Today is our wee Sadie’s birthday. Our creative, zany butterfly-trapped-in-person’s body of a child is lucky seven years old.
To put it mildly: she’s a personality. As my sister describes her, she’s what you might imagine Tina Fey was like as a child. Sadie's hilarious, and so in her own world. She can draw better than any kid I’ve ever met, and does a mean robot dance.
|Me: "I want to take a picture for your birthday."|
Sadie: "How about one with me drinking apple juice."
Celebrating her birthday also reminds me of what I was doing when she was born. Seven years ago I was working on the toughest campaign I’ve ever been a part of, a special election in February in Upstate New York.
But it was most memorable to me for one thing that happened – and it involved our then three-day-old little girl.
I wrote about it a few years back, as I tend to do. The story has lived in a file on my computer since. Here it is:
It was February 12, 2008. I was in the basement, lost in my work world, editing a press release on yet another subject, when I heard a scream.
“She’s not breathing!”
The words were being yelled by my mother-in-law. She was frantic.
“The baby’s not breathing!”
When the scream registered, I moved without thinking. I bound up the basement steps and burst into the living room, my mother-in-law was holding three-day-old Sadie in front of her. The baby’s face was deep red, and she looked like she was on her way to blue.
Frantically, “She’s not breathing.”
She handed her to me.
“Was she drinking, spiting up, anything?”
I took the baby, and quickly swept my finger through her mouth to remove any possible obstruction. Nothing.
“Call 911,” I barked to my wife.
Then I flipped her quickly, but gently, onto my forearm with her face down in my upturned palm, her legs up my arm. She was so tiny. I patted her back to see if anything was lodged. Two pats, and nothing was there.
I turned her back over. She was still dark red. “C’mon, breathe.”
I held her up right, close to my shoulder, looking into her face. “Please breathe! Please!” I pleaded.
I caressed her back, and begged and begged her to take a breath. I didn’t know what else to do.
Time was ticking, and I knew it. I thought, this is what it’s like to hold a child that is dying. No, she can’t be.
“Breathe, my Sadie. Please.”
Then I felt it, and saw it in her face. She took in one tiny breath. It was a struggle. Then she took in another.
“She took a breath,” I announced in relative relief. She was still struggling.
Her color was returning to normal, but breaths were hard to come by. I walked in circles in the living room, past the windows, as her labored breaths continued.
A police officer arrived first, and came through the door as I paced in tight circles, rubbing the baby’s back.
When the ambulance pulled up in front of the house, the baby’s breathing was almost normal again but not quite. The breaths weren’t deep or regular. It was like she forgot how.
The paramedics came through the door, a large man and a small woman, dressed in blue. They took her from me, and began asking what happened. My mother-in-law and wife described the scene, as I continued to pace the same circles.
I looked into the next room and saw our two other daughters, age two and five (at the time), huddled under the dining room table, hugging each other in fear.
I coaxed them out from under the table.
“Is everything going to be okay, daddy?” the oldest one asked, looking shaken, scared and lost.
I didn’t know the answer.
“I hope so, dear. I hope so.”
The paramedics placed a tiny oxygen mask on our baby and asked my wife and I to go with them.
They radioed in as we walked behind them to the awaiting ambulance. “Infant child in respiratory distress.”
We climbed into the ambulance, numb from the last several minutes. Sadie was too small for the stretcher, instead the women paramedic held her, keeping the oxygen mask in place and watching her breathe closely. My wife was shaking, and looked white as ghost. I’m sure I looked the same. We’d only left the hospital the day before. And now, we were returning the same route in the back of an ambulance.
The emergency room bed looked gigantic with a three-day-old baby in the middle of it.
Cords as thick as her fingers ran away from her feet and her hands to machines and screens, letting out piercing beeps and drawing jagged lines. A green line, a blue line and white line all crossed the screen together, jumping and bouncing to separate but in sync rhythms.
Everything looked normal, said the doctor. She was tall and attractive, with long curly red hair and serious, attentive eyes. Other doctors and nurses came and went, seemingly at her direction. Running tests and awaiting orders.
The room was small, and sterile, with the beep every second or two drowning out the noise from the busy emergency room hall outside, and the chatter from the nurses’ station within a few feet. I guess they like to keep newborns in the ER close to the nurses. Our older daughter would’ve called it a money spot. But it didn’t feel like money.
My wife and I sat and watched our baby, watched the screens, and listened to the sounds of normalcy. The beeps and the blips were steady and reassuring, but we were consumed with wonder and worry about what had happened to take our baby’s breath away. We hugged, and cried, and tried to absorb it all.
The doctor asked repeatedly how long it lasted. I counted out in my head all the actions I could remember. Mother-in-law noticing. 10 seconds, maybe. Scream registering, 6 seconds. Climbing the steps, 4 seconds. Taking baby, 2 seconds. Sweeping the mouth, 2 seconds. Back compressions, 3 seconds. Holding her upright and begging her to breathe, 18-20 seconds. It was for less than a minute, we guessed, but at least 45 seconds. Maybe more.
She asked what shade of red Sadie had turned. She wanted to know if it was blue at all. I knew what she was getting at. It was dark red, not blue. Maybe a little blue around the lips. But the rest of her face was dark red, not blue. That was good.
She called it an Apparent Life Threatening Event – ALTE – stressing that was a description, not a diagnosis. The cause was unclear, and could be a number of rather mundane and ordinary things.
