Posts Tagged ‘hospital’

Going into this week, it was not without a little trepidation, but I wasn’t fully aware of my own feelings.  I just knew there was an uneasiness hovering, lurking, in the back of my mind.  When I finally put my finger on it, I realised that I wasn’t wrong to be a little uneasy.

Blogging has not come easily to me lately.  I’ve chalked it up to everything that’s been going on, but I know that’s just an excuse.  After all, we’ve been through a lot of fraught and stressful times in the past few years, and I’ve been able to blog right through them — no sooner would I sit down at the computer than the words would spill forth, so fast that I could hardly type them all out.  But, just lately, the words have… stopped.  Just stopped.  I sit down at the computer and nothing comes.  My mind goes blank, even as only moments before I had been writing blog post after blog post in my mind.  When I come to type those thoughts out, I find they are no longer there –just gone — and trying to force the words out is as futile as trying to push a pile of sand up a hill.  And that has caused me to panic a little inside, because I don’t want to stop writing.  I don’t want there to be nothing there.

I have never been overly keen on those blog posts that recap and look back at other blog posts from the past.  I know they’re useful and relevant sometimes, but they remind me too much of when you turn on your favourite television show and find all the characters are sitting on the couch, drinking coffee and laughing, and saying, “Do you remember when…?” while the screen fades out to various clips from old episodes.  Arghhhh… I’ve seen all this before, and I switch over to something more interesting.

But, wading through the deep sand of this dry spell, I’ve considered doing one of those “looking back” blog posts, to sail through this drought on the coat-tails of what I’ve written before.  I know I’m not writing anything of worth these days, but look!… look!…  I’ve written good things in the past! So I sat down for a moment and looked back at my past posts, from this time a year ago, two years ago.  Of all the weeks in the year, and with that strange feeling of foreboding looming in the back of my mind, I choose this week to look back.

It was a year ago almost to the day that we rushed E2 to the Emergency Room for the first time, as her breathing grew slower and slower and more laboured and we finally realised that this was serious.  It was the night that they gave her breathing treatment after breathing treatment that had little effect, and the doctor finally explained to me — exhausted and hardly believing what I was hearing — that if she didn’t respond to this last treatment, they would have to cut a hole between her ribs and insert a tube into her lungs, because her muscles were going becoming fatigued and she was not going to be able to keep breathing on her own.  It was the first sighting of her (now diagnosed) asthma.  It was the night I realised that my daughter had nearly slipped away…  that had we been living only a couple of generations ago, she probably would have slipped away quietly as we slept.  And that was the night I realised that her own mother hadn’t spotted the seriousness of the situation and that, if I’d been left to make the call on my own, she might well have died.

It was two years ago exactly that I finally couldn’t take another moment of this mysterious, excruciating pain in my breasts and, with all the doctors’ offices closed on a Sunday, spent seven hours waiting to be seen in the Emergency Room, where the doctor examined me and thought she found an “irregular lump” and — eight days into our new life in the United States — I contemplated all the dark and frightening scenarios that come rushing in after those words.  It was the day that we tumbled head-first into the ridiculously complicated pit of confusion that is the American healthcare system, with only a high-deductible temporary policy to break that fall, and learned first-hand that it is not only the uninsured who face misery when disaster strikes, but America’s under-insured as well.  It was the start of the difficult journey to eliminate soy from my diet that led me to realise not only what a detrimental effect this seemingly innocuous food can have, but also to nearly turn my life upside-down in order to avoid the all-pervasive soy in the typical American diet.

So, two years and two trips to ER.  Two years and two stressful days that I’ll be glad never to repeat again.  And then I cast my mind back one more year, to three years ago…  You can’t read about that day — I wasn’t blogging back then — but we spent that one in hospital too.  We made another rushed and stress-filled journey along icy roads in the dark of night.  And there were hours of pain and an awful lot of blood, and that strange sensation of time slowing down and everything coming into sharper, excruciating focus.  And it went on for hours and then… it stopped.

And I looked down and asked the midwife in surprise, “Is it a girl?!?”, because I’d been sure we were having a boy.  And the midwife nodded, and my baby took in a great lungful of air and let it out with a loud cry, and we all smiled with relief.  And then without any delay — without even cleaning her off or even cutting the cord — the midwife lifted her onto my belly, so the baby and I were skin-to-skin, and she latched on and began to feed hungrily, drawing comfort from the warmth of my milk and the warmth of my skin, and slowly letting go of all the fear and stress that the last few hours had been — for her as much as for us.

