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Thursday, October 28, 2010

Definitely Pancreatitis

As the saying goes, when it rains, it pours, and it has sure been pouring around here.  I apologize for the long break between posts, but I had more pressing issues to deal with at home.

Before we pick up where we left off, here are links to the story so far.  In order, starting with the oldest post first:

  1. Into Hell...the First Weekend
  2. The First ER Trip
  3. Back to the ER
  4. Finally...Some Hope
  5. In Isolation

When we last left off, we were in the middle of our first morning in the hospital. I had just discovered my son was in isolation, and I had no idea why.  That's where we'll pick up today.

I had been sending status updates to Twitter and Facebook via text message.  I'm still in the dark ages with a "dumb phone" and am too cheap to pay for internet access on my phone, so I had no idea if anybody had been seeing or responding to my updates.

  • doesn't have net access for indiv replies. We appreciate all your comments, prayers, & good thoughts. Update soon  6 August 9:57am

I'd had my Scrubs episode encounter before I ran home.  When I returned, one of those doctors was waiting for me.  With news.  I don't remember much of what she said.  Blame it on fatigue, blame it on now once in the hospital, everything seemed to run together.  Blame it on whatever you like, it won't change the outcome.  I still won't remember a lot of it.  I do remember her saying initial bloodwork showed elevated amylase and lipase levels, which is why they had to cut off my son's food and drink.  I also remember her saying the bloodwork results could indicate Pancreatitis.  The plan was to restrict food and drink for a couple of days and they still thought we'd be out over the weekend.

While I'd heard of Pancreatitis, I couldn't really tell you what it was.  I'd had no reason to know.  I'd never had it, and as far as I knew, nobody in my family had either.  When I spoke to my mother shortly after the doctor left, I asked her to google it for me.

  • LittleDude was feeling better, but symptoms have returned. Bloodwk shows levels still up. Waiting to talk to drs.  6 August 10:32am

We'd been hopeful, since despite my son's hospital admission he'd been feeling so much better, but that first morning we had a couple setbacks.  First was the news about the possible Pancreatitis diagnosis.  Then LittleDude's diarrhea, which he hadn't experienced for at least a day, returned.  Follow that with a return of chest pain, and I was extremely concerned.

A nurse returned with a new medicine for LittleDude.  His chest pain had been diagnosed as heartburn, and he would get regular doses of Zantac through his I.V.  As long as it meant my child stopped having chest pain, I was all for it.  She also told me that she'd seen my son's bloodwork, and the levels were still up, despite only having the equivalent of only a half dozen crackers and twelve ounces of Gatorade in two days.

  • Dr just came in. Says it's def Pancreatitis. They don't know what triggered it. LittleDude not allowed to eat. 6 August 10:53am

Before long, the doctor returned as our nurse had promised.  At that point, she confirmed the diagnosis of Pancreatitis.  Unfortunately, that meant LittleDude would not be eating or drinking until his enzymes came down to acceptable levels.  Neither of us wanted to hear that, but I admit I was grateful that we finally knew what was wrong with him.  To me, that meant he could finally be treated.  Unfortunately for my LittleDude, that treatment meant going even longer without food or drink.  Even worse, the doctor mentioned the possibility of needing to find alternative ways of supplying nutrition to my son in the event they had to restrict food more than a couple weeks.  It looked like that weekend discharge we were hoping for was out.

When the doctor left, I called LittleDude's school.  I had been keeping his teacher informed of his condition via e-mail, but the last one I'd sent her was on the second day of school, the day before our second ER trip.  And that one had been hopeful he would return by the end of the week.  I now knew that wouldn't happen.  I left a message for his teacher with the school registrar.  She was extremely sympathetic, but gave me even more bad news.

  • was just told by LittleDude's school if he doesn't start by next Fri, he'll be withdrawn & have to re-register. 6 August 11:41am

To say I was devastated by this news would be an understatement.  And I was confused.  My son's entire school career had been spent in this district.  Other than kindergarten, his entire elementary school career had been in the same school.  He was in the hospital; a legitimate reason for absence from school.  Now they were kicking him out? 

And then I'd realized I'd forgotten to ask the doctor about my son's isolation.  11:41 am, and the day already sucked.

