Part 2

Part One is here.

Monday
Monday brought me a nap, and a department head visiting our son, with resident doctor ducklings following studiously behind.  The department head decided Ivan had a stomach virus and it didn’t matter which one, since the treatment was all the same – keep him hydrated and comfortable, and no food by mouth for 24 hours.

Ironically, Ivan Jr had an ultrasound appointment to check his hips for dysplasia – at Egleston – an appointment that was made a few weeks ago.  Ivan Sr asked the department head if we could go ahead and keep that appointment.  She said that she didn’t think it was a good idea for a child so “acutely ill” to keep a routine appointment.  Awesome.  Our nurse, Jennifer, felt awful about it, and got us an appointment for Wednesday next, the little miracle worker.

We spent the bulk of that day watching him and trying to keep him entertained, which was admittedly much easier to do with him too weak to demand much “up” time.  He had a few wet diapers, which we had to weigh, and his color was back.  Good signs.  We also found out that his cyst was caused by klebsiella, and was responding well to Clindamycin, which replaced the Bactrim.

He was still throwing up his own saliva.  Bad sign.

And he still didn’t have a fever, and he didn’t act like a baby with a virus.

Dr. Gong probably didn’t mean to get testy with me when I tried to tell her that I thought we were off track with the virus diagnosis, but I guess I’d be a bit irritated in her position, too – she might have felt that I was challenging her knowledge and authority because she was a resident.  The truth is that I would have challenged the department head, too, if I’d had a chance.  But she barely gave me a glance and didn’t acknowledge my questions at all as she swept out the door.

So by the time I worked out our game plan for the night – I would go home, shower, grab more clothes and diapers, and come back to relieve Ivan for the night shift – I was fuming.

On the drive back, I couldn’t stand it, and called my friend Jessie and vented all over her (belated thanks go here – you are my angel once more).  She agreed that it seemed like the diagnosis was wrong – if the symptoms don’t fit, look for other reasons instead of trying to fit the illness to the symptoms – and encouraged me to write down my questions and ask Dr. Gong, carefully and tactfully, to consider other options.  By the time I got back to the hospital, I was ready with a plan for the following morning.  I had four questions.

Why is my son producing so much more (and excess) saliva?

Why is he continuing to throw it up, with nothing else irritating his stomach?

Can you test for the destruction of the klebsiella and presence of other bacteria, and is there potentially anything else mechanical for which we have not tested?

How do we know he's better?

Tuesday morning
I thought about these questions for the six long hours Ivan Sr slept as I tended to our son.  He took over for the morning shift, and I got some much needed rest – almost missing Dr. Gong again.  But I was able to stop her and ask my questions, and this time she listened.

She came back with a different department head – Dr. Taylor – who listened, felt Ivan Jr’s tummy, and ordered an ultrasound.  Yes!  We had a plan of action.  That brilliant man I married asked her if she’d include an order for a hip scan as well, since we were going to be there already.  She acquiesced.  So now I don’t have to go back in a week, hurrah!

I sent Ivan Sr home to get a shower and check on things.  His dad Peter was flying in that afternoon and Ivan would need to go meet him.  At 1130 I took Ivan Jr for his ultrasound.  I won’t go into detail about the construction noise or the spontaneous reboot of the ultrasound machine which drove Laurie the tech nuts.  Suffice to say that while she was able to reassure me about Ivan’s hips… she couldn’t tell me anything about the stomach images.

I knew right then.  She found something mechanical.

Sure enough, within the hour we were back on the ward… and Dr. Riley from Surgery was talking to me about pyloric stenosis.  Apparently the surgery to correct the problem is fairly routine at Children’s, and he was going to see what he could do to get us scheduled as soon as possible.  I called Ivan and told him the good news.

I felt exultant.  I felt vindicated.  I didn’t once feel scared.  Maybe I should have, but to me, routine surgery at one of the best hospitals in the Southeast beats the hell out of “we’re not sure but we think it’s a virus” any day.

Unfortunately, it also netted Ivan Jr a NG tube to clear the contents of his stomach, since it was clear that they'd be coming back up anyway.  I chose to step out of his room and make phone calls and get something to drink while they installed it.  He was still shuddering and whimpering when I returned and looked at me like I'd abandoned him forever.  I held him and talked him to sleep.

I called Ivan Sr and I think he set a new land speed record getting back to CHOA, arriving around 2.  I tagged him in and went down to the cafeteria to get some lunch since I had missed the room service hours (free food for nursing mothers, score!)… and sure enough, as soon as I picked everything out and got in line to pay for it, Ivan called me.  We would be in surgery as soon as I got upstairs.

That was at 3 PM.  So, 3 hours from the time a surgeon reviewed the images to us going down to the surgery ward.  Pretty impressive.

There is nothing more difficult than watching a nurse carry your baby off through the surgical ward doors and trying to be good and not cry.

I kinda failed the “not cry” part.

So did Ivan Sr.

It was time to go get Ivan’s dad, so he went off on the MARTA while I sat in the recovery waiting room.  An agonizing 47 (okay, one and a half) hours later, Dr. Bhatia came out and gave me the thumbs’ up.  Ivan Jr came through the anesthesia and surgery just fine, and the procedure was a success.  His NG tube had been removed, and if all went well tonight with feedings, we’d be discharged in 24 hours or so.  I would meet my baby back on 4 West.

To be continued (again)…