trusting in miracles

Before I ever got to work on Tuesday night, I knew I was in for a busy night. I had been called down earlier to help get Obre settled on CPAP (a way that we can provide a bit of pressure and oxygen to the lungs). Obre has a bilateral cleft lip and palate and earlier had aspirated (inhaled) some formula into his lungs and now had an aspiration pneumonia. So, I came to work knowing I would have him and that his very underweight body (he's 4 months old and weighs 3 kg or 6 1/2 lbs) would not help his healing from the pneumonia. I was prepared for busyness. I had no idea, though, what the night really had in store for me, for him.

I got report from the evening shift nurse and started off with my regular work. Safety equipment at bedside, check. Code sheet at bedside, no. Complete code sheet, check. Now on to Obre...full assessment, check. Even with the CPAP, Obre's body was still working fairly hard. The muscles around his ribcage were pulling in harder in order to try and help his breathing, his oxygen level was in the 90's but on 60% oxygen and he was requiring help in the form of CPAP. At 11pm, Obre's oxygen levels started falling and I was having to move his jaw forward every couple of minutes to keep his oxygen up. Then I tried going up on his oxygen thru the CPAP. Everything worked for a few seconds and then he would start drifting down on his sats again. So, let's adjust his mask. At this point, Jenny, the other ICU nurse starts helping and ends up stuck for the next while with me. After 20 minutes of adjustments here and there and Obre just not settling, we call down the anesthetist Fotius. More adjustments, more work, no improvement after 20 more minutes. At home, at this point, we would have intubated (put in a breathing tube and placed on a ventilator), no questions. But, with our limited resources and his very malnourished body, this was not a decision without risk to him. So, we called Dr. Gary, the surgeon to see what he thought. And thus ensued another 40 minutes of working with Obre's body working harder and harder. His retractions were now severe, his oxygen level averaging between 60-80, his heart rate in the 200's, his breathing rate in the 80s.

At 1220am, we decided to intubate. As Jenny and I drew up medications and gathered supplies, it got quiet over by the bed...we looked over to see Dr. Gary and Fotius were praying. Jenny and I came up as the prayer was finishing and Fotius moved the CPAP mask off to just beside Obre's face. And, his oxygen level went up and his heart rate came down and his breathing rate came down and his retractions came back to mild. And we just watched for a minute and Obre didn't need intubation...in fact, we didn't even put him back on CPAP, we put him on just a simple face mask (oxygen without pressure). This is 5 minutes after the decision to intubate! We are doing less than we were before! I couldn't, at that point, call it what it was but as the night progressed and I just watched my baby in awe move closer towards normal vitals signs and his work of breathing settle even more, my mind whispered (a bit in disbelief) while my heart shouted in praise....MIRACLE! Jenny and I kept saying we can't believe it. At one point, Obre's vital signs actually dropped into the normal range and I started hovering even more (all PALS trained nurses know a pediatric body at stress can go for a while but vital signs dropping may actually by an ominous sign). But no, Obre was just getting more and more settled.

The night ended with me giving report and Jenny and I continuing to say we couldn't believe it but now quite willing to call it what it was...a miracle.

I went home and was walking thru the night again in my head. When I thought about getting concerned when his vital signs dropped to normal, it was if the Holy Spirit nudged me and said, "you didn't trust Me to finish the miracle." And it is true, I didn't trust despite what I had seen. Dr. Gary and I talked about a bit the next night and he said if that was the case, "he didn't fully trust it either because he wasn't sure we hadn't done it later without calling him down again." He also talked about feeling the peace settle as they prayed.

This night, what I saw, it was nothing less than miraculous, amazing. I am thankful the Father healed Obre. I am even more thankful that He let me see it. It was beautiful.