When you’re in the NICU, you can really ever know what to expect. Truthfully, when you’re in the hospital period, you can never really know what to expect.
There are about a million different potential health problems your baby could have, depending on why you went in to labor early, the gestational age of your baby, ethnicity, family history, you name it. Each of those problems comes with several possible treatments. Those treatments all come with their own laundry list of possible side effects or complications.
We were extremely fortunate in that our son was born with a very short list of complications. Unfortunately, our big scare came from a leak in his PICC line.
My son, Kaden, was born at 29 weeks 2 days gestation.
Upon being admitted to the NICU, the medical staff started an umbilical line. An umbilical line is a catheter, inserted through one of to veins/arteries in the umbilical cord. It’s function is similar to that of an IV, in that the doctors and nurses can quickly and easily administer fluids, medicine, and even blood if necessary. Premature babies (and even term babies) are so small, and going through the umbilical cord stump is easy because there are no pain receptors, and the cord is still connected to the baby’s circulatory system.
This was great, but Kaden’s doctors told me they did not want to leave the umbilical line in for more than 5 days, I believe it was. (My research shows that an umbilical line needs to come out anywhere from 5 to 7 days.) Also, while Kaden had the umbilical line, we could not hold him because the line was not very secure, and they didn’t want it moving or leaking. That was enough motivation for me to get him on something more sturdy and sustainable.
The next option I was presented with, as Kaden’s mother, was to start a Peripherally Inserted Central Catheter, or PICC line. A PICC line is also a catheter that is typically inserted in the peripheral vein in the arm (but I think I remember being told they could use Kaden’s leg also). The catheter is inserted so that the tip rests at the heart, and it can remain in place for long term. In fact, from my understanding, PICC lines are only really used if the patient needs more than two weeks of treatment.
Inserting the PICC line required me to sign a consent form, and while it was done at Kaden’s bedside and not in an operating room, it is a sterile procedure. As with any procedure, there are risks and side effects associated with the PICC line, though not common.
I signed the consent form, the PICC line was put in, and I was able to hold my baby boy for the first time.
About a week later, Kaden had a fever and seemed a little more lethargic than usual (not that a baby of his size and gestational age could be considered lively, but there was definitely a noticeable difference still). They drew blood, thinking he may have an infection, and sent it off to the lab.
The next morning, I got a phone call from his doctor at the NICU. I had saved the NICU number in my phone so I could call and check on Kaden throughout the day or night, and to see that number pop up on my caller ID was terrifying.
The doctor told me that Kaden’s PICC line had leaked and his chest cavity, around his lungs, had filled with fluid. Kaden had stopped breathing and had to be intubated again. The PICC line had been removed and a traditional IV had been placed instead.
A leaky PICC line is not a common occurrence, so I was not prepared for this.
When I made it to the hospital, they told me that they had to place chest tubes in to drain the buildup around his lungs. Since there was so much fluid, his lungs weren’t able to properly expand, which is why he stopped breathing on his own.
The chest tubes were put in, and the fluid drained out over a 24 hour period. After the 24 hours were up, the chest tubes remained in place for an additional 24 hours, just to make sure no more fluid started to drain out. 48 hours after the tubes had been inserted, they were removed, and Kaden was extubated not long after that.
Even after the fluid was drained, Kaden still didn’t want to breathe on his own.
From what I remember and what I understood, a sort of bubble formed under, or around his diaphragm, so it hurt every time he took a breath. The doctor compared it to when you hit your arm on something hard and it swells up, then your body reabsorbs the fluid as you heal. A similar process was happening in his chest. After the trauma of his chest being filled with fluid from the PICC line, then having chest tubes inserted and removed, his body was swollen and trying to heal itself. Understandably, he was in pain from everything that had happened, and unfortunately, that pain flared when he took a breath. It seemed that Kaden figured out that if he didn’t breathe, it wouldn’t hurt.
It hurt my heart to see him in pain, and struggling. Before the mishap with his PICC line, he had been slowly weening off of oxygen assistance and he was doing great! After the PICC line leak, it felt like he was back at square one, if not worse.
Never fear, this story has a happy ending.
It took a few days, but Kaden did improve and was able to be extubated and put back on a ventilator, providing oxygen through a nasal cannula. Once the bubble (for lack of a better term) dissolved, he continued to improve until he didn’t need the ventilator anymore and was just attached to the oxygen fixture on the wall, which was providing more of a light pressure to help his lungs open than any real assistance with breathing.
It’s scary being in the NICU, and even more terrifying when procedures that are supposed to help turn south and you have to helplessly watch your baby literally fight for his life.
It was scary watching Kaden through everything, but ultimately his story turned for the better and he bounced back incredibly quickly. Other babies don’t have such a successful outcome, and I can’t imagine how devastating that must be for the parents.
Hug your babies tight tonight. You never know what to expect. You never know what’s coming next.