Well, Madison got to be the first of our triplets to ride in an automobile, for whatever bragging rights that will be worth to her someday. I happened to be at Swedish when the transport crew came to take her to PSL where she will have her surgery. They have an incubator that looks a lot like the regular incubators the kids are in except it is, 1) slightly smaller, 2) attached to a series of IV pumps, oxygen canisters and other goodies to make it self sufficient, and 3) bolted to the top of one of those ambulance stretchers with the collapsible wheels. Madison was alert and slightly pissed off as they packed her up in the new incubator, and I’m always relieved when I see her acting like a regular baby.
A quick aside to earlier in the day. They had decided to replace her IV with a central line to make it easier to give medications. However, she needed some minor surgery to have that happen. I was not aware this was going on, so when I first came to the NICU I walked in and saw an open table with four nurses crowded around it. All of them were dressed head to toe, from hats to booties, in blue surgical gear. It’s not unusual to see new babies fresh from the OR, so I strolled past the commotion to take a quick peek at my babies. I flipped open Madison’s covers to find…no baby. My parents afforded my a fine education so I quickly deduced that she had either strolled out to the front of the hospital for a quick smoke, or she was the center of attention I had seen just earlier. Sure enough she was the current highlight of the day. Her veins are too small to see through the skin, so they had to make a small incision to expose the vein before it was threaded with the line. After the procedure, the doctors wanted to keep an eye on the incision so they covered it with clear tape instead of a cotton ball. Where a cotton ball would soak up the blood in a small dot, the tape wicked the blood across its surface area making it appear much larger than it actually was. You could have seen Madison’s picture next to the headline of “Baby Recovers After Attack By Bit Bull” and probably not thought it out of place. She was perfectly fine, she just looked a little gory.
Back to the transport. The company that does the transport is contracted to PSL to bring them cases from the surrounding five state area. The have ambulances for city travel, helicopters for remote pickups and two Lear jets for the long distance rides. The driver mentioned that half of their routes are back and forth from the airport.
The new hospital (again Presbyterian St. Luke’s, aka PSL) is a main treatment facility for the most difficult or severe NICU cases for the region. One doctor noted to Julie’s Dad that half the patients they see are from Colorado and the rest are from the surrounding states. They have divided it into two main areas, a Level III NICU where Madison will be, and a Level II NICU on a separate floor. We are hoping that space will clear so we can move Noah and Chloe in to the Level II area so the kids are at the same hospital again. PSL is already over crowded and we’ll need to wait until a couple of kids graduate before that can be considered.
The Level III area is very different from the NICU at Swedish. It’s busier, bigger, more crowded, more brightly lit and our unfamiliarity with it makes it seem much more confusing. Much of this is due to the fact that it is more highly staffed. Rather than having a doctor on call, for example, there is a doctor on site 24/7. Any procedure they will need to do, be it routine or specialized, can be done at this location. So while we are not happy Madison is in the situation she is in, we feel good that she is in a place where the best care is readily available. PSL is much less homey and peaceful than Swedish, and we will miss that environment and their wonderful nurses if all of our kids come to PSL.
Madison is scheduled to have a CT scan this morning, which will replace the ultrasounds as the main diagnostic and monitoring tool for her condition. The scan should give the doctors a much better view of what is going on, particularly in that mystery area near the posterior of her brain. A radiologist should be able to read the scan today, and hopefully we will also get an update from the neurologist. If the situation is critical, they will perform the surgery as soon as possible. Since it is always safer to wait until babies are larger and more stable before they have general anesthetic and surgery, if the situation is not an emergency, they will wait as long as they can. We will hopefully know more about the timing later today.