Adeline Starts to Struggle

Wednesday

The next day when we got to the hospital, the nurse informed us that Adeline was a struggle overnight. 

Over the day, we had struggle and struggle. It was getting to the point that the doctors were running out of options, and they needed to start pulling out all stops.

Influenza A

Adeline had contracted Influenza A.  

What?

How?

When?

What?

Knowing this would obviously help the doctors treat Adeline. They could give her an intense course of Tamiflu and be optimistic it would help. Most of the time, a person would take Tamiflu for five days. The Infectious Disease Doctors felt strongly that Adeline needed to do at least seven days. The Influenza had appeared quickly in the culture, so they knew it was bad.

It was going to be a rough 24 hours as we waited for the Tamiflu to do its thing. Adeline was getting worse and worse. We all hoped the medicine would kick in quickly and start giving Adeline some relief.  

Adeline got a Belly Catheter placed to help drain a LOT of fluid.

Adeline Gets a Belly Catheter

Then, it was decided that Adeline would head down for a CT scan that morning. She was not in a very stable place, but steady enough, and they needed to look. They got Adeline ready to go, which given her status, was quite the task. They had Adeline prepared to go, and away she went. 

Luckily, the CT scan did not take long. 

The results from the scan were about as fast as the scan itself.

After Adeline got back, we learned nothing had shown up on the CT. They had anticipated that they would see a buildup of fluid somewhere on Adeline, but none was found. The next plan of attack was a bedside operation.

Within one hour, we had a Pediatric Surgeon in Adeline’s room preparing for a “quick” bedside procedure. 

The Surgeon was going to insert a belly catheter into Adeline’s side to help the fluid drain. We were able to watch as the Surgeon used an ultrasound machine to carefully insert the long, sharp catheter into Adeline’s side. After the Surgeon placed the catheter right where he wanted it, the fluid started draining fast.

Over the day, Adeline drained over 300 mL’s of fluid from her belly, with most of it being within the first hour. For a baby so small, that was such a large amount of fluid she was carrying on her body. 

After the fluid was mostly drained, Adeline looked much better, and the swelling in her belly went way down. At least one thing was looking up!

The Oscillator

The last significant event of the day was that they decided to put Adeline on the oscillator ventilator. As Adeline’s condition continued to struggle, the traditional ventilator wasn’t doing the job anymore. Adeline just needed more support than the typical vent could give her.  

An oscillator is a strange-looking machine. It looks very outdated, but it does the job, and it does it reasonably well. It was a tough machine to get used to. 

The oscillator is a very loud(it sounds quiet in this video) and sounded like a small little tractor engine running. The machine also took up a lot of space, so our room grew smaller than it already was. And, since Adeline was so little, it just shook her whole body.  

I have said this so often, but we never realized just how bad Adeline’s condition was becoming. 

I mean, people get the Flu all the time, they pull out of it too. Adeline would have to do the same; we just knew it. We took the situation seriously, but we didn’t, mainly because of our ignorance.  

Adeline was continuing to struggle, we just didn’t realize how bad it was.

Reflections

We didn’t know how to read the machines, tests, or even our baby yet. In essence, it was a blessing, not knowing how much she was struggling. We needed to rest at night, and if we had known what we do now, we would have been a wreck. Exhausted is not a good state of mind at the hospital.

To show how bad my ignorance was, every day, I would check the Mayo App to see if they had an x-ray scheduled. I didn’t want to harass the doctors, but I thought this would indicate how long we would still be in the hospital. Unfortunately, at the time, they had x-rays scheduled as far out as it could go.

When the doctors had mentioned the Adeline had to take the Tamiflu for seven days, all I could think, geez, we must be here seven more days?! I just can’t believe myself, thinking such foolish thoughts, but at the same time, I was scared. We were supposed to be going home, but here we were, stuck. Adeline just needed to get back on track so we could go home. 

And, I knew she would pop right back here shortly, I just knew it.  

But she didn’t. She just continued to get worse and struggle more and more, and it was scary. Even scarier because all I could focus on was crazy things-going home.

~Jessi

To start reading where this all began, start here.

