Micropreemie Milestone: Getting Off The Ventilator
There are a ton of important milestones that a mother looks forward to in her baby’s life. In the early days of my pregnancy, I spent too much time daydreaming about the first laugh. I imagined our smiles and adorable outfits in front of my open work laptop. Perhaps I should’ve been taking notes about the meeting I was damn near asleep in. I had perfect, flawless dreams of the perfect, flawless family that I would commandeer toward success. Doe-eyed naivety is a skill I’ve unfortunately mastered. I couldn’t imagine that one day my son’s biggest milestone would be coming off of a ventilator.
Even a healthy full-term delivery is a bloody, painful and soul-altering experience. My emergency c-section at 25 weeks left me about as scared and unprepared as a woman could possibly be. Soon after he was born, we realized that his biggest struggle would be with his lungs. His brain and heart were relatively mildly affected but his lungs were terrible. Just typing the words “ground glass opacity” makes me shiver, bringing to mind hazy, white patches on his chest x-ray.
I can very clearly divide my memories of the NICU into two distinct eras: pre-extubation and post-extubation. We entered the second era on the morning of April 29, 2016. It was one of those dark grey mornings that was as intriguing as it was ugly. There was something surprisingly refreshing about the chilly mist that day. We scrubbed in, set our bags down and sank into the two rockers facing his incubator. I kept an eye on the hallway for the team as they made their morning rounds.
Preparing for Extubation
The attending doctor reminded me of a lion, with fluffy ginger hair that fell just to her shoulders. Surrounded by residents scribbling notes, she wheeled her podium over to greet us. Then she sanitized her hands and opened the bubble doors of his isolette to take a good look at him. I searched her face for a sign of uncertainty or hesitation. His oxygen requirement had crept up to nearly 40% that morning. Since this was a planned extubation, I expected her to reschedule. He was understandably cranky, from the steroids he received to prepare his lungs for the challenge. The doctor felt comfortable moving forward and assembled the team around his bedside.
The respiratory therapists programmed his new SiPAP machine to settings that resembled the support he was getting from the ventilator. They fiddled with thick tubing and adjusted the silver knobs on the wall mounted oxygen supply. It emitted this long and loud whistle, shrill enough to make your teeth ache. When all preparations were in place, the lid of the isolette shot to the ceiling. My cranky, four pound baby was exposed, surrounded and outnumbered.
Reaching A New Milestone
We could hardly see or hear what was going on, only catching quick glimpses over their shoulders. The doctors and nurses shouted numbers and commands back and forth. Then we heard a hoarse little yelp, like an angry newborn kitten. It was only the second time we’d ever heard him cry. The first time was 71 days earlier when he was born, right before the first breathing tube was inserted. His nurse placed the mask over his nose and wrapped his head in a soft helmet with velcro straps. His supplemental oxygen requirement dropped from 40% to 25% and he was finally off the ventilator after 10 long weeks.
We were elated, the giant wave of pride and relief was one of the highest points on the NICU roller coaster. When you live through a traumatic experience you learn to take it in minute by minute. There were many days I didn’t dare to let myself dream about what extubation would look like. But on that beautiful April morning, I swelled with pride and hope. It signaled a turning point in the journey and marked a giant milestone in his fight. Even now, four years later, the anniversary of his extubation is significant. I am reminded of our strength as a family, and of the grace of God. Though it was a milestone I never imagined, I am just as proud of it as any of the other incredible achievements my son has accomplished.