Yih-Chun: The Last 10 Hours of Cece’s Life (Part 3)
The main reason they wanted to transfer Cece is that the neurosurgery team at Carle doesn’t work on infants, and they were concerned that she would need surgery.
Cece was wheeled up to the PICU while the social worker took me up using a different elevator. Once she got there, they transferred her off of the hospital bed and moved her onto the crib-like bed in the PICU. This was going to be her home until they could get someone to take the transfer. They got her hooked up to the monitoring in the PICU and set up the Arctic Sun to depress her body temperature to 36°C. They also had started her on 8% hypertonic saline in an attempt to draw fluids out of the skull.
By then it was time to figure out what I needed in order to stick around for her transfer. I was famished and my cell phone battery was dying. I asked the social worker for some food and a USB-C charger. Dr. Rosado-Barreras showed up with the charger and the social worker showed up with a sandwich and some snacks. I hungrily ate whatever was in that box. I had already asked friends to bring me two pairs of socks, some thicker tops, a pair of sweatpants, my laptop, and a charger.
Someone came in on the phone with St. Louis and was reading vitals off of the heart monitoring and ventilator. Vitals fluctuated up and down; sometimes she had a heart rate around 160, sometimes it shot up to 200+. Blood pressure also varied; sometimes the diastolic pressure dropped into the 30s. Dr. Rosado-Barreras was working on managing the medicine and managing the transfer.
I had some time to think about what I wanted for Cece’s life— what should I even pray for? Obviously a full recovery, but given what I saw in the trauma room, that seemed unlikely. “Serious brain injury”— was this recoverable?
I was told around 8:25pm that St. Louis had accepted the transfer. Good news, I guess? We were going by Carle’s flight team; they could come in as little as five minutes. Sijia came with my bag of clothes and electronics; I paced the floor. They briefly considered putting in a central line, but thought it might take too long, and decided to leave that for the flight crew or for St. Louis.
Dr. Rosado-Barreras called me into her office to review imaging. There was bleeding into the brain. She had suffered a major skull fracture, quite a bit bigger than her fissures. The one thing the fracture did improve, though, is that it served as a pressure release for her intracranial pressure, which is exactly what the surgery team would have wanted to do if there was no fracture (and were no fissures). And while intercranial pressure was being relieved, unfortunately in the imaging we could see that a significant amount of cranial matter had ejected through the fracture. Perhaps neurosurgery could patch that up once they got the bleeding fixed, I thought. We looked through the rest of the CT— blood in the brain ventricles, seems bad, but otherwise Cece was remarkably intact skeletally. The doctor told us we did everything right, and the car seat had done its job, it was just too much impact force. She also told me Cece would very likely not survive. “Ct is bad” I texted Evelyn. The time was 8:43pm.
I went back to Cece’s room in a blur. Pastor Mike came and prayed for me. Dr. Park sent Dr. Suarez up to pray with me as well. I was still in a blur, I didn’t even know what to pray for myself. I started working on logistics for St. Louis. I figured if I was in the hospital for a while, I might need some local support. I reached out to Chenxi by email. The flight crew arrived around this time. They gave me a form to sign— permission to transport, and acceptance of costs. Carle also had a form for authorizing the transport. When I was presented with the transfer paperwork, I for a moment considered not signing it, but I decided we had to give her the best chance we could, without regard to the cost or the chances. They switched all the drips and the vent over to AirLife's and hopped aboard N585CH St. Louis Children's Hospital. “Engine started. One way or another, see you in stl.” I texted Evelyn at 9:42pm.
