A Beautiful Heart

Happy New Year.  Salt Lake is blanketed with fresh snow.  It feels like a beautiful, hopeful fresh start.  The snow is welcome--the crisp moisture falls from heaven and brings new life, covering all below.

There is much from the past ten days that I would like to erase and forget, much like snow disguising filthy muck.  But when the snow melts, the sludge will still be there--best not ignore it.  And some things are too important to be forgotten.

Plus, maybe that muck isn't so ugly after all.  Sitting in this hospital room listening to my daughter chat with her Dad, I feel like I am on holy ground.  This space is a place of miracles.  The dirt and grime of adversity is fertile soil for new life.  Annika knows this--she has always loved digging through the mud in search of bugs and other creatures.  We’ve always loved her adventurous spirit, but today we cherish it.  With each breath, we thank our Creator that we get more time with her beautiful heart.

***

The Collapse

On Friday, December 23rd Annika woke up happy and chipper.  It was the last day of school before winter break, and she was excited to celebrate with a class movie and hot cocoa party.  She got out of school at 1:45, ran an errand with me, then came home and hopped on the computer.  I was happy to let her play a few games since I was running around like crazy, trying to get everything ready to drive up to Heber to celebrate Christmas with the Wheeler family.  Around 3:00 Jason came home and was headed out to deliver Christmas baskets to some families in the neighborhood.  I encouraged him to take Annika with him, just to get her away from the screen.  She was pretty cranky about being asked to go.  The situation started to escalate but I took a deep breath and decided we needed to reframe.  I reminded her how she had a beautiful heart and explained how this Christmas service would be a great way to share her love with our neighbors.

Jason and Annika drove to the 4th and P chapel, where he backed the car up the sidewalk so they could load up the baskets.  Annika helped carry two, but on the next trip she said they were heavy and just took one.  According to Jason, as she started to walk back up the stairs she stopped and said, "My chest hurts.  My jaw hurts."  Then she collapsed.

For a moment Jason thought she might be acting melodramatic.  As soon as he realized that she wasn't pretending, he threw her in the car and raced her to Salt Lake Regional Medical Center, screaming her name the entire way.  Every ten seconds or so she would take a shuddering agonal breath, the body's response when the brain isn't getting enough oxygen to survive.

Fortunately Salt Lake Regional Medical Center was literally four blocks away, less than half a mile.  Jason got there, laid eyes on the ambulance entrance, and literally kicked his way in with our daughter in his arms.  He cried "Somebody help me!" and they got her onto a table immediately, beginning compressions and rescue breathing.  When it became clear that she wasn't stabilizing, he went back out to the car to get his phone and call me.

***

My Story

When the phone rang, I heard Jason's voice telling me that this was the worst phone call I'd ever receive.  He told me that Annika had collapsed and that they were at Salt Lake Regional.  Confused, I thought she had just fainted.  After all, twenty minutes ago I'd shooed a completely healthy nine year-old girl out the door to play Santa.  I'm embarrassed by this, but the first thing I asked was whether our insurance worked there or if we should take her to a different hospital.  Jason stopped me and said, "Kara, it doesn't matter.  Her heart's not beating."

While I didn't fully understand what was happening, I grasped that it was serious.  I screamed to the other kids that Annika was in the hospital and we needed to get there immediately.  We raced over to the ER entrance, where security was waiting to let us in the door.  They immediately ushered the kids into a separate room.  A few paces beyond I found 20-30 healthcare workers huddled around a tiny body stretched out on a table.  Annika’s torso was bare but she was still wearing her purple stretchies.  Her pink snow boots peeked out from beneath the table.  Her face was completely gray, but her two little messy buns looked neater than usual. 

There's no way to describe the horror of watching your child code.  It's far more intense than anything you've ever seen on TV--worse than you imagine.  I just stood there violently sobbing, wrapped in Jason's arms, as they rotated between compressions and electric shocks, regularly calling for more doses of epi or pausing to check for a pulse.  Despite the shouting and there being SO many people in the room, it was anything but chaotic.  It was more like a well-choreographed dance where everyone had their specific role to play.  Yet as parents, there was absolutely nothing Jason nor I could do but pray.  We had to trust completely in these capable healthcare providers and pray to our Heavenly Father that He not take our little girl home.

