Once Christopher was taken from the surgical room to the intensive care unit, Woody and I breathed a sigh of relief. Being our first baby, nevertheless a premature baby, we really didn't know what to expect. But now, still riding high on the experience of seeing him born and hearing him cry, we shared a joyful moment together. I had decided to stay with Woody while the doctors completed the operation. The monitors showed Woody's blood pressure still high, but for the first time in weeks, trending downwards.
Following the surgery, I followed Woody to the recovery room where she was to wait until the effects of the anesthesia wore off. After making sure she was resting well, I gave her a kiss and headed toward the neonatal intensive care unit to look for my parents and to see how Christopher was doing.
Out in the waiting room, my parents and sister were anxious to hear the news. "Woody's doing fine. She's in the recovery room," I said. "We had a baby boy, he weighed 2 pounds, 7 ounces and we named him Christopher David - and he cried when he was born!" After a few hugs and kisses, we headed down to the nursery.
The neonatal nursery was tucked in the corner of Santa Rosa Children's Hospital and was on the same floor as the surgical and recovery room where Christopher was born. It was quite large and actually made up two separate areas. The first area was termed the intermediate care nursery. This area was for infants who needed to be watched and monitored while recovering from less serious surgeries or illnesses or who "graduated" from the other area. The second area, which Christopher was in, was the neonatal intensive care unit or NICU. This area was for the more sickly infants that required a high level of monitoring and care.
The room, brightly painted white with white wallpaper, looked so clean as I peered through the windows in the hallway door. A blue and green and yellow pastel wallpaper border made a path along the top of the walls and around the poles that suspended the ceiling. Just inside was a large nurses station with several nurses typing on computer terminals.
As we attempted to enter we were informed that we were to wait in the waiting area because Christopher was undergoing a surgical procedure. The procedure, called an umbilical catheter, or A line for arterial-line, involves cutting the skin around the naval and inserting a small catheter into the artery of the umbilical cord. The procedure was commonly performed on premature babies to allow the doctors to monitor the babies’ blood more accurately and easily. However, it was often complicated in premature babies because of the small size of the artery.
While we were waiting, we were able to find out Christopher's Apgar scores, which are used to indicate how well a baby is handling the transition from the uterus to the outside world. His scores of 9 at one minute and 8 at five minutes were considered normal to high for a full term baby and caused us to feel a little more at ease. My sister telephoned Woody's Mom, who also was a nurse, to inform her of Christopher's arrival while we continued waiting.
After a long period of time, Christopher's doctor entered the waiting room. I had met him prior to the delivery but was unable to recall his face since most of it was hidden behind a mask in the surgical room. He informed us that Christopher was having difficulty breathing on his own, and that he had placed him on a respirator and was waiting on X-rays to determine the severity of his lung disease. He also informed us that he was unable to get the umbilical catheter into Christopher and was requesting a pediatric surgeon to come and perform the procedure later that day. Prior to the arrival of the pediatric surgeon, he cleared us to visit Christopher, but told us that only parents and grandparents were allowed in the NICU at Santa Rosa, and only two at a time.
By this time, Debbie had caught up with us. After the doctor's departure, she led me through the double doors into the nursery. Opposite the nurses station was a sink, antiseptic soap, and some gowns, which looked like yellow bathrobes made from sheets that you put on backwards. I received a quick lesson on scrubbing and off I went to see Christopher.
Inside the nursery was a different world. The intermediate care area was nearly empty. A few plastic domes, or incubators, contained small infants wearing only diapers. Purple tinted fluorescent bulbs illuminated a couple of babies sporting miniature eye visors. Rocking chairs with mothers bottle feeding their babies rocked back and forth as I walked through the intermediate care area into the intensive care area. Here there was a dramatic change. Various types of electronic monitors which all seemed to be making loud and annoying beeps and whistles surrounded the babies in the intensive care area. Nurses and technicians made their way from bed to bed reading monitors and making marks on charts.
Most of the babies in this area were sprawled out on open tables called ‘radiant warmers’. The tables contained four small folding glass walls that prevented the babies from rolling off onto the floor. Directly above each bed, two heating elements generated heat to maintain the babies' temperature. Surrounding their beds were monitors, respirators, and all types of electronic devices each displaying numbers and graphs. It was difficult to tell why all of the babies were in the ICU. Many of them were small and were obviously premature. Others had birth defects or were recovering from operations. It was amazing to me that any of them could sleep amidst all the commotion. And oddly, I saw no other parents.
