Monday, July 16, 2012

Spoiled by the PICU

Norah is so close to being at her baseline. She's just one tiny setting away from getting there, and they are going to wait quite awhile to change it. We have a care conference tomorrow. We'll discuss the short- and long-term plans, which I'm almost entirely certain include going back to South Davis Community Hospital within the next couple of days. (I'll send out birthday invitations once we know for sure!) We'll also decide on agreed upon protocol for managing things like illnesses, transport, etc. 

I'd be lying if I said I wasn't a bit nervous about the meeting. I almost always cry afterwards. This time, I know I will, so I've been preparing myself by chatting with some of her caregivers about it. Jeff and I are going to bring up our concerns of Norah's safety at South Davis. Don't get me wrong - they saved Norah's life when they did CPR for those nine long minutes in November (and I will forever be beyond grateful to them). We know how much they love Norah. But South Davis isn't the PICU, and we know it isn't supposed to be. Simply put, the PICU has spoiled us. They've set a tough standard. At South Davis, we worry about vent management as well as their response to acute situations. I want to do everything we can to avoid anything that remotely resembles the awful state she was in when we arrived at the PICU. Here's the thing: if we didn't bring up these concerns now, and something awful was to happen to Norah... or if Norah was to die.... I would never ever forgive myself. I've been thinking about this a lot lately. It may have triggered a need for me to seek out an Ambien prescription.

My emotional sensitivity has been overwhelming these last few weeks. Before visiting Norah today, I dropped Harper off at the park with his Auntie Emily and his cousins Logan and Emma. Emily and I were chatting at the park, and I found myself fighting tears. I was surrounded by kids having a great time at the park while their caregivers sat on blankets on the grass to watch them have fun. In that moment, I didn't envy them. But I felt this severe longing for Norah to be with us. I wanted her to laugh and smile with us. I wanted to nuzzle her in the shade and giggle at her brother's shenanigans. I wanted to have to stop her from crawling into trouble. But none of those things are our reality. Norah is still in the hospital.

It sure is a good thing she's feeling better, or else that would make things so much more difficult. Below are a few photos from the last couple of days. She's back to her perky, smiley self, but she's begun to develop a little "stranger danger" as well as separation anxiety. Needless to say, it makes it so much more difficult to leave her at the end of the day.

Music Therapy was a blast! Her feet were twirling, her entire body was bobbing, and her smile was shining! She had the best time! ...And wow - the therapist and intern were amazing musicians!

Food? YES PLEASE! Norah finally got to start eating again. Her Speech Therapist was ecstatic with Norah's progress. She was beyond enthusiastic about eating, and it showed! And can you believe the pigtail cuteness?

Her nurse Angie, Norah, and I had a blast watching soccer and playing on the floor. Go Seattle Sounders!



2 comments:

  1. Hi, I am leaving an anonymous comment because I don't want it to be taken wrong and have some backlash. I am nurse for a large pediatric homecare company here in Utah. We provide private duty nursing for children just like your daughter. I have been doing this for years. I came across your blog through the Pack family blog. I noticed your concerns about South Davis and I wanted to agree with you. A few years ago a family of ours decided to admit their child to South Davis hospital for some R & R. Well, because of their poor handling the child became decannulated and died. It sounds like you have had some scary situations yourself and I would hate to see the same thing happen to your little one because of poor handling on South Davis' part. I would NEVER send my child there. I know they have made some changes however in my opinion they are not enough. May I ask why they are making her go to South Davis instead of home with you with a homecare nurse? I can only speak for the company I work for but we have some great experienced nurses who can handle trach/vent dependent children who are quite critical. Yes, you would have to provide some of the care on your own however once she is tolerating her vent settings, I don't see why that can't happen. I may be speaking too soon because I have only read a few of your posts and don't know the extent of Norah's medical situation. At very least I would ask why she can't go home once she is tolerating a vent that can be brought home. Ask about the Trilogy vent! It is wonderful and is the newest technology. Other DME companies are changing all of their vents over to the Trilogy however IHC doesn't want to switch over to those vents due to cost so they are resistant to use it. You are Norah's only advocate. FIGHT FOR HER!!! I have seen families be told they cannot bring their children home and after some fighting they are thankfully home with their kids who are happy and much more comfortable. I would be happy to talk to you more however I cannot reveal my identity. If you want more information I will be keeping an eye on your blog and watching the comments here. Maybe we can exchange a phone number or email in the future where I can be more free with what I say. Good luck and I will be thinking of you and your cute Norah.

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  2. Thank you for your well-intentioned comment. We, however, would recommend South Davis to any of our family and friends. We have an open, honest, respectful relationship with the management there. They listen to us, create protocol just for Norah, and even have implemented changes to their processes at our recommendation. Their hearts there are enormous, and I've seen nothing but love and dedication from the staff towards their patients.

    The harsh reality of any family with a medically complex child is that death is a heightened risk. This is a risk anywhere: long-term care, at home, in the ED, in the ICU... anywhere. This is the case for healthy children for that matter. I recently heard a story of a child who decannulated at home and died. Regardless of where or how it happens, it is always a tragedy. Fortunately, I have every confidence that South Davis will respond to any of Norah's emergencies. After all, they saved her life back in November.

    As far as going home goes, all of Norah's caregivers know that our family is more than capable of caring for her at home. The problem is that Norah's situation is literally one-of-a-kind. She is dependent on equipment that can't come home. We are already working on transitioning her to the Trilogy 100. IHC has contracts that don't allow for using the Trilogy, but South Davis has no such restrictions. Just another reason why they're a good fit for our family.

    I understand that you heard of an awful incident at SDCH, but as a healthcare provider, please remember that it can happen anywhere. More kids die at PCMC than SDCH - in exponential volumes, but that doesn't make either of them worse or better a place. I would recommend both places in a heartbeat.

    I considered removing your comment, though I understand it is completely well-intentioned. I just don't want anyone to think that your opinions are my own. But I've decided to leave it, as I understand your concern, and truly appreciate it. I encourage you to read through my blog to learn more about our family's journey, and see how it is so unique to that of other trach/vent dependent children.

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