Taylor's Miracle ~ Part Five

It was Thursday, June 15, 2006 and we waited for Taylor’s turn in the operating room to install the dialysis catheter. There were no changes overnight for hopeful signs of kidney function. I methodically checked the urine bag that hung at the bottom of his ICU bed as we watched, waited, and prayed for the precious return of what we called “liquid gold”. But, as was the case all week long, there was only about a tablespoon or two of a pale liquid that the nurses assured us was not good urine.

The blood counts continued to show extremely high and rising creatinine and BUN counts associated with kidney failure. It appeared more certain he would need the dialysis as the kidney’s were refusing to function.

By mid-afternoon, the operating room alerted the ICU staff they were ready for Taylor. He was wheeled down the hall in his ICU bed by the surgical nurses in green scrubs. They paused at the double entry doors to the O.R. so his dad and I could give him a quick kiss goodbye. Taylor was calm, yet sleepy and smiled back at us as he nodded in agreement with our assurances everything would be just fine. He was very relieved his pleas were accepted to be put under anesthesia for the procedure.

After saying our goodbyes, we made our way to the surgical waiting area after being told we could rejoin Taylor back in his ICU room within about 30 minutes. His brief recovery could be handled in his ICU room instead of the busy O.R recovery area.

As we signed in at the surgical receptionist’s desk, Chris and I each received a paper name badge. The receptionist told us that a nurse would make rounds every hour and give updates to each waiting family. We casually acknowledged the statement, but knew the hourly update information didn’t necessarily affect us. Taylor’s procedure would be completed quickly and he’d return to his ICU room shortly.

We saw the update nurse the receptionist just mentioned as we found a seat in the waiting area. She was carrying a clipboard with information and talking to families about their child’s latest hourly progress. There were many families waiting, reading, playing cards, or just chatting on this busy surgical day. Every so often a surgeon would emerge and talk to a group of family members about the completion of their child’s operation. One by one, groups of families left with relief of their child’s successful surgery.

After nearly an hour had passed, we were starting to get a bit nervous when we finally noticed the nurse making her hourly update rounds again. When she approached, she told us they were running behind and Taylor’s procedure had just begun within the last few minutes. He would be done very shortly. She confirmed it was a quick procedure and the surgeon would be out soon to talk with us.

Relieved that it was just a delay, we continued to wait. Fifteen minutes, 30 minutes, 45 minutes and soon our wait was over another hour. Only one other family was now waiting along with us.

It was just after 5:00 and the waiting room receptionist’s shift was over. We watched as she closed the waiting area for the day and we continued our wait.

By now, Chris and I were becoming very anxious and felt fear creeping in as our minds imagined a complication or something. We tried to reassure each other that it was a routine procedure and one that could have been conducted at his bedside with just a local numbing anesthesia. There simply shouldn’t be anything to worry about.

Finally, the update nurse arrived with her clipboard. My eyes met her eyes as I searched them for a reassuring look. She quickly looked away and approached the other family with their child’s update. As she talked to them, my heart began pounding louder and harder and my hands were ice cold and sweating. I felt it. Something was wrong.

Then, after quickly completing the update with the other family, she approached Chris and I and knelt down in front of us as we sat in our chairs. Immediately, I saw the concern in her eyes. While clutching her clipboard tightly to her chest, she softly and calmly said, “There has been a complication with Taylor. The doctors need to see both of you. Please come with me.”

Oh NO. This can’t be happening, I silently prayed as we quickly gathered our belongings to follow her. As she led us through the O.R. double doors, she said, “He’s okay, but there was a bleeding problem.” She ushered us into a tiny conference room with three chairs and said the doctors would be with us shortly.

Immediately, the surgeon entered the room in his green surgical scrubs and cap and sat in the remaining chair directly facing us. He leaned forward and rested his forearms on his thighs while clutching his hands together. I noticed he was pale and obviously shaken and doing his best to prepare to deliver the news with calmness and professionalism. My mind kept reminding me, the nurse said he was okay, however a feeling of great despair filled the room as Chris and I sat squeezing each other’s hand and waited for the surgeon to begin speaking.

He began by saying they had the dialysis catheter inserted into his neck and chest and everything appeared fine, except when they attempted to test the line, they heard an airy sound. They decided to pull the line back out to reinsert it and that’s when it happened. Taylor’s jugular vein ruptured inside his chest near his heart.

He paused briefly as we absorbed the shocking news and he prepared himself to continue. Then, with an emotional quiver in his voice he said, “Taylor flat-lined on the table. We had to crash in and open his chest to stop the bleeding.”

With that, it was more than I could handle. I burst into tears as Chris put a comforting arm around my shoulders. The surgeon patiently gave us a moment to grieve before continuing on. He needed the brief moment to keep it together as well.

Then, in professional surgeon mode, he took command of the room. He quickly began to draw a diagram and explain how the jugular vein Y’s after it enters the chest cavity and is given different vein names as the two branch off. Normally the catheter tube follows the vein in the direction towards the heart instead of the other direction towards the arm. However, in Taylor’s case, the thin flexible tube did not turn towards the heart. It went straight through and punctured Taylor’s jugular vein at the Y location near his heart.