Tucked way back at the end of the nursery, we came upon Christopher. He looked much different from what I remembered in the delivery room. He had been placed flat on his back without any clothing. A tiny diaper lay open underneath him and a small cylinder was taped on him to collect a urine sample. His skin was thin, red and translucent which made him look as if he had been sunburned. And he looked abnormally skinny - like a fluffy dog when it's getting a bath.
Three electrodes with smiley faces were stuck to his chest and thigh and were attached to a heart monitor. Another round disk, that was stuck to his stomach, contained a heat monitor to automatically adjust the heating elements above. A small IV was inserted in the back of his hand and another one in his foot.
For the first time, I was able to see the small rigid tube that had been inserted down Christopher's throat and into his trachea. White bandaging tape had been wrapped around the tube where it left Christopher's mouth and, combined with yellow glue, was placed across his upper lip onto his cheeks to hold the tube in place. The smaller tube was connected to a longer blue flexible tube, which in turn was connected to the respirator. Each inhalation of the machine was matched by a rising and falling of Christopher's chest. Occasionally Christopher would attempt to take a breath at his own pace only to be overridden by the monotonous breathing pattern of the machine.
The nurse, knowing that this was all new to me, began to explain the various monitors and machines that surrounded his bed. I smiled as I listened thinking that all of this was only temporary until God came to the rescue. As she was talking, I began to witness many of the unpleasantries associated with premature babies. Besides all of the strange noises, IV's, and the tube inserted down his throat, there was the requirement of evaluating the amount of oxygen in his blood. Since the neonatologist was unable to start an umbilical catheter, a respiratory technician, or RT, would come by every half hour with a small, razor sharp, pricking pin. With a quick jab, he would stick Christopher's heel and begin to squeeze his tiny foot, coercing whatever blood he could draw from the wound.
It seemed that each time Christopher would settle down to sleep, it was time for more blood. It was quite evident to me that despite being premature, he could definitely experience pain. Many of the monitors and probes required adhesives to remain attached to his body. As these things were moved or accidentally pulled off, tiny bruises and tears would appear on his thin skin. A blood pressure cuff would occasionally inflate and deflate squeezing his tiny thigh. All I could think of was being thankful that we do not remember pain well and I prayed that all of these experiences would become just a blur in Christopher's memory.
When the X-rays came back, the neonatologist did not look pleased. "Severe lung distress," he said to me as if I would understand what that meant. "The next 24 hours will be very critical," he went on to tell me as I stared at the X-rays not really knowing what I was looking at. From his expression and his use of the words "severe" and "critical" I gathered that Christopher's condition was more grave than I would have ever guessed from looking at him.
After the doctor left, Debbie went out to let my mother and father come in and make their first visit to Christopher. Both of them acted with the same assurance that Christopher was going to be fine. At this time and throughout Christopher's life, their support and encouragement continued to give us strength. My father, as most grandfathers would do with a healthy baby, brought his camera and took Christopher's picture.
Meanwhile, Liz had gotten in touch with her husband David, who was a second year pediatric resident in the Air Force. As God had orchestrated, David was serving as the resident in charge of the NICU at Wilford Hall. Wilford Hall was one of the largest Air Force medical facilities and, unbeknownst to me, had a world class NICU. He was due to arrive shortly after finishing some work and making the fifteen-minute trip to Santa Rosa. When he arrived, he of course shared congratulations, but wanted to know how Christopher was doing medically. Despite his sister Debbie's high position, he was unable to get around the rule that only parents and grandparents are allowed in the NICU. So I began to shuffle information between the NICU and the waiting room, where David was giving me instructions on how to read X-rays.
Premature babies at Christopher's gestation age, are generally, completely formed except for their weight and a chemical in their lungs called surfactant. Surfactant is a soapy type substance that begins to develop toward the latter part of the gestation period. It acts as a lubricant for the small pockets that contain air in our lungs. Without it, the small pockets collapse and stick together when we exhale, making the process of passing oxygen and carrying carbon dioxide away from the blood stream more difficult. X-rays are one of the tools doctors use to determine how much air is being exchanged in the lungs. When the lungs are healthy, they appear black, so much so that it is difficult to see the rib cage. The more white that appears, along with the more ribs you can see, the less amount of air is being exchanged.
