And Then We Mitigate
My husband is an Emergency Preparedness Merit Badge Counselor for Boy Scouts of America. I do not remember now why he signed up for the responsibility, but for years he has counseled young men through the badge. Many of those years our sons' troop dedicated an entire weekend camp out to helping the boys earn the badge, including an mock emergency with injuries. While sorting campfire smoke laden clothes in the laundry room on Sunday afternoon, I would listen to Rich share about the accident, find out which boy in the troop suffered severe injuries, and ask questions about how the troop solved the crises. I always wanted to hear how our boys responded and what role they played. I learned a new application of a word through that process - mitigate. At the end of every drill the troop would mitigate the accident; they would sit around and discuss what could be done next time to lessen the severity of a similar emergency.
When preparing to take Nathaniel, I participated in a tracheotomy crises simulation class for parents. Working in groups of two care givers, we would go into a room set up as a nursery with all the machines and supplies we would have at home for a trach baby. The dummy baby was connected to the same monitors that our children would be attached to at home and to a computer. The class facilitator manipulated the dummy's vital signs through the computer in order to simulate an emergency. Care givers would problem solve the crises and offer intervention. A video camera filmed their actions and sent a live feed to another room where other class participants watched. After each scenario, the class would come together and a nurse would mitigate each care giver's actions. This last piece of the drill, talking about what went wrong, what went right, and what could be done differently next time, was the most helpful portion of the class.
Monday night, Rich sitting on the emergency room gurney, me sitting next to him on a hard chair with my feet up on the bed next to his feet, and Nathaniel climbing between our laps like a restless tiger in a zoo cage, we started the mitigation process of our most recent crises.
"I think when you ran to the bedroom for a a new trach, you should have announced what you were going for so I knew what help was coming..." Rich said.
"It was super helpful for you to yell for an ambu bag," I said, "I was so focused on getting an obturator or new trach, I didn't think about the bag."
"I need to learn how to open the tank of oxygen again."
Monday's accident requires we mitigate every aspect of our lives. What will we do if that type of emergency happens in the car on the highway in rush hour traffic? At church when Nathaniel is in Sunday School with a volunteer care giver? In his favorite hiding spot behind the love seat in the living room looking out the picture windows? What do we need to change about our lives and Nathaniel's life to lessen the severity of the crises when Nathaniel's trach tube accidentally comes out again?
Nathaniel's airway is very precarious. It is an accident waiting to happen. It is like a time bomb with no visible countdown clock. Nathaniel's chance of surviving these accidents, literally his ability to live through them, and his chance of avoiding oxygen deprivation neurological damage is 100% dependent on the response of his care givers. This is the reality we live with twenty-four hours a day seven days a week. It is the reality Nathaniel's doctors have to take into consideration as they continue to wait to offer a surgical solution to resolving his airway abnormalities. Nathaniel's ENT visited us in the emergency room and wanted to hear how the accident happened, how we responded, and how Nathaniel coped. These conversations are like dancing on a tight rope. Doctors want more time. We want our son to live. We want to reduce the chance of neurological damage. Nathaniel being discharged from the hospital three hours after such an intense crises with little else offered is a good-job-go-do-it-some-more-call-me-when-it-happens-again pat on the back.
It will happen again.
I heard that loudest when my pastor told me the hard news. It was after our second airway emergency that he shared the insight. Not in a morbid fear filled way. But in a realistic - be confident God will be the same tomorrow as He was today and meet you in that moment just as He did today - sort of way. Knowing that truth is where we find the strength to put one foot in front of the other. 24/7. Mitigation and preparation for next time is very important. Trusting that God will be in the next time is our ultimate preparation.
