First...
We've slowly discovered over the summer that Emma has illness-related asthma. This means that when she gets a cold, her lungs react by tightening in the bronchial passage ways. As a result, all the stuff that gets down into her lungs as a result of a cold has an impossible time getting OUT because the airways are restricted. We have Albuterol on hand for Emma in two forms: an inhaler and a nebulizer (a cute little panda bear machine). This medication is only to be taken as-needed, spaced 4 hours, at least, between each dosage. So far, these two tools have helped Emma greatly through two summer colds.
Second...
I've recently been reading C.S. Lewis' classic Mere Christianity. Though I've been a Christian for more than 20 years and it has been suggested to me many dozens of times before, I've never read this book before. As I read now, I am absolutely flabbergasted at both Lewis' understanding and his communication of Christian theology. The way he presents and discusses difficult, but essential, topics in the Christian faith is incredibly refreshing, encouraging, and freeing! I have been especially impacted by the chapter in which Lewis discusses Time (Book 4, I think). I couldn't possibly relate that information here in any way that would do it justice, so...just read the book. Seriously. It's very good stuff. Just keep in mind as you read on that this is what is bouncing around in my head, heart, and spirit as we found ourselves in an urgent medical situation last night with Emma.
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Emma has picked up another cold. The germs could have come from any number of settings and any number of other children. The source of the cold is not terribly important to me. What is, however, of great importance is the fact that colds are not a simple affair for Emma. She develops asthma when she is sick, which complicates her medical situation very rapidly.
The cold symptoms began for Emma on Friday morning: drippy nose led to post-nasal drip which led to coughing. She did okay on Friday, but we did have a busy day with grocery shopping and other household chores. Friday night she slept poorly because she was waking up coughing or so stuffed she was having trouble breathing well enough to sleep. I also had a bad night. Not just because of Emma, but because even after Emma settled down into good sleep, I was wired and didn't fall asleep until close to 2 a.m. This did not bode well for either of us for our planned zoo trip on Saturday.
Emma woke up Saturday seeming much better. We were in a hurry to get to the zoo (with my sister and her family, who were visiting after long-last from Springfield), so I didn't take the time for a full nebulizer treatment for Emma. Additionally, she didn't get her morning nap, so by the time we got to the zoo, she wasn't really in a great state of well-being. We figured, however, that she would be somewhat stationary for this trip (riding in the pack on Daddy's back), so she would be okay. Before going into the zoo, I gave her an inhaler dose of her medication and we set off.
Emma continually coughed (light, but persistent) throughout our trip. Around and after lunch, she seemed downright miserable and exhausted. She was having a little more trouble breathing, so I went ahead with another dose on the inhaler, even though it hadn't yet been 4 hours. This helped a little and she feel asleep on my back for a little while, but she was still a very unhappy baby.
After a quick trip to Abby's favorite animals, the elephants and the giraffes, we bid our farewells to my sister, brother-in-law, and nieces and headed for home. On the way home, I called the advice nurse via Emma's pediatrician's office. Based on my conversation with her, we went ahead with a nebulizer treatment for Emma when we got home, even though it wasn't yet 4 hours since the inhaler. This seemed to help Emma relax and we put both girls down for naps. Emma slept...sort of...but not well. (I got some sleep, too, which was very good, because Emma's continued coughing was turning me into a tearful mess in my exhausted, worried state.)
Emma woke from her nap cheerful, breathing somewhat better, and playful. But as she played, her breathing became again more rapid than I thought healthy and her tummy seemed to be working awfully hard to keep the air going in and out of her lungs. (I was to understand later that what I was observing was, in fact, retraction...which is bad and a sign of distressed breathing and the need for medical support.) I called the advice nurse again and she told me what to watch for: rapid breathing (check), bluish-white hue around her mouth and nose (not so much), and retraction (check). She was two for three.
At 6:30, Emma and I were in the car (which was low on gas) and on our way to the 24/7 Urgent Care clinic at PeaceHealth in downtown Vancouver. I was beginning to feel fearful and emotionally exhausted, and dreaded another "ER" type visit. I am so grateful for how the Holy Spirit got my attention and reminded me to pray. I had put in our "Hidden in My Heart" lullaby CD as we drove, and the song for Philippians 4:6-7 came on.
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Lord, You created Emma and you knew at her conception that her lungs wouldn't be just right. You have been with every parent of a child who is suffering throughout history and in the present and I know You are with us now. You know what Emma needs. Please be with me and help me to be strong and brave and calm. Help us to be good patients and to have the grace we need for each moment of our journey tonight. Help us feel Your Presence.
From that moment on -- miraculous -- I felt a wonderful, blessed peace over us. Emma was calm and even somewhat chipper. I knew that, whatever happened, I could trust God with the process and the results.
Emma and I arrived at the 24-hour urgent care clinic at 7:00 pm and were in a room by 7:15. This was the first blessing. Because of her age, her history, and her breathing pattern, they got us in quickly. We immediately had two nurses tending us. They were lovely women, very gentle and caring, very thorough and confident in their initial analysis of Emma's medical needs. The nurse found Emma's temperature was up to 101 and her o-sat (oxygen saturation) level was down to 92% (which is low for a healthy infant). After this initial assessment, it was mere minutes until the "provider" (doctor) was with us. After observing Emma's breathing behaviors and listening to her lungs, the doctor quickly sent for assistants who would set Emma up with a nebulizer treatment of two asthma medications AND oxygen. The assistants were there with the oxygen tank, neb mask, and meds almost before I could blink. Emma was receiving the support she needed and her body immediately showed improvement.