E2 is three this week — and she is beautiful… wonderful… everything I could have hoped her to be as I gazed down on her in my arms that night she was born.  Over the next few days, we will sing “Happy Birthday” to her and open gifts and celebrate these amazing three years and the miracle she is to us.  And I will thank God that she is with us — because there are so many ways that she might not have been.  And I am aware of them every day.

And if we don’t end up in hospital this year (touch wood), that will be fine too.  Because things come in threes, and we’ve done our three, thank you very much.  This year then, perhaps just a nice quiet birthday, eh?  And maybe another slice of that (surprisingly good) egg-free, dairy-free, nut-free, soy-free birthday cake.

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In the end, we did go to the emergency room, and a very good thing too.  As I said in the postscript to my last blog post, E2 got me back up again around 3.15am (though I say she “got me up”, I had yet to actually sleep) and, this time, she was having to work very, very hard to breathe.  She was asking for milk, but what she really needed was an immediate breathing treatment, and I carried her straight downstairs to set it up.

The medicine is a strong stimulant — this is what forces the airways open again — and the result is almost always a burst of activity, as if she’s suddenly ingested four cups of strong coffee.  It’s hard to judge her breathing at this point — I have to wait until she’s calmed down a bit to get a true idea of whether the treatment has worked.  She ran around until around 4am, and then slowed and I could begin to see…  and I just wasn’t happy with what I saw.

She was still working to breathe — less than before, for sure, but still visibly working.  And that meant it was probably time to go to the emergency room.  But… I wasn’t sure.   It was 4am, I hadn’t had much sleep for nights on end and no sleep that night at all, I was exhausted…  it was chucking down rain and cold, and dark, and hospital has recently moved to a new location which I don’t know that well…  I thought of my other daughter, fast asleep in her bed upstairs…  I wasn’t sure what to do.   She was working for the breath but…  was it that bad?  Or was it just the usual struggle from having a cold? I couldn’t decide.

I woke M from his deep sleep and made him watch her breathe.  He  wasn’t sure either.  She was so happy and lively in herself, smiling at her daddy, but still… there was that rasping, the belly working with each breath, a slight collapse at the base of the neck…    “Mmmm… ” he weighed it up, “I think she’s ok.  Let’s just wait a bit and see.”

I agreed, relieved to share the burden of the decision.  “But I don’t want to put her in her room.  I want her to sleep here with us.”  It was a sign of his true uneasiness that he agreed immediately — he has always been adamantly against the girls sleeping in our bed.

She didn’t sleep.  She tossed and turned, and sang, and played with her daddy’s ears and his nose, and smacked me gently on the face.  So exhausted was I that I managed to slip into blessed unconsciousness even still, and so grabbed my only sleep of the night — about 30 minutes.  But when I came to again, there was no question — she was not getting better.  I rang the doctor’s office — it was now about 5am.  The nurse on call listened to my description and then said, “You know what I’m going to say, don’t you?”  I did.  “I’ll ring ahead to let them know you’ll be coming…”

Poor E1 sat up with a start start when I rudely flicked on the light, and she blurted out in confusion, “What’s… what’s going on?!?” I told her we were going to hospital and I needed her to get up, use the toilet, and get dressed.  My recognised my tone and followed the orders without complaint.  But when her knickers wouldn’t cooperate, the sleeiness got the better of her and she faltered.  “Mummy, I think I might cry…”  Big eyes, wobbling lip.  I fixed the knickers, gave her a squeeze and a big kiss, and she composed herself again and carried on — so exactly the big girl I needed her to be at that moment.

I rang my mother and asked her to meet us at the hospital, then grabbed a change of clothes and whatever food I could find — breakfast would be corn muffins and leftover pasta with garlic-tomato sauce — and bundled everything and everyone in the car.

I took a wrong turn in the dark and got lost in the city, then found my way again, then took another wrong turn and got lost again.  “Sweetheart, are you ok?” I called out every few seconds, and she’d squeak a small sound in reply.  I barked at E1, “Watch her! Watch her breathe!  Is she breathing?”  This time, the nurse had not suggested an ambulance.  And we’d made the trip every time before in the car so I just hadn’t thought…  Oh, why hadn’t I called an ambulance?!?  I turned left… found it was a road I recognised, worked out the way to the hospital, and gunned it.

