Surgery Week Day 2: IMSU

I asked our nurse in the PICU what determines whether we would get a shared or a single room in the IMSU (Infant Medical Surgical Unit). She said there were a variety of factors, but a lot of it comes down to what the patient is being seen for, and whether there was enough room to not have to share. I was really hoping to avoid a shared room for a couple reasons. 1. If it's a single room, they at least have one of those sleeper couches like in labor and delivery. They still get a 3-4 on the comfort scale, but that beats out the fold out chairs offered in the shared rooms. 2. I was concerned about Pierscen keeping the roomie awake all night crying - and visa versa. 
When we were transferred to the IMSU, I was disappointed to see that it was a shared room, but also grateful that we didn't have a roommate. At least not yet. The charge nurse came in to introduced herself and told us that with cases like Baby P's, she tries to keep them alone seeing as they have really bad headaches. :( I was grateful for her consideration and just crossed my fingers that it would stay that way.

After getting Pierscen settled, Ryan and I went down to the cafeteria to get some food. Ryan only had about an hour left before he needed to drive back to Casper. We talked at length about what I should do that night. I had no desire to try and sleep on that pull out chair. It isn't even comfortable as a regular chair! But I also didn't want to leave Baby P. I knew there was nothing I could do for him except talk to him if he was crying. And as I have mentioned before, though I know how important that is, I also know how much harder it makes things too. It made me feel very helpless. As his mom, I felt like (and feel like) it is my responsiblity to make things better, to make the hurting stop. I felt like by leaving him at night to go back to the Ronald McDonald House, I was abandoning him. I felt like I was "dumping" my maternal responsibilities on the nurses and techs. And yet - I know that does not make sense! The feelings, yes. But the reality, no. The nurses are there to keep him healthy, calm, and relatively pain free. They are far more capable of helping him than I am. But still, the thought of leaving him just tore at me. However, I also had a very strong feeling that I would be so much better able to cope and help him if I was rested too. Ryan and I had planned to turn in the key to our room that morning, but as we were leaving, we talked to the resident manager and she told me that there is a shuttle that runs from the hospital to the house and back, so the fact that I wouldn't have a car any more wouldn't really matter. She urged me to think about it, and that if I decided to turn in the key, just to call her and let her know and I could drop it off with the shuttle.

Undecided, we went back up to the room to spend a little more time with Pierscen before Ryan had to leave. Sometimes time drags when you are dreading what's coming when the deadline approaches... and other times it flies by and you are left with a panicky pit of frantic butterflies crashing through your chest. Ryan's departure was definitely the latter for me. Having him there for the surgery was a miracle - a direct blessing from a loving Heavenly Father. I know I would have been upheld by the faith and fasting of friends and family if he wasn't there, but oh - having him there...

I had almost forgotten the anxiety and worry I had felt thinking about facing the surgery alone. With the worst behind us, I knew everything would be just fine, but I still melted into a pool of tears as he stood by Pierscen's beside, softly crying as he said goodbye to his little boy.   

I did my best to plead with the internal butterfly turmoil to calm down, but I had difficulty swallowing the urge to scream, "Please don't go!" I succeeded, but only just. Asking, pleading, or even demanding that he stay wouldn't have helped. Just watching Ryan cry said more than anything. He would have given anything to stay. Yes, I was scared to be there "alone" again - but what was that compared with leaving your wife and child behind to drive 400 miles away to be completely on his own? No, his lot was far greater than my own.

Ryan mentioned on the way out that his mom has sent him a text letting him know that she was more than happy to come up at any time. She was totally "on-call" but didn't want us to feel like she was pushing her way in. (On the contrary! I was more than happy to have any one come up and spend time with us!) She told him that she would even be willing to stay over night with Pierscen so that I could go get rest. I personally didn't see how this would help a ton - seeing as there isn't anything she can really do for him either, and then I would feel guilty that she was there sleeping on that awful chair instead of me. But we decided to discuss it later when she came up.

After Ryan left, but before Ellen arrived, the social worker, Karla, came in to talk to me. I think social workers are amazing. They have a really tough job. I am sure they see a lot of crazy things up there, and their job is to listen and offer support, comfort, and guidance. Because I know that it is there job to do so, and I felt a little silly unloading my anxieties about leaving Pierscen on her, but it was really good to talk to someone else about it. And it was also helpful because she was able to tell me that there are lots of parents that don't stay with their kids at night. (I couldn't help feeling that I was the only parent that didn't stay with their child. More self inflicted guilt.) She reiterated that if I felt comfortable at all with leaving for the night, that it would actually do more for not just me, but Pierscen as well if I could get the rest that I needed. It helped to have a staff member tell me that - even though I already knew it. The only debate then was whether to take the shuttle back, or call a cab. The shuttle's last run of the day was at 6 pm. I didn't want to go back that early! What was I going to do all night? (Yes, I could have blogged. It would have helped me stay caught up, but I didn't want to go that soon.)

During this time, the staff came in and helped me hold Pierscen. It was a difficult task with him being attached to so many things - and it definitely was NOT a 1-person job, but it was SO wonderful to hold him. We supported him with 3-4 pillows and I just sat in the rocking chair and rocked back and forth, sometimes talking to him, and other times just watching him.

Ellen showed up around 5 pm. With the help the nursing staff, we were able to switch places so that she could hold him for a while.



We talked a lot about what I should do that night. She then offered to stay the night in my place if it would make me feel better knowing that family was here. I explained that it wasn't so much having family there or not as it was my own guilt in leaving him. And then the added guilt knowing that she would be there on that horrible chair not getting any sleep. I just didn't see the need for either of us to lose sleep. I knew that the staff there would take super good care of him and that it wouldn't make a difference if we were there overnight or not. But she insisted. She said she really wanted to stay. It was something that would make her feel like she was helping. I wasn't going to say no if she honestly wanted to do it. And in a situation where I felt so helpless, who was I to deny someone for wanting to help? "Besides," she said, "If I stay through the night, maybe I can help him eat enough so they won't have to poke him again."

Overnight in the PICU, one of IVs in his ankle infilrated and they had to take it out. That meant they were just down to one IV (since they had pulled the right art line as well). When we arrived in the IMSU, they checked his IV because it appeared to be leaking. They flused it with saline, and it flushed fine, so they decided to keep using it for a while. However, later that day that one also infilrated, so they pulled it. They said as long as he was eating enough (enough meaning just shy of an ounce an hour average) they wouldn't need to poke him again. If anyone is capable of getting that boy to eat, it's Ellen! I credit her more than anything else for getting him to the 15 lbs mark. Whenever he went to grandma's, that boy would eat! So yes, if it meant that we kept his fluids steady and he didn't need to get poked again, that would be great.

Bit by bit we were working on getting Pierscen off the heavy pain meds and spacing his doses farther apart. He did pretty well with it. Of course we didn't want him to be in pain, but we also didn't want his system to be used to getting the medicine on the dot every couple of hours. More specifically, he had to be off all IV pain meds, which was the Morphine. That was the constipation culprit anyway, so we were more than willing to get him off that as soon as we could. Besides pain management, he was doing really well. Even the amount coming out of the drain wasn't too bad.

Ryan made it back to Casper around 9:30. Ellen and I spent the evening together until around 10-10:30 pm. Then, since she decided to spend the night, she let me take her car back to the Ronald McDonald House. It was a real blessing. It was wonderful to be able to walk into my room and feel the pressure of the day sliding away. I know sleep is required for all man kind, but I have always felt that I depend on it more than some. It makes tasks that seem unsurpassable a little less daunting.