As time passed and the beeps stayed steady, the activity in our little emergency room ebbed. Nurses came less often, and the doctors focused on other patients. Was it nothing? A one-time incident? Were they going to give us a clean bill of health and send us home with a baby, who not that long ago, forgot how to breathe? How were we supposed to just leave? Go home. Live normal.
Then in a moment, it changed again. One beep became sustained, the lines on the screen dipped, her heart rate dropped, the baby went limp on the bed. The redhead doctor and two nurses were at her side before I could even stand up from my chair. She turned red. Then took a small breath. And then another. The doctor hovered over her closely, as she slowly remembered how to breathe again.
ALTE number two.
The doctor turned to us, even more serious than before.
“We’re going to admit her.”
She was uncertain what had happened, just then and before. There were a series of potential causes, some very manageable. They would need to do tests.
“Keep us here as long as it takes,” I replied.
The battery of test lasted four days. We stayed at the hospital on the 5th floor – three floors down from maternity. Once a baby’s out in the world, they can’t come back to maternity, even if she’s three days old.
My wife slept in the room, on a fold out chair next to Sadie’s industrial looking crib, with appropriately sized wires and screens for an infant under constant medical care. The nurses were there at every moment, all day and throughout the night. But only one parent was allowed to sleep in the room. So I slept in the waiting room on the same floor in another fold out chair. I had my own television, a few coffee tables and lots of magazines to read.
After the doctors witnessed the episode in the emergency room they gave it a more descriptive name than just an Apparent Life Threatening Event: they called it Infant Apnea. Of course, this too was descriptive and not a diagnosis telling us the cause. Apnea just means a cessation in breathing. In adults it can be normal during sleep. In infants, it is more of a threat and there is usually a cause. There are many potential causes, actually. Some manageable, as they said, and some more challenging.
Every few hours there seemed to be a new potential diagnosis. And each time I was convinced this was it, until the tests proved otherwise. Epilepsy was thought possible. It could be seizures. I remembered times during pregnancy when my wife would say it felt like the baby was moving rapidly. That must be it, I thought. Then the doctors in a small room in the basement of the hospital attached little tweezers and suction cups electrodes to her head and tracked her brain waves for almost an hour. Normal. No residual trace of seizure activity. They did a CAT scan to rule out brain tumors. They ran blood work. They did a spinal tap.
I’d had a spinal tap once. It was painful. This time the patient was my tiny newborn, and I had to hold her still while the doctors probed repeatedly looking for that small pocket of fluid at the base of the spine. It took a few times as I held her firm and still and my wife wept.
Each time the doctors would analyze the results and rule out a cause. Each day new possible causes would be presented, and ruled out. And each night, I would go home to get us a change of clothes, tuck our other daughters into bed, and return to my waiting room on the 5th floor for another night.
Increasingly the doctors implied that we might never know. That after all this, we would have to go home with our child and keep her hooked up to an apnea monitor, in case it happened again. I couldn’t stand the thought. We’d be nervous forever. We had to know what happened.
Late on the third day of tests, through the process of elimination, a new diagnosis was presented.
A new doctor sat us down and told us it could have been the unlikely result of a rather common problem. Many premature babies and a few full-term ones are born before the muscle atop their stomach is fully formed. This is the muscle that closes to prevent food and acid from flowing into the esophagus. This common condition is known as infant GERD, or gastro-intestinal reflux disease.
Reflux? Really? My baby has reflux. That’s it?
The doctor continued. This condition usually presents itself in the form of frequent spit up, discomfort after eating, even what is traditionally called colic. Occasionally the reflux can be so intense that it stimulates the vagus nerve, which runs along the outside of the esophagus. When the vagus nerve becomes stimulated, it can cause a cessation in breathing as well as a drop in the heart rate. It was manageable and would go away with age.
The day’s diagnosis had arrived, and it was one we could live with. The doctor then said there was a test to make certain of the diagnosis. It was up to us if we wanted to do it.
“Do the test.”
It would require them to insert a tube up her nose and down the esophagus to measure PH above the stomach.
“Do the test.”
And the baby would have to stay in the hospital for another night.
“Just do the test.”
On the final night in the Hospital, they did the PH test. During my stop at home to get clothes, I searched the internet to learn about GERD and the vagus nerve. I ought to know better than to do that. But I wanted to know. It was manageable, but GERD and the vagus nerve were also cited for a possible correlation with SIDS – Sudden Infant Death Syndrome.
Crap. I guess we weren’t going to be sleeping all too soundly for a while.
When the test results came back, she had passed. Or failed, depending on what result was desired. Her stomach acid was off the charts. She had an acute case of GERD, and that was causing her to stop breathing.
We were going to go home. She would need medication. She would have to be hooked up to the apnea monitor for the next few months. But we were going home. And we knew what had happened.
When we got home that evening, my wife and I took turns holding Sadie and just looking at her. The other girls wanted to hold her too. We let them.
We sat with our children on our couch, in the living room of our home, and just tried to enjoy the fact they were all there with us.
The campaign I was working on at the time ended two weeks later. For the next few months, we barely slept as her apnea monitor and our nerves kept us up most nights. But, after a year of taking medicine, Sadie was still fine.
Each year on her birthday, we celebrate a little extra that she’s with us -- in all her wackiness.
Each year on her birthday, we celebrate a little extra that she’s with us -- in all her wackiness.