Wednesday, October 13, 2010

In Isolation

Sorry for the week without a post -- my kids had a week off school for Fall Break and I took time from posting to try and prevent them from driving me absolutely bonkers.  I'm still not sure if it worked, but I'm back and ready to continue the saga of LittleDude's illness.  He's better now, BTW, but it was still difficult for our entire family.

Before we pick up where we left off, here are links to the story so far.  In order, starting with the oldest post first:

  1. Into Hell...the First Weekend
  2. The First ER Trip
  3. Back to the ER
  4. Finally...Some Hope

When we left off, I'd just been told that my son, who'd been sick on and off for almost a week, was being admitted to Children's Healthcare of Atlanta Scottish Rite.  The admitting doctor estimated a minimum 48-hour stay.  I still had no idea what was wrong with my child, but I had hope that we would finally get to the bottom of it and get him well.

It was close to 3:45 a.m. when we were moved from the emergency room to an inpatient room.  LittleDude had long since fallen asleep, and I could barely keep my eyes open.  Once we left Emergency, the hospital corridors were dark and quiet, and if I hadn't been so tired, I might have found them to be a little eerie.  As it was, I just thought they were long.  I was so ready to get some sleep.

We finally got to our room, where the night nurse was waiting for us.   She got us settled, showed me where my linens were, and somewhere between 5- 5:30 a.m., I went to sleep.

  • was sent frm 1 ER to another yest, still no clear ansr. Good news - LittleDude admitted to Scottish Rite last nt. 5 August 9:25am

Our first morning in the hospital arrived with a gaggle of doctors surrounding LittleDude's bed.  LittleDude was still zonked out when the doctors came in.  Despite sleeping, I didn't feel very rested and was unbelievably groggy when the docs gathered 'round my kid's bed.  I may not have been able to sleep well, but my son was sleeping like a rock.  At their request, I told the doctors my son's story to that point, the whole time wondering why they didn't just consult the doctor's notes in his chart.  I would later liken that experience to being in an episode of Scrubs, but without the funny.   

LittleDude finally woke up, and he was famished.  As the day nurse brought him something light to eat (I can't remember for certain, but it might have been some Jell-O and Gatorade), I secured permission to run home and grab the few things we would need for a hospital stay into the weekend.

It was weird.  We'd just arrived the day before -- hadn't even been there a full twelve hours yet -- but still when I climbed into my truck, it felt like I hadn't seen it in forever.  And when I pulled out of that parking garage, man was that sun bright!  I raced home, threw a few things into a bag, made a few phone calls, then raced right back to the hospital.  LittleDude was in a strange place, filled with strange people, and I wanted to leave him alone as little as possible.  I wasn't sure how he'd handle it; he'd been through so much already.

It turned out I didn't have to worry.  When I got back to the hospital room, LittleDude was happy as a clam (considering the situation), laying comfortably in his bed, watching one of the DVDs the nurse had secured for him.  When I walked in the door, the first thing he asked me was if I'd taken his Nintendo DSi with me (I had -- unintenionally -- it was in my bag).  The second thing he told me was he'd been told he couldn't eat anymore.  He wasn't too pleased about that -- neither of us had eaten much of anything in the past twenty-four hours and he had been craving tacos since he'd been in the previous ER (he'd smelled something that reminded him of tacos).

With the news he couldn't eat or drink anything, that mild craving that had started the day before escalated to obsession that would continue throughout his hospital stay.  My son was fantasizing about a big bag of tacos.

Something else had changed while I was gone, as well.  A yellow notice had appeared on my son's door instructing all who entered to wear gowns and masks and to wash their hands before and after.  In other words, my son had been put on "contact".    I later found out from the lady in the hospital library that "contact" is their version of isolation.

My son was in isolation and I had no idea why.


The story continues:  Definitely Pancreatitis

Saturday, October 2, 2010

Finally...Some Hope

Today is Part Four in the ongoing tale of my son's (LittleDude) recent illness.  If you need to play a little catch-up, I'll link the first three parts for you:

When we left off yesterday, LittleDude had had an abdominal x-ray and an ultrasound, had spent the afternoon and evening back in the emergency room, and had gone for a CT scan.  We still didn't know what was wrong, and had just been sent to an Atlanta children's hospital in the hopes of finding out.

