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Friday, April 6, 2012

playing ambulance

On Wednesday when I put Maya to bed, I was sighing with relief. 

She had been cranky and willful all day and I had had to carry her kicking and screaming out of Ella's school after first grade lunch.  On Wednesday's we go in to volunteer at lunch and then stay to help with math time in the classroom.  It is Maya's favorite part of the week. 

This week however, she had been whining and demanding at lunch, insisting that I get her a pencil and paper "Right now!" so she could show Ella how she can make the letter E.  Then she didn't want to sit down, didn't want to wash her hands after handling the kids trays at clean-up, and lastly she spit in my face.  Warnings turned into consequences and she had to miss math.

As I sat on the couch Wednesday night I could not make myself go to sleep.  I was relishing the quiet to a degree that made tiredness inconsequential.  Then I heard footsteps pounding upstairs. Child awake. Angry stomping child.

I went upstairs to find Ella getting back into her bed. "Maya is making so much noise that I can't sleep," she said indignantly.

Maya was quiet, but tossing and turning as usual.  I sent Ella in to my bed to sleep then returned downstairs.  Within a few minutes she was back up, saying Maya was keeping her awake.  "How can she be keeping you awake if you are in my room?" I asked.  And then I heard it . That sound that comes in the deep part of the night that never means anything good.

Barking and groaning from Maya.

Unsure of how I missed it before, I scooped her up and took her downstairs to give her a nebulizer treatment.  Maya has asthma- an atypical type characterized mostly by coughing, a compromised airway in the face of the common cold and greatly aggravated by allergies (this last one being the reason we had to find a new home for our cat last year.)

I had never seen Maya quite like this before.  I started the nebulizer and called Sandi who, of course, was in Portland.  All alarming medical situations await Sandi's departure.  Maya was crying and not really speaking and each inhale had a deep long bark to it, each cough tight and fearful.  We talked about the possibility of needing to take her to the emergency room and I hung up to attend to Maya.

Time really became skewed  at this point. All of a sudden, it became clean that she needed to go to the ER. I called Trish to come stay with Ella. No answer.  I called Emilie.  No answer.  But within moments, I realized I could not wait for them to drive the 2 miles to my house anymore anyway.  Maya was in trouble. Her breathing was severely compromised. I wrapped her in a blanket, threw on my shoes, called to Ella (who was luckily still awake) to come downstairs and searched frantically for my phone in case I needed to call for help.
Within the space of 5 minutes, I had gone from discovering the need for a nebulizer to contemplating an ambulance. The only reason I didn't call the ambulance was because I thought I could get there faster than they could since they would still have to drive to me.  I was very scared that Maya was going to stop breathing.  She couldn't speak.

And there is Ella in the back hallway trying to decide, the brown jacket or the pink one.

I said to her, "Ella, this is a real and true emergency.  Your sister is in trouble and we need to go right now."  I'm pretty sure she thought, "blah, blah, always say we need to leave right now."

I drove 60 mph in the 35 zone by my house, praying there wouldn't be a cop because I wasn't going to stop and then my silver mini van might be the next clip on those car chase shows.  I was twisted around holding Maya's hand, asking Ella to keep her eyeballs on her sister, and trying to say soothing things even though I'm pretty sure I had that shrill, fake-calm tone that crazy people in thrillers get as I told my girls it was going to be okay. Adrenaline was coursing through my body, I was sweating and shaking and the most terrified I have ever been in my life.

A friend of mine who survived leukemia told me that when she feels stressed now she says to herself, "Is this life and death?" And if the answer is no, she doesn't stress about it.  In those moments, driving like a maniac, I knew exactly what she meant. Nothing mattered to me except Maya's airway.  I didn't care about the staggering student loans, the 5 pounds I gained or the fact that my closets still had not been cleaned out.  I just wanted my baby to be able to breath.

I knew I would never forgive myself if calling an ambulance had been the right move and I had compromised Maya by driving her myself.  I cursed the fact that these emergency situations (because this is not the first one) fall on me to make judgement calls I'm not remotely comfortable making. I was reviewing in my head the steps of CPR on kids.  Had Sandi told me that you skip rescue breaths now and just do compressions or do you just do one breath instead of two?

Halfway to the hospital in downtown, I saw a cop on the two lane road and was able to pull alongside him and yell out that I needed an escort to the hospital.  Blue lights flashing ahead of us, we followed the cop through red lights and intersections.  All the while, I said to Maya, "Look! It's a parade for us! Follow the lights!"

