I think it started on Saturday, although it’s so hard to tell… he was spitting up more than usual on Friday, but I assumed it was because we swapped out his formula or even that he didn’t like the Bactrim.
On Saturday I went to Costco and left the prince home with the king guarding the castle (what?). When I came home, Ivan was wearing a worried look and his third shirt of the day – Ivan Jr had been throwing up. That was when I decided that we were not feeding him that formula anymore. I figured a couple good nursings and he’d be back to normal, or at least down to just an antibiotic-induced upset tummy. I fed him and while he slept, went out and bought some more Similac Advance. By the time I’d returned home, he’d thrown up once more. Okay, maybe he has some residual old formula in his system. I held him and fed him and around midnight we all went to bed.
Around midnight thirty, I woke up to the sound of my son gasping for breath and retching. I cleaned him up, changed the bassinet sheets, and tried to suction his nose out, since he was snuffling so badly. Apparently that triggers the gag reflex, and he threw up again. I apologized profusely, cleaned everything up again, and soothed him back to sleep. It happened again within the half hour, and again when I touched him to pick him up. I took his temperature – 97.1 under the arm. Okay. I figured he might be growing into acid reflux, and propped up his mattress with a pillow. Around an hour later he threw up again – this time it was brownish clear. And my mommy radar started screaming at me. He still had no fever, but something was definitely wrong.
We went out to the office and I sat with him on my lap while I looked for the Horizon Nurse Hotline number. He was so good and quiet while I was sitting that for a while I really thought it was likely acid reflux… maybe he couldn’t tolerate lying down? I was hopeful until he threw up again. The Horizon nurse was very nice and patient and sympathetic, and recommended I go ahead and call the Children’s Hospitals of Atlanta Nurse Hotline. When the CHOA nurse heard how often Ivan had thrown up, she told me to take him to emergency.
I learned something very important later that day, and I wish I’d picked up on it with that first nurse. She said she was required to advise me to go to the closest emergency room. If I’d read between the lines, I would have saved my poor baby precious hours and agony. But I was worried sick and operating on zero sleep. We went to the hospital where he was delivered – Emory Eastside.
Sunday Morning
We arrived at Eastside around 0730, and sat and waited to be seen. Earliest diagnoses were a reaction to the Bactrim, a stomach virus, and possibly a condition wherein the muscle connecting the stomach to the intestinal tract becomes enlarged and blocked off. But the ER doctor ruled out all those causes. He had us wait til 1130 to see if Ivan Jr would repeat his vomiting and then gave us his diagnosis.
Colic.
Which is also shorthand for “beats the hell out of me.”
Or “overreacting mother.”
I went home, flabbergasted. And furious. But not scared enough yet.
Sunday afternoon
By this time, Ivan Sr was awake and worried sick. We decided I should at least keep trying to nurse to keep the kiddo hydrated, soothed, and maybe help work out whatever was wrong. Around 2 PM I sent Ivan Sr out for some gripe water.
Ivan Jr threw it up within minutes of swallowing it. Along with the breast milk. And what looked like brown saliva. I couldn’t stand it anymore.
I called Children’s back. The nurse I spoke to shared a birthday with baby Ivan and lived in Grayson too! And everything finally started clicking into place.
This time the nurse made it very clear to me. “I am required by law,” she said very slowly and carefully, “to advise you to return to your nearest emergency room. Should you choose to go to another emergency room, that is your decision. If you were to do so against my advice, you may wish to consider going to Egleston. Again, that is not my advice, but if you go straight down route 78, you’ll likely be there in half an hour.”
I got a clue. We did indeed choose to do so. The nurse wished me well and told me to hurry.
Ivan Sr did Mach 2 while I watched Ivan Jr try to avoid swallowing his own saliva so he wouldn’t throw up anymore.
Can you break my heart more than that? Apparently yes.
We arrived at CHOA Egleston and hit the emergency room waiting area. I was discouraged to see that there was a posted waiting time of about 2 hours, but Ivan Jr decided to short-circuit the process by throwing up on the scale when the nurse tried to weigh him.