Upon losing his blood pressure, they immediately performed a good sized chest incision of about 12 inches long and had to quickly separate his ribs so they could pack the chest cavity to absorb the massive blood loss. CPR was performed. Then, they unpacked him to view where the damage had occurred and quickly repaired the jugular vein. Taylor lost nearly three fourths of his blood volume and required many units of blood to restore blood pressure. While he was currently stabilized in O.R., he now had a drainage tube on the side of his chest that would remain for several days. He was also on a respirator and for how long the doctor could not say for certain.

“I’m so sorry,” the doctor apologized profusely.

“I’ve installed thousands of catheters in my years as a surgeon,” he continued on. “It’s a very rare complication.”

“This happened to me only one other time in my early years as a surgeon,” he said moments later. “That incident, thankfully, prepared me with the vital skills necessary to save Taylor’s life today.”

We both sat stunned, shakened and unable to mutter a word.

“Taylor is going to have a very large scar and I want to apologize for the jagged incision,” he continued. “We had to act very quickly and didn’t have time to carefully cut through the muscles and gently separate the ribs. Unfortunately, his recovery will be more painful because of this, but he will remain on pain medication and sedation for as much relief as possible in the coming days,” he finally concluded.

We sat numbly trying to comprehend everything he was telling us. Shock and disbelief drew the room quiet. I envisioned my son’s haggard body lying unconscious and helpless somewhere in the depths of the operating ward. A few moments later, I mustered a small voice and gratefully said, “Thank you, doctor, for saving his life.” The doctor humbly nodded with a softened “your welcome”.

“Now, the kidney specialist needs to talk with both of you,” the surgeon said. The kidney doctor was listening outside the door and entered the room on cue.

“I’m so sorry for Taylor and all you’re going through” he gently said. He then gave us a moment as the tears returned in disbelief with yet another confirmation of the horror we were living.

Then, in his soft spoken voice and without delay, he needed to address the next option for Taylor’s kidney recovery. Obviously, the hemodialysis catheter was no longer an option for dialysis. He needed our permission for the surgeon to install hardware for Peritoneal dialysis. It is a less common procedure in which a coil of tubing would be implanted inside Taylor’s lower abdomen via a two inch incision. Another external port would protrude outside his belly for connection to a dialysis machine. Later, if dialysis became necessary, they would fill Taylor’s abdomen cavity with large amounts of fluid to absorb the waste toxins. Then the fluid would be drained and the procedure repeated, over and over. It was a much longer dialysis procedure that would take days for relief instead of hours like the hemodialysis would have provided; but it was the only option left now. He needed our signatures on the permission slip so the surgeon could return to the O.R. where Taylor remained under anesthesia to surgically implant the hardware.

We listened to the doctor thoroughly review rare potential risks with the peritoneal surgical implant. No longer were rare risks casually discussed. They were relayed with greater emphasis for our understanding. As Chris and I signed the permission slip, I asked the kidney doctor through tears, “So, if this doesn’t work, what’s next?”

He calmly replied, “It will work, Mrs. Ramsay.”

I was not content with that response. Nothing had been working for weeks. It was one rare complication after another as we continued to spiral in this horrible nightmare from which there appeared to be no end.

I said, “No, you don’t understand. Nothing seems to work for us. I have to know. Please... what is our next option when this doesn’t work? Is it a kidney transplant or what?”

Again, he calmly and softly replied in a very convincing tone...”Mrs. Ramsay, it WILL work.”

We gave him the signed permission slip and he left abruptly to forward it to the surgeon who was with Taylor. Chris and I remained alone in the tiny conference room. Neither of us could speak as we tried to fully comprehend within our own minds what just happened. Instead, we just held each other and cried. When was this ever going to end?

A short time later, the doctors returned with news the peritoneal implant was successful and he was now in the O.R. recovery were he would be held for a while.

The surgeon gave us two complimentary dinner passes to the cafeteria and politely encouraged us to try to get a bite to eat or save them for later while we waited for Taylor to be released back to his ICU room. We graciously accepted the coupons, but were too distraught to even consider eating food.

He also explained that the Ronald McDonald House sponsored an in-hospital suite called “The House at Riley” which offered a few sleeping rooms to parents of the most critically ill patients of the day. The surgeon knew our nightmarish journey and I’m sure by the looks of us it was clear we had received very little sleep in the past two weeks. The surgeon said he had reserved one of the six rooms for us which was free of charge for the evening if we wanted it. He assured us Taylor would be kept sedated through the night and his critical care would be closely monitored by ICU doctors and nurses. The ICU staff would call our room, only minutes away, if we were needed anytime during the night. He strongly urged us to consider the offer.

We nodded with appreciation and told him we would think about it; but all we wanted right then was to see our son again and remain at his bedside.

As we made our way out of the tiny conference room and into the hallway, the update nurse was there with her clipboard. She was concerned and was waiting around to see us before we left the O.R. corridor.

“We’re so sorry about what happened to Taylor,” the nurse said. “I’ll be praying for all of you.”

We nodded and kindly thanked her as we slowly walked away into the hospital abyss.

                                       **** to be continued ****

"May my cry come before you, Lord; give me understanding according to your word."          ~ Psalm 119:169