Norah pneumonia update

While Norah was visiting her grandparents in Nampa, she had a mild case of pneumonia. She took some breathing treatments and was unhappy for a couple of days but recovered without having to be admitted to the hospital.

On Sunday, April 17th we drove from Boise to Moscow and we heard Norah cough a little. By the morning she was coughing and struggling with breathing so we went in to our doctor’s office and they sent us to the hospital in Moscow. Norah was struggling to breathe—indicated by her neck and belly muscles having to work to breathe. For Norah, being poked and prodded at the E.R. was terrifying. First, a pulse oximeter—a little red light thing that wraps around the toe and measures how much oxygen is in the blood. Second, a blood draw and an intravenous catheter (I.v.). Norah was screaming, mom was crying. Meanwhile, what to her must have been a scary plastic thing got shoved over her face (for oxygen). By the time the E.R. had called the anesthetist to put a respirator tube in, Norah had passed out from exhaustion and respiratory failure. I was crying too. They raced her up to the O.R. for the intubation—that’s what they call it when they shove the tube down into her lungs. Hilary and I hadn’t realized how dire this was until we saw the panic of the doctors, nurses, anesthetist.

The intubation was not easy and took two tries. When we got up to Spokane, the doctors said that Norah had likely aspirated something, and that it was probably stomach acid that had pulled up and sucked down because she was breathing with so much force. I guess this is typical. At one point her oxygen saturation in her blood dropped into the single digits. They decided that Norah had to be flown to Spokane. So the helicopter came. The helicopter people loaded Norah onto their gurney. Then they decided that Norah would be better in the jet because the jet has better respirator equipment and respiratory drugs. So they unloaded Norah and we waited for the jet to dodge a snowstorm and land in Pullman.

Our good friends from our ward and law school, Eric Reiersen and Nate Cuoio, were there. We gave Norah a priesthood blessing: a special prayer with hands placed on her head. Hilary and Norah rode the ambulance to Pullman and the jet to Spokane, then an ambulance to Sacred Heart hospital. Norah is now in the Pediatric Intensive Care Unit (PICU). She had her 15-month birthday here and tomorrow will be her 1-week anniversary.

On her first days here, Norah got a little worse. We’ve learned a lot about respirators and pneumonia treatment. Though the doctor told us that the respirator machine is fairly simple technology, I am impressed. And my description here is based on a limited and probably faulty understanding, but I’ll give it a shot. The machine can control the volume, frequency, humidity, pressure (in various forms), and oxygen concentration for each breath. When Norah was first here, it only “assisted” her by adding a little pressure to open up her lungs as she breathed. But Norah wanted to breathe quick and shallow—like a pant, and that wasn’t getting enough oxygen into her system. So they had to paralyze her by giving her muscle-relaxing drugs (in addition to the sedatives—some kind of narcotic I think), and leave the breathing to the respirator entirely. They also turned Norah on her stomach because the best blood flow in the lungs comes from the posterior inferior region of the lungs, and so if you lay on your back gravity pulls the edema and mucous down and doesn’t allow the blood to circulate well. (Hilary told me to put that last sentence; I don’t know what it means).

Norah has been stable but not making too much progress for the past 4 days. She gets respiratory therapy treatments every couple of hours. It includes a percussive massage thing and inhalation aerosols of some sort. They have not been able to identify exactly what caused the infection, but they say that it is typical to not know what caused the initial infection when it was a virus. Norah has also been on strong antibiotics. The doctor says that her biggest pneumonia factor now was probably the aspiration: the breathing in of some fluid, probably stomach acid, likely during the initial intubation. Norah has great nurses, doctors and respiratory therapists. Norah is making slow progress, it seems. The doctors, when pressed for an optimistic but reasonable prognosis say that Norah might be able to come home in another week. We thank God we live in a time and place where her life could be saved thanks to technology and medicine and care available. We’re thankful for the good doctors and especially nurses.

We are overwhelmed with how much love and support we have received from our families, friends, and even strangers. Tonight Hilary and I were invited to a wonderful Easter dinner at the home of a friend of a friend of the mother in law of Hilary’s sister. We always have to wonder why bad things happen to the innocent and vulnerable like Norah. And though I’m not trying to answer that question fully here, I can say that Hilary and I have learned much and seen many great things come of this—

We have learned that our Heavenly Father loves and cares and worries for us as we would worry and care for Norah, but in a more infinite and perfect way. We have learned that our faith needs to grow, but also that it is strong enough for us to rely on. We have seen the grace of God manifested in the kindness of others. This one is hard to explain but it is undoubtedly the clearest truth we have learned from all of this. When others fast, pray, bring gifts, and feed us, we witness how friends, family, and strangers are all God’s family and there are powerful bonds of love. The bond that I see as I watch Hilary at Norah’s side—combing her hair, holding her hand, singing to her “whenever I hear the sound of a bird or walk by a lilac tree”—is the same bond that Heavenly Father has for us. And I see that bond between everyone who is praying for Norah or helping me by sharing notes or feeding us dinner. God’s love is always there among us, but it is made more powerfully manifest in trials like this.

Why all this learning for her dad has to be at Norah’s expense I can’t explain, but someday I’m confident I will understand it. Thank you all for your love and prayers and healing thoughts.