Saturday, February 6, 2010

The night that changed our lives

Everyone has been asking what exactly happened last Friday night, so here it goes...

Reagan and I had enjoyed a good post call day, lots of playing and napping, nothing out of the ordinary. She didn't act sick or have a fever. Chad got home from shows in Atlanta around 630pm, and we spent the rest of the evening playing and watching Superman. At around 1015pm, we started getting her ready for bed. Our routine involves letting her use the potty before going to bed. She used the potty, and after a few minutes of sitting there with her, she says she's still not done. So I got up, started cleaning up her room, and looked for all the toys she normally likes to sleep with. We could hear her singing loudly with an occasional "I'm pooping!" thrown in her songs. I guess about 5 minutes had passed when we heard a loud thump. We both ran into her bathroom to find her between the toilet and wall. When I picked her up, she was limp and her eyes were fixed up and to the right, and she was totally nonresponsive. Chad called 911, and I took her to her diaper changing table. That's when I noticed she was blue and her attempts at breathing were not moving any air. Instinct kicked in and I started CPR. While doing mouth to mouth breathing, her color got a little better and she never lost a pulse. In between breaths I was screaming, crying, pleading to God for mercy. Her eyes stayed fixed to the right this entire time, then her teeth clenched, and her hands became stiff. My first thought was that she had fell off the toilet, hit her head, and bled into her brain.

The EMTs arrived after about 7 minutes, swept her up and put her in the ambulance. They wouldn't let me ride in the back with them, so I had to ride in the front. They put an oxygen mask on her face; I told them to use the ambu bag because I knew her feeble attempts at breathing where not moving air. They bagged her off and on but said that since her oxygen saturations were about 90%, she must be breathing. If I had it to do over again, I would have jumped back there and grabbed the ambu bag myself. The ambulance driver raced through town, running red lights, sirens and all. I turned around to see them cutting off her Superman pajamas, those pjs we had searched Augusta for, her very favorite Christmas present. It was at that point I almost lost it, I just knew she was going to die.

When we got to the Children's Medical Center (CMC) the peds ER team were waiting and ready for us. They hooked her up to all the monitors, assessed her, popped in an IV, and drew labs in minutes. They too knew she wasn't breathing so they got ready to intubate. She then vomitted and some of the stuff went into her lungs (aspiration). They also gave her ativan for possible seizures. Her temperature was 101.7 on arrival, so a febrile seizure was on top of the list of diagnoses. Her labs came back and her blood gas was terrifying. Her pH was 6.9 , pO2 was 70, and pCO2 was >120. All my medical friends will understand the panic I felt. It basically confirms that she was NOT breathing during transport. Her chest x ray was consistent with aspiration. While they were doing the chest x ray, Chad and I sat outside the room and prayed for God's mercy on Reagan. She was taken to CT scan, which was negative for any head trauma. We went straight from CT scan to the Peds ICU. One of my favorite PICU attendings was on call so that was reassuring. Her blood gas was repeated around 1am: pH 7.1, pCO2 71, definitely improving but still a ways from normal. They drew more lab work and did a spinal tap to see if she had an infection, but everything was normal. The only other lab that was not normal was her glucose of 320. Apparently that can happen with a seizure; the next day it was normal.

Overnight she was left on the ventilator to give her body a chance to rest. It was so frightening to see my baby girl intubated. Her face didn't look like Reagan - she had tubes in her mouth and nose, there was tape all over her face. I sat by her bed so she would see me if she woke up and not be scared. But they had her sedated, so around 3am Chad and I went to sleep on the chairs in her room. At around 6 am we woke up to the ventilator beeping, she was waking up and trying to breath on her own! They wanted her to rest a little while longer until her blood gas was completely normal, so they gave her some more medicine to let her sleep. Later that morning the gas was normal and she was waking up again. I hated to see her gag and try to pull the breathing tube out; thankfully it didn't take long for them to pull it. She was breathing fast and loud for a couple of hours after extubation so they gave her some racemic epinephrine, which helped immensely!