I've never prayed so hard.  If you add up every prior yearning of my heart, I'm not sure it would equal the intensity with which I pleaded with our Heavenly Father to allow Annika to stay.  I know that I'm supposed to concede, "Thy will be done," but I'm selfish.  I wanted my little girl here.  So I pleaded and I bargained.  I'm not exactly sure what I promised God, but it is a lot.  

The resuscitation felt like it went on forever.  According to her chart, they performed lifesaving CPR for a full 20 minutes, rotating compressors every minute because it is physically exhausting.  As horrible as it was to watch, my biggest fear was that they would call it and stop.  I will forever be grateful for the healthcare workers who never gave up on her.

Once they got Annika’s heart going again, it was still incredibly unstable with multiple arrhythmias.  They called for a LifeFlight helicopter to take her to Primary Children’s Hospital, even though it is a seven minute drive up the street.  It felt like it took forever to transfer her there on the helipad, but her condition was so dicey that they had to be exceptionally careful. I think the hardest part was when they invited Jason and I to come and kiss her goodbye.

By the time Jason and I got to Primary Children’s, Annika was already in the CICU (Cardiac Intensive Care Unit) undergoing surgery to place her on ECMO (Extra Corporeal Membrane Oxygenation.)  This is a form of external life support that takes over the work of her heart by pumping all the blood out of her body, running it through a circuit where it is oxygenated, then returning it.  It’s extremely risky and kind of considered a last-ditch life-saving measure, but we were desperate.  Once again, Jason and I found ourselves huddled outside a room watching a huge crowd of care providers fight for our little girl.  Once again, there was order in the chaos—each team member knew what needed to be done and played their part well.

A dozen people offered me a chair as I watched from a distance, but I couldn’t sit.  I could scarcely breathe.  My only comfort was a navy blue Minky Couture blanket that Jason had been saving for Christmas.  I swear, that blanket held me together as the tears flowed and flowed and flowed.

Miraculously, the ECMO worked.  As soon as she was on the machine, the arrhythmias stopped.  Her heart was able to rest and recover as ECMO pumped the blood for her.  Don’t be misled—her condition was still extremely fragile.  There are many risks associated with being on ECMO.  Our hearts are incredible, and despite the most sophisticated machinery and two nurses at her bedside 24/7, ECMO just doesn’t work as well as our bodies do.  It wasn’t a long term solution, and I was terrified that her own heart might not ever function again.  Still, it bought us some time.

***

Foreshadowing

Wow, this story is pretty heavy.  Just know that it is developing into a beautifully happy ending!

I will say, there are a few things that happened right before Annika collapsed that feel eerily portentous.  I find it odd that the very last words I spoke to her before she left for the church were about her beautiful heart.  It’s also strange that a couple hours before the cardiac arrest, we dropped off some donations at the Ronald McDonald house, never imagining that this organization would soon be offering much needed support to our own family.  Lastly, on the morning of her heart failure, Annika asked me if she had ever flown in a helicopter.  Crazy, huh!  Well, she hadn’t then, but she certainly has now.  

***

Miracles

The more I reflect on Annika’s cardiac arrest, the more grateful I feel for all the unseen miracles.  Annika’s heart condition was completely unknown with no prior signs or symptoms.  This could have happened anywhere—at home, at school, or while out hiking in the backcountry of Zion.  Yet this miraculously occurred at the best possible place, just blocks from a hospital, and the best possible time, when she was closely chaperoned by her father.  While I have always loved Jason, he has literally catapulted to superhero status—strong enough to sweep our daughter up in his arms with enough presence of mind to kick in the ambulance door and get her the help she needed immediately.  

If this had happened while at home or at school, I doubt she would have made it.  Every second counted.  So while some may think of church service as a burden, I see their Christmas basket delivery as a miracle that put Annika in the just the right place at the right time.

I likewise feel so fortunate to be right here in Salt Lake, living a mile away from Primary Children’s Hospital.  We truly feel we are receiving the BEST possible care from knowledgeable and committed caregivers who put their patients first—even on Christmas.  Annika has likely had this heart condition her whole life, yet fortuitously this happened after we converged here in Salt Lake, providing an amazing network of family and friends.  Our hearts are overflowing with gratitude for those supporting us from within this hospital and without.  Yes, it truly is a happy New Year, and I am so grateful we get to share 2023 with Annika and her beautiful heart.