Emma took this all like a champion, even the nurse finding her temperature in the MOST personally intrusive and uncomfortable manner. Emma doesn't much like the nebulizer, but she's become really patient with the mask and tubes and vapor blowing in her face. I was so proud of her and so thankful for this working of God's grace in our situation.
The hospital which houses this urgent care clinic does not, to my understanding, house a pediatric unit. Therefore, in order for Emma to get the best care, the doctor felt it best for Emma to be transported to an ER in the area with doctors who would know better how to care for a pediatric patient with breathing trouble. To my surprise, this was not as simple as my putting Emma back in the car and driving to the suggested hospital. Rather, the doctor wanted us to go by ambulance, so that Emma's status could be monitored throughout the journey.
I ran out to the van to grab the car seat while the nurses held Emma and the medics prepared the ambulance to transport her to Randall Children's Hospital in Portland. The medics were very kind and gentle and competent in their tasks. However, the medic attending to Emma told me that he wanted to fit Emma with an IV before we headed off. I think this is standard procedure. I was none too thrilled to hear this bit of news. I've had my own trouble with IVs and I just really, really didn't want to have Emma go through that. But I steeled myself for the task ahead and continued to pray. God had faithfully surrounded us with His grace so far, so I had no reason to doubt His continued help for the steps ahead.
After settling Emma and I in to the ambulance, the medic said, "I'm going to see if I can find a clear, easy shot for the IV. If I can't, we won't try. We'll just wait until we get to Randall."
I have never been more thankful for my body's tendency towards tricky veins! I'm pretty sure Emma has inherited a lot of my physical characteristics because, thanks be to God, the medic could NOT find that easy shot. So, he gave up on the IV and we headed out for Randall.
Along the way to the ER, Emma was still on Oxygen and her O-sats were up to 100%. It was a short, easy journey and we were settled in at the Randall ER before 9:00 pm. The nurses and providers at Randall were wonderful. So kind and gentle and quiet and calm. I told the doctor later that it felt like 5-star medical care. I was amazed at their efficiency! Yet they did everything calmly and used quiet voices and took such care with Emma and myself. Such a contrast to our previous experience at a hospital ER in a small city elsewhere in Oregon. (I don't wish to criticize that ER staff too much, because we were in a small city and they were not pediatric specialists.)
The doctor was in to see us very quickly. He determined to give Emma a steroid tablet (in order to calm the inflammation in her lungs) and wanted to observe her for another hour or so before deciding if she needed to be admitted. There was no further talk of IVs or blood draws or chest X-rays. Her lungs, at this point, were free of wheezing and the doctor heard no indication of pneumonia. Praise the Lord!
By 10:00, the doctor had determined that it was more than safe to send Emma home, with a 5-day Rx for steroids and a plan for us to follow-up with Emma's doctor on Monday. Emma, by this point, was sleeping soundly on the hospital bed, breathing easily and so at peace. I almost hated to disturb her to go home, but I was also so thankful for the good news and positive outcome of the evening. By 10:30 we were packed up in a cab and headed back to the van, which was still parked at the hospital in downtown Vancouver. God even demonstrated His grace in our cab ride, in that I felt confident to direct our cabbie back to the van, rather than taking us home. If we had gone home, instead, we would have had another $20 or so on our cab bill and would have had to figure out how to get back to our van, and Abigail's car seat, on Sunday.
Emma and I were home, and she was settled peacefully in bed, by 11:15 pm. I guess 5 hours probably sounds like a long time, but -- truthfully -- it didn't feel long as we experienced it. There no long, drawn-out waits to be seen by a provider or to receive the prescribed treatment. The cab even arrived at the hospital in only 10 or 15 minutes, instead of the predicted 25. Every person who attended us was kind, gentle, caring, calm, and confident (without being arrogant) in what they were doing to support Emma. We got home "early" enough to get a full-night's rest.
As I drove home from the hospital, I was reflecting on our evening and became overwhelmed with gratitude for our experience.
God made His Grace tangible for us, throughout our evening.
Now, I don't know why He chose to show His grace in our having a smooth, relatively easy evening with a very positive outcome. I know there are parents still sitting at their suffering child's bedside, wondering if their child will survive another day. I can't fathom their pain and anxiety. But this I know: God is showing His grace even to them.
God lives outside of the construct of time, so He exists in the past, present, and future all at the same time. To Him, these long nights of suffering are but a blink...less than a moment in the setting of eternity. He has, ultimately, shown His Grace by providing for our eternity with Him: His Son Jesus. When our future with Him is settled by our acceptance of that Grace, then everything in this life gets put into a new perspective.
A suffering child is no laughing matter and nothing to glaze over with biblical platitudes. My understanding of God's supremacy over time, His sovereignty over our history and future, and His great love for us -- understandings recently driven deeper by the ideas CS Lewis writes about in his book -- carried me, with hope and confidence in God, throughout our ordeal. I ended the evening feeling this verse to be true, even for me, in a very real way...
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