, and this was not how it could end. This is the second time in his short life that I could feel him slipping away. I didn't call anyone to tell them how serious Cathal's condition was that night, how could I ask people to expect the worst when every time I thought of him leaving us, my mind would totally and completely reject the idea.

Finally, god knows at what time, we were told that it was starting to work. He was expelling more fluid than was going in. Everyone could breath. Once we were reassured by everyone that he was out of danger, we bleary made our way home for some broken sleep.

It was only when his consultant recently told us that he did not know if Cathal was going to pull through or not that night, that we really realised how close he was to dying.








I am sure your all glad that you know there is a happy ending to this story, I certainly am!

4 comments:

Mel said...

Wow. I don't know what else to write. Wow.

Thank heavens for little boys. Big cuddles from us please :)

Mel and Luke

Anonymous said...

Well done for committing to recount your experiences - retelling the story must be so difficult but i know it will help many people, parents an professionals.
I'm going to email the link from your blog to a friend of mine who teaches student nurses on under grad and the icu course.

You're bravery adn love is to be commended
Welldone
Ceegee & Co

Anonymous said...

c'est courageux de ta part de "revivre" ces moments. merci de partager cela avec nous afin que l'on comprenne mieux ce qui c'est passé et ce qui peut être votre quotidien.
merci et encore tout notre amour
dom et co de nantes

Hammie said...

Oh you brave wonder of a woman.
How hard to feel that the best thing was to let go and allow the medical team to take over. When the lioness of a mother's love would make you want to hold him and breathe health into him as hard as you could.

I'm feeling this so strongly for you. Will be thinking of you on Monday, walking for all the mothers and nanas who have to go through this - and Good on You Cathal for being so strong!!!

xx