During this entire ordeal, I updated Facebook/Twitter via my cell phone -- I'm still in the Dark Ages with a "dumb" phone, so I didn't have internet access.  The updates I had sent up to this point were:

  • is worried. After doctor visit & trip to ER, LittleDude still not getting better. Back at doctor's office now.  4 August 11:27am
  • is back in ER w/LittleDude. We're still not sure what's wrong. Reg dr wants him admitted to hosp. Pls pray 4 us.  4 August  3:39pm

When we left that emergency room, LittleDude looked great.  He felt great.  He even talked about it.  "I come to this hospital feeling really bad and I always leave feeling really good," he declared in the parking lot.

"I know you feel good," I said, "but you're still sick and we still need to find out what's wrong."

"I know," he said as he climbed into the truck.  "I know."

The ER doctor had opted to leave the IV catheter in my son's hand in the hopes it would still be good when we got to Atlanta -- that way the poor kid didn't have to get stuck again.  LittleDude and I were both all for it.  Anything to make the process a little easier.

We made a quick stop at the house, ran through the McDonald's drive-thru so I could finally get my first meal of the day, then went straight down into Atlanta.  The hours was late, the traffic was light, and we made it in less than an hour. Still, LittleDude was asleep when we pulled up to the emergency room doors at Children's Healthcare of Atlanta Scottish Rite, and I was pretty exhausted, too.  Which made the free valet parking they provide to all ER patients that much nicer. 

We were instructed to sign in then take a seat and wait for our name to be called.  Past experience with other hospitals told me it would take a while, so I settled in for a long wait.  To my surprise, we were called within a couple minutes.  I wasn't complaining.

After my son's information was entered into the computer, we moved on to the triage nurse.  For the umpteeth time that day, I chronicled the timeline of what LittleDude had endured thus far, adding in what I'd been told earlier that day.

Not the ER, but the same shade of green
I had an amusing Damn, I'm tired moment when, while weighing my son, the nurse asked me if I thought his color was off, or if he was always that color.  I studied my child a moment, then told her he did look a little green to me.  She laughed, and told me it could be because of her walls.  I looked at the walls around me and saw for the first time they were all painted bright green.

I couldn't help but laugh at myself.  "How did I miss that?" I asked her.  "I must be even more tired than I thought."  Outwardly I was laughing it off -- inside, I was worried about my own state of mind.  How could I have not  noticed those bright green walls?  And more importantly, if I was really that tired and my son wasn't admitted that night, how the heck was I going to get us both home safely?

From there, we saw another nurse then were ushered in to waiting room #2.  This room was filled with tiny, child-sized chairs and maybe a handful of people.  A large screen on the far wall was showing the movie Toy Story 2.  I figured that was the spot we'd be sitting a long time, but I was mistaken once again.  Shortly after we went in, we were whisked away from that room and straight into an exam room.

The nurse assigned to us gave us our first bad news that night.  After trying repeatedly to flush the IV catheter the other ER had so kindly left in LittleDude's hand, she finally deemed it unusable.  She would have to remove it and put in a new one.  My son, who had already been through so much, dissolved in immediate tears.  I explained how much trouble he has, and showed her all the places he'd already been stuck.  Then gave her the speech about my child and needles and screaming.

For some reason, hospital personnel don't believe me when I give them that speech.  This nurse gave me that look, the look that says you poor, delusional, overprotective mom, and assured me it wouldn't be a problem.  She'd get it on the first try.  She did take one precaution, though.  She grabbed another nurse to help hold LittleDude down.  I reiterated the fact that he'd scream but stay perfectly still, but that wasn't believed, either.

Once again, I wasn't looking so overprotective when she had three unsuccessful attempts under her belt, my son was screaming and crying, and they were running out of spots to stick.  They give in and brought in a ringer, who did manage to get that IV into my son on the first stick.

The first doctor we saw insisted the ultrasound showed no problems and pointed out that both the vomiting and diarrhea had stopped and he wasn't running a fever.  I freely admit that I argued with this doctor at this point.  I could blame it on fatigue.  Or exhaustion.  And both would be plausible excuses.  But the truth is, I read the writing on the wall.  This doctor thought I was overreacting and my son didn't belong there.