Adeline Starts Having ” Events “

Monday

After Easter, things became even more eventful for Adeline. Little did we know just how serious these events were. During rounds that morning, the doctors discussed how they might get to the “sweet spot” with all the meds. Typically, this isn’t easy, but it isn’t hard either. No matter what they were doing, nothing worked.

They really wanted to focus on getting Adeline’s fluids down as she was still overloaded with fluids from her surgery. Reducing the fluids would involve lots of diuretics. With diuretics, they must be careful since they can hit the kidneys hard. Sometimes there isn’t fluid to “give,” but usually, the lab test they do can indicate whether that is the case or not.

Adeline & her octopus. He helped her through her events <3

As the day went on, Adeline continued to dwindle. The doctors were not sure if her sedation was not quite right or if there was something more. At times, the nurse would start doing Adeline’s daily care, and Adeline would have an event where her saturations and heart rate would drop to concerning levels. After this happened a few times, the doctors started talking about how they could approach Adeline with a better plan.

Hearing this was great news! One step closer to Adeline getting breathing tube out (can you tell where our concern was?!) and talking her home! We felt good about things, so Jeremy decided to bring the girls home, and he would come back the next day.

Tuesday

That morning when I got back to the hospital, the room was quiet. Adeline had a rough night, as she had about ten events overnight where her saturations and heart rate drop. The doctors were getting very concerned since this is not part of the normal process. They had decided to start nitrous oxide overnight to see if it would help with these episodes. Doctors wanted to do a CT scan, but it appeared with all these events, Adeline was in no condition to go anywhere.

They decided to wait on the CT scan, and they settled for an Ultrasound instead.

Adeline kept having events and we were getting so worried about her!

The Ultrasound had shown nothing, and the doctors were puzzled as to what was going on. Pulmonary Banding Surgery is a complicated procedure, but this just was making matters worse.

The night had been so eventful, they had done all those things before 8:30 am!

That morning during rounds, the doctors were a little bit at a loss of what to do next. The obvious next step to them was to start doing some checking for illnesses. It was the only thing they had left to do since Adeline wasn’t responding to any other treatments and tests. They took cultures from Adeline’s breathing tube as well as her blood. Now we had to wait at least 24 hours to see if or what would come back. It was like watching water boil.

I cried that day in Adeline’s room because I felt so helpless. Adeline had been a “normal” baby when we brought her in, and now our whole world was falling apart. The day before, we talked about getting a plan together so we could get the breathing tube out and Adeline home. Now, she was getting sicker by the minute. My baby didn’t look healthy, she looked sick. Very sick. As a mom, you want to fix everything, and in this situation, it was entirely out of my hands. I honestly hardly knew my baby yet; I didn’t know what she was trying to tell me. It was hard not to feel guilty for something I had no control over. I let her come here to have surgery, and now look. It was in God’s hands.

~Jessi

To read about our journey, you can start here.

Moving Forward After Multiple Surgeries

Friday

When we got back to the hospital on Friday, and we were headed into the weekend.  We were hoping the weekend would be quiet after the big hiccup from the day before. We wanted to be done with surgeries!  I couldn’t handle any more surprises from this little girl!  

Friday’s meant a new ICU consultant, so a new doctor that had to get familiar with your child.  Every morning would start with rounds around 8:30. Rounds would include the ICU doctor, the Nurse Practitioners or Physician Assistants, also known as the “mid-levels,” the Charge Nurse, a Respiratory Technician, a Dietician, a Pharmacist, Cardiology, several Cardiology Fellows and other specialties if you were working with them.  A lot of great minds working together for the best approach.

That morning at rounds, the doctors discussed that they just wanted a quiet day for Adeline.  She needed the rest after the multiple surgeries; her little body was just so tired after what had happened over the week.

The great thing about this Friday was that the ICU Consultant was not by as often to visit as they had been earlier in the week.  It is always a good thing when you are not seeing the ICU Consultant more than once or twice a day.  We knew Adeline was still very much on their radar, but they also knew they had to leave her alone.  

On Friday, one of the single ICU rooms opened, which meant we got to move.  We moved to the room Adeline would call home for the next five months.  No longer would we have to worry about sharing a room with someone, especially an adult.  It was great to move rooms, as the new room had a great view, and we were almost always first on the dock for rounds.  For a planner like myself, it was nice to have some sort of stability in this kind of situation.  