She didn’t respond to the first treatment, even after a full hour.  The wheezing continued, the effort with every breath still painfully apparent.  And, more worryingly, even the stimulant no longer perked her up much — she laid on the hospital bed, listless in a little blue gown covered in dinosaurs.  They tried another treatment, with a different medicine and, thankfully, that one.  She began to breathe more easily and her eyes brightened.  We stayed another hour for observation, and then we were released, and left feeling disorientated, surprised to find that it was lunchtime.

The doctor had asked me — no, ordered — to take her for a follow-up the next morning.  He was adamant that he did not want it delayed until after the weekend.  But when we arrived, the pediatrician was running behind, and we sat in the waiting room for over an hour, surrounded by all the other children who also so sick that they couldn’t wait for Monday.  One mother, her arm around a bleary-eyed, coughing girl, told the woman next to her that 300 children had been out that week from her daughter’s school with suspected or confirmed swine flu.  I made E2 put her book down, and slipped into the bathroom to wash her hands.

The doctor’s eyes went immediately to E2’s chest and belly, from the moment she walked in the room.  “She’s working for it now, isn’t she?” she observed before we’d even begun.  “She needs a treatment now.  We could do it here… but, no, that will cost you.  How far are you from home?”  Ten minutes, I told her, and we agreed we could do the treatment the minute we got home.

I like this doctor very much — she is gentle and respectful with my daughters, shows them all the instruments before she uses them, and sings a quiet and soothing  song as she examines them.  More importantly, she genuinely understands that I am generally hesitant to resort to medication, because she is of the same persuasion herself.  So when she suggested at our previous appointment (that is, after the last breathing-trouble run to ER) that perhaps we should consider giving E2 a nebulised steroid treatment — daily steroid, for the next six months — my initial gut instinct to reject the idea was tempered by the knowledge that she wouldn’t be suggesting it if the situation weren’t really that serious.  And yet…  and yet, I couldn’t hide my revulsion.  “Think about it for awhile,” she had said, writing the prescription.  “Pick up the medicine from the pharmacy…  Maybe discuss it with the allergist too.  But the way she goes down so fast…  I think we might need to do something to help her get on top of this, for the future.”   And now the doctor brought the subject up again, suggesting in her gentle manner thatperhaps we should be using that daily steroid treatment — and this time I had to agree with her.  It all gets so critical so quickly with E2…  It’s dangerous to carry on like this.

I asked about swine flu: could the girls be vaccinated, given their egg allergies?  No, but M and I can.  In fact — she pointed her pen at me, concern on her face — we probably should be as soon as possible.  With E2’s history…  She didn’t finish her thought, but I understood.  I have no doubt that if this child contracts swine flu, it will not be the “mild case” that we’re told most people get.  I will be that mother praying fervently, with her forehead resting on the edge of a hospital bed, next to the child fighting for her life.  I need to register the two of us with a doctor — or perhaps ring the allergist — and hope my explanation of the situation is enough to persuade him or her to bend the rules and give the two of us the H1N1 vaccine.

But for now, sat here at the computer and up far too late again, I am just counting my blessings — grateful that we made it to the hospital in time, and that my daughter responded to the treatments at last, and that tonight she is sleeping peacefully upstairs… her little chest rising and falling gently in the dark.   The last few days have been exhausting, draining.   Tackling the next hurdle can wait until tomorrow.

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This time I spotted the signs much quicker — the belly breathing; the way the base of her neck caved in on the inhale; the listlessness, so much so that she was lying flattened on the floor and wouldn’t even lift her head — and I knew what to do.  My mother held her on her lap as I put the mask over my daughter’s face and turned on the nebuliser.  She would be fine, I knew.  I’d done my bit by spotting the signs and now her breathing treatment would open her airways again.  It would not go to croup this time.

And she did perk up for a time — the adrenaline rush to her system gave her a jolt of energy that spilled out in songs and giggles and, once she was eventually free of the mask and the machine, the kind of crazed dancing that only drugs can produce.  I watched her mania with waves of relief.

So the shock rocked me to the core when I realised only thirty minutes later that she was struggling to breath again.   Again, the belly-breathing.  Again, that horrible pulling at the base of her neck.  It was too soon to use the nebuliser — much too soon, it should have lasted four hours!  How could she have fallen back so badly in only thirty minutes?