Ivan Sr pointed and said, “Are those red streaks in that vomit by any chance blood?”
And the ER staff galvanized itself. We were in a triage room within 2 minutes and had an assigned nurse (Stacy), tech (Seth), and doctor (Dr. Merrill) within ten.
And this is where my heart really breaks.
I’ve been through colic with Kate, and RSV with Savannah. I spent Savannah’s first Thanksgiving in a hospital room, watching her fight for breath in an oxygen tent. Kate did her best to break her arm playing soccer, and it took forever to get her to a hospital and X-rayed. She screamed hateful expletives at me when we committed her to Summit Ridge.
I made it through all of that knowing that things were going to get better.
I knew Ivan would need an IV, because he’d thrown up so much. But because his veins have been so small from birth, and because he was already so dehydrated, this was not the easy procedure that it should have been.
It took four hours.
They called in three different nurses, including two from the NICU.
They stuck my baby seven times, while he continued to throw up his saliva.
It was not getting better. And no one was trying to lie to me and tell me that it was.
And Ivan Jr was getting weaker, crying less with each time they stuck him, and trying to sleep in between bouts of vomiting.
I broke down.
Sunday evening
During all of this, Ivan Jr had his first X-rays, which didn’t show anything abnormal. He also tried to take some Pedialyte on Dr. Merrill’s orders. And kept throwing it up. The volume was astonishing. We got him changed out of his soiled clothes and into a hospital gown and covered him with blankets to keep him warm. He seemed beyond caring.
I really did try to be good. I wanted to be patient and not get in the way of the medical professionals. But my child was getting weaker and scarier by the minute, so we cornered the doctor the next time she came in and made her give us our options, because looking at our son, we felt we didn’t have a lot of time left. She gave us our options:
One more try with the IV.
Inserting a nasogastric (NG) tube and doing a slow drip to feed him, bypassing the gag reflex and hopefully keeping food in his stomach.
Performing surgery and inserting a central or PICC line.
We rejected the NG tube. He was throwing up his own saliva and the Pedialyte. So a slow drip wouldn’t do much good, we thought (and as we found out much later, we were right). I was on the verge of demanding a PICC line – which required a surgical procedure – when Dr. Merrill pleaded with us to give her one last chance at an IV line. We conceded.
Enter Saint Joe.
I don’t know if we were ever told his last name, but he is an assistant manager of the NICU at Egleston. Dr. Merrill had apparently been waiting for him to arrive for his shift and had several different nurses calling the NICU every ten minutes until he did. He immediately came to the call of, “Come quick, we have a baby for you.”
He spent an hour looking over Ivan’s veins with a hand held light while we held him on the table and stroked his head, watching him grow paler and quieter and crying less and more weakly. Saint Joe looked at every point on every limb and the scalp. Multiple times. He was quiet and careful.
And then he was ready. He had Ivan Sr controlling the light in the room so he could really see Ivan Jr’s veins. The lights in the room went on and off while he focused on slowly but steadily finding the vein and inserting the catheter.
He did it.
I broke down again.
They strapped my baby’s arm to a board and began rehydrating him, and we willed him not to go into shock.
At some point, we ate some crackers and drank some Gatorade and tried to take stock of our diaper supply. And finally got to breathe.
Thank you, Sara and Amanda as well as the others I’ve named, for caring so much about our son, and crying when you had to hurt him. We appreciate you trying so hard.
Sunday night
It was a given from about 1800 on that Ivan Jr would be admitted to the hospital, and around 2200 we got our marching papers to head upstairs. We were assigned to 4West and Joselyn was our first nurse. She cooed and fussed over baby Ivan and wrapped him in so many blankets that you could barely see him. Sindhu was our care manager, and sent Ivan Sr off to get food and brought me a ham sandwich. We met Dr. Gong, who was a first year resident, and would be following Ivan’s care. We would watch our son through the night, and see what the tests for different viruses and other infections would bring. We would see her in the morning.
I drove home to grab clothes for all three of us and enough diapers for another 24 hours. We settled in, neither sleeping, and took care of our son.
To be continued...
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