We pulled in at the ER and I ran in with Maya in my arms and Ella trailing behind.  I asked the registration lady where to go and she said, no joke, "I'm going to need you to fill out some papers."  I proceeded to stand there rocking a struggling Maya in my arms while she confirmed our demographics, printed off some paperwork, and obtained my signatures. Admittedly, Maya was in less distress but she was not well.  A nurse popped her head out and peeked at Maya, assessing that she wasn't critical and said they couldn't do any hing until she was registered.  Then we had to wait for at least 3 or 4 minutes more after the paperwork for a triage nurse to call us in.  I said to the woman, "Clearly this is not an emergency to you."

(I've since called and complained about this process to patient relations.  It is possible I cried a little to the woman on the phone when I told her how unfair it is to further distress a distressed mother.)

Tricia and Brock to came to pick up Ella and get her back to home to sleep and Maya's breathing improved considerably from there. The doctor felt she had croup, not an asthma attack, which is a swelling and narrowing of the airway above the vocal cords. This is why her voice and cough was so deep and barky. Apparently this can happen in some kids from just a cold and before we treated her with a steroidal inhaler, it used to happen a couple of times a winter to her, a few times where I had to rush her to walk-in care, but never like this. Between the neb I had given her before we left and breathing the cold night air, the swelling had lessened and she could breath.  Yes, I did feel a bit like the ER staff might think I had overreacted.  But being a good mother means not having to apologize for putting your child's safety first. She got a dose of steroid and I took her home where I met Sandi who had thrown everything in her car and driven home from Portland.  It was 1:30 am.

The terrifying part to me was that this time she was fine, no sign of a cold or upper respiratory issue, when I put her to bed. If Ella had not come to get me, TWICE, I would have been clueless to Maya's distress upstairs and I don't know what would have happened to Maya's airway. How is a mom to do her job with such unknown variables as unexpected respiratory distress?

I have been filled with what ifs.  What if Ella hadn't woken up?  What if Maya had stopped breathing in the van?  What if I had gone to bed when I should have and had been less alert when her airway was so compromised?  What if Ella had been asleep and I had had to drag her downstairs, causing us to be delayed in getting to the hospital?  What if the girls didn't share a room?

 Ella later told us Maya was trying to say "Momma" and "Mommy" but she couldn't.   Sandi's mom suggested that we get Maya a bell to ring.  Sandi did one better.  She bought a remote doorbell and mounted the button to Maya's headboard for her to ring if she can't breath.

We told Ella she was a hero, if an accidental one, and we bought the girls a gift to celebrate them. Maya for being so brave through her ordeal and Ella for sounding the alarm.   Ella has had her eye on these dolls Target makes that is more reasonable than the American Doll and sort of goes with the horse she just bought herself last weekend.  And Maya wants what Ella wants, especially if it means they can play together.

The unveiling:

I am unashamed to admit that we are using gifts to insure Ella's future investment in her sister.  I told her she is her sister's guardian.  And then we gave her a doll to seal the deal. 

After they opened the dolls, Maya came up to me and said, "Thank you so much Momma for my doll."  I swallowed a lump and thought, thank you so much Maya for still being alive.

When things like this happen to me, it is like the thin veil that separates my tidy ideas of life and the reality of life is lifted.  Since that scare,  I have wanted my family close, very close, because I know that there is no guarantee that we will always be together.  Tragedy befalls people, even mother's and children, all the time.  We are not special or immune.  We are blessed.  Pure and simple.  And there is no reason, not ever, to take each other for granted.  Even if you oldest cries her heart out because she can't find the key to unlock the doll's clothes chest.  Even then.

I also no longer sleep with my phone on silent. You never know when someone might have an emergency.  After all, they aren't usually planned. Sandi has also reviewed child CPR with me.  No rescue breaths, just quick, steady compressions to the rhythm of (get this) "Stayin' Alive." 

When Sandi was getting Maya settled back in bed after her exciting trip to the ER, she said, "Maya, you scared Mommy tonight."  Maya looked up at her and said, "Yeah, I scared Momma too."  You got that right.  That is the most scared I have been in my life and I hope to never have that experience again.  I also hope to never hear that doorbell ring in our house.  I like adrenaline but I will leave ambulance driving to the professionals.


Emilie said...

wow. I feel like I was there with you during this. And I feel like I need a drink! You are all my heroes. xoxoxo

Zoe K said...

The doorbell is genius! It sounds to me like you handled this perfectly. And I know it is so much harder in practice than to hear it, but I'm going to tell you what I always need to be reminded of. Please don't languish in the "what if's". You WERE awake, Ella DID come get you. You did exactly the right things. Instead, relish the blessings you're cradled in. Emilie is right, you're ALL heroes.

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