Saturday, March 8, 2014

No Morning is Ever Easy

Dear Ellie,

No morning is ever easy.  Every day I come to the NICU an hour or two early, wait in the cafe down the hall, and wonder what happened during the night.  My dreams the night before are rarely optimistic and, unfailingly, they pertain to your condition in the NICU.  While I sleep, you've always gone backward somehow or the doctors discover that you have some terrible, often ridiculous condition that I never knew existed.  I once had a dream that your blood turned orange.  Or that you were missing both kidneys.  Or that you have a rare chronic disease like "armadillo-itis" where you become a leper and grow armored scales.  Even on the occasion that I don't remember my dreams clearly, I wake up nonetheless with a sense of loss or discouragement.

That lurking sensation persists until I finally arrive at your bedside.  As is often the case, my worries from the night before are not born out.  Like this morning.  Since yesterday, your condition had improved ever so slightly.  You looked a lot more comfortable on your back than you ever had before and while your respirator stats hadn't improved, your blood gases were incrementally better.  Basically, when the air sacs in your lungs aren't properly inflated, they can't purge carbon dioxide properly.  This excess CO2 gets absorbed into your blood, kind of like how excess carbon dioxide in the atmosphere gets dissolved in the ocean.  In both cases, that carbon dioxide turns to carbonic acid and acidifies your blood.  When your blood gases improve enough, that is a sign that your lungs have made a general improvement.

Still, all of the news isn't entirely rosy.  The endo-tracheal tube is irritating your throat, which has responded by producing an extra large quantity of mucus to remove what it "perceives" as an invasive object.  Were this invasive object something like a few grains of sand, that mucus would be helpful at removing them.  Since it is a tube, though, the mucus is only making it harder for you to breath because it either slides down toward your lungs or gets sucked into the tube and becomes an obstruction.  Yes, I know, a pleasant description.       

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