The Story of Jonah

pertusis

Melody had developed the cough a few weeks before she delivered Jonah. It had been a trying pregnancy; morning sickness for nearly 10 weeks and then constipation, headaches, weird cravings. Several times she had wondered if this was the right time for a baby? She had married Richard less than three years ago after a whirlwind romance; yet now, having held Jonah, she knew it was not only right, it was perfect. Richard was working out of the country, and had wanted to be with her for the delivery, but it was not possible to take a leave of absence for the next week. Then, he promised Melody, he would be home for three months.

She had met Richard in college. She was agriculture major; he was an adjunct faculty member, graduate student ecology. It was a chance encounter; she wasn’t in any of his classes. They met in the student union. She was poring over her statistics paper, and he was catching up on his lectures. As he walked by, he noticed a stack of books and a seemingly very young woman sitting nearby. One title caught his attention: “The Future of Ecology.” He stopped at her table for a moment, looked down and smiled. “That’s a really good book” he commented, and she looked up suddenly, not realizing his presence. “Is it? I have to read it for my intro class.” He nodded, looked at his watch and said, “Oops, class is starting.” And he was gone. After he left, Melody picked up the ecology textbook and leaved through a few pages. She found herself smiling, and returned to her statistics paper.

Looking back, their relationship was like a tornado. He happened by the following week, and seeing her again deep in study, he brought her a cup of coffee. She smiled, looked somewhat surprised, and asked him if he wanted to sit down. The two where soon so deep in conversation that Melody missed her next class altogether. What came next in rapid sequence were a number of dates to movies, dinners, a few daytrips to the beach, and then the proposal only five weeks later. Despite the brevity of their relationship, and her age, she quickly said yes. The parents were both shocked and surprised. This was her second year in college; she was barely 20. Richard was 26, and about to embark on a full-time career. They warned her it couldn’t and wouldn’t work. Richard agreed to slow things down and suggested that a longer courtship might be in order. Melody, in tears, asked if he had changed his mind? “Of course not. But I want to keep your parents happy if I can” he confessed. She asked him whom he wanted to marry? Her or her parents. And that settled it. They were married three months later. Looking back, Melody will tell you that there were some difficulties, but the good times far outnumbered them. One of those difficulties was being home and pregnant and for the most part, alone.

When Richard called, Melody was sleeping. She was excited to speak to him and bring him up to speed on everything. The delivery had been without incident, her labor was relatively short, or so she was told. Her mother and sister were with her in the delivery room, and Jonah’s APGAR was a solid 10. He asked how she was feeling? Aside from being really tired, and having the annoying cough, she felt wonderful. But the cough. The cough was getting worse. She asked the nurse about it, but she shrugged and said it was probably the dry air. Yet overnight and throughout the next morning her cough grew worse. Her doctor prescribed a cough suppressant and that seemed to do the trick.

Melody and Jonah went home two days later. Everything seemed perfectly normal, with the exception of her mother and sister staying in their apartment and of course the new addition to the family. Richard called every day, sometimes twice a day to check up on his little family. Melody assured him everything was fine and they were both resting comfortably. She told him Jonah hardly ever cried and looked just like his father.

Over the next few days everything seem to be perfectly normal. Melody’s mother and sister helped out with the baby, and Melody caught up on her sleep. But her cough continued to bother her. It wasn’t any worse, but it wasn’t any better either. Richard came home the following Friday and couldn’t wait to see his new son. He did look just like Richard, the same big green eyes, and the same red hair. Richard asked Melody if he was supposed to drool this much? She assured him that all babies did. Then Richard asked about the sneezing. Melody had not heard Jonah sneeze, but then, she had been sleeping a lot. Her mom and sister have been doting on the baby so much that she didn’t feel the need to stay by his side continuously. When Melody took Jonah out of the bassinet, he felt warm.

A phone call to her obstetrician’s office was answered by a nurse who suggested that she bring Jonah in the morning, if things had not gotten better. Neither Melody or Richard got much sleep that night; she continually checked the baby’s face and forehead for fever. At 8:30 the next morning they drove to the obstetrician’s office, and waited for her to come in. When the obstetrician came in, she brought Melody and Jonah in, and asked questions about the past week at home. Then she checked the baby. Jonah did have a fever, but it was hardly noticeable at 99. At this point the obstetrician checked Jonah’s ears and nose, looked in his eyes and listened to his heart and lungs. The obstetrician assured Melody and Richard that everything seemed fine. They were both healthy, and Jonah seemed to be healthy as well. It is natural to be overly worried about every little cough or sneeze, but in this case, there was nothing to worry about.

The couple thanked her for her time, and bundling up Jonah, drove back to the apartment. That night, Jonah was unable to keep down any milk. Melody sent Richard to the store for formula thinking that breast milk might somehow be a problem, but he couldn’t keep that down either. His cough also was getting much worse. The next morning, another call to the obstetrician, and an explanation of the new symptoms. This time, the nurse put the doctor on the phone immediately, and he told them to drive to the emergency room.

Jonah was started on an IV to prevent dehydration, and the couple was told that he would spend the night just to be observed. The next morning Melody, who had been asleep in a chair next to his bed was woken by activity. Jonah had begun coughing more, early in the evening, and a nurse had been requested to take a sputum culture. It had tested positive for pertussis. Jonah was being moved to the neonatal intensive care unit or NICU. When the nurse took Jonah’s vitals, she found his oxygen was at 78%. That afternoon, in the NICU, Jonah was placed on 100% oxygen. Melody will tell you that the next few days were a blur of doctors and tubes and IVs and nurses. Melody and Richard were required to wear gowns and face-masks to go into Jonah’s room. The hospitalist in the ICU ordered a feeding tube for Jonah, so they could maintain weight and the antibodies from his mother’s breast milk. As Melody stood next to her infant son’s bed, an alarm again sounded and nurses rushed him. Jonah had stopped breathing. The doctor inserted a ventilator tube to help him breathe. Melody recalls that her son looked helpless lying there with tubes and wires “going everywhere.” “He was so tiny and innocent,” she recalled, “How could this be happening?”

The third day in the NICU, Jonah began having seizures. At first they lasted only a few seconds, but sooner lasted more than three minutes. Another doctor came in the room, he introduced himself as Dr. Baine and that he was a neurologist. He explained to Melody that there was concern for brain damage because of the low oxygen level. Another machine was brought in, an electroencephalograph to monitor Jonah’s brain activity. On day five, complications arose when Jonah’s seizures intensified. At this point, Melody and Richard had been awake for nearly 30 hours. Neither felt they could rest while their son was so sick, yet despite this, they were losing the battle with exhaustion. At three in the morning, on the sixth day of his hospital stay, Melody and Richard were awoken to say goodbye to their son. There was nothing more that could be done. As the doctors unhooked the tubes and the monitors, and turned off the oxygen, Melody and Richard held Jonah’s hand. Melody recalls, “His tiny body was swollen and dark blue from lack of oxygen.” As the couple held the tiny hand, Jonah passed.

To this day, Melody has no idea how Jonah was infected with pertussis. Most likely she had come in contact with someone who was infectious in the last few weeks before giving birth. It is likely that Jonah was infected during the birthing process.

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