Code blue

I'm writing this from the nurse's station, sneakily using their computer, so apologies for its brevity and ineloquence.

On the eve of discharge from hospital, whilst we are busily making preparations at home for Reuben's homecoming, transforming a little used apartment into an oasis of delight and comfort for Reuben, we get a call from the social worker at Children's to say that Reuben has stopped breathing for "a few minutes". We recall Jiffy's information on the length of time it takes for the brain to be starved of oxygen, 4-6 minutes. Dr Kevin who'd been called up from the PICU as part of the crash team, gets on the phone and explains the Code Blue.

A Code Blue was called whilst Reuben was struggling to breath during his bath. He was deep suctioned, but the nurse was unable to remove the secretions from his trach. They just kept coming and were blocking his airway. The Code ensures that every available Dr and nurse, the crash team, rushes to the scene to resuscitate and administer oxygen. The Code is communicated to the experts in the PICU.

Dr Kevin Madden to whom we are so gratefully indebted for his compassionate care over these past 3 months, along with Dr Charlie Golden (Reuben's new paediatrician), have quite simply been amazing, healing both Reuben's and our own heavy hearts on so many occasions in the NICU (May-June) and PICU days. Always going above and beyond.

The incident is a worsening of that which befell when I arrived at Reuben's bedside on the Bad Day. We clarify that it wasn't minutes, but less than a minute, the time Reuben was unable to breathe. Our relief is that it wasn't his heart. I guess you could say it was a mechanical obstruction caused by a blockage in his airway.

I've stayed by Reuben's bedside during the night and he's slept through blissfully whilst on the humidifier, requiring little suctioning beyond the deep suction at bedtime and this morning, whilst Jason returned home so at least one of us was fit today to look after him.

The mucus plug, a heavy build up of secretions, caused the suffocation incident. Dr Charlie came up later to talk to us, to ask us how we feel about discharge today. Whilst racing along the Freeway to the hospital yesterday brought feelings of "this will delay his discharge considerably and we wouldn't want to take him home whilst he's unstable anyway", the realisation now is that this is the trach. It's something we just have to get used to dealing with at home, without the protection of the Code Blue crash team. We have specialist CPR training under our belt, we will have a nurse for 16 hours a day, Jason is on compassionate leave finally and previously untaken vacation, until the end of the year.

I thank everyone for their help in a rapidly deteriorating situation and thank too the wonderful PICU nurses who heard "Code Blue 632C? That's Reuben!!!" and shortly afterwards came up from the PICU to the floor... Tonette, Carole, Rachel, Jennifer and later Susan. It was most overwhelming to see your faces, to have that neck massage Tonette with thanks, to have your messages of support and empathy regarding the m/c which you'd read about on the blog.

I've missed seeing you all. Wayne (RT) got a few tears from me down the phone the night Reuben left the PICU. The last 3 months has quite simply been the happiest worst experience of our lives.

For now, we await the Drs decision re discharge whilst Reuben gazes around the room, Daddy having just arrived, suck, suck, sucking on not only his thumbs, Reuben that is, but 2 soft fists stuffed into his mouth...