Urgent prayer request for one of our tiniest and sickest. Please pray with us! (side note: We haven't had internet for two weeks...I haven't fallen off the face of the earth, and I have 2 other blogs that are cueing in my outbox, but this takes precedence.)
Pequena (means very small in Portuguese as she is 9 months and only 10 lbs. I am referring to her this way instead of using her name because we recently made the choice as a medical team to do our absolute best not to put medical information regarding our children up on websites in an effort to protect their identity) is very ill with HIV and Tuberculosis and malnutrition. We've had her for a bit, and she's getting stronger, but not really gaining weight.
This afternoon (well since it's the wee hours of the morning, yesterday afternoon) she aspirated her milk (vomited it and then breathed it into her lungs) and began having very serious breathing difficulties. I was called immediately and on arrival she was gray, and floppy and not responding very well. We gave her two nebulizer treatments, chest physiotherapy to help loosen and liquify it all so she could cough it up. This helped a bit, but she was still in a lot of trouble so we rushed over to the clinic and gave her oxygen with a bag and mask to provide continuous positive airway pressure (CPAP) which forces air into her lungs to keep them open so she won't have to work as hard. We kept her on CPAP (the oxygen by bag/mask) for over an hour and she continued retracting (breathing really hard) horrifically, flaring her nares (in an attempt to get more oxygen), breathing insanely too fast, and not responding appropriately. Without the oxygen, she immediately looked even worse. We were all afraid she wouldn't make the 45 minute trip to the city without the oxygen, so we got several boys to carry it and put it in the back of our ambulance (a truck with a mattress in the covered back bed)....the tank is practically as big as I am. Everyone was praying on the base. I prayed and sang worship songs over her the entire way and cried.....mainly cause memories of the 3 little ones that have died in the last year in the hospital due to respiratory complications was flooding into my mind, and I clearly haven't dealt with all those feelings yet! Anyway.....by the time we arrived, she had gotten worse. I rushed her in and they actually listened to me, 10 minutes and 3 doctors later, we were in an ICU treatment room with a nasogastric tube in (tube through her nose into her stomach) which they had used to suck out all the air I had forced in with the CPAP and any remaining food in her tummy, started an IV, drawn labs, checked her glucose (blood sugar), and put her on a cardiac monitor. Her heart was beating 200 times per minute (think 130's as the upper limit of normal), breathing 80 times a minute (30's-40's is pretty normal), and her oxygen saturation was 49% (anything below 90 isn't good if you aren't on oxygen). By this time she was barely, and only occasionally, responding to painful stimuli which means she wasn't getting enough oxygen to her brain. They scooped her up and took her to a real ICU room and started her on oxygen through 1 (that's right not both) of her nares at 1.5 L/min (pretty normal for her size/age)...well by the time they got her hooked back up to the monitor she still only had an oxygen saturation in the 50's. I gently mentioned to the doctor that we had her on a lot more oxygen and with CPAP for over 2.5 hr before she arrived and her nasal cannula with a tiny flow wasn't going to do it for her. She ran off and got a mask and cranked up the oxygen to 14 liters. OK, so that's a huge dose for an adult, much less a 10 lb 9 month old, but finally after 5 minutes her oxygen saturation came up to normal and her heart rate dropped just a bit to 185, but she was still struggling to breathe as well as breathing really fast. After talking with the doctor a bit more to find out what all they were going to do for her and knowing that they were going to keep her on a monitor that beeps very loudly and annoyingly when she's breathing too fast, too slow, not at all or her oxygen saturation is too low, I felt ok to leave for the night (also I didn't want to outstay my welcome especially since I wasn't really allowed back there and they hadn't said anything to me about it-thankfully). Also, they had listened very carefully and with many questions to all I had to say about her and wrote it all down.....so I know they were taking me seriously...the doctor seemed hopefully, but I'd call her condition unstable and critical when I left, so I'm not sure.
Please join us in prayer.....Praise the Lord for the small miracles and favor-actually having a functional oxygen tank with an ambu mask; a quicker than normal trip into the city; favor with the doctors that seemed knowledgeable and acted quickly and sanely; favor to be able to stay so long with her when they don't normally allow it; doctors that actually listened and believed me; and some progress shown from the treatments they have given. At the present, they are pretty much doing all they can do for her. Please pray for Pequena. She is a very very sick little girl at this moment. Pray for her father who is being notified and will hopefully go see her tomorrow. Pray for the doctors and nurses-for wisdom, discernment, knowledge, and a soft heart for her (as they can often write off "orphans" that have HIV and TB and sentence them to death by their inactivity). Pray for the tia who has to sit in a small hard chair by her bedside all night long without being allowed to sleep or rest....essentially being her nurse after having worked the last 3 days and nights (she'll go home tomorrow and be replaced by a new, fresh tia, who will have to sit by Pequena's side 24 hrs a day without sleeping or leaving or resting). Pray for all of us here that care for her, who have seen so much death over the last 2 years and are scared for little Pequena. Pray that the treatments work, that Pequena's breathing is eased; that she can rest tonight; that she feels safe, comforted, and peaceful. I'm going into the city first thing in the AM to see her again and bring more supplies in. I'll try to give updates as I can. Thanks for praying with us! We have seen what the power of prayer can do and believe this for Pequena now!
Posted by erin at 01:21