The best thing about this Friday was that Adeline’s sisters came down to visit for the whole weekend.  We were not expecting to be in Rochester for long, but we did not know what was ahead of us either after the hiccup.  It would be nice to have some familiarity with our lives.  The weekend after Adeline’s surgery was Easter.  For us, this would be our first Holiday with Adeline, and we were in the hospital.  We would make the best out of it.  The girls got down to the hospital just before supper, so we headed out for the night after a much-needed quiet day.

Saturday

Saturday’s plan was more of the same; let’s have a quiet day.  The big goal for the day was to start weaning off the meds so Adeline could wake up more.  If we wanted to get her off the ventilator, she was going to have to be more awake.  Throughout the day, they slowly started backing off on the meds, and Adeline seemed to be doing ok considering all she had been through. 

Rounds were over, and we were setting in for our day with Adeline.  The Pediatric Surgeon and his fellows stopped by to check on Adeline.  After doing a small assessment, they were pleased with how Adeline was doing.  Her incision looked tremendous, and Adeline looked comfortable.  

Saturday was also the first full day of the girls visiting.  When we went to the hospital, we would typically stay there all day with Adeline.  Being in a hospital room all day (obviously) made for such a long day for the girls. It is hard to entertain them and keep them reasonably quiet.  Because of this, it ended up making for a long day for everyone, so we ended up leaving the hospital early that day.  In all fairness, the girls did as well as a three and nine-year-old can do!  Thankfully, the Child Life group had activities that the girls could do.  

A nice, quiet weekend after multiple surgeries

Sunday – Easter

This Easter morning was a little different than the ones in the past.  I usually host my family’s Easter get together, but this year was different.  This year we were in a hotel room, but my parents were going to make the trip down to see us since they had nothing else going on. 

In the morning, when I got up to do my pumping, because yes, I was still doing that, I was sure to leave out some stuff, so the girls knew the Easter Bunny made visits to hotels too. 

Soon, after I started pumping(discreetly), the rest of the hotel room started to wake up.  Of course, the girls had to come and immediately ask if the Easter Bunny had been by to visit.  I pointed them in the direction of the kitchenette, and sure enough, it had! They were so excited!

Before we knew it, we had all gotten ready, ate, and were headed off to the hospital.  Luckily, the hotel is very close to the hospital, just across the street.  Once we got to the hospital, we had been told Adeline had a good night.  We both hoped that today would be the day that they would take out the breathing tube.  We asked the nurse about it shortly after getting to the hospital, she wasn’t sure today would be the day, but we would have to wait and see what the doctors said.

It was finally that time when the doctors came around for their morning rounds.  Sunday morning, the doctors didn’t have a lot to discuss.  Adeline still had a lot of fluid built up, and they were trying to figure out what the best medical “cocktail” would be to help her get rid of it.  They decided they would be aggressive with the diuretics to see what happened.  

The best thing about the day was my parents came down to see Adeline, the girls and us.  It was nice to see them as it gave us some normalcy to something that wasn’t normal.  After we all had a great visit and lunch in the hospital cafeteria, my parents headed out for the day.  

Besides having visitors, Adeline had a pretty quiet Easter.  We had needed some calm days to recoup from the eventful week.  We were now looking ahead at our next few days, hoping that the doctors would start talking about taking the breathing tube out again.  And, once the breathing tube came out, we could discuss going home.

~Jessi

The First Hiccup After Surgery

The first day after post-op was a long one.  Little did we know the curveball that Adeline was going to throw at us. It was the first hiccup after surgery, one of many. 

Adeline had a few “episodes” overnight where she was having some dips in her oxygen saturations.  At the time, Jeremy and I didn’t pay much attention to that number as we do now. I am not sure how low these dips were getting, but enough that they were starting to become more concerned. 

The other thing that continued through the night was that fluid was continuing to accumulate around Adeline’s belly.  They were still not sure what was causing it as they felt they had done everything they could think of to pinpoint it.  

This hiccup after surgery meant Adeline was still intubated (the breathing tube in).  At the time, since I was so unaware of things, I was just sad to see she still had the breathing tube.  As much as I wasn’t looking forward to Adeline screaming, which is encouraged after surgery, I wanted to hear her again! I did not realize at the time just how concerning things were starting to get. 