A cursory call to the doctor’s office, only to confirm what I already knew — we were to go directly to the Emergency Room, by ambulance if necessary.  I calmed my racing heart, told it that those words came as no surprise — to no avail — and began to pack our bags.  We needed enough nappies to perhaps see us through the night, more wipes, and food.  We can go nowhere without bringing our own food — even the hospital struggles to cope E2’s extensive dietary restrictions.  Last time, it produced an apple and a bowl of plain rice noodles covered in canola oil.  She’s two years old: of course she turned up her nose.

But the timing was terrible and the cupboard was bare.  “I’ll make something,” my mother said, hastily shoving a pair sweet potatoes into the microwave.  “You…” she looked at me, still in my pajamas and with great globs of snot dried in my hair.  E1 had cried through the night with a sore throat so pitifully that I’d slept (or, rather, not) beside  her, contorting my too-long body into her toddler bed, where she’d sneezed repeatedly, violently, all over me.  My mother winced a little, “You have a quick shower — quick — and get dressed while I make the food.”

I looked at my daughter, judging her breath.  She was working at it for sure, much more than she should have been so soon after a treatment, but she was ok for the moment.  I could see that. There was time, I thought, and dashed to the bathroom.  My shower lasted two minutes — soap on, soap off — but  I kicked myself for it the whole time, stepped out onto the bathmat in a guilt-induced near-panic.

In the car as I drove, my mother kept her body turned around in the passenger seat, watching E2’s chest rise and fall, and periodically telling me to slow down.  My wet hair dripped down the back of my neck.  E2 kept breathing.

At the hospital, they issued us with masks first and read the registration paperwork.  “Breathing troubles”, I’d written and they waved us straight in.  Weight, blood pressure, stethoscope — ah yes, that wheeze and rattle — and they settled her down for another breathing treatment, this one lasting an hour.  She perked up again almost immediately and asked to take the mask off so she could dance with her fidgetting, bored sister.  “No, sweetheart.  You just breathe,” I told her.  She sang instead, which was just as good.

The treatment finished, they left us for a while to see how it took.  But when they returned at last, the rattle was still there, so she had another — shorter this time, a steroid.  And that one did the trick.   After another long observation period, made more difficult by one child who was now totally wired and the other who was bored beyond her tolerance, they declared her fit and released us, with a prescription for more steroids.

We drove home in the falling dusk.  E1 succumbed to sleep immediately and, as the adrenaline rush began to die away, her little sister followed suit.  I watched them both in the rear-view mirror: their faces relaxed and angelic, their mouths both hanging open, and their chests rising and falling …easily, rhythmically.  I counted my blessings.

And then I counted something else: four colds so far this year, and all four times, we’ve had to use the treatment to keep her breathing.  Four colds so far this year, and two have ended up in the Emergency Room.  What gave the rest of us sniffles and coughs brought E2 to the edge of disaster every time.

We pulled up to the pharmacy and I turned off the car.  It was dark now and I was exhausted, ready for bed but knowing it would be another long night with two sick little girls.  “Oh, Mum… I hope she outgrows this.”  I reached to open the car door when another, darker thought suddenly chilled me.  “But…”  I turned my head and looked at my mum.  “But if she doesn’t…  if she’s this susceptible to everything…  how will I ever be able to send her to school?!?”

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An envelope arrived today from the insurance company and I knew immediately that it would be the paperwork for E2’s trip to the Emergency Room. Every time we’ve got one of these envelopes before, it’s always been bad news — thousands of dollars worth of bad — and so my hand nearly shook as I began to open this one. I quickly scanned past line after line of itemised costs and focused on the big number at the bottom…

Just over $3000.  My heart stopped.  $3000 in one night!

And then I looked over to the box marked “Amount You Owe Provider”. It said $25. I closed my eyes with relief and lent my head back against the wall, and thanked God in his heaven that my kids are covered by the state’s CHIP programme (the only policy that I could find in the entire marketplace that they qualified for). To owe so little for a bill so high is really quite extraordinary here in the US.  Even most “good” policies here would require me to pay a percentage of that amount and the most common split I’ve seen is 80/20. That would put our portion of E2’s impromptu night in hospital at $600 and — with a gas bill that was higher than that last month and M’s hours ever fluctuating — even that reduced amount would have been a crippling bill for us to pay.  And if, God forbid, we’d been uninsured…

This is why I believe, wholly and completely, that the US healthcare system is fatally flawed and needs to be overhauled entirely.  I have heard the arguments for the status quo — argued with passion, most often, by people who have never been in a position of being trapped by their (un)insurance.   I understand the concept of a person neatly choosing the coverage they need, of deciding how much deductible and max-out-of-pocket they want to budget for.  But the reality is simply not that neat.  Most people can’t choose the coverage they want, because their healthcare options are dictated by their employer.  And buying the policy that suits your pocketbook best simply doesn’t work once you have a pre-existing condition — and we will all have one eventually — and so you can no longer pick and choose freely in the marketplace.  And even when you can, the cost of buying that coverage outright is completely prohibitive for most people on average wages.

