The hospital at night is not as quiet as you might expect. Unless you’re in a room by yourself because your child is still in constant care with breathing problems. Then it is unsettlingly quiet.
Deane is still struggling with secretions blocking his airways. He had a rough night last night and is starting off the same way tonight, after a long day of suctioning and chest therapy.
The oxygen saturation level in a healthy person is usually between 97% and 99%. Your “sats” measure the oxygen in your blood. That oxygen, of course, gets to your blood through your lungs. At the moment, Deane’s lungs are so wet (according everyone who listens to his chest) that he is not able to pass enough oxygen through to his blood.
I’m not sure what his sats without the aid of an oxygen mask would be. With at least 40% oxygen through a mask, Deane is able to keep his sats above the 90% for about half an hour to an hour at a time. Then he “de-sats”, goes below 90%, and the alarm goes off.
When the beeping of the alarm sounds, the medical team valiantly tries to help Deane clear his lungs by thumping on his chest and encouraging him to cough. If he can’t muster the strength to cough up these secretions (mostly clear phlegm) then they have to suction them out with various different sized tubes.
I was OK with that yesterday. I held Deane’s hand and stroked his head as they stuck tubes down his throat or up his nose. But part way through today I found myself wincing in sympathy as they fed tubes further and further into him.
After a day in which he had a stronger cough and reasonable success coughing stuff up, Deane seemed to get worse about 4 p.m. It’s been many hours of de-satting followed by intense suctioning and repositioning.
He is now sound asleep and still dipping below the acceptable level but is generally bringing himself back up. He is keeping the nurses hopping.
Deane seems caught in a catch-22. He needs to rest to get the strength to cough up these secretions. But, if he de-sats during the night, he needs to be suctioned which – not surprisingly – wakes him up.
He is fighting a battle of inches: progress when he is rested coupled with relapses when exhaustion overwhelms him. And there is nothing the rest of us can do but hold his hand and encourage him to cough.