Blue Baby

Yesterday we had one of our scariest moments yet with Timmy's trach.  All during church, he just sounded so dry.  I could tell he was having a hard time breathing.  The air has just become so dry that it doesn't take long for his trach to dry out and his breathing to become raspy.  He had had a hard time the night before too (especially when Landon woke up and both boys wanted to snuggle).  I had tried getting him cleaned out and putting on a HME (heat-moisture exchanger) so that I could bring him in bed with me and get him to sleep snuggling, but that was a no-go.  I'm not sure if having the HME on made it harder to breathe or not, but it definitely didn't seem like it helped him breathe any easier.  So, after about 20 minutes of that, we returned to the moisture collar and the rocking chair and he eventually was able to go back to sleep.  (I have to be honest, I love that little guy so much but I still sleep so much better when he's asleep in his crib.)

I couldn't get him to nap before church yesterday in spite of the rough night.  Also couldn't get him to keep the HME on.  (It's actually kind of cute/funny to watch him yank them off and throw them.  I'm telling you, this kid has an arm!  He throws overhand really well.  We have to watch him with balls and things around other little kids because he can bean someone pretty hard at close range.)  I tried all during sacrament meeting to get Timmy to sleep but he was breathing so hard he couldn't relax.  Suctioning is a catch-22.  With the help of saline to moisten the dried blood and mucous in the trach, I can get the cannula cleared.  However, this also leaves his airway more open to the dry air, which irritates his trachea and generally causes it to bleed a little bit by the time I'm done suctioning which, in turns causes more secretions and results in more dried stuff in the trach.  He used to be okay with suctioning but now Timmy fights it.  As soon as I turn the machine on, he has his arm ready to push me away.

Poor little guy.  I could tell he was exhausted by Relief Society.  I should have just brought him home then but figured we were only about 40 minutes away from being done with church so I just tried to keep his airway moist by putting in a few saline drops.  Bless all the sisters who helped.  I got in one piece of prelude music and then he just wanted Mom.  I forget the name of the sweet woman, but she offered to cover the hymns so I took her up on it and took Timmy out into the hall.  He was finally able to fall asleep.  But not comfortably.  I could tell that he was still very dry.  Everyone could.  So many people asked why he was making that noise or if he was okay.  I was honest - no he was not.  He needed moisture.

It was a relief finally to be taking him home after three hours.  However, no sooner had I gone to get him from his car seat when I could hear his already labored breathing get even more sporatic, like he was fighting harder to breathe.   As I opened the straps, he went into panic mode, stretching his arms out so that I was a little afraid of hurting him because I couldn't bend his arms to pull them out from under the straps.  I had already taken the suction machine to his room so I raced down the hall with him, calling to James that Timmy was having a really hard time breathing.  In my mind, I was just thinking that I could really use James's help holding Timmy's arms down so that I could suction more efficiently.  However, one unresisted attempt at suctioning made it rather obvious that suctioning wasn't the answer.  By that point, Timmy had started turning blue.  I can't tell you what fear that sent into me.  Fortunately, James was with me so I knew I would have someone to help me and, after changing trachs for months and having had Timmy's room better organized for the past few, I knew right where the spare trachs were and it wasn't really that big a deal to undo the Velcro on his ties and pop in a new trach.

As soon as the new trach was in, Timmy was instantly able to breathe easily and his eyes started to close.  Which also scared me at first.  Fortunately, however, it was from sheer exhaustion, not something critical.

Callie had fallen asleep in the car so James brought her in and took Landon and Trevy to eat dinner so I was able to get Timmy hooked up to the monitor and moisture collar and all snuggled in a warm blanket and then just rock him for an hour or so.  Such a sweet little miracle.  Amazing how one event can trigger so many memories.  This was by far the scariest moment we've had since bringing Timmy home from the NICU but not the first time it has hit me how fragile his little life is  Believe me, he won't be out of my sight off the monitor any longer than a bathroom break until the trach is history.

Even though it all ended well and I feel very capable of dealing with the situation, I hope it never happens again.  I never want to see any of my kids turning blue from lack of oxygen. So very glad that we were already home.  We always have his emergency bag with us - which contains a spare trach and even a bag for artificial respiration - but I'm really hoping to turn it in completely unused one day.