Page 18 - Journey of Hope by Raymond Moldenhauer

Three nurses began trying to restore her vital signs and fix the kinked tube. They
quickly decided to cut the line and splice it back together. Finally, Alyssa’s “pulse-ox”
rate was climbing back to the desired levels. Her heart rate was now in the high 180’s,
but that was expected as a result of the stress on the baby.

At 4 PM, Kathie and I arrived at the hospital and were walking into the NICU waiting
room. Our hearts stopped beating as we saw the tears in Heidi's eyes, and worry and
stress painted on her face. I went back to the NICU where Jim was still watching the
nurses hovering over Alyssa, while Kathie stayed in the waiting room to comfort Heidi.

At 5 PM, the Respiratory Therapist, Physician, and Nurses all agreed that the tube
would need to be replaced (the current tube was moving too much within Alyssa’s
esophagus). Since removing the tube and “intubating” Alyssa would be additional
stress on her, no one was really anxious to do it. The care team decided that since they
were most likely going to “extubate” her on Saturday (because she had been doing so
well with the low vent settings) they would try it now.

At 5:30 PM, the vent tube was remove and a “c-pap” (continuous positive air pressure)
mask was placed over Alyssa’s nose. She was now breathing on her own! The mask
only provided enough pressure to keep her lungs from collapsing during an exhale. For
the next hour, she was breathing all by herself – although we were all holding our
breath hoping she could sustain the independent breathing. That hour seemed like an
eternity. We were glued to the NICU chairs adjacent to the basinet. Our eyes glanced
only from Alyssa’s expanding and contracting chest to the monitor readings. We also
all knew that as long as Alyssa was breathing on her own, none of us were going
anywhere - no dinner, no going home.

For the very first time, we saw Alyssa’s chin (previously covered by the vent tube) and
her mouth with nothing in it but her hands. You could hear sucking sounds as she
mouthed her fingers. But our time for cherishing those moments was limited to one
hour and fifteen minutes. Her pulse-ox rate began to drop along with her heart rate.
Her breathing rate went to 0 on the monitors (although she was still breathing).
Maggie, Alyssa’s nurse, quickly raised the top of the incubator, moved her position a
bit and then gently slapped her on her feet and her bottom to restore deeper breaths.
It was a good attempt by Alyssa to go “solo-breathing”, but it was now time to intubate
her once again. Thankfully, the tube went in very easy – and Alyssa’s eyes were open
the entire time. In a few minutes, her vital signs were right where they should be.

Everything was OK once again. But we had a 3-hour reminder that she is only at the
very early stages of a very long journey, and that we need everyone’s prayers for this
journey.