David asked me to describe how the area where the lungs were and to count the number of ribs on his X-ray. I was no expert, but I could see that Christopher's X-rays were not black but hazy. And I could count most of the ribs in the lung area. David would send me back into the NICU to gather more information, this time from the respirator.
One of the great inventions doctors use to help premature babies with lung disease is the respirator. When the lungs aren't functioning efficiently, they often turn to a respirator to help breathing. The respirator basically serves two functions: it delivers a pressurized percentage of oxygen into the lungs and it keeps the lungs slightly inflated so they won't collapse. After several lessons on the various respirator components, I went to and from the nursery several times examining the respirator's meters and knobs trying to remember the settings. Each return to the waiting room made the severity of Christopher's lung disease more apparent. David gave me a brief explanation of lung disease in a premature infant and what the numbers meant on the ventilator. I was to learn that the higher the pressure and the greater the percentage of oxygen, the more severe Christopher's respiratory distress. Christopher's oxygen settings and pressure were both high.
I returned back into the nursery to be with Christopher. I watched the flurry of activity surrounding the care of my son and prayed silently for his recovery. I remember the doctor saying the first 24 hours were critical and I set myself to be with Christopher in case God would choose to take him.
Confusion reigned in me as I pondered "faith". Was faith the ability to speak out and command my son to "be well"? Was it never having a doubt that God could miraculously rescue my son from this nursery? Was my being here a demonstration of my lack of faith? But the Lord reminded me of my teaching on worship: that the Presence of the Lord chose to reside within me. I didn't have answers to my many questions, but I felt at ease knowing God was with me.
The nurse informed me that Woody was leaving the recovery room and was on her way over to the nursery. She arrived through a set of double doors in the back that opened near Christopher's bed. They pushed her bed through the doors and into this strange new environment. And despite all of the equipment, machines and people, her eyes became quickly focused on her son. Christopher's red hair seemed to be even redder as she came closer to his bed and seemed to say, "Look at me Mommy!"
Still drowsy from the surgery, she reached up and began to stroke his hair. Oh how she wanted to hold him close, to count his fingers and toes, to cuddle and nurse him. But God had other plans for our "beloved Christ-bearer". For now, the feel of his hair, still matted down by amniotic fluid, would have to be enough.
© Copyright 1987, 2016 by Rick Murata. All Rights Reserved.
Following the surgery, I followed Woody to the recovery room where she was to wait until the effects of the anesthesia wore off. After making sure she was resting well, I gave her a kiss and headed toward the neonatal intensive care unit to look for my parents and to see how Christopher was doing.
Out in the waiting room, my parents and sister were anxious to hear the news. "Woody's doing fine. She's in the recovery room," I said. "We had a baby boy, he weighed 2 pounds, 7 ounces and we named him Christopher David - and he cried when he was born!" After a few hugs and kisses, we headed down to the nursery.
The neonatal nursery was tucked in the corner of Santa Rosa Children's Hospital and was on the same floor as the surgical and recovery room where Christopher was born. It was quite large and actually made up two separate areas. The first area was termed the intermediate care nursery. This area was for infants who needed to be watched and monitored while recovering from less serious surgeries or illnesses or who "graduated" from the other area. The second area, which Christopher was in, was the neonatal intensive care unit or NICU. This area was for the more sickly infants that required a high level of monitoring and care.
The room, brightly painted white with white wallpaper, looked so clean as I peered through the windows in the hallway door. A blue and green and yellow pastel wallpaper border made a path along the top of the walls and around the poles that suspended the ceiling. Just inside was a large nurses station with several nurses typing on computer terminals.
As we attempted to enter we were informed that we were to wait in the waiting area because Christopher was undergoing a surgical procedure. The procedure, called an umbilical catheter, or A line for arterial-line, involves cutting the skin around the naval and inserting a small catheter into the artery of the umbilical cord. The procedure was commonly performed on premature babies to allow the doctors to monitor the babies’ blood more accurately and easily. However, it was often complicated in premature babies because of the small size of the artery.
While we were waiting, we were able to find out Christopher's Apgar scores, which are used to indicate how well a baby is handling the transition from the uterus to the outside world. His scores of 9 at one minute and 8 at five minutes were considered normal to high for a full term baby and caused us to feel a little more at ease. My sister telephoned Woody's Mom, who also was a nurse, to inform her of Christopher's arrival while we continued waiting.
