Friday, August 8, 2014

Stupid snake

 Many, Lord my God, are the wonders you have done, the things you planned for us. None can compare with you; were I to speak and tell of your deeds, they would be too many to declare. - Psalm 40:5
I'm afraid if I start at the beginning, I won't be able to finish the story. So I need to start at the end--or at least at the present--and continually remind myself of God's faithfulness as I recount the details of our week.

And right now, in the present, we are in a good place. Levi is improving daily. He's out of danger. He's home from the hospital. In time, with therapy, he should be as good as new. Right now, I know that one day, this will all be behind us. Just a very, very bad memory.
"I will recount all of your wonderful deeds. I will sing praise to your name, O Most High!" - Psalm 9:1-2
I have been asked to tell the story a hundred times in the past few days. By EMTs and friends and ER doctors and family and hospital staff and parents in waiting rooms with stories of their own. And it's easy to tell, and I can even get through it without crying now. But it's not easy to recall. I doubt it ever will be.

So I'll start with what Justin told the 911 operator.

My two-year-old son was bitten by a copperhead snake.

The gravity of those words is not lost on me.

Levi had followed Justin and others around the front of the house to peek at the garden. I stepped out front to bring him inside while I made dinner. What happened next transpired in only a few seconds, but seemed to us to occur in slow motion.

I heard a scream--that scream, the one all parents everywhere know requires immediate attention--and I turned to see Levi falling backwards. I got to him before he even hit the ground, and as I scooped him up, there it was.

Coiled up, five feet from my front door. A snake. As I jumped back up onto the porch I yelled for Justin.

"There's a snake. You need to come look at it."

He asked if Levi was bit. I scanned his body and saw blood pouring from his right hand. "Yes, he's bit on his hand," I yelled.

"It's a copperhead," he replied. "I'm calling 911."

As I tried to keep Levi still, I yelled for the other kids to come inside. A neighbor was walking by, and I flagged her down to come take care of the other kids for me.

Less than a 30 seconds had passed. I held Levi's hand tightly to his side, trying to keep him from moving it.

I prayed. I prayed more urgently and more desperately than I have ever prayed before.

"Lord Jesus, watch over my little one and keep him safe. Jesus, protect my Levi." Over and over and over. I could think of nothing else.

He was in so much pain. I tried to find his blanket, and eventually located it upstairs in the laundry room.

I asked Abby to try to find my phone. I wanted to keep her busy, and I knew I would need it. Caleb followed her, while our neighbor prepared dinner for the kids and tried to get them seated.

I heard Caleb's voice calling me from the next room.

"Mommy," he started. I could see in his eyes just how scared he was.

"Mommy, is Levi going to die?"

I paused. And at that moment, I lost it. On the outside, I stayed calm, and I did what I knew needed to be done. But inside, I lost it.

I had no idea how to answer that question. Because truly, I did not know the answer. I have never been more scared in my life than I was at that moment.

We have talked countless times about what to do if someone is bitten by a snake. We know to keep the victim still. We know to try to identify the snake to see if it's venomous. And when we've discussed it, we've always said that if it's a copperhead, we will call 911 immediately. It is because we had this plan that we were able to jump into action the way we did. It was like a fire drill we had rehearsed in our heads hundreds of times. We knew not to waste any time. Because with a copperhead strike, there isn't much time for a two-year-old.

I looked down at my 5-year-old who was frantically looking back and forth from me to his little brother who was screaming in pain in my arms. He needed an answer. And I didn't have a good one.

"Caleb, you need to pray for Levi," I told him as calmly as I could manage. "God is going to take care of him."

It was the best I could do.

Less than two minutes had passed. Someone was yelling for me to keep Levi's hand below the level of his heart. His hand and wrist were already swollen and bruised beyond recognition. A neighbor was in my kitchen putting food on plates for the other kids. Many more were in the front yard. I headed outside to find Justin. We sat by the road and listened for the sirens.

The fire department arrived first. They asked what had happened, and my heart dropped when I saw their reaction as Justin explained it was a copperhead bite.

There was nothing they could do.

Seconds passed, and we heard the ambulance roaring down the street. I heard one of the firemen say, "Metro is here. They'll take care of it." Someone was interviewing Justin, verifying that it was, in fact, a copperhead that had bitten Levi. He knows his snakes. There was no doubt.

