Day 2

Man, this kid is going to run me ragged. This has been quite honestly the toughest, hardest day of my entire life and I've only been a dad for 48 hours. At this rate I'll be bald by one week! Here's the low down....

So this morning at about 7 am, after getting my first real sleep in 2 days, I woke up and went in to check on my little warrior. They said that during the night he took some steps back, suffering some cardiac problems and congestion. They changed his medication and put him on a stronger antibiotic to combat the infection. They said that he hemorrhaging had completely stopped and he was doing better, but that he wasn't progressing. His oxygen saturation was at 80-86%, when it should be up to 90-95%. His blood pressure was faltering some and so they put him on dopamine to help his heart. They said that his heart was fatigued due to the load it was bearing and that it needed to have some help. Apparently during infections like this, the heart overcompensates to help out, and his got tired and wasn't providing good oxygen.

Later in the morning Lisa and I both went and Kai didn't look so hot. His color had deteriorated because of the lowered oxygen levels and they mentioned the need to put him on a high frequency ventilator. They were trying to get one relocated to the hospital to help him out, just in case it was needed. We left the NICU a little broken seeing Kai struggling and praying for improvement.

At this point in the day, I needed a break. There is only so much stress and complication that one brain can handle, and mine had reached it's saturation point. At the urging approval of my wife, I escaped for some much needed "me" time (which sounds incredibly selfish considering the situation). I went and changed clothes, got some food, and went to run an errand at the Post Office before heading back. In the process of licking stamps for some envelopes I get a frantic call from my wife telling me to rush back because they needed to transfer Kai.

I flew from the Post Office lickity split (no pun intended) and made it to the hospital in no time. I rushed to the Nursery to speak with the pediatrician. The situation was that Kai was not improving and they were at their limit with the equipment available in this hospital. He needed the high frequency machine and needed it now. Cultural Clarification Moment: our hospital is a private hospital and one of the nicest facilities in El Salvador, however it is not government run. Government funds go to State hospitals and therefore they have the best equipment.

Back to the story now. His oxygen levels weren't great, his blood pressure was ok, but his chances were not good on a regular machine alone. Plus, since the ventilator was running at high capacity it was putting a lot of pressure on his lungs, which could cause a rupture in his lungs. He needed the high frequency machine, which keep all his passageways and air sac completely open, providing maximum oxygen flow without all the pressure on his little lungs. If he stayed in our hospital, his chances of survival were very low. He would deteriorate and possibly die. The option was to transport him across town to a children's hospital (government run) where they had this machine waiting. As it is, there was only 1 machine of this caliber in the country for rent and it was being used elsewhere. So, the only option was to go to the state hospital and use theirs. The risk was this: to move him they had to remove him from the ventilator and run a hand pump until we arrived. He could deteriorate and possibly die in transit because he was very delicate and critical. Cultural Clarification Moment: El Salvador is not known for giving right of way to emergency vehicles and it was rush hour.

I broke down. No ifs, ands, or buts about it, I simply lost control. What parent of less than 48 hours should ever have to make such a difficult decision? Life and death literally in the balance, teetering on my decision. After composing myself, I went back to Lisa to explain and she lost it. Was this some sort of bad joke? As if Day 1 wasn't hard enough, now our very decision could cost the life of our child!

There really was no choice in the matter. Stay here and die. Move him and live, with the great risk of death in transit. With the scales of life teetering precariously, Kai was prepped, the ambulance readied, phone calls made, and poor mama left with friends to console her. I jumped into the back of the ambulance with the pediatrician, neonatologist, 2 nurses, the ambulance staff, and the all the equipment, and headed out on our adventure across town through the worst possibly traffic (Friday night mind you!). Just as we leave the hospital, we come to a halt in the middle of the road and just sit there. We asked the driver the situation and he said we had broken down. They had to call another ambulance to come and take us. WHAT!!! Are you kidding me? What kind of Archie Bunker operation are we running?

A few minutes later, as I sit there on the verge of cussing (I'm a Christian and missionary, but at this moment I almost lost it all!), I hear the wail of sirens as our new chariot approached. We quickly unload and reload Kai, neonatologist pumping his little lungs without fail. Off we go, in our brand new, dented up little ambulance, weaving in and out of traffic, lights flashing, sirens and horn blaring. In what should have taken over an hour to accomplish due to conditions, we miraculously arrived at the children's hospital in about 20 minutes. Kai stayed completely stable the entire ride and his oxygen levels actually increased in transit. I think possibly he just got cabin fever and wanted some fresh air!

We rush him inside the hospital, me holding the heart rate monitor on top of the incubator as we all maneuver through the corridors. Upon arrival in the NICU ward, Kai is rushed to the Promised Land where our wonderful machine awaited him. As I took care of the admission papers, the medical staff worked to remove him from his current incubator and transport him to the new one, attaching all the appropriate hoses and such to the new machine.

Literally within minutes of arriving, Kai was hooked up, the machine firing on all cylinders, and already improving. The neonatologist came out and was more optimistic than she has been in the the last 48 hours. She would have done cartwheels if we weren't in an emergency ward. He was stable and doing much better on the new machine.

I was allowed to see him after washing what seemed like every square inch of exposed flesh and putting on a "long sleeve" smock, which for me was more like a three quarter sleeve baseball shirt. Cautiously and anxiously I moved into his room. Kai looked a hundred times better. It was a completely different kid from just minute earlier. His color was restored, his oxygen levels were 92-95%, blood pressure stable, heart rate perfect, and daddy sighed the greatest sigh of relief ever since the creation of the world. I sheepishly asked the doctor, "This may sound stupid, but can I kiss him?" "You can kiss him all you want," was his confident reply. And kiss I did!

I returned home after our little adventure to be with Lisa. Kai is doing much better and happier on his new machine. Lisa is jealous, but she will get her chance soon. He is my little warrior and is fighting like crazy. We love him so much and would do anything for him. But I'm praying this is the last of our adventures with him until later. I'm ready for some boring, nothing exciting happens but us holding him, kissing him, and changing diapers. Looking forward to good things tomorrow morning!