The silver haired doctor seemed to almost put Nick at ease, he wasn’t sure why, maybe it was because of his age that Nick felt he would have the right knowledge and expertise then a younger doctor or maybe it was to do with the fact that he bared a great resemblance to his grandfather, either way Nick knew he felt comfortable.
“How is he?” Shannon asked quickly getting up from the bed.
“Miss McKenzie-”
“Shannon,” she corrected.
“Shannon and I take it your Dad?” He said addressing Nick.
“Nick,” He replied shaking the Doctors hand.
“I’m Dr Grant, Why don’t we sit down,” he said and once again Nick felt sick to his stomach, the last time he had been asked to sit down in a situation like this he had found out his Grandmother had passed away. Uneasily he did what the doctor suggested, finding Shannon’s hand and placing it in his, giving it a squeeze to reassure himself as well as her.
“Charlie is stable for the moment but I will warn you he is a very sick little boy. An echo shows that he has transposition of the great arteries, without a VSD or an ASD” Dr Grant informed. Nick had absolutely no clue what that was or meant but going by Shannon’s sudden intake of breath and the fact that she seemed to become more upset he had a feeling it wasn’t good.
“So are you going to do a switch? He’s a good size to do a switch right? The quicker we get it done the better it will be,” She asked quickly.
“He’s a bit too unstable to do a switch at the moment, the PDA shut which is why he started becoming cyanotic, we’ve started prostin but it’s not working as well as we hoped so we are going to transfer him to Morgan Stanley’s Children’s hospital so they can do a steptostomy.”
PDA? Prostin? Sepsomething? To Nick they may have well been speaking in a foreign language, hell he still didn’t know what was wrong, was it a heart problem was it a lung problem? How did they treat it? What were the odds? To him it was almost as if he wasn’t there, that because Shannon dealt with this everyday he didn’t matter.
“Sorry but can we back up?” He interrupted making the Doctor and his fiancé look at him. “What’s going on? What is this Transposition? Is it his heart?”
“I’ll explain it to you later,” Shannon said quickly.
“No I want to know now,” He said quickly before she could start asking more questions. “I can’t make decisions with you when I don’t know what’s going on.”
“You don’t trust me enough to make the right decision?” She accused.
“I didn’t say that Shan, I just want to know what’s going on, he’s my son too,” He told her.
“I’m sorry Nick, it’s a force of habit when one parent works in this field,” Dr Grant apologised. “Okay let me draw you a diagram.”
“Charlie has Transposition of the Great Arteries or more commonly known TGA which is a problem with his heart. In order to understand what’s wrong you need to know normal blood flow through the heart so I’ll go over that first okay?” He said making Nick nod.
“Now your heart has four champers, two at the top called atria’s and two at the bottom called ventricles, so blood that has travelled all round the body and has no oxygen left in it comes into the heart via the right atria and it travels down into the right ventricle. From there the blood is pumped through to the lungs where it picks up oxygen now to get it there it has to travel through a tube called the pulmonary artery. So now we have nice oxygen rich blood so it travels back from the lungs into the right atrium again it goes down into the left ventricle where it’s then pumped to the rest of the body through a another tube called the aorta. Are you with me so far?”
“Yeah,” Nick replied.
“Now in Charlie’s case his problem lies with the two tubes, the one that gets the blood to the lungs and the one the gets the oxygen filled blood to the rest of the body, in essence they are the wrong way round. The aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle - the exact opposite of a normal heart's anatomy. Oxygen-poor blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected aorta back to the body, it doesn’t collect any oxygen essentially it by passes the lungs, so no oxygen is travelling to where it’s needed. Oxygen-rich blood returns to the left atrium from the lungs, passes through the left atrium and ventricle, then goes into the pulmonary artery and back to the lungs so he is just basically sending the blood filled with oxygen back to his lungs to collect more.”
“I just don’t understand why he was turning blue and why it took so long to happen I mean he was almost twenty four hours old,” Nick said confused.
“Babies have a duct between the aorta and the pulmonary artery now this closes once they are born in some cases it can take a few days but Charlie is one of these babies where it closes sooner. So for the first few hours he was okay because oxygen rich blood was managing to escape from this hole and be pumped around his body but now that it’s closed that’s why he started turning blue,” Dr Grant tried to explain.
“Because his body wasn’t getting enough oxygen?” Nick asked trying to see if his understanding was correct.
“Yes, exactly. Now we can give a medication to try and reopen this small duct which we have done but unfortunately it’s just not opening it enough. He needs a place in his heart where the deoxygenated blood can mix with the oxygenated blood so what we’re going to do is make a small hole between his atria’s,” He said drawing on the diagram.
“Sorry you are going to what?” Nick asked a bit shocked.
“I know that it sounds wrong but it’s what we need to do.”
“Why can’t you just go in and fix the problem now? Why do you have to make a hole in his heart?” He asked.
“Although it sounds simple enough the procedure to switch the vessels back is very tricky, there are lots of other factors involved which I’m not going to go over now because I’m very aware with loading you with too much information. We need to run some more tests do a more detailed echo which looks at his heart and where everything else is, make sure there are no other anomalies and stabilise him more before we even think about operating.”
“If he doesn’t…if you don’t make this hole will he die?” Nick asked making Shan hiccup back a sob.
“Yes he will. But if he has this procedure he stands a very good chance. I know this is a lot to take in but we do need to move quite quickly. Now we can’t do the procedure here, he will need to be moved to Morgan Stanley’s but obviously we need to get consent off you guys for the procedure,” He said.
“Just do it, I know the risks I know what can happen, I’ll tell you later Nick I promise,” she said looking over to him with pleading eyes, “You just have to trust me. We just need to sign so they can do it,” she said squeezing his hand.
