Liam is “riding his vent” as I type this.
What I mean is that he is currently breathing at the minimum rate his vent allows — 16 bpm. When he’s awake you’ll never see Liam ride the vent. Any breathes over the 16bpm set by his ventilator are called “breathing over the vent.” These are breaths that are generated by Liam and his lungs. Breaths triggered by an awake and active little boy, and so it can be said that if Liam is “riding that vent” it can only mean one thing. . .
Deep, deep sleep.
Many times he’ll sleep just fine and never come close to riding the vent and that’s just fine too. Any time it’s Liam’s lungs doing the work and not a machine is a good thing but tonight I’m counting breaths.
Tonight I need him to ride that vent.
I’m writing this from the big red comfy chair in Liam’s room where I can get a good look at him. The light from the laptop is enough to see him clearly but not enough to wake him. Any other night I’d be down the hall in the living room, baby monitor close by, watching TV and having a snack without having to be so quiet that I don’t wake him up. Any other night I’d be able to trust in Liam’s vent and pulse ox alarms long enough that I may even catch a couple of z’s right along with the boy. But tonight I’m staying awake.
Tonight I need to stay awake.
The cord that connects Liam’s pulse oximeter to the probe that attaches to his foot wears out from time to time. It’s happened before. It’s about 15 feet long and gets caught on things and tripped over, not to mentioned coiled over the machine itself over and over again so that it’s bound to fail eventually. Liam is monitored for oxygen saturation and heart rate 24 hours a day so how could it not fail?
Well another one failed this morning.
It shouldn’t have been a big deal. It usually isn’t a big deal. As I’ve said this has happened before.
But that was before our medical equipment company was bought by a larger, meaner, cheaper medical equipment company. The first time this happened over a year ago now it was late on a Saturday night. I’m talking 11pm late. The on-call tech hopped in his truck and brought it right to us. But that was before the big buy.
The last time this happened the dispatcher from the warehouse, knowing that they didn’t have a truck in our part of the state that afternoon and seeing that our address was only a few towns over from his, brought us a new chord on his way home from work. Again — before the big takeover.
And so it was no big deal this morning when Karin called the company and told them what we needed. “We’ll get it out to you today Mrs. Olson.” they politely assured her.
She even received a phone call half hour later from a gentleman who had wanted to make sure that he was “putting the right part on the truck” and confirmed the serial number on the monitor. It’s the “part on the truck” part that really pisses me off.
By 4:15pm Karin was getting concerned. She called the warehouse dispatcher to see when she should expect our cord and was told that it would be coming by UPS. Hopefully by tomorrow.
“You never said tomorrow. You said it would be out to us today.”
“Shipped out to you today. Yes.”
We’ve been at this a fair amount of time. IF they had said anything about shipping Karin would have picked up on it. We know the code.
. . .
Let it be known here and now that it is unwise to stand between my wife and the needs of her son. I can assure you that the poor rep on the phone would have had a much better afternoon had she missed Karin’s call.
“What do you mean it’s coming UPS? You do realize this is life supporting equipment right?”
“Well, Mrs Olson we do know but it’s more cost-effective to ship things than deliver them.” Uhhhhh wrong answer lady.
“Who’s going to come over tonight and ensure that my son’s oxygen saturation is acceptable? Are you going to sit up all night and make sure my son’s lips don’t turn blue? Check his pulse every few minutes?” Let’s be honest. We all know that at his baseline we have very little worry of Liam turning blue (anymore) but that’s not the point. The point is we know quite a few people whose needs are that severe, what if it were them. The point is that anything can happen and the information in those numbers can be crucial to our response. The point is you are running a MEDICAL EQUIPMENT COMPANY.
All the usual comebacks were used. “I can only see what’s put into the computer. It’s a different department that sends it. We have a whole new system now since we are a new company.” and my favorite “It’s cheaper this way.” mmm-hm. It’s cheaper to put my son’s health at risk, got it asshole.
After stunning the girl on the phone with her questions Karin calmed enough to ask “is there any prioritizing of items by importance? Is there a difference in your system if I say I run out of 2×2 gauze sponges than say a ventilator circuit?”
“No, not really. whatever you say your out of just gets tacked onto your monthly supply order.”
Well I feel safer already.
Look, I understand that each rung up the ladder from the girl answering the phone to the guy packing the part onto the truck is just doing their job. That’s fine. But 8 months ago making sure that the patient had everything that they needed to stay healthy and safe WAS their job. Now it seems their job is to help just enough to help the bottom line. Just enough to keep the account. Just enough that some doesn’t get hurt, get sick, or get dead.
Liam is doing very well. At some point soon we’ll be keeping him hooked up to his monitors less and less. He’ll be free of one of the many wires and tubes that keep him safe but tethered, but even then we’ll have the option of hooking him up for a quick spot check. The option of hooking him up for a long spell should the need arise. Like if a seizure lasts a little too long or if he needs to have an emergency trach change when knowing his sats is vital.
But tonight I don’t have that option.
But tonight I have no chord.
Tonight I count breaths.
Tonight I stay awake.
Tonight I make damn sure that Liam keeps on “riding that vent.”