I asked her if the ultrasound showed nothing unusual, why weren't we sent home when the original report came in?  Regardless of what she saw or read, the technician who originally read that ultrasound saw something that prompted my son's primary care physician to send him to the emergency room.  She continued to disagree.  Insisted the ultrasound showed no anomolies.  They were going to run bloodwork, but I had the distinct impression she intended to send us home.  I panicked because I knew that if that happened, LittleDude would be just fine for a few hours then would end up worse than before.  And he'd have to go through this crap all over again.

Lather, rinse, repeat.

Nobody came back into the room for a while, and that was just fine with me.  LittleDude clicked around on the television, found a Disney movie to watch, and soon fell asleep.  Somewhere between 2 and 3 am another doctor came into the room.  She introduced herself as my son's "admitting doctor."

Admitting doctor.  Hallelujah!

To say I was relieved would be a gross understatement.  She couldn't yet tell me what was going on with him, couldn't say why he'd been feeling so sick before and not so much then.  What she did tell me was somebody would be coming to take us to a room so we could get some rest and they'd be running a few tests the following day.  She estimated a minimum 48 hour stay.

When she left our room, I felt better.  We'd made progress.  I still didn't know why my son was so sick, but I knew we'd find out.  And I knew he'd get better.


The story continues:  In Isolation

Friday, October 1, 2010

Back to the ER

Welcome to Post Three of LittleDude's Hospital Adventure.  The first and second posts in this saga are here and here.

When we left off yesterday, we were on an upswing.  Our family physician had sent us to the ER where LittleDude was treated for dehydration.  LittleDude was feeling better and things were looking good.

Tuesday arrived, and things were still looking good.  We'd ventured into cracker territory for food with no adverse reactions.  LittleDude had awakened that morning with a very mild fever that was so low it might not have even qualified as a fever.  At any rate, I was starting to plan on a Wednesday start of school for my son.

I made a little chicken noodle soup for him that afternoon, and tanked him up on water and Gatorade.  No matter what, I would not let him dehydrate again.  He seemed to be handling everything okay -- no vomiting, no diarrhea, and a non-fever fever.  I dared to breathe a sigh of relief, and even went to bed that night feeling pretty good.

Little did I know...

2:30am arrived with my husband shaking me awake.  "Where's the vomiting medicine?" he asked me.  I struggled to blink the sleep from my eyes and process the question I was being asked.

"Medicine," I mumbled.  "Cabinet."

My husband disappeared from the room, but returned again just seconds later.  By that time, I'd managed to sit up, but I was still confused.  Why was he looking for the nausea meds?

"How do I use it?" he asked, little brown pill bottle in his hand.

"You're supposed to give it to him at the first sign of nausea."  At that point, his questions finally clicked in my head.  "Why?  Is he not feeling well again?"

"He's throwing up."

Crap, I thought.  Crap.  Crap.  Crap.  "I don't know if it'll work after he's throwing up.  We were supposed to give it before the vomiting started."

"It's worth a try," he said over his shoulder as he left the room.

I still wasn't fully conscious, but I managed to get out of the bed and to my kids' bathroom without running into anything.  Believe me, that's quite a feat, as I've been known to randomly slam into walls.  Especially when tired.  SoundGuy spotted me.

"Go back to bed," he said.  "I've got this."

I don't remember what happened next, but I must have stumbled back to the bed.  The next thing I knew, it was morning and the sun was coming up.  LittleDude was asleep and the house was quiet.  I crept into his room to check on him.  The vomit bucket was within his reach, but empty.  Maybe it's over, I thought.  I kissed his forehead and left as soundlessly as I could.

It wasn't.  Over, that is.

A couple hours later, LittleDude was up and seemed to be feeling okay despite the night he'd had.  Together, we decided not to attempt any food; we'd stick with water and Gatorade.  We started with just a little water and the antibiotics the ER doctor gave us on Monday.

Bad idea.

The moment that stuff hit his stomach, it came right back up.  And up.  And up.  How could 4 ounces of water and a couple tablespoons of medicine take so long to come back up?  My poor child was on the floor in front of the toilet in the downstairs half bath.  I ran up to his room and grabbed his bucket, then tried to get him up to his bed.  If he had to go through the pain of heaving up his insides, at least he could do it comfortably in his bed.