Less than three minutes had passed. Levi and I were ushered into the back of the ambulance. With Levi strapped down and the doors shut, we were gone before the other kids even knew the emergency vehicles had arrived. I'm glad they didn't have to see their mom carrying their little brother into the back of an ambulance. I'm glad they didn't have to see their dad asking where they were taking us. I'm glad that sight is not one they have to recall.

It would be a fifteen minute ride to the hospital. It felt like years. I prayed. I sang Zephaniah 3:17 over and over and over.
"The Lord your God is with you; He is mighty to save. The Lord will take great delight in you; He will quiet you with His love. He will rejoice over you. If you could only hear His voice, you would hear the Lord rejoice; rejoicing over you with singing."

Twenty one minutes after the call came in to 911, Levi was in a trauma room at the ER. The doctor raised his sleeve and marked the level of swelling above his elbow, indicating how far the venom had traveled.

Twenty one minutes. Later, a doctor would say the venom had traveled halfway to his heart, and would commend my husband for calling the ambulance when he did. I don't like to think about that.

An order was put in to prep the antivenom that he would be given. He was hooked to an IV and given morphine for the pain. For the first time in almost a half an hour, he stopped screaming.

Justin arrived. The doctor asked how big the snake was, and seemed relieved to hear that it was an adult, between 2.5 and 3 feet long. Adult snakes, it turns out, control the release of their venom, while juvenile snakes will release all their venom in a single bite. A smaller snake would have been so much more dangerous.

The nurses and doctors located a mark on the back of Levi's wrist that indicated an initial warning strike by the snake, with no venom released. The second strike, somewhere around his index finger, was the venom strike. His hand and arm were so badly bruised and swollen by this point that it was impossible to gather any more information about the bite. Later, we would discover only one fang mark, in the joint of his right index finger, meaning he likely received only half the venom the snake released in this attack.

The antivenom was hooked up to his IV and immediately took effect, stopping the spread of the venom and halting the swelling. With Levi stabalized, we were moved to the pediatric intensive care unit where we were told we'd stay for monitoring. They didn't give us a time frame.

Grandparents and friends were called on to care for our other kids and to pray for a miracle. Our pastor and other members of our church showed up to pray with and for us. We were tired, and scared, and emotionally drained. But we were loved. And we were lifted up. And we will never be able to adequately communicate just how thankful we were for the prayers and comfort of others.

Levi finally settled down and fell asleep around 11 p.m. We didn't sleep that first night in the PICU. We stayed awake, watching Levi's monitors, watching his chest rise and fall, and listening with joy as his nurse hummed familiar hymns when she came in to check on him.

We lost track of time on that first full day in the PICU. Levi was in a lot of pain, and was being given a lot of morphine to manage it. By Monday afternoon, he was on his fourth round of antivenom treatment, and was showing no improvement. He wasn't getting worse, but he wasn't getting better, either. He had little to no mobility in his right hand, but an occupational therapist explained that was likely due to swelling. He began using his left hand for the first time, and desperately wanted to do things himself, like turning pages in a book, holding his own drink, smearing chapstick on his face and belly, and pressing the bright red button to call his nurse. He did begin talking more, and we were able to get him to eat, even if it was just popsicles and chips.

Our neighbor called to report the offending snake had reared its ugly head again, and had been promptly slaughtered with a nearby shovel. We celebrated with a dinner of bacon and eggs (the only thing Levi would eat besides chips) and prepared for another night in the PICU.

By Monday evening, the weariness began to really set in. We had met with blood specialists who were running tests to try to get to the bottom of a clotting issue that they couldn't resolve. Levi had blood drawn about every 6-8 hours. It was excruciating for him, and for us to watch. The fact that his clotting times were three times higher than they should be, combined with the total lack of any improvement during the day meant another night in the ICU was inevitable.

Levi was exhausted, and still in a lot of pain. He would occasionally become very combative and violent, and the episodes lasted anywhere from 30 to 40 minutes, during which time all we could do was try keep him from hurting himself further.

We prayed for signs of improvement. We tried not to lose hope. And we tried to sleep, knowing so many were praying alongside us.

And big things happen when God's people pray.

After a great night's sleep for all of us, our Tuesday started at 4 a.m. with a blood draw to check Levi's clotting levels. We could tell almost immediately that while people around the world had been bringing Levi before the throne in prayer through the night, God had been listening and working a healing miracle. Levi was playing and smiling, and finished off two bags of potato chips while we waited for the kitchen to open so we could order him a decent breakfast.

