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Jacques & Dad Get Rushed to the NICU

Jacques is in the clear Friday night was not a very good night at all, the pediatrician came to see us in Denise’s room and told explained to us that Jacques had aspired some liquid from the delivery into his lungs and that his little body had spent the last two days fighting to expel it. In the process he worked himself up pretty badly and took in too much air. Because he was breathing in so much and not giving his body the time to exhale, some of the air in lungs had leaked into his chest cavity. This extra air was starting to create pressure around his lings and it his body was no longer able to get rid of it. Basically he was having suffering from something called a pneumothorax (the link takes you to a Wiki article). This was not very good at all. They had increased his oxygen level greatly to help him out but his body was now so tired from the marathon it had been running that it could no longer deal with what is essentially diving into the water after hyperventilating. He needed a lot more help than the Lakeshore could provide, our pediatrician was very good and he understood this early on, so he contacted the Montreal Children’s Hospital who found him a bed in the Neo-Natal Intensive Care Unit (NICU) at the Jewish General Hospital. The Children’s also arranged for the transport.  So at 4:00 AM, they put Jacques inside a 100% pure Oxygen bag to stabilize the pressure in his chest and then rushed him downtown for what would likely be an intubation and  the insertion of a chest tube.

The trip to the hospital is one that I will never ever forget, I never knew American trucks could go that fast. I guess the big threeJacques Pheumothorax were able to get a few things right after all. Upon arrival at the hospital, the nurses and doctors were very kind to me and made sure I understood everything that they were going to do, they made me very comfortable and gave me a nice cup of coffee to help me fight through all the tears. I say it was a nice cup of coffee but for all I remember about it, it was black, hot and smelly. They immediately did a X-Ray and discover that the pneumothorax was quite severe but that the 100% O2 transport had in fact calmed him down. The doctors explained to me that there were in fact two ways of treating this condition, the first and the most invasive and troubling is to put a hole in Jacques little chest to let the pressure ease and then stave off infections while the body heals. The other way is to usePascal’s Law of gases and to treat Jacques as i he had been SCUBA diving and had suffered from the Bends. Basically the extra air in Jacques lungs could be bled through if the pressure in lungs were increased and he was then fed a very rich O2 mixture. Like what they had done in the ambulance but now they would increase the pressure of the air flowing into his lungs in order to keep the alveole open and therefore allowing the nitrogen to escape his body. All of this while maintaining his blood oxygen saturation at 100% so that all of his organs continue to function and work hard. They do this by introducing a nose tube just inside in nose (CPAP) and then controlling the mixture with a very fancy computer.

Jacques Pneumothorax, not good but not worse Needless to say that they chose the less invasive technique and treated my little marathon runner for the Bends. Oh my what a day he is having, I am 36 years old and have done neither, he’s not even two days old… The second X-Ray came back and showed that although he had not done remarkably better, he had definitely not gotten any worse.  The doctors and nurses decided it would be good to continue and finish the 6 hour O2 treatment and then take a third X-Ray to see how he was doing.  Any sign of distress or worsening would then mean a surgical procedure and the intubation tray was ready and waiting besides Jacques’ newest incubator.

So a very lovely nurse, named Anne, with the sweetest voice and the gentlest manner worked with Jacques all through the day and showed me ways of calming him when he got himself into distress and caring for him in the incubator. If you change a diaper in one of those boxes, you are pretty good. That was quite possible the longest day of my life. By the time the X-Ray was ordered, Jacques had been taken of of 100% oxygen and was gradually being brought back to room ait which is 21% O2, he still need the nose tube to create that extra bit of pressure to help with the air exchange. When the results came back from the third X-Ry, I was sitting in an armchair by his beside side, the resident  doctor took the X-Ray to the light box and as she lit up the third one, I could already tell that things were better from twenty feet away. She ushered me over and as I got closer and closer to the third picture, my eyes started to well up and as I was pushing tears out the way I couldn’t Jacques Pneumothorax? Where is it? find a single air pocket on the X-Ray. I asked the young resident to show me the pockets of air, and she simply said: “I can’t find any, but we’ll ask Doctor P. just to make sure.”  So I headed back to my new home, a vynl pink floral arm chair and simply smiled at my little trooper, he had done all the work and he had worked so well. By the time the attending Neo-Natologists came around, Dr P., I had managed to recompose myself a little, but when she turned on the light box again and then too three dramatic steps back before turning around and ushering me over, the waterworks had set off again.

Let me just explain what to look for in these three black and whites. In the first two, the heart has clearly moved to the left with all the pressure of the air on the right lung. The left lung is now being compressed by the heart itself and on the verge of collapse, which is very very bad. In the 6:15 view, you can see the air pocket along the ride side of the right lung,  X-rays are reverse negatives, hard mass is white, air and water is black. The air pocket reaches all the way up to the first rib and heart is almost touching the left rib cage. The 9:15 snapshot reveals that the air pocket is now only reaching the third rib and the heart has started to move away. The change in the two X-Rays is not very big at all but the simple fact that Jacques condition had not worsened mean that we the procedure could continue. In the 3:50 view, the heart is right in the middle of the chest and the pressure has been removed from the left lung altogether.Jacques starts to adjust to Room Air

The rest of the day went pretty well from their on, Jacques continued to come down to room air and I manged to get outside for a cup of coffee and a bagel, Dr P. had recommended a great restaurant with a $1.99 breakfast, but the line went around the block, so Tim Horton’s it was. My Dad should be coming around a little later with a fresh t-shirt and pants and some more food. Hopefully, I can get a wash too. I have just realised that the exception of the scrubs, I am wearing the same clothes since Thursday. I am just releived things are going well and that he is well on the way to recovery, I’ve been calling Denise at the Lakeshore and relaying messages trying to find out how Frédéric is doing. Looks like things are little calmer over there. The big sisters helped to give him a bath despite the amount water on the floor, he appeared to be enjoying it more. They had a few visitors around in the afternoon and both grand mothers shared the duties of sitting with Denise. I am very grateful to have the family around.

  • Daniel Masson

    Salut Jean-François

    C’est très touchant comme histoire. Heureusement, nous connaissons déjà la fin. Les néonatologistes font de vrai miracle parfois. Je le sais mon père en était un. J’ai déjà vu des bébés qui ne pesait pas une livre, j’avais huit ans et je m’en souviens encore. On voit déjà que Jacques est un vrai battant. J’ai hate de lire la suite. Bonne chance pour la suite.


    Félicitations à la maman

  • Schultzter

    Yeah, crazy story, I’m glad we already know that everything turned out okay. This back-posting is a bit scary when your news reader only shows the headline (I thought Jacques was back in the hospital when the title showed up in iGoogle!!!).

    I’ve got that Guiness set aside for you, but Lindsay’s on antibiotics again so I’ll wait a couple more days before I drop it off.

    Congrats to mommy, daddy, and the big sisters.


  • mike wilding

    RECIEVED: I before E except after C! Must be the strain! Congratulations to you both. Mike.