Buying healthcare coverage is completely unlike any other purchase a person usually makes in their entire lives.  Nothing other than healthcare is so fundamentally compelling — truly life and death — and yet has such devastating potential to create skyrocketing and utterly unmanageable costs literally overnight.  Healthcare provision is quite simply in class by itself and, as such, it has to be treated differently.  To leave to the marketplace as if it were any other ordinary commodity is…  well, is to create an unacceptable situation like the one we’ve got at the moment.

And it’s unacceptable because of this horrifiying thought:  if, when that on-call doctor told me to take E2 to the Emergency Room… if I’d had to think about what 20% of that trip was likely to cost, then I might not have been hesitating solely on account of the snow and my mistaken belief that things weren’t yet that bad.  I might well have been weighing up the doctor’s advice — and my daughter’s well-being — against my wallet.  And if — as so easily could have happened to us — we’d been completely uninsured, I think it’s quite likely that I would have followed my own flawed judgment and waited to see how the night went, and thus brought on all the unthinkable consequences that could have created.

It was not us that night, but there are 47 million others.

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Here’s the thing: I wouldn’t have called the doctor.  I wasn’t going to — I didn’t think it was that dire yet.  I was all stiff upper lip… soldier on… mustn’t grumble…  It was my mother who was convinced we should call the doctor, and she had to goad me a bit before I agreed.  Go on, then, I said reluctantly.  You make the call. And she did.  She made the first call — not me.

When I told M what the doctor had said at the follow-up appointment, his face was grave.  “You know, if you hadn’t taken her into ER, I don’t think she would have made it.  I don’t think she would have kept breathing through the night.”  And I think he’s right.  With hindsight, watching how her condition progressed that night, I don’t think she would have kept breathing either if we’d stayed at home.  And yet, I hadn’t wanted to make that phone call.  I hadn’t wanted to make a fuss, hadn’t wanted to be a bother…  I hadn’t wanted it to be anything so serious.  I’d teased my mother after I’d got off the phone… (in pantomime voice): We’d never have had to go out on these roads if you hadn’t made me make that call! And again when they told me we had to stay the night… I’d be at home with a nice cup of tea…  None of this would have happened if you hadn’t made me call! The joke of it was patently obvious to me — the situation was clearly a serious one and I was glad to be in the hands of experts.  It was only an attempt to lighten a frightening situation …and perhaps to alleviate my own discomfort at the realisation that my judgment was so off the mark.

My mother cried when I relayed what the follow-up doctor had said — the severity of our near miss suddenly painfully real.  I didn’t cry — not because I didn’t feel the same rush of emotion, but because I felt… instinctively guarded.

“Well,” she said, and laughed a little, “I do feel vindicated!”

“Vindicated?”  I asked.  I don’t know why I asked — I knew exactly what she meant.

“Yes, after all your saying it was my fault we had to go to ER, I do feel vindicated!”  And the laugh again, the one that was meant to cast a tone of jest over true words.

I was right and you were wrong. Isn’t that what she was saying?  I told you so!..  That phrase which gloats over someone-else’s mistake, the same words which we tell children it’s not nice to say…   I was suddenly angry that she would feel the need — feel free — to share with me her feelings of victory, at the very moment I was feeling all the terrible gravity of what might have been.  Why make a point of how right she was just as I realise how wrong — how dangerously wrong — I was?  Suddenly, the conversation became stilted and I wanted off the phone.

But she is right: her vindication is well deserved.  I was not going to make that call.  I didn’t see the danger — the danger right before my eyes, lying right there listless in my arms.  I would have just carried on as we were, watching my daughter struggle to breath as we went into the night.  No one should be more diligent than me, no one a better advocate for my daughter — a louder, more biased, more demanding advocate — than me…  her own mother.  And I got it wrong — on the one night that she really could have died.  I am actually having quite a bit of trouble with that.

