Friday, July 10, 2009

The long story.

On Tuesday around 12:30pm, BBZ's teacher called and said he was pulling on his right ear. I noticed him pointing at it while in the bathtub both Sunday and Monday nights, but I figured he just found another cool place to put his finger...kind of like how he found my nose and my ears recently. I picked him up from school and by the time I got there he had thrown up everything he ate that day, which hadn't been much. I took him straight to the doctor and saw one of the nurse practitioners.

She diagnosed an ear infection and said the vomiting was likely from drainage, but he didn't have a runny nose. I drove to the pharmacy and got his medication and took him home. He was absolutely miserable. N was out of town so I was pretty much stuck in the house. BBZ refused to nurse, so I had my friend bring us some pedialyte to try and keep him hydrated. He was vomiting about every hour or so. My friend also let me borrow her pump which was great since he just wouldn't nurse. He also stopped sucking his thumb, which was weird to me.

After he had vomited a few times I got worried and called the nurses exchange. She said that I should watch his wet diapers and if he didn't pee for 10 hours I should take him to the hospital for IV fluids. He was up pretty much all night either crying or wanting to be held. I packed a bag for the hospital just in case we had to go. I was so scared! I called my mom and cried a lot about not being able to tell whether he was just sick or if something was really wrong. I felt like something was, but also didn't want to be over paranoid.

My mom was scheduled to come in town today actually for my friend's shower, but she changed her flight to land Wednesday morning. She could tell how scared I was and N coming home just wasn't an option. Why would I ask him to if all he had was an ear infection anyway? BBZ had a wet diaper at 10:30pm, so no emergency room for us. He woke about every hour and either vomited or just repositioned. The times he didn't vomit I gave him a 1/2 teaspoon of pedialyte. It was a very long night.

Wednesday morning my mom came in around 9am and I went to pick up my pump from work. She sat with BBZ. He held down most food all day and didn't vomit. I called his doctor around lunch time and explained what was going on. She said to bring him in if he doesn't seem better. He actually did seem better although he had this very blank look on his face. He didn't smile and he showed very little emotion besides crying screams I had never heard out of him, even when he was brand new. I took him to the doctor anyway because of his weakness. He could barely hold his little arm up. She looked at him and did not like the way he looked. She asked us to take him to the emergency room for IV fluids. She said she thought he was dehydrated and acidotic. He was tolerating sips of pedialyte and hadn't vomited all day. We went to the ER.

He saw a nice young doctor who did a physical exam and determined that he was not dehydrated. BBZ drank 2 ounces of pedialyte and held it down. There was no reason to believe that he was not getting better so he sent us home. The doctor said that he thought BBZ was a very sick baby, but not a critically ill baby. I have learned in the past few days that doctors are people who go to work every day, just like I do. Their work is different from mine, but they are not all-knowing. They do their best to make the right decisions, but do make mistakes. This doctor was wrong about BBZ, and while I am upset that he ignored my pediatricians recommendations, I do feel that he thought he was doing what was right.

When got home I nursed BBZ and he vomited all of it up. He did this twice so I called the ER doctor and told him that he was no longer holding anything down. He again reassured me that this is to be expected from a sick baby and asked me to follow the plan we set earlier that included a trip back to his pediatrician Thursday for a re-check. BBZ had also lost 1 and 1/2 pounds in 24 hours. The follow-up visit was to also check his weight. Wednesday night was a bit better than the night before...BBZ slept for about 4 hour stretches. He woke and 3:30am and drank 2.5 ounces that I had pumped. I figured he was getting to much when he nursed so I did bottles. He was so excited when he saw the bottle. It was the first sign that he showed that was even close to his personality. He was otherwise blank and very much in pain, from what I thought was either his ears or his tummy from the vomiting. He was crying and reaching toward the empty bottle so I figured he was still hungry. I gave him 2 ounces of pedialyte that he drank way too fast and also vomited up. I brought him to bed with me where he slept for about 20 minutes at a time and would wake and be uncontrollably irritable and scream out in pain.

