Yesterday was a banner day for little Zac. All of a sudden, home doesn't seem so far away.
 Kapi`olani Medical Center stands guard over lower Manoa. |
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| The adjacent Moanalua Freeway after dark. | The view to the south, a church and Waikiki. | |
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| Zac, finally off the respirator, needs only an oxygen boost. | And just like that, the bandages come off as well. | |
Friday didn't start off feeling all that great. By the time Jen and mom showed up shortly after sunrise, I pretty much hated people. I hated the people joking loudly in the cafeteria, I hated Zac's nurse, I hated the families of other patients, and I hated Ben Cayetano for having said something unusually stupid on the morning news.
Of course, there was no reasonable explanation for my sudden xenophobia, apart from the lack of sleep. And I knew Zac needed good vibes more than anything else. So after a weak attempt at cheerleading a disappointed Jen (who was upset that Zac had needed yet more blood overnight), I headed back to the apartment.
Jen came home for lunch, but I was dead to the world. She walked back disappointed.
When I woke up at about 2 p.m., I was glad to have gotten the longest block of sleep I'd had since Sunday (complete with vivid but surreal dreams), but I was a bit worried when I realized I couldn't even remember the drive home. I knew I absolutely could not push my luck much further.
William called, and offered to come down to the hospital to visit. Just after I got off the line with him, the phone rang again, and it was Jen. Breathless. "Honey, can you come down?"
I had one of those instants where you hope for the best, but prepare for the worst.
They're going to take the breathing tube out," she said. I was out the door in a flash.
When I got there, I was glad to see Marci was again Zac's nurse. Loretta wasn't incompetent, I suppose, but Marci was definitely where it was at. I whispered to her that she was my favorite.
Marci helped get me caught up on things, and they were good things indeed.
At 10 a.m., they initiated the long process of taking Zac off the respirator, turning off his milk feed as well as the Versed sedative. At 2:20 p.m., they essentially turned off the respirator, setting it to only contribute volume, not initiate breaths. Then, at 2:45 p.m., they cut off his morphine. Zac was about to surface.
Meanwhile, his lab results from a noon sample came in, and they clearly showed that the improvements he saw after the overnight transfusion had continued unabated. His hemoglobin was 12.1 (up from 11.4), his hematocrit was 34 (up from 32), his platelets were at 182 (up from 160), and his clotting time (PTT) held stead at 32.
He even pooped twice.
The next thing I knew, people crowded around his bed, and the tube was out of Zac's throat. He opened his mouth wide, but was only able to muster the scratchiest of small cries. They suctioned out his throat and nose, and put an oxygen mask on his little face, and just like that, he was once again in charge of his own breathing. He wasn't all that happy about what had just happened, but Jen and I were.
When William arrived, with all the activity, there wasn't much room in the PICU. So instead we retired to the cafeteria to talk.
Eventually, Jen came down too, fleeing briefly as Dr. Morita was removing the stiches from Zac's eyes. By the time we'd walked William to his car and returned to the PICU, our Zac — breathing independently and completely uncovered — was waiting for us.
The sight, no doubt, would have shocked anyone. But even though he was bald, even though his eyes were bruised and shut tight, even though there was a scar running from ear to ear over the top of his head, and even though his head was swollen to maybe 30 percent bigger than normal, I swear to god he looked beautiful to us. Without hesitation, Jen and I quietly cheered. He was two very big steps closer to freedom.
Indeed, as the afternoon wore on, Marci slowly disconnected and took away tubes and machines that Zac no longer needed. Instead of seven separate devices pumping assorted drugs and fluids, there were eventually only three at his bedside. And even when Zac's oxygen mask accidentally fell off, he maintained a near perfect oxygenation level in his blood the whole time.
Encouraged, Jen went with mom to pick up Katie and have dinner.
The evening PICU team trickled in. Dr. Lane, who hadn't been in since his last shift as attending doctor on Monday night, spotted me at Zac's bedside and asked with mock incredulity, "Have you been sitting there for three days?"
Another familiar face followed him in: Reid Hamamoto, the resident who was there when Zac was first admitted. (Another resident, Shelly Loui, had covered the last two nights.) He came over to chat, and I probably monopolized his time more than I should have. We talked about Zac, kids in general, and our respective plans for the future — career-wise and offspring-wise. We had one thing in common: a long-term dream of settling down on the Big Island.
He was very attentive and took the time to explain everything, and clearly someone who was motivated simply by the desire to help people. He'll be a great doctor.
Eventually, the results from Zac's 8 p.m. lab tests came in. Once again, they were normal across the board.
Zac's oxygen supplement was reduced again, and he got a bath. He also, much to his dismay, had a feeding tube shoved back down his nose so he could start getting breastmilk again. Off and on through the night, he would wake and fuss a little, but a small dose of painkiller would settle him down pretty quickly.
At one point, when he was especially mad over the fumblings-about of his nurse, he got out a couple of good, loud cries. It struck a good nerve inside me, as it sounded, finally, exactly like the very vocal and strong-lunged son I last saw Monday morning.
To keep from falling asleep, I tried to see if I could remember the names of the other kids in the PICO. I could recall James, Micah, Melissa, Sam, Justicia, and Happyvalley — that last one being impossible to forget. Many of these children were facing challenges much tougher than Zac's, and as I started to feel more and more confident about Zac's recovery, I said an extra prayer just for his neighbors.
As the sun began to rise, Zac's milk input was boosted, and his oxygen turned down again. He seemed to be comfortably sleeping, but not so far away from the surface so as not to stir with noise, or a touch. After spending most of the last several days with a low-grade fever, now he was wavering between 95 to 97 degrees, and now he's looking cozy with a thick layer of blankets over him.
I'm leaving now to bring Jen over (she'll be glad to know that Marci is again on duty), and to take Katie out to Mililani for our regular weekly visit (and laundry fest). I suspect, however, that I'm going to spend a lot of time on the couch. There better not be a "Walker: Texas Ranger" marathon today.
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