After a long period of time, Christopher's doctor entered the waiting room. I had met him prior to the delivery but was unable to recall his face since most of it was hidden behind a mask in the surgical room. He informed us that Christopher was having difficulty breathing on his own, and that he had placed him on a respirator and was waiting on X-rays to determine the severity of his lung disease. He also informed us that he was unable to get the umbilical catheter into Christopher and was requesting a pediatric surgeon to come and perform the procedure later that day. Prior to the arrival of the pediatric surgeon, he cleared us to visit Christopher, but told us that only parents and grandparents were allowed in the NICU at Santa Rosa, and only two at a time.
By this time, Debbie had caught up with us. After the doctor's departure, she led me through the double doors into the nursery. Opposite the nurses station was a sink, antiseptic soap, and some gowns, which looked like yellow bathrobes made from sheets that you put on backwards. I received a quick lesson on scrubbing and off I went to see Christopher.
Inside the nursery was a different world. The intermediate care area was nearly empty. A few plastic domes, or incubators, contained small infants wearing only diapers. Purple tinted fluorescent bulbs illuminated a couple of babies sporting miniature eye visors. Rocking chairs with mothers bottle feeding their babies rocked back and forth as I walked through the intermediate care area into the intensive care area. Here there was a dramatic change. Various types of electronic monitors which all seemed to be making loud and annoying beeps and whistles surrounded the babies in the intensive care area. Nurses and technicians made their way from bed to bed reading monitors and making marks on charts.
Most of the babies in this area were sprawled out on open tables called ‘radiant warmers’. The tables contained four small folding glass walls that prevented the babies from rolling off onto the floor. Directly above each bed, two heating elements generated heat to maintain the babies' temperature. Surrounding their beds were monitors, respirators, and all types of electronic devices each displaying numbers and graphs. It was difficult to tell why all of the babies were in the ICU. Many of them were small and were obviously premature. Others had birth defects or were recovering from operations. It was amazing to me that any of them could sleep amidst all the commotion. And oddly, I saw no other parents.
Tucked way back at the end of the nursery, we came upon Christopher. He looked much different from what I remembered in the delivery room. He had been placed flat on his back without any clothing. A tiny diaper lay open underneath him and a small cylinder was taped on him to collect a urine sample. His skin was thin, red and translucent which made him look as if he had been sunburned. And he looked abnormally skinny - like a fluffy dog when it's getting a bath.
Three electrodes with smiley faces were stuck to his chest and thigh and were attached to a heart monitor. Another round disk, that was stuck to his stomach, contained a heat monitor to automatically adjust the heating elements above. A small IV was inserted in the back of his hand and another one in his foot.
For the first time, I was able to see the small rigid tube that had been inserted down Christopher's throat and into his trachea. White bandaging tape had been wrapped around the tube where it left Christopher's mouth and, combined with yellow glue, was placed across his upper lip onto his cheeks to hold the tube in place. The smaller tube was connected to a longer blue flexible tube, which in turn was connected to the respirator. Each inhalation of the machine was matched by a rising and falling of Christopher's chest. Occasionally Christopher would attempt to take a breath at his own pace only to be overridden by the monotonous breathing pattern of the machine.
The nurse, knowing that this was all new to me, began to explain the various monitors and machines that surrounded his bed. I smiled as I listened thinking that all of this was only temporary until God came to the rescue. As she was talking, I began to witness many of the unpleasantries associated with premature babies. Besides all of the strange noises, IV's, and the tube inserted down his throat, there was the requirement of evaluating the amount of oxygen in his blood. Since the neonatologist was unable to start an umbilical catheter, a respiratory technician, or RT, would come by every half hour with a small, razor sharp, pricking pin. With a quick jab, he would stick Christopher's heel and begin to squeeze his tiny foot, coercing whatever blood he could draw from the wound.
It seemed that each time Christopher would settle down to sleep, it was time for more blood. It was quite evident to me that despite being premature, he could definitely experience pain. Many of the monitors and probes required adhesives to remain attached to his body. As these things were moved or accidentally pulled off, tiny bruises and tears would appear on his thin skin. A blood pressure cuff would occasionally inflate and deflate squeezing his tiny thigh. All I could think of was being thankful that we do not remember pain well and I prayed that all of these experiences would become just a blur in Christopher's memory.