At 9am I called the doctor and scheduled the follow-up for 9:30am. I went un-showered to the appointment and she took one look at BBZ and sent us back to the ER for fluids. She was very upset that the doctor sent us home the night before. She called ahead and spoke to a different doctor at the ER and insisted that they begin IV fluids for dehydration as soon as we got there. We walked into the ER, again, and they brought us back to the same room he was in about 15 hours earlier. The nurse stood at the door and watched him as she asked us to tell her the whole story. After I was done she just stood there and watched us. She watched how BBZ would pull his legs to his chest, scream out of pain, then crash to sleep from exhaustion about every 10-20 minutes. She was eventually the one who diagnosed the problem and told us exactly what would happen, and was exactly right.

They got him set-up on IV fluids and ordered an x-ray of his abdomen. They were concerned because a stomach virus often has vomiting and diarrhea, so since he didn't have diarrhea they were concerned something else was going on. The xray confirmed that BBZ had a bowel obstruction and possibly intussusception, where the inside of the intestine sort of turns in on itself. It was exactly what the nurse thought it was, just by watching his behavior. Every 10-20 minutes or so his intestine would try and push out his bowels and couldn't because they were turned inside out. This is why he was puling his legs toward his chest and screaming so regularly. They transferred us to the ER at Children's Hospital because although the original treatment didn't include surgery, they knew that surgery was a possible outcome and wanted pediatric surgeons on standby. I rode on the ambulance from the hospital and N and my mom met us at Children's. N finally came back in town while we were at the doctor so he had met us at the ER. Children's admitted him, did an ultrasound and confirmed the diagnosis of intussusception.

They explained the treatment plan that first included a non-surgical method of reducing the obstruction and un-twisting the intestine by using an air-powered enema. They said the success rate of this method was 80-90%, but a little less for BBZ because his blockage was fairly large. They brought him into the room and I had to hold his arms as he laid on his back while they did this procedure. They tried for about 20 minutes without success. The whole time I had to hold him down and talk to him to try and keep him calm. I had to look at his face while he screamed cries of absolute terror and pain for 20 minutes. It was probably the most horrible experience of his life, and I had to share it with him.

My poor baby.

And it didn't work.

The doctors were so disappointed and I tried to stay positive, but I just lost it. I knew surgery was the next step and that terrified me. I held him in my arms as he slept better than he had in the last 2 days. I can't put his exhaustion into words. The traumatic experience he just had knocked every ounce of energy out of his tiny little body. He slept soundly on my chest and I stroked his soft skin scared to death that this was the last time I might even hold him. I was allowed to keep him on my chest and ride with him up to where he was having the surgery. They explained all the worst case scenarios, because they have to, so as they rolled him away I felt that I would never see him again. Perhaps this was over-dramatic, but I was thinking the worst.

How could a doctor, just another human being, be able to use his big hands and go into my baby's tiny little body and fix what was wrong? There is no way he will be ok.

Then suddenly it happened while I was in the waiting room with my mom and N, an overwhelming peace came over me and I knew he would be ok. About 2 hours later the surgeon came in and gave us the best news...the surgery went great! Their original hope was to open him up, massage the obstruction, undo the twisting and allow his bowels to move as they should. BBZ's case was a bit more complicated. They ended up have to remove a piece of the intestine that was affected, his appendix, and a small pollup of tissue that included a small mass of acidic tissue that could cause ulcers down the road. Removing the piece of intestine was the best way to ensure that this won't happen again. If they had massaged the obstruction and it has passed through the intestines, he would likely be able to eat today and be home in a few days, but now he has to let the intestine heal completely before he can eat and has to eat before he goes home, which will likely be 5-7 days.

We all slept ok last night and BBZ is resting quietly now. He still has a very blank look on his face, but he started sucking his thumb again, which makes me think he is almost back to his old self. The last few days went by so fast, but feel like the longest days of my life. I started to think about why I didn't do this or do that, and maybe if I had done something sooner the surgery could have been avoided, but it's amazing how things really do just work out. If it had been sooner N wouldn't have been here at all, and if he didn't need the surgery they wouldn't have found the small mass and removed it. I have faith that things are ok and can't wait to see my baby boy smile at me. Thank you for your love and prayers...we know how very lucky we are.