It wasn't to be, though.  He got as far as the bottom stair in the foyer and could make it no further.  At this point, I was beyond worried.  I was so far past concerned it was but a speck in the rearview mirror.  I'd sped right past those things and was firmly in the realm of scared.  Terrified.  What was wrong with my child?

This wasn't good.  This couldn't be good.  Why did he keep getting sick?  What was going on?  I called the doctor again.

Initially, I was told our primary care physician was to be in surgery all morning, but they could get us in that afternoon.  Whatever.  I took the appointment.  In the meantime, I'd just sit over my son and fret.  Seriously -- this kid couldn't even keep water down.

Maybe twenty minutes passed before my phone rang, the doctor's office number appearing in the caller ID.  The doctor had come out of surgery early and he wanted to see my son immediately.  No argument from me.  I got my son dressed, grabbed the bucket, and we went to the doctor's office again.

This time, LittleDude fell asleep on the examination table before the doctor even came into the room.  We had to wake him up, and it wasn't easy.  More reason for me to worry.  The abdominal pain was still there, still in the same place, and the doctor was very concerned.  This time, he got his x-ray, and what he saw prompted him to send us for an ultrasound of LittleDude's gall bladder.  He couldn't tell for sure from the x-ray, but thought it might be enlarged.  We were sent to a diagnostic center in the next county and told to wait there for the results.

LittleDude didn't vomit again for the rest of the day, but it could have been because there was nothing left in his body.  After what I'd seen that morning, I found myself wondering if he even still had a stomach.  My son was tired, a little listless, but otherwise seemed okay.  We had the ultrasound done, and when the results came back, our doctor sent us back to the ER.

"I want him evaluated for admission," he'd said.  "We need to find out what's going on."

On the way, I called SoundGuy and updated him, not there was much to tell.  We'd had an x-ray, and ultrasound, and were going to the hospital ER.  I promised to call with any new developments.

First thing they did at the hospital was put another IV in.  My son hates needles.  I know, many people do.  But needles don't seem to be to fond of my son, either.  On Monday, it took them four tries and three different spots before they finally managed to get that needle into my child.  When the nurse and her student came to put the new one in, I warned her.

"His veins dislike IVs as much as he does," I said, "and he's a screamer, but he will stay perfectly still for you."

She smiled at me like I was out of my mind and assured me they'd be just fine.  Fifteen minutes later she wasn't smiling anymore, and the student had given up.  They did finally get one in, and it happened just like I'd warned.  It took a while to find a good vein that didn't run and hide as soon as the needle approached his skin, and he'd screamed like a banshee, but he stayed perfectly still. 

We spent the rest of the day in that ER.  Thank goodness each bed had it's own tiny television -- that little idiot box kept my kid from going completely stir crazy since he was trapped in the bed the entire day.

The ER doc looked at LittleDude, listened to what he'd gone through over the past five days, looked over the meds he was taking (I'd learned after the last ER visit and had packed up everything he takes and brought it all with us), and after consulting with the pediatrician on call, ordered a CT scan.

Apparently, when those results came back, there was quite a bit more consulting going on before a verdict finally came to us sometime after 9pm.  They had no idea what was going on.  It seemed all my kid's symptoms indicated different things, and each negated the other.  The ER doc told me the pediatrician said, "There's too much going on with this kid, and I'm afraid he might need a higher level of care than we're equipped to give."

Not very promising, is it?

From there, they'd called a pediatrician at one of Atlanta's children's hospitals who suggested maybe they should just hydrate my son then send him home and see what happens.  Thankfully, this ER doctor wasn't willing to do that.  Even though he didn't know what was going on, he was certain my child was sick, and he wanted him seen.  That night.   I'm extremely grateful to that doctor for not being willing to take no for an answer.

At that point, he said LittleDude was being transferred to a children's hospital in Atlanta.  Together, we decided my son would be more comfortable and at ease traveling in my vehicle, so I was allowed to take him myself as long as I promised to take him that night.  And so, with paperwork and a CT scan disc in hand, we left one ER, only to head for another.


The story continues:  Finally...Some Hope