Ah, the ever-expanding vocabulary of the parent of a premie. I feel like Alicia's time in the NICU has not only strengthened Linda and I's relationship, our faith, and our perseverence, but also our vocabulary. I feel like with each new condition that Alicia develops, I learn a whole new set of terminology that I never even knew existed.
Granted, I think I would have been just fine if I never had to learn these words, and I think I would have led quite the full life despite my ignorance. But God in his wisdom has given us homework to do and that includes learning about a bevy of medical conditions and vocabulary that I was completely oblivious to.
Since I am an English teacher and we are talking about vocabulary, allow me to change things up a bit and borrow a chapter from the magazine that I work for.
(disclaimer: the following has been slightly dramatized for effect)
What is wrong with Alicia?
(Campbell and Linda walk into the NICU.)
Campbell: I wonder how much milk Alicia is drinking today.
Linda: I know. Me too. Yesterday she was up to 8cc.
(arriving at Alicia's incubator)
Linda: Look, honey. Her ventilators back up to 25. I wonder what happened.
Campbell: Yeah. I wonder. Maybe they just suctioned some mucus. You know how they usually turn up the ventilator when they do that.
Linda: Yeah. That's true. (speaking to Alicia) Hi, baby! Oh, look at you. Good morning! Your eyes are open. Can you see us? Mommy and Daddy are here.
Campbell: Hi, sweetheart! How are you? Mommy and Daddy are so proud of you, little girl. You're doing so well!
Linda: Yes, baby. Good job! Keep going. Mommy and Daddy love you.
Campbell: (to Linda) Honey, does Alicia look a little pale to you? I wonder what's wrong?
Linda: I don't know. Is she breathing OK?
Campbell: Yes. Everything looks normal.
(A nurse comes over.)
Nurse: Good morning, Mommy and Daddy.
Linda: Good morning, nurse. How is our little girl doing today?
Nurse: Well, we just fed her 8cc. And she's eating pretty well.
Linda: How's her mucus?
Nurse: She still has a lot of mucus.
Campbell: And her breathing? How's she doing?
Nurse: Well, Mommy and Daddy, I'll ask the doctor to come over and give you more details about your baby's condition.
Linda: Is everything OK?
Nurse: I'll ask the doctor to come over and explain. In the meantime, enjoy looking at the baby. The doctor will be over shortly.
Campbell: OK. Thank you.
(The nurse walks away.)
Campbell: Hey, honey, look over there. What's that thing with the bubbling water.
Linda: I don't know. Is that attached to us?
(Campbell follows the tube with his eyes.)
Campbell: Yes. Look. It's connected to that thing on the floor that has a tube going into Alicia's incubator.
Linda: Hmm. That's new. I wonder what it is.
Campbell: I don't know.
Linda: Oh, look, honey. They took out that thing that was inserted into Alicia's surgical wound. But what's that new tube sticking out from there.
Campbell: Uh. I don't know.
(A second nurse comes over.)
Nurse: Good morning, Mommy and Daddy.
Linda: Good morning. How are you today?
Nurse: I'm doing well. Has anyone come over and told you what happened with your baby last night?
Campbell: (slightly alarmed, but trying not to show it) No. Did something happen? What happened?
Nurse: Oh, well, I'll ask a doctor to come over and explain it to you. Just wait right here.
(The nurse walks away.)
Campbell: Is it just me, or does everyone seem a little bit on edge today. What happened?
Linda: I don't know. Just pray.
Campbell: OK. Heavenly Father, we just pray protection over Alicia. We speak life and health over her. And we just proclaim that Alicia, you will live and have life. Father, we ask for complete healing over her body and that you would just bring completeness and wholeness to her whole body from head to toe. We pray for complete brain development, and that she would continue to receive the milk and continue to gain weight. Thank you, Father. In Jesus name we pray, Amen.
Linda: Amen. Alicia, honey, you're doing so well! Mommy and Daddy love you, honey. You are our precious girl.
(Twenty minutes later.)
Doctor: Daddy and Mommy, good morning. I'm sorry for the delay. I was doing my rounds.
Campbell: No problem.
Doctor: Has anyone explained to you what happened last night?
Doctor: OK, well, blah, blah, blah, lungs, blah, blah, blah air, blah, blah chest, blah, blah pressure, tear, blah, blah.