Thirty six hours after the bite occurred, Levi showed marked improvement in mobility and swelling in his hand and arm. The concerns with his blood work turned out to be a product of a clotting inhibitor in the snake venom and not an underlying blood disorder, as one doctor had feared.

Justin and I were able to take turns going home to shower, and as soon as he saw me, Caleb told me he prayed that we would have a safe drive home from the hospital. (Oh, to have his confidence when bringing my requests before the Lord!) I assured him that God always hears, and always answers our prayers. But sometimes the answer is "Wait." Justin and I were confident by this point that we were coming home soon, but knew we would spend at least one more night in the PICU.

The difference in Monday and Tuesday was nothing short of a miracle. After a few more pretty violent tantrums, we made the wise decision to taper off the morphine. Levi had damaged his IV lines so badly by that point that the nurse had to remove them. This turned out to be a huge blessing!

We were able to take Levi on wagon rides all over the hospital, free of wires and needles and monitors. Being up and about, and at one time even outside kicking a soccer ball around, helped tremendously with his recovery.
We welcomed a number of visitors, which was a much needed and welcome distraction. We were learning pretty quickly that there is only so much we could do to keep a very active 2-year-old busy while trying to protect a very badly wounded hand.

His two favorite babysitters came by and were able to give him his first bath in days and entertain him with some new toys. Magnet letters, it turns out, are a perfect one-handed activity for a 2-year-old snake bite victim.

After our breakfast of potato chips at 4 a.m., Levi managed to stay awake for 13 hours, only to fall asleep 15 minutes before he had to have blood drawn again. He finally fell asleep again at 11 p.m. after a wonderfully busy day.

The nurses by this point were all enamored with his sweet little smile and sunny disposition, but they seemed even more excited about petitioning for our release the following day. In hindsight, I realize just what a rare occasion it must be that a child is discharged directly home from the PICU.

By Wednesday morning, Levi's bloodwork was slightly worse, but the hematologist was willing to discharge him since his overall recovery was going so well. We will have follow up visits to monitor his clotting factors, and were instructed to be careful not to let him fall or get bruised.

Our nurse, whom Levi was smitten with by this point, flagged us down on one of our many wagon rides around the floor to give us the good news: Our discharge paperwork was ready.
God is good. And we were going home.

We have played the what-if game a thousand times since making that frantic 911 call on Sunday. What if we had gone out to ride bikes instead? What if I had brought Levi inside while I made dinner? What if the bite had been more severe? What if it had taken us longer to figure out what had happened? The possibilities are endless when our minds wander.

But the truth is that God's grace is so evident in all of this. By His grace, we were right there when it happened and were able to jump into action as the situation demanded. By God's grace, plenty of neighbors were outside at the time to help care for our older kids while we focused on getting Levi the help he needed. By God's grace, we live mere minutes from a hospital that keeps the antivenom we needed on hand. By God's grace, Justin and I were able to stay calm under pressure and administer immediate appropriate care as we waited for the EMTs. By God's grace, the snake that bit Levi only got one fang into him, cutting in half the amount of venom that could have gone into his blood stream.

And while I am counting graces, I count the hundreds of people who prayed for our son and for us over the past week. The prayers, presence and service of friends and family and strangers have held us up this week as we have cared for our son under very difficult circumstances. From the bottom of our hearts, we are so, so grateful.

Levi is beyond thrilled to be home, and is improving moment to moment. Indeed, his rate of recovery is nothing short of miraculous, and is a testimony to the power of prayer and the God who heals.

We will have follow up appointments with occupational therapy and with a hematologist for some time to help him regain full function of his hand and finger, and to monitor the clotting factors in his blood.

I am beyond mad that words like "severe envenomation" and "hematologist" are now in my vocabulary. Neither Justin nor I have fully processed all that has gone on this week, and reading through our discharge paperwork and going back over all that was explained to us in the ER and the PICU is really bringing the severity of Levi's situation to light. Right now we are staying focused on his healing. I'm sure the stress of it all will catch up to us eventually.

But the great news is that he is doing well, and that God has been so faithful to us and to him.

I will never tire of saying thank you to all who prayed, who shared my updates with friends, and who called or reached out in some way. We have been overwhelmed by the outpouring of love and the prayers of total strangers.

We serve a great and awesome God, who is able to do infinitely more than we ask or imagine. We serve a God who did not spare his own son, but gave him up for us all. It is God who watched over our son and saved his life. To God be the glory!

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