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We went to the doctor’s today for E2’s post-hospital follow up, and saw the same doctor whom I’d spoken to on the phone and who’d told us to take her into ER.  She looked at the notes and, when she saw that they’d kept E2 in for the night, I could see how relieved she was that we’d listened to her and gone, despite my protestations about the weather.

“So, tell me what happened…”  I explained about the steroid shot in her leg, the breathing treatments, the chest x-rays, and I demonstrated the way I’d had to hold my daughter as she went into her strange, back-arching panic attacks.  “Yes, it sounds like her breathing was going into spasms.  It happens with croup — they get to a point where they can’t control it.”

When I told her about the third breathing treatment, she paused in her note-taking and looked up at me, her hand dropping to her lap.  “They did three treatments?”  I nodded.

“They don’t usually have to go to three treatments.  She must have been in a very bad way, worse than I realised.  You know, I debated in my mind whether to have you drive her into ER or to have her go by ambulance…  but from your description, I think she should have gone by ambulance…”

I looked up at her, stunned.

“Children can develop a tendancy toward croup, particularly when they are so small, as she is, and when they’ve had it so bad before.  If she ever starts to show those symptoms again,” she leaned in to make sure I was taking in every word, “don’t hesitate to go straight to the Emergency Room.  And if she ever gets bad like that again, she needs to go by ambulance.”


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At 1am, I was alone with E2 and a nurse on the darkened hospital isolation ward, watching my daughter strain to draw breath and answering all the same questions that I had answered four hours earlier in the Emergency Room.  I appreciated the nurse’s thoroughness and I felt safer for being in a place where I knew we’d get the best help, but I was feeling exhausted, alone, and so frightened.  When she asked me to strip E2 down in order to weigh her, I took off her shoes, top, and trousers, but left her onesie and nappy on — it was a bit chilly, and my baby was sick — but, when she saw this, she corrected me, “No no, I need you to strip her right down.  We need to know exactly how much she weighs so when they weigh her tomorrow, they will know precisely if she’s lost any weight.”  And with that one comment, I realised just how serious the situation was — if they were worried about how much weight she might lose in one night, then there was little room for error.  I took off the rest of her clothes and placed my daughter naked, gasping — her neck and chest and stomach collapsing grossly inward with every slow breath — onto the scale.  It read 10.89kg.  Two years ago to the day, just moments after she’d been born, the midwife had placed her on an identical set of scales, and she had weighed 4.22kg.  Two years…  two years… and she’s barely doubled her birth weight, something most babies do at four or five months.

When the nurse handed E2 back to me, I picked up one of the nappies from the pile the hospital provided and realised immediately that it was far too big: the legholes gaped around E2’s skinny legs with an inch to spare on either side.  They were size 6 — perfectly right for a girl her age — and I asked the nurse if we could have 3s instead.  E2 wears 3s and she has for the last twelve months.  In a year, she has never gone up in nappy size.  Any mother will tell you that’s not right.

Later, when two doctors came in, I had to repeat the whole story again — how she’d had a runny nose for two days, how today it had taken a turn for the worse and she’d developed a fever and become miserable and listless.  When her breathing became laboured — so difficult and wheezy that I could hear her struggling for breath even from the next room — we’d rung the doctor, who’d told us to go straight to the emergency room and specified that she’d wanted us to go the specialist children’s hospital in the center of the city.  My heart had sank at that.  Seeing how bad E2 was that morning, I had canceled our planned birthday lunch and my mother had come round for an improvised mini-party at the house instead.  As the day wore on, the birthday girl wanted nothing more than to rest her head against my chest and try to breathe.  We spent much of the day on the couch, watching the heavy snowfall cover the road, and the cars as they each slid sideways down the hill.  It was turning out to be a good day to stay home and I quietly gave thanks that we had no reason to have to brave those roads ourselves — until the doctor ordered us to ER, through the snow and mess, and at rush hour.