Morning

Adeline kept holding onto her fluids and she wouldn’t put out any urine.  Her tummy was starting to look like she was a balloon.  Cardiology had been by to see her, but they couldn’t see any concerns from their perspective.  I guess it was a good thing, but it sucked that they didn’t have any answers we desperately wanted.  

The doctors decided they would do one more x-ray and ultrasound to see if they could see anything. 

Nothing was showing up.

The doctors were running out of options since something was obviously not right.  

Their last option was to take Adeline down for an exploratory surgery.

The first hiccup after surgery…which was another surgery

Surgery #2

Since Adeline was collecting so much fluid in her tummy, the doctors knew they had to put a belly catheter in to help drain the fluid. The decision was made that they would bring her down to the operating room; if they found something more, they would be able to manage it in a controlled environment.  

As Adeline went down to the operating room, I was so scared for what lies ahead of her.  Hopefully, they would find nothing, they would just put the catheter in her tummy, and she would come back up – recovery could resume.

After Adeline went down to the operating room, we waited in Adeline’s room for word of what they found.  After a little while our ICU consultant came to give us an update on what was going on.  The surgeon had decided that he had needed to open Adeline because it was going to require more than a belly catheter.  After they opened Adeline’s tummy up, they had found that part of her intestines had died from something called NEC, Necrotizing Enterocolitis.  This is very common in newborns and preemies.  Adeline had it happen for a different reason, it was due to the perfusion in her body not being very good after surgery.  

I was devastated.

How did this happen?! 

I brought my baby in for surgery, she seemed healthy when we got here, what is going on?!

This can’t be happening.

The nurse told us surgery had went well and that the surgeons would probably be by to talk to us later.  She asked if we had any questions and left us be.

I was in shock.  

My little girl, not even a month old, already went through her second surgery.  This recovery process was just supposed to be 5-7 days.  Now, what was it going to look like? I just wanted to go home.

Adeline post-op with her new battle wound.

Post-Op-Surgery #2

Adeline got back up to the room, and it was crazy busy as the operating room doctors gave our nurse a rundown of everything.  Before too long, the pediatric surgeon was by to see us.  He explained what had happened, why they made the decisions they did, and so on.  Honestly, I do not remember a word he said; I just remember staring at him, overwhelmed. 

When he left, Jeremy and I sat back in our chairs and watched everyone work.  He held my hand as tears streamed from my eyes.  I just couldn’t get past the thought of what was happening. 

Soon, things started to calm down.  The nurse told us if we wanted, we could come by Adeline and see her new stoma if we wanted to.  I could hardly move, but Jeremy took the opportunity to go look.  

The ICU Consultant, the midlevel’s, and the nurses would check on us and apologize for what had happened. 

I am going to get a little science like on you now, so bear with me.  Part of the thing that made this so difficult for the doctors to diagnose was Adeline wasn’t giving the typical red flags that something this serious was wrong. Usually, when perfusion is not good after surgery, someone will have a high lactate, and they do not like it over 2.  Adeline’s never got over 2. Having elevated lactate would have been a critical indicator that Adeline was potentially having something happen like NEC. But, instead, the only symptom she showed was a swollen belly.  

Because of Adeline’s new battle wound, she would now have an ileostomy. We weren’t really sure what this meant, we just knew it was there.

That night, when we left the hospital, I fell apart in the car.  I just felt so overwhelmed by what had happened.  First, Adeline had heart surgery and then a significant complication shortly after.  Who knew what this would do for the recovery process as well as for her future?  

I just couldn’t process it all, I needed some sleep to reset myself.

Little did we know, this is how Adeline rolls.  She never fits the mold, nor does she do what she is supposed to.  The next few days become even more difficult; this was just the first major hiccup after surgery, of many. 

~Jessi

If you would like to go back and read about Adeline’s first surgery, start here.

Post-Op of the PA Banding Surgery

Time went by so slowly during Adeline’s PA Banding surgery.  It is like watching paint dry, except you must add anxiety into the mix.  I had brought things to do while we waited, but I really couldn’t concentrate.

We sat in a large waiting room full of people.  But, these other people, families, their loved ones were more than likely much older than Adeline.  I wondered if they were feeling the same way I was, nervous about the surgery outcome.