Campbell: (pretending to understand) So what you're saying is that Alicia has a tear in her lungs?
Doctor: Yes and there is air in places where air shouldn't be. And blah, blah, blah.
Linda: Is it serious?
Doctor: Well, we've inserted a tube that will help us to suck the excess air out. We need to get the air out or it may end up crushing the lungs and heart.
Campbell: Is she OK?
Doctor: Well, for now she's stable, we were able to get to the problem before it got worse. Sometimes when there is a tear in the lungs, it crushes the lungs, which then affects the heart and some people even die.
Linda: So what's being done now?
Doctor: Well, as I said, we've inserted a tube that will help us to suck out the extra air. And in the meantime, we'll see if the lungs can heal themselves. Once things are more stable, then we can remove the tubes.
Campbell: This must be something that is pretty rare.
Doctor: Oh, no. Actually, this is a common problem with premies.
Linda: Well, why did this happen?
Doctor: We're not sure. It could be from the tubing we had in there post surgery. Or there might be a leak somewhere from the ventilator. We're still checking it out. But in the meantime we do have something in there that will remove the excess air. We'll keep monitoring things to see how your baby is doing.
Campbell: OK. Thank you, doctor. Please let us know if there is any change.
Doctor: I will.
Question of the Day
What would you do if your doctor told you that your baby had a tear in his or her lungs? Why?
OK. So, that's kind of what happened this morning. I kind of paraphrased and condensed certain parts of the conversation and the dialog isn't word for word, but you get the idea.
Basically, at least twice this morning a couple of nurses came over and usually, they'll just greet you with the basic vitals. "She ate this much, she gained/lost this much weight, she's breathing pretty well, her blood pressure is stable, we had to suck out a lot of mucus." But today something was off. First, it was all the new equipment in and around Alicia's incubator. Then it was the nurses demeanor. Usually, when you ask a question, they'll answer you. But today, the nurses seemed extra cautious, and wouldn't really talk too much. Anytime we asked anything, they would respond with, "We'll let the doctors talk to you." Usually, that's a sign that something's up.
When the doctor came over and started explaining, seriously, I felt like she was speaking a foreign language. I was only able to pick up a few key words here and there, and so I kind of got the gist of what she was saying. I wanted to ask more and ask her to clarify, and I tried. But honestly, I didn't even know where to start. I mean I didn't even know what I wasn't understanding enough to ask for clarfication.
But what I did gather was that Alicia had some sort of damage to her lung, causing air to leak into the chest. When I got home, I looked up the condition in our premie book. I had no idea what to look for, so I just looked up air leak. And there it was.
Now here is our new vocabulary for today:
Say it with me:
Did you say it? Good.
A pneumothorax is a collection of air or gas between the chest and the lung. A pneumothorax can be caused by many things, in Alicia's case, doctors suspect she may have a small tear in her lung tissue allowing air to escape. The air is dangerous, because it presses down on the lungs and prevents it from fully expanding, and in more serious situations it can cause the entire lung to collapse. And since the lungs and the heart are so intricately connected, any lung problems ultimately also affect the heart, and if left untreated pneumothorax might even result in death.
Thankfully, it seems like the doctors have a handle on the situation. They're using some sort of vacuum equipment to suck the excess air out of Alicia's chest. Conveniently she already had an opening from her PDA surgery in which they could just insert the vacuum tube so they didn't have to open a new hole. And actually, I read in our premie book that pneumothorax sometimes is a complication of PDA litigation.
Once again, what I'm learning with all of these new things that happen is that all of these things are potentially life-threatening if left untreated. However, due to the advances of modern medicine, doctors are well-educated and trained to catch symptoms of these things and treat them before they become huge problems. So with the air being suctioned out, it's now up to Alicia's lungs to heal themselves. How? Well, the tear is similar to a small cut, so however our body heals itself after a cut, that's pretty much how the lung will seal up the small tear.
So doctors will be checking to see if the tear gets worse, if it doesn't, then it should heal itself in a few days and they should be able to remove the suction tube from her chest.
So here's the prayer request for today.
Please pray that the air would clear up, and that if there is a tear that it would heal quickly and that there would be no permanent damage or complications from what has happened.
We're now into week 4 and Alicia is 9 days from being one month old. How time flies.
We look forward to seeing her tonight and seeing if her condition has improved.
I'll keep you all posted!