The first doctor left — so soft spoken and heavily accented that I’d struggled to understand a single word she’d said — and the second doctor pulled a chair up.  He smiled warmly — no one had done that yet, and it surprised me to realise how much I needed that smile.  “My name is Tom.  Let me explain what we’re going to do…”  He was a few years younger than me and nice looking…  I stopped listening to him and started thinking about how he could be so good-humoured and kind and… well, awake at 2am.  I found myself thinking that he must be the kind of person who meets life head on.  That’s the kind of person who gets themselves through medical school, isn’t it?  Someone with enthusiasm and energy and a positive outlook on life?  I wondered what my life would be like if I’d ended up with someone like that, someone driven and positive and enthusiastic.  A few weeks ago, M had told me that he thought the innate positivity of  the US had been rubbing off on him and that he reckoned his own positivity had increased probably 40% since moving here — and I was gobsmacked at this declaration.  Where? When?  …At work? Yes, he agreed, probably at work…  Must be, because at home, I see no change.  He allows all his exhaustion, fears, insecurities, and negativity to come to the surface unhampered.  I know it’s better that he show his positive side at work, even if that means his reserves are empty when he gets home, because that’s where our bread is buttered, but it’s hard to live with someone who spends the rest of his life just waiting for the day to end.

When I stopped myself and tuned back into what the doctor was saying, he was explaining that she had an ordinary virus, but that it was dangerous because she is so small, and so the inflammation in her chest was threatening to close her airways.  They wanted to do another breathing treatment — nebulised epinephrine, her third treatment since we’d arrived — because her breathing was so strained that they were afraid her breathing muscles would fatigue.  “Fatigue?” I repeated, knowing what it meant but wanting to be wrong.

He paused, and then saw that I needed it said more plainly.  “Yes…  her muscles might… stop.”

I asked what would happen in that case and he said they’d have to insert a tube into her lung to keep her going.  At least, that’s what I think he said.   I hadn’t eaten since breakfast, I was so tired, so mentally exhausted, and my mind had ceased working when he’d said there was a chance her breathing might stop.  I don’t know what he said to me, or what I said to him.

It was a strange night — she spent half of it flailing wildly in my arms, arching her back and screaming blue murder.  I held her to me forcibly and she finally, finally succumbed to exhaustion and fell asleep in my arms.  I adjusted myself into as comfortable a position as I could in the chair and watched her breathing — still laboured, but still breathing.  I mused to myself that we’d been in hospital this same night two years previously and then realised with a start that we’d been in ER exactly one year and a day ago as well… and decided I didn’t much like this trend.  But eventually, my thoughts faded and sleep over came me, at long last.

Fifteen minutes later, the nurse woke me to say they’d felt so bad to see me sleeping upright that they’d found me a reclining chair.  I lifted myself out of my seat,  gently…  gently…  and let them swap the chairs about.  Someone took a mis-step, the chair came down with a bang…  and she was awake, screaming and crying wildly for another full hour.  Finally, at 4.30am, I calmed her enough to sleep again, and laid beside her.  She woke again three times before 7am, but it was sleep, of a sort.

The doctors came around to see her again in the morning: the Indian one I couldn’t understand, a specialist of some sort, and a team of eight medical students.  Her breathing was better and they were pleased, but the specialist was not fully convinced, and ordered chest x-rays.  Mid-afternoon, they came back clear, and we were ok’d for discharge.  Her breathing was still strained, but nothing like it had been, and her fever was gone and she had returned to her lively self again.  With strict instructions to watch her closely and return immediately if she worsened at all — and a deep sense of gratitude that the worst was over and she was going to be alright — we headed for home.

The house looked much as we’d left it the day before, birthday presents lying where they’d been left.  The girls were both out of sorts after all the upheaval — alternating between playing and disoriented crying.  My mother tried to soothe E1 while I went to make us all a cup of tea.  …I didn’t see the snowglobe on the edge of the fireplace.  My mother had brought it as a “little something” for E1 amid all the birthday fuss over her sister and, when she opened it, I had winced inwardly.  A glass snowglobe does not seem to me like an appropriate toy for a three year old, but my mother doesn’t think of these things, and I am not permitted to express such criticism without it creating a problem, so I bit my tongue and planned to secret it away (with the other two equally inappropriate snowglobes) at the first opportunity.

But in our rush to leave for ER, it had been left right there on the corner of the fireplace.  And as my mother soothed a confused and crying E1, and I stood sleep-deprived and dazed by the kettle in the kitchen… little, wheezing, curious E2 had spotted it and picked it up to look, and promptly dropped it at her feet, where it broke into a hundred shards of glass that sprayed in an arc ten feet across the room.  I ran in in an instant and lifted my barefoot daughter up and away from the glass, and told my mother to do the same with E1 — no, lift her out, don’t walk her out.  And then, I took a deep breath, and  got down on the floor and began to clean up the mess.

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