When the X-rays came back, the neonatologist did not look pleased. "Severe lung distress," he said to me as if I would understand what that meant. "The next 24 hours will be very critical," he went on to tell me as I stared at the X-rays not really knowing what I was looking at. From his expression and his use of the words "severe" and "critical" I gathered that Christopher's condition was more grave than I would have ever guessed from looking at him.
After the doctor left, Debbie went out to let my mother and father come in and make their first visit to Christopher. Both of them acted with the same assurance that Christopher was going to be fine. At this time and throughout Christopher's life, their support and encouragement continued to give us strength. My father, as most grandfathers would do with a healthy baby, brought his camera and took Christopher's picture.
Meanwhile, Liz had gotten in touch with her husband David, who was a second year pediatric resident in the Air Force. As God had orchestrated, David was serving as the resident in charge of the NICU at Wilford Hall. Wilford Hall was one of the largest Air Force medical facilities and, unbeknownst to me, had a world class NICU. He was due to arrive shortly after finishing some work and making the fifteen-minute trip to Santa Rosa. When he arrived, he of course shared congratulations, but wanted to know how Christopher was doing medically. Despite his sister Debbie's high position, he was unable to get around the rule that only parents and grandparents are allowed in the NICU. So I began to shuffle information between the NICU and the waiting room, where David was giving me instructions on how to read X-rays.
Premature babies at Christopher's gestation age, are generally, completely formed except for their weight and a chemical in their lungs called surfactant. Surfactant is a soapy type substance that begins to develop toward the latter part of the gestation period. It acts as a lubricant for the small pockets that contain air in our lungs. Without it, the small pockets collapse and stick together when we exhale, making the process of passing oxygen and carrying carbon dioxide away from the blood stream more difficult. X-rays are one of the tools doctors use to determine how much air is being exchanged in the lungs. When the lungs are healthy, they appear black, so much so that it is difficult to see the rib cage. The more white that appears, along with the more ribs you can see, the less amount of air is being exchanged.
David asked me to describe how the area where the lungs were and to count the number of ribs on his X-ray. I was no expert, but I could see that Christopher's X-rays were not black but hazy. And I could count most of the ribs in the lung area. David would send me back into the NICU to gather more information, this time from the respirator.
One of the great inventions doctors use to help premature babies with lung disease is the respirator. When the lungs aren't functioning efficiently, they often turn to a respirator to help breathing. The respirator basically serves two functions: it delivers a pressurized percentage of oxygen into the lungs and it keeps the lungs slightly inflated so they won't collapse. After several lessons on the various respirator components, I went to and from the nursery several times examining the respirator's meters and knobs trying to remember the settings. Each return to the waiting room made the severity of Christopher's lung disease more apparent. David gave me a brief explanation of lung disease in a premature infant and what the numbers meant on the ventilator. I was to learn that the higher the pressure and the greater the percentage of oxygen, the more severe Christopher's respiratory distress. Christopher's oxygen settings and pressure were both high.
I returned back into the nursery to be with Christopher. I watched the flurry of activity surrounding the care of my son and prayed silently for his recovery. I remember the doctor saying the first 24 hours were critical and I set myself to be with Christopher in case God would choose to take him.
Confusion reigned in me as I pondered "faith". Was faith the ability to speak out and command my son to "be well"? Was it never having a doubt that God could miraculously rescue my son from this nursery? Was my being here a demonstration of my lack of faith? But the Lord reminded me of my teaching on worship: that the Presence of the Lord chose to reside within me. I didn't have answers to my many questions, but I felt at ease knowing God was with me.
The nurse informed me that Woody was leaving the recovery room and was on her way over to the nursery. She arrived through a set of double doors in the back that opened near Christopher's bed. They pushed her bed through the doors and into this strange new environment. And despite all of the equipment, machines and people, her eyes became quickly focused on her son. Christopher's red hair seemed to be even redder as she came closer to his bed and seemed to say, "Look at me Mommy!"
Still drowsy from the surgery, she reached up and began to stroke his hair. Oh how she wanted to hold him close, to count his fingers and toes, to cuddle and nurse him. But God had other plans for our "beloved Christ-bearer". For now, the feel of his hair, still matted down by amniotic fluid, would have to be enough.
© Copyright 1987, 2016 by Rick Murata. All Rights Reserved.