Monday, July 22, 2013

THE RACE TO SAVE XAMI’S LIFE




It was Monday morning after giving Xami a bath when Bong asked me to feel Xami's forehead because he seemed to be running a fever. I took his temp and it was 39 degrees C. We decided to wait for 24 hours before taking him to the hospital, giving him fever meds for the whole day. We waited for his fever to abate, for 6 hours, then 10, then 12, then 15, then 20, still the fever persisted. I read up on possible diagnosis for a fever that won't listen to antipyretics, with no other signs and symptoms. Instead of waiting for the 24-hour period to pass, we took him to the ER at 3 in the morning because his fever was even getting higher then stayed at 40-41. We arrived at the nurse's station where everyone was asleep. One of the nurses stirred and sleepily interviewed us, took Xami's temp and weight. She gave us instructions to take Xami to the lab for a blood count and urinalysis. On our way to the lab, we met the resident doctor and she told us to go back to the ER because she'll examine Xami there. She asked me a few questions, and then asked the nurse for a tongue depressor. After opening and closing drawers for a couple of minutes, the nurse came back with a 10cc syringe, saying that the hospital has ran out of tongue depressors so we'll have to make do with the syringe. So in vain, we pried open Xami's mouth and tried to use this big cylindrical plastic as a tongue depressor. I did not see Xami opened his mouth enough to see through his throat but apparently the doctor saw that his throat was red and swollen. She concluded that it was most probably a streptococcal infection so she prescribed an antibiotic with instructions to get Xami checked again if the fever persists for three more days.

Xami was still febrile the whole day Tuesday until early Wednesday afternoon. He seemed to have gained strength late afternoon Wednesday and was running around the house for a whole two hours. At 5:30PM though, he crept into bed and was looking very ill again. The fever shot up to 39.6-41 again and stayed within that range the whole night even with Paracetamol. On Thursday morning, he was at 38-39 and seemed to be just a little weak but seems to be recovering. So we decided to go straight to Bagabag to teach my morphology class at the LCI and to drop by the doctor's office on our way back. While I was teaching my class, Bong tried to get Xami to drink Gatorade as much as he can. At 11AM, we took him to a new pediatrician. Upon seeing Xami, she quickly decided to send  us to get Xami tested for Dengue. We went to another hospital because the test called Dengueline is not available at the Danguilan clinic so we went to MMG. The medtech took Xami's blood and we waited for more than two hours for the result. While waiting, we went to have lunch at a nearby restaurant and Xami thirstily drank half a glass of iced tea and then a few drops of water but refused all the solid food we tried to give him.

We went back to the lab to get the blood test results and I saw that it was negative for dengue. We brought the results to the doctor's office but the pediatrician already left and we were told that she won't be back until 4:30PM. It was already 2PM at the time, and since the dengue test was negative, we decided to go home, and just come back in the morning. We arrived at our apartment, and Xami and I  fell asleep. When I woke up at 4:30, I saw that I missed three calls on my phone and there were 6 messages from the same number. It was all from the pediatrician saying that she is waiting in her office. I told her that the dengue test was negative and that we'll come see her in the morning. At that moment, I looked at the lab result more closely and I saw that there were actually two different tests, and the second page was a detailed CBC, where it was indicated that Xami's platelets were at 45 when the normal range is at least 205 upwards. I also noticed other numbers that were either too low or too high compared to the indicated normal values, so I immediately sent the abnormal values to the doctor and asked for her advise. She immediately texted back that we need to get Xami to the hospital asap because although the dengueline test was negative, the very low platelet count was still indicative of dengue. I asked her to meet us at the only tertiary government hospital in the province but she said she is no longer connected with that hospital but that she can refer us to someone. She named a doctor, and that was the doctor with whom we had a very bad experience regarding Xami's past seizure disorder.  She named another one and it was someone I never consulted in the past but I have heard good reports about her from my relatives.

