My thoughts & feelings from yesterday persist, but today I’m choosing to focus on a positive. It’s nearly unheard of that a hospitalization doesn’t result in a life flight transfer to Omaha these days, and this time it did not. This hospital has taken the time to carefully consider all of Emerson’s past medical history as well as her current medical complications. They’ve talked extensively to transplant surgeons and the PICU team in Omaha, even communicating events as they happened in the middle of the night.
All in all, there have been a lot of positives in the past three weeks and, moving forward, I’m choosing to focus on at least one a day for the remainder of this admission. Mind you, it won’t magically erase my exhaustion or frustration; but that’s okay. Those feelings are real and justified. Sitting in a PICU with your daughter as she struggles to recover from septic shock is far from invigorating or fun.
Today I am very thankful for the psych team. It began as a consult to address psychosis coming off the vent, then blossomed into many lengthy discussions about Emerson’s mental status at baseline. She’s struggled for many years with violent behavioral outbursts as well as extreme perseveration. It can be difficult to believe just meeting Eme – she is very sweet, quiet, and well-mannered much of the time. When she launches into an outburst, though, a switch flips and that sweet little girl is nearly unrecognizable.
For years it was attributed to her spending too much time in a hospital & becoming accustomed to getting whatever she wanted whenever she wanted it. I’ve been given much parenting advice over the years – walk away from it, don’t give in, detach, yada yada… News flash – I have 2 older boys and this is not my first parenting rodeo; I know how to manage a temper tantrum! What’s more, I have very deliberately not treated Emerson differently when she’s sick. I have the same expectations for her behavior when she’s sitting in a PICU as I do for her when she’s sitting at home.
Mental health is one component of Emerson’s medical picture that has been largely unaddressed. Omaha is not a pediatric hospital and there is no pediatric psych team to consult when we’re there. That’s not to say anyone dismisses it, just that the resources haven’t been available.
The biggest blessing from the psych team this week? They discussed Emerson’s case at length, reviewed all her medical history, and concluded with certainty that her outbursts and perseveration are biologically driven (i.e., they’re not a result of past circumstances or parenting style). Can I get a Hallelujah?! Thank you. It’s not me. I always knew and now it’s medically documented for everyone else to know too! They think it may have happened in one of her cardiac codes, or it may simply be part of her underlying condition. The “why”, though, is less important than the “what” do we do about it.
They eliminated one med, replaced it with a different one, and are starting another new med tomorrow. They’re watching her closely and increasing doses as she tolerates it. The goal is to calm her, but not sedate her. We may not have time to reach the perfect cocktail of meds at the perfect doses for Eme this admission, but I’m so thankful for a team of doctors that is addressing this seriously, and I’m hopeful we’ll, at very least, be in a better spot when we leave. They’re reaching out to psych doctors in Omaha now to find us ongoing support for after discharge. All good and a definite something to be thankful for today!
I had a lengthy discussion with a PICU doctor this afternoon to lay out the plan for Emerson’s drug, fluid, and electrolyte weans. If all goes as planned, she should be buttoned back up and ready to discharge sometime next week. I’m not holding my breath, but I am certainly crossing my fingers. It can’t come soon enough.
Finally, my heartfelt appreciation for sharing your purposeful activities yesterday – I can’t tell you how much fun they were to read! I’m so touched that we’re able to impact others in such a meaningful way. It helps me to see the positive in this crazy journey we are on. Your homework now is to think of one specific thing you are thankful for today…
And one last positive from my day – I stepped outside this afternoon for the first time in three weeks! And with the help of two nurses, a giant IV pole, a big wheelchair, and a travel monitor… Eme came too 🙂