It was amazing how fast Reagan was Reagan again! I asked her if she wanted me to hold her and she said no, then I asked if she would hold me and she said yeah. I jumped in that bed with her and held her for the rest of the time she was in the PICU! They gave her some moist sponge mouth swabs (wanted to make sure she wouldn't vomit again before giving her drink). She spent hours that afternoon dipping the sponge "lollipops" in water and sucking them. That was so much like Reagan, she likes to do the same thing over and over. =)

So many friends and family came to see her that day. The love and support of everyone was overwhelming! On Sunday we got to move to a regular floor bed. When she saw the elevator, she suddenly knew where she was. She and Chad come to see me all the time when I'm on call in the hospital. She immediately asked to go to "old McDonalds" and get a crabby patty (her lingo for a cheeseburger)! Of course when we got to McDonalds she fell asleep. We spent a lot of that day resting. She was feeling a little better and asked to go play on the playground in one of the waiting rooms. Poor little thing could hardly walk she was so wobbly and weak, but she still played!

As many of you know, Chad and I had made plans to go to Atlanta that weekend for the Royal Rumble (one of Chad's Christmas presents). With the tickets and the hotel room, we had already spent over $500 on the weekend. But neither of us cared one little bit! Being there together with our daughter through this ordeal was priceless. How is it that I fell more in love with my husband during this time? I married the best man in the world. So Sunday night we sat on the couch while Reagan slept and read updates online on who won. I'm almost glad we didn't go because I really don't like the wrestler who won! ;)

On Monday, Reagan was stronger, more like her old self playing and talking. She had an EEG that morning. I was so impressed with the lady who did it. She was professional, but knew exactly how to calm Reagan down and get her to cooperate. Later that afternoon the neurology attending came to see us and said she had had good news and bad news. The good news was that the EEG was normal, the bad news is that they have no idea what really happened that night. It could have been a febrile seizure with a prolonged postictal state, but the neurologist said she had only seen one other case of a febrile seizure where the patient had a prolonged apneic event and had to be intubated. She wrote a prescription for some Diastat in case she does have a seizure in the future, and arranged for Chad, his mom, and my mom to be taught CPR in case she ever does this again in the future. We stayed one extra night to make sure Reagan was eating, drinking, and peeing enough. We left the CMC for home on Tuesday. When I got home, all the memories of that night overwhelmed me and I started crying. My sweet little girl is so sensitive, she knew her mommy was upset and that made her upset too. I quickly tried to get it together!

Can you see how God worked EVERYTHING out? Chad and I were both home that night. I had been on call many nights that week and Chad had been out of town doing shows. Then we were going to be gone the next day to Atlanta. Reagan was with her grandparents in Waynesboro while I was on call. If this had happened then, it would've taken a lot longer for EMTs to arrive, longer to get to the hospital, its very likely she wouldn't have made it. Thank God as an anesthesia resident, I have been trained in CPR and knew what to do when she wasn't breathing. And thank God he gave me the strength to do it... but I don't ever want to do it again please! If for no other reason, I know God led me into anesthesia so I would know what to do that night. And I'm so thankful for such an awesome children's hospital to be 9 miles from our house! How perfect are His plans for us! How can we ever doubt Him??


  1. Oh, Lindsay, I was holding my breath as I read this. I couldn't imagine going through that and keeping my head straight the way you did to know what was best for Reagan. I added her to our prayer list at church when I saw she was in the hospital. Prayers were answered! I am so glad she is doing much better!

  2. My goodness Lindsay! GOD IS GREAT AND POWERFUL! While I was reading your story, I got so anxious for you and then, very thankful that you are who you are b/c you have an awesome gift as a doctor and obviously as a mother. I have been praying for you during this whole time since I found out and I will continue to be praying for you and your family and especially sweet Reagan. Please let me know if there is anything that you need. love you!!!