A Night in the BC Children's Hospital Cancer Ward

Tonight I will describe for you what it is like to spend a night on the cancer ward at BC Children's Hospital. Last night I dutifully recorded what happened right through the night, recognizing that few readers have shared this experience, and that I will probably forget much of this over time.

March 2, 2011, 10:00 pm
Humidified oxygen is bubbling from a vent on the wall, an intervention that seems control Wren's dry cough, which is a response to the antibody. She is sleeping and the antibody has run its course for the day. She is doing well and it is time to rest. We are in good hands tonight and the prospects for sleep are not too bad. As usual, I am wiped.

Wren is presently attached to eight I.V. pumps, though not all are running right now. There are also heart rate, respiration rate, and oxygen saturation monitors. A separate machine records her blood pressure--it has been used frequently and her skin has become so sensitive that sores encircle both arms. She is tethered to a large, forked candelabra by a spaghetti of tubes and wires. Lights from the screens of the pumps and monitors are bright enough to illuminate the words in my notebook.

Ours is a large room with a window into the playroom. This is frustrating for Wren because she is not able to leave the bed owing to the number of instruments that are attached. A peripheral I.V. was removed today because of localized swelling. It was moved to the other hand, though it took two tries without freezing to get the new line started. Now her right hand is receiving medicine while the left slowly deflates. I held her close as she cried for Mama.

But Wren has just fallen asleep and a feeling of peace has settled in. The oxygen is providing plenty of white noise and I imagine that I can taste its sweetness. Time for me to crawl into the cot and close my eyes. It is now 10:30 pm.

11:00 pm. The nurse tries to encourage sleeping Wren to accept an oral dose of Tylenol without luck. My efforts are equally rebuffed. I must have fallen asleep. Before 11:00? Wonderful!

12:00 am. Recording blood pressure and temperature (vital signs) necessitates (?) a familiar series of beeps and bongs. I've slept for the past hour. Wren too. So far so good.

1:20 am. Another visit from the nurse. Wren calls out in her dreams. It is too warm. The hiss of oxygen is missing.

1:30 am. The oxygen monitor bongs as her saturation momentarily drops to 86 (normal is in the 90s). In a dream, Wren wimpers. Then everything returns to normal.

2:15 am. Wren's heart rate climbs above 185 bpm and her breathing is over 40, which sends the monitors bonging again. Her heart rate has been as high as 215 bpm during our most anxious days many months ago, so this doesn't phase me. I try to give Wren the Tylenol, which should settle her down, but she still refuses, so I put a cool cloth on her forehead. A pump alarms and small green letters repeat "SYRINGE EMPTY". I get up and ring the call bell and then change Wren's diaper. She is shivering and has a temperature of 39°C. She needs the Tylenol to bring down the fever, and finally she agrees to take it. Within a few minutes her heart rate and respiration drop by 10. How is it that I've become comfortable when her resting pulse is 175 bpm, more than three times my own?

Wren decides that she would like to go potty, so I go and get the plastic tray that we have been using (note, no potties in the Children's Hospital...a bit odd, no?). I take off her diaper and carefully lower her onto the flimsy tray. The tangle of wires must come as well, but the procedure causes one of the heart rate leads to come off and the oxygen sensor to temporarily fail, setting off a series of alarms. I spend a few minutes sorting this out and then try to settle Wren back into bed without kicking over the tray of pee. She is restless and coughing again. 3:00 am approaches and the requests begin. First it is to lie beside her, then to read a story, then she asks me to get Mama (who is at the Little House), then to blow bubbles with her, then a dry diaper. The requests continue. Some I fulfill, others I cannot. The oxygen is turned back on. It is 4:00 am and Wren would like to play with pretend cupcakes. Her eyes are closing and soon she rolls onto to her side, curls up, and falls back asleep.

5:20 am. An alarm signals the completion of another medicine. I have slept for another hour!

6:00 am. Wren is startled when her temperature is taken. She wakes crying.

6:30 am. "SYRINGE EMPTY" and its accompanying sound effects.

7:45 am. Wren wakes and asks for my hand while the nurse checks her blood pressure and temperature. My day begins. I change Wren's diaper, find her some new pants to wear, fold and tuck away the cot, and check the wall clock to see if it is too early to phone Paula back at the Little House.

This is a typical night in the hospital, better than many, and there have been many.

If all goes well, Wren will be discharged tomorrow and we will spend a night all together at the Little House. Then we will go to Union Bay to visit with Paula's family before returning to Smithers on Monday night.

Sleep well.