We went to the nearby provincial hospital in town since that's where the other pediatrician is connected. The scene that greeted us was rows after rows of ill people lying on cot beds outside the hospital buildings.  We went directly to the ER and the admitting resident and nurse immediately hooked Xami to an IV line with a Paracetamol push. We were at the ER for almost an hour waiting for the doctor to come see Xami for further instructions, as the nurses promised to inform the doctor that she has a new patient in the hospital. We were wheeled into a room with five other patients already occupying the room. By this time, Xami was profusely sweating and growing weaker. I saw a doctor entered the building, and she fits the physical description I was given, so I asked a nurse if that was this particular pediatrician. It was indeed her so I made a request to the nurse to inform the doctor that the patient referred to her was at Room 5. The nurse told me that if we were referred to her, she will certainly drop by our bedside. After a quarter of an hour, no doctor came, so I went in search of her. I found her at a nurse's station in another building and after a moment hesitation I drew near and I introduced myself saying that I am the mother of the 1 year-old dengue patient who was endorsed to her. She said no one has endorsed anyone to her and I was stunned. Having no other choice, I begged her to come see my baby. She came after another quarter of an hour or so, and then after looking at Xami, she asked me to step out with her. We went to the back of the hospital building to talk. She said many things but the gist of it was that she cannot accept the responsibility of caring for a patient who clearly needs more care than that particular hospital and the staff can provide. Apparently the staff in the hospital are all new (due to the change of government in the province) and she does not want to entrust my baby's care to them because of past mistakes in the past few days in implementing her orders.  She also said the hospital has no ICU and that my son clearly needs close monitoring preferably in a well-equipped ICU. I asked her if she can recommend another hospital and she mentioned the one we went to on Tuesday morning. A nurse made a call to that hospital and the answer was that we have to bring our own bed and be satisfied to stay by a porch because the wards and the hallways were already full.

I called the doctor who saw Xami that morning and asked her to take Xami back as her patient but she said she's traveling to Manila the next morning. I also told her that we will be moving to another hospital near her clinic but  she said that that particular hospital was also full. At that point, I was already thinking about going to Baguio City but I know that the distance will be a big problem for Xami. It is a good thing, the second doctor I was talking to suggested a relatively new private hospital in the province (which never crossed my mind although I know of its existence) and she encouraged us to go there. After Bong settled the bill, Xami and I boarded an ambulance, while Bong followed us in the car. (I wish nurses who come along sit with the patient and not beside the driver where one cannot really ask for their assistance while the ambulance is navigating the traffic at 100kmph. I needed help trying to keep my seat and keep Xami on my lap and not to get his IV line dislodged but I was alone at the back of the vehicle.) Xami's IV needle was indeed dislodged as a result.

At 9PM, we arrived at the new hospital and by that time Xami's condition was already worsening. His breathing was shallow, his heartbeat and pulse were erratic, his skin was looking gray and his eyes were lifeless and staring... all pointing to the fact that he was already deep into septic shock. The doctor who admitted us called a consultant to ask help regarding Xami's care. After a few minutes of talking on the phone, the doctor mobilized everyone to do all the orders that the other doctor on the other end of the line must have instructed. She said the priority was to pull Xami out of the shock. She feared that Xami's kidneys were shutting down. He did not have any urinary output for more than 8 hours already. They hooked Xami on another IV line and tried to collect blood for another CBC from the line before connecting it to the IV fluid but his blood has already gotten too thick that it won't even flow no matter how they squeezed.