Once, a person made a comment to me that completely made sense.  It is always hard when little kids have severe heart defects, or really any kind of defect.  These kids do not set themselves up for their health problems like many (but not all) adults do.  But these kids just buck up and do it, and the way they recover, it is just amazing.  They are my heroes!

Did these other families sit here now, wondering what they would do differently from now on? 

Anyways, I watched my phone so closely that day.  We would get periodic updates about how the PA Banding surgery was going.  We didn’t have any additional family with us that day, so we would update the family periodically, letting them know we still hadn’t heard anything yet.  

Finally, a little after lunch time, the nurse came and got us to go meet with the surgeon.  The main part of the PA Banding surgery was done! 

We went and met with the surgeon where he told us that surgery had went well.  He said we were going to have to keep a close eye on the band, as it was a little loose.  He felt this was an ideal situation as it would give her time to grow into the PA Band.  Having that time to grow into the PA Band would allow us to do her next surgery, the Glenn, when it was right, not when we “had” to. 

The surgeon had some pictures of Adeline’s actual heart with the PA band for us.  He pulled them out of the envelope and showed Jeremy, because I just wasn’t ready to look at that.  There was a reason why I wasn’t in healthcare, after all!

We shook the surgeon’s hand and he led us and the nurse out of the room.  He warned us it would still be a few hours before we would be able to see Adeline but assured us again of how happy he was with surgery.  

We went back up to that waiting room to wait some more.  At least we knew that the surgeon said it went well.  Hopefully, that also meant recovery would go well, and we could resume our lives sooner rather than later.

Adeline in Post-Op of the PA Banding Surgery

First Seeing Her

This is the another thing no parent is every prepared for-seeing your child with a breathing tube down their throat.  This is especially true when your child is just a baby, so small you have hardly had any time to bond with them yet.

Not only was Adeline breathing with the assistance of a breathing tube, but she had so many machines hooked up to her.  Here I thought she had a lot of machines hooked up to her in the NICU.  I was wrong! 

The room Adeline “landed” in was a shared room.  On the other side of the curtain there was an adult patient, whose wife complained about how there was now going to be a baby sharing the room with them.  At least the room was large and provided plenty of room for all of us.

On our side of the curtain, the room was very busy.  We had the nurse who was finishing up getting everything situated from surgery.  There were lab techs, ICU Consultants, Physician Assistants/Nurse Practitioners(mid-levels), additional nurses helping as well as PCA’s.  They all worked like well-oiled machines.

One of the nurses grabbed us chairs so we could sit in the room with Adeline.  They told us we could come up to the bed and see Adeline, but I wasn’t ready.  I knew I would start crying, so I coped by keeping my distance.  Just observing the hustle and bustled and attempted to read my book was probably the best bet for me.  I mean, I would wake up from this dream eventually, right? 

After things started getting situated, the mid-level ordered an ECHO to make sure everything was going alright. The technician quickly came in and did Adeline’s ECHO.  After she finished her part up, she called the Cardiologist to take a look at the images.  

When the Cardiologist came by, he looked closely at the images.  When he finished up doing his informal analysis, he said he was very happy with the way things were looking.  He also talked to us about what the surgeon had told us.  The PA Band was probably a little loose, but that was the more ideal situation to give us time.  Before he left, he told us that if everything continued to look alright, that Adeline’s breathing tube could be removed(extubated) that evening. 

We were very happy with that news!  On track to a quick recovery!

Adeline’s Room had a lot of equipment!

Within a few hours, something wasn’t right.  Adeline’s tummy was expanding, and they didn’t know why.  They were running labs, and nothing appeared obvious. By this time, the evening ICU Consultant was coming on.  The two discussed how maybe they would attempt an ultrasound to see if they could see anything.  They also decided they had better do an x-ray.  

During all of this, we just watched on, but not overly worried.  I mean, the doctors were the experts, it was going to be ok. If we needed to be concerned, they would tell us, right?  Earlier in the day, the nurse had encouraged us to get some rest that evening, so we left and headed to my aunt and uncles for the evening.  

WE WERE SO OBLIVIOUS!!  But this was probably a good thing at this stage of the game.

The next day, things got a little more, well, interesting. 

~Jessi