“Okay,” He nodded knowing that if Shannon was on board with all of this that he had to be too.
“Can we see him?” Shannon asked as she signed the consent form.
“Of course. We have the transfer set up we’ll be leaving in thirty minutes so it’s going to have to be short I’m afraid.”
***
Hospitals always gave him the heebie-jeebies, it was a combination of the smell, the noises, the sights, the mass of sick people and also the fact that he knew people had died there. But now it was worse then ever, he remembered the sights of the PICU Matilda had been in, remembered feeling so helpless, so out of his depth and he had naively thought that the NICU would be the same, that because he had experienced this type of environment before he would be prepared.
He wasn’t.
The NICU was totally different. It was quieter, slightly darker and it was one huge room filled with what looked like spaceships, the incubators housing tiny infants you would miss if you didn’t look hard enough. That’s why Charlie looked so out of place compared to his two neighbours. He looked like a giant, he was nearly double the size of any of the babies in this unit and maybe that was why he wasn’t in an incubator but a bassinette instead.
“Oh baby,” Shannon said as she picked up his tiny hand and placed a kiss to it. “Mommy’s here sweetie. You okay?” She asked looking to Nick who just nodded, his eyes filling with tears that he was trying so desperately to hide. “No you’re not,” she said reaching her hand out for his.
He took it before saying, “Just concentrate on him, I’ll be fine.”
“You gave me a scare Charlie Warley,” she said softly as she stroked the top of his head. “You have to be a strong boy,” she said kissing him again before the nurse moved to the opposite side of the bassinette.
“Hi I’m Shelly, I’ve been looking after Charlie. You both know what’s happening? Do you have any questions?” She asked with a soft smile.
“I want to know why he’s ventilated we don’t usually ventilate pre op,” Shannon asked motioning towards the tube coming out of his mouth.
“You a PICU nurse?” She asked with a knowing smile.
“Can you tell?”
“We ventilated because we’re having problems keeping the PDA open so as soon as he gets to Morgan Stanley’s they are going to do the balloon catheterisation then to make the hole in the atria, it’s probably safer for his transfer too. I know it’s only thirteen minutes away but you must know you don’t want to be worrying about airway management.”
He let Shannon ask the questions, chat to the nurse because he didn’t think his voice would hold out on him, he didn’t know whether he would be able to keep his exterior cool, calm and collect if he had to communicate with anyone. He pulled his hand free from Shannon’s as he took one of Charlie’s small hands his thumb almost big enough to cover it completely. This just wasn’t right, he had paid his dues already, he had already had enough bad luck, so why was this happening? Was it because he was a bad person? Because he hadn’t made up with his Mother? Because he had been spoilt and conceited in his younger years? Even so he still didn’t think he deserved this, didn’t deserve to have another one of his children connected to a ventilator.
He placed a small kiss to his sons hand before offering up a silent prayer, please please just let him be okay, I’ll do anything, just let him be okay.
“I hate to do this guys…” Shelly said.
“I know, we have to go,” Shannon said with a sigh, her eyes also filling again.
“Be strong little guy,” Nick whispered to his son before giving him another kiss.
“I love you sweetie, we’ll see you soon,” Shannon said also giving him a kiss. She hovered for a few minutes and Nick knew she was having a hard time leaving.
“C’mon,” He said taking her hand in his, “I know it’s hard but we have to go, let them do their job,” he tried.
“But it’s my job too,” She said softly a few tears escaping her eyes.
“Not today it’s not, C’mon,” He said pulling at her.
“I don’t think I can do this,” She cried.
“Yes you can, come on we have to go,” He said walking her towards the door wiping at his own tears.
“Wait, wait,” she said pulling at him, “I just have one more question,” she told him and he let her go. “When he gets there they’ll let us know won’t they? Is he going to the NICU or the PICU?”
“He’s going to PICU,” Shelly told her.
“Can you tell him that he’s mine? That he’s Shannon’s baby and that she wants Matthew as his surgeon.”
“Of course I can.”
***
She had sobbed the whole way back to her room and as soon as she walked in the door it was as if something inside her clicked, the tears stopping immediately as she quickly threw her bag onto the bed and began collecting her things together.
“What are you doing?” Nick asked.
“What does it look like I’m doing? I’m not staying here, I’m leaving I have to be with him,” She said as she threw everything into her holdall. “Did you tell my Mom when I called you?”
“No she was sleeping and I didn’t want to waste anytime in getting here.”
“Maybe we should call her, you need to call your Dad too,” she said hissing slightly, grabbing at her stomach obviously because of some pain.
“Okay you need to stop and slow down,” He said taking the sleeper out of her hand making her sit on the bed.
“I can’t I have to get there,” She said trying to fight against him.
“No you need to be okay because I can’t get through this without you,” He admitted getting frustrated when his bravdo crumbled and his tears fell freely. She stood and threw her arms around his neck, bringing his head down to the crevice between her neck and shoulder, weaving her hands through the hairs at the nape of his neck.
“I’m sorry,” She whispered placing a kiss to his head. “I just have to get there, I have to be with him.”
“I know you do but you need to slow down a bit,” he said still hugging her. He was just about to say something else when the door opened.
“How are you guys doing?” The nurse asked.
“We’re leaving,” Shannon told her as she went back to packing.
“You need to be seen by a doctor first.”
“Well go get him then,” Shannon said.
“Rounds don’t start till ten,” The nurse informed.
“I’m not waiting four hours, you either get him now or I’m self discharging,” She replied angrily.
“Shannon you have to-” Nick tried.
“I have to what Nick? Listen to the people who told me my child was fine? I’m not waiting around for hours, I’m not leaving my son by himself in an intensive care unit, so she either goes and finds a doctor or I’m walking and if she doesn’t find one in the next ten minutes I’m walking anyway.”