They fast dripped 300ml of IV fluid and waited for Xami to pee, but still nothing; fast dripped another 300ml, still nothing, not even tears or sweat. Fast dripped another 150ml, still nothing. They changed the IV fluid and fast dripped 300ml of the new fluid, but still nothing. They alternated different fluids and different rate of drops to keep the integrity of Xami's vein. Too much fluid too fast can also cause vein collapse and that would also be fatal. By that time, Xami's vital signs were already going extremely low. The consultant doctor came to see Xami for herself and she and the resident doctor discussed further procedures. The consultant jokingly told me and Bong that if she met an accident along the way, her husband will blame us and take us to court. Apparently, she does not drive at night but her hubby is out of town, so she forced herself to drive to the ER to see Xami. She was coming from another town. Of course, the Hippocratic oath was also to blame. :-)

The staff wheeled us to the ICU and hooked Xami to more tubes and wires; some for monitoring and some as precaution for emergency life support in case things get from worst to more worst (OK, that is ungrammatical but what can I do, we are already past worse). Two nurses were stationed there to monitor Xami every 5 minutes until he pees and his vital signs stabilized. The monitor kept flashing red and going toot, toot, toot, every few minutes because of the unstable heart rate, respiration, pulse rate and oxygen intake of Xami. Bong and I just kept holding our son, silently praying that the Lord would give us more time--years to spend with him. At 4AM, everyone sighed when we checked Xami's diapers. The nurses weighed the diapers and found that Xami had a 300ml output. After that, his vital signs started to become more stable and the monitoring changed to every five minutes to every 15, then 30, then every hour. Xami's situation continued to stabilize but his temperature was still extremely high. They kept watching for signs of bleeding. Apparently, he already started to bleed because when Bong changed Xami's nappies at 4:30PM, he had blackish stool, indicating intestinal bleeding. The doctor decided to keep Xami in the ICU until all his vital signs normalized.

This morning, when the doctor came to see Xami, she told us that she already had brain  and heart muscle  stimulants prepared in case Xami's other vital organs start shutting down, and that she was really worried that all her solutions would not be able to pull Xami out of the shock. That was short of saying it was a miracle Xami was revived.

All those hours of watching Xami fight for his life, I had two alternating thoughts.  I was blaming myself, thinking why I did not take Xami to the hospital earlier than we did or that I should have forced it at the hospital last Tuesday to get his complete blood count. I kept thinking that if we lose him, I would certainly lose my mind. Then Bong would hold my hand and then I would be reminded to pray, and tell myself to trust the Lord and thank Him because it was truly by His guidance and wisdom that we were able to take Xami to the right place and right doctor/s who were willing to interrupt their sleeps and leave their children at home to save another child's life.The Lord also knew that I would go crazy worrying and blaming myself, so as it happened, I had accepted an online writing job the day before that was due that Thursday. So when Xami was hooked to all the tubes and wires at the ICU, with the nurses hovering every few minutes, I stepped out of the room to look for a corner where I could write. I had to write five search engine optimization articles with a minimum of 350-words each about a certain topic. The thought of beating the deadline took my mind off my self-blame and worry for a whole hour and that was a gift. My submission was late as I finished writing at 2AM Friday but my kind and considerate agent accepted the articles.

We are home now with a son who continues to be a source of joy not only to us but also to our extended family. I also told Bong that he won. He is okay with only one child, I would like one more.  But after undergoing this ordeal, I told him, I will never ask him for another child again because I do not want to feel so brokenhearted, helpless, and fearful about losing a child ever again... Bong smiled his smile that says, Yeah Right. I guessed that's because he knows I change my mind and my mood ten times a day.

Special thanks to Dra. Remigio, Dra. Padre and the resident doctor and all the nurses at PLTC-Luis A. Tiam Memorial Medical Center for your part in restoring Xami back to us. We are forever indebted to you.

Now, I thank my Father God for His gift of life and healing for my son and I thank Him for the gift of a husband who has shared and shown no less than sheer strength, quiet trust and unwavering faith in God that He is in control, and gentle support for me even when I and everybody, even the medical and nursing staff was already on the verge of panic. I thank my Lord Jesus for friends all over the world who were there to intercede for us through their prayers. I thank my God the Holy Spirit for the peace and comfort He gave to my heart, knowing deep down that no matter what happens, the Lord knows best and that His Name will be glorified.




THIS GIFT THAT IS XAMI

Five years ago today, I felt specially blessed because at last, I was coming home from the hospital with a living and breathing 4000g baby ...