Thanksgiving was going so well! We completed a solid dressing change early in the day, we were able to cook both our dinner contributions in time, and Walker’s outdoor waterproofing at Nana’s was so good we stayed outside all dinner long. Family members got to meet Terran for the first time and he was calm and happy in mama’s arms all night. Between dinner and pie we did Terran’s TPN change and that’s when it happened… about 5 minutes later when we were back outside and sitting down for pie and a bottle, Walker’s sister points and asks, “is he supposed to be bleeding?” I look down and lift Terran of my chest to see his onesie and my shirt both soaked in blood. We run inside, rip open his onesie, and see the entire dressing filled with blood and oozing out. It’s clear the line broke but we can’t tell where. Is it internal or external? We immediately apply pressure and run for the car.
Gratitude #1: The roads are clear at 8pm on Thanksgiving night. We get to Seattle Children’s in record time.
Walker drops me and Terran off at the ER entrance. I run inside and after giving the triage nurse Terran’s name and situation, “central line failure, he’s bleeding out,” another nurse hops up and immediately escorts us back to a room. Within 5 minutes the room is filled with doctors and nurses assessing the situation, making a plan, and stabilizing Terran. Maybe it was the blood loss, maybe it was holding mama’s finger while she stroked his head, for whatever the reason Terran was in the perfect mood of calm but alert. Thank goodness! The whole situation was already beyond scary. If he had fallen asleep, that would’ve taken us to another level. Did he lose too much? Will he wake up??
Gratitude #2: The Thanksgiving staff was quick, attentive, and on their A game. Turns out several staff members choose to work Thanksgiving day so our staff was top notch!
The break was exactly where we thought it would be. A couple months ago we noticed a specific part of the line twisting in itself and causing repetitive occlusions. We mentioned it to the LIFT and home care teams and they each agreed, that weak point is typically the first place to break. Apparently there weren’t any proactive steps to prevent the break, just wait. We didn’t like that option. We finally decided to go rogue on the dressing change instructions and secure the weak part underneath the dressing instead of leaving it out as directed. Occlusions stopped, but the damage had already been done. The pressure of the saline flush during that night’s TPN change was the straw that broke the camel’s back. The line blew out like a popped tire.
Gratitude #3: The line was repairable. If it had broken closer to his chest, or internally, a surgeon would’ve needed to remove the line and place an entirely new one in a different location. There’s a finite number of places for central lines so we don’t want to dip into that bank if we don’t have to.
Gratitude #4: We now know the best way to protect the weak point so this new line will remain strong for much longer.
Terran did his part and stayed calm through the entire sterile procedure of repairing the line. After the repair, we had to wait 4 hours for it to set before using it. In that time, his brand new TPN bag would be expired (needs to be pumping to stay good) so when we got home at 3:30 am Walker did a second TPN change. In the meantime, the hospital had Terran on a solution of glucose and electrolytes to keep his blood sugar stable (just missing the vitamins and fats from his standard infusion). While we waited in the ER room, Walker crawled into bed with Terran to sleep. There was only one bed so I stayed awake (not by choice!).
Gratitude #5: The Children’s staff are true angels. One nurse who heard we had to leave before having Thanksgiving pie, brought us a giant pumpkin cookie from her lunch and a bunch of hospital snacks. It wasn’t the dessert we imagined, but the holiday spirit was strong. ❤️
All things considered, this was the best case scenario for a line break. It was repairable, and now that weakened point is stronger than before and will remain that way with our upgraded dressing style. We were close to the hospital on a night with no traffic. We were holding him when it happened so stopped the blood loss very quickly (imagine it happened at night when we were all sleeping… no actually let’s not think about that). Even though our Thanksgiving didn’t go as planned, there’s plenty to be thankful for.
Gratitude #6: We spent precious time with family we hadn’t seen in two years. They got a front row seat to Terran’s “extra” situation!
Gratitude #7: Terran is growing every day and showing more of himself through babbling, laughing, playing, and interacting with the world. We’re so lucky to have him in our family! ❤️❤️❤️
Wow! That is a Thanksgiving to remember!! He has such a wonderful smile and you guys make a beautiful family. Blessings to all of you as we approach Terran’s first Christmas. Much love to all, Ellen
Your attitude of gratitude is awesome! Wishing you all a calmer ER-free remainder of the holiday season! Love from Va! (Chris, Doug, and E)
Dear amazing Smith family,
Even though I knew what had happened Thanksgiving night, I was in tears reading through what you went through event by event. You never cease to amaze me. I’m so thankful you have a good team at Seattle Children’s Hospital! I’m sure your positivity and love for Terran allows him to be calm under these scary circumstances. You are all loved very much! (You will have to show me your new “trick” with the central line). Love, Grammy
Wow, once again the parents come through! Glad Terran was able to meet some family members, all went OK even with the drama that you three handled incredibly well! Keep up the incredible parenting!
OMG!! So much to be Thankful for! So fortunate that the staff at Children’s is so on top of everything and were able to repair the line. And what a trooper, Terran! He’s so adorable, and that smile!! Love all the pictures. especially Dad and Terran sleeping!
Glad you were able to see family and introduce Terran. Love to all!
Wow, how scary for you all. Amazing how everything fell into place and went so well. Great parenting under such stress, you saved his life. Glad many others got to meet Terran, and see you two in action. I feel for you that you had to go through that, thinking of you often, love Aunt Karen
You are all so resilient through all of this. I am so moved by your love for this little guy and seeing his happy little smiles! Stay strong- we are thinking of you! 🥰
Hope you all had a very merry Christmas!!