Hospital Story, Part One

As you may or may not know, Amelia was in the hospital from Tuesday, February 15, through yesterday (Wednesday, February 23). A lot of friends and family have gotten the story in bits and pieces through texts and interrupted phone calls, or not at all, so this post should fill you in. Plus I am hoping it will be therapeutic to write this down.

Amelia was sick with a cold at the end of January and then with what we thought was a stomach virus after that. You can read about the "stomach virus" below. Last Monday afternoon and evening, Amelia felt very bad and spent about 3 hours just dozing my my arms. When Dean came home, we noticed that Amelia's stomach was distended, so I called the pediatrician on call (for the 6th or 7th time). She said that that could be part of the diarrhea but to call if it was stil going on on Wednesday. Monday night was rough; Amelia was waking up at a lot with a fever and diarrhea. Tuesday morning, she seemed a little better. Her fever was lower, and when she saw our leftover pasta in the frig, she said, "num num num" and "nooo-dle".

She ate some nooo-dles and some toast. Then she slept and we played a bit. The diarrhea stopped for awhile. But then she started fussing again, so I soothed her to sleep in my arms on our bed. When she woke up, she was kind of whimpering and her fever was a little higher, so I called the doctor. I had just decided I could not go through any more time not having her checked out, and if they told me it was a stomach virus and to come back tomorrow, so be it.

Amelia's pediatrician, Dr. Staerz, is a great doctor who has a solo practice. She shares calls with another doctor a little farther away from us, and sometimes their patients go to the other's office. We ended up going to the partner's office because they had an earlier appointment. On the way, Amelia was talking to herself and had perked up.

However, when we got to the doctor's office, Amelia took another turn for the worse. She began vomit ting while we were trying to get a urine sample. Both of us were covered in partially digested penne. Luckily had I had some extra clothes for Amelia, but not for myself. The doctor decided to draw some blood to run some tests, but when her nurse tried to find a vein, she was nervous that Amelia was too dehydrated and asked me if I would mind going to Dr. Staerz's office so that she could do it. I did not mind because I wanted Dr. Staerz to see Amelia anyway, so we packed up and headed to the other office.

In the meantime, the nagging worry I had felt all week had become acute. I was just starting to feel like something was very very wrong. Amelia slept on the way to the second doctor's office, and she slept in my arms while we waited for her blood to be drawn. She woke up and started vomiting again, so I rushed her to the bathroom. Most of it got on me. At that point I was pretty much in for a penny, in for a pound vomit-wise. When Dr. Staerx saw Amelia, she said, "She isn't well." Indeed. She drew the blood, and then told me that she wanted to me to stay and have Amelia sip some melted Popsicle or Pedialyte. If she couldn't keep in down, she wanted to me to take Amelia to an emergency room for fluids.

It was almost a relief to hear that, because I just wanted Amelia to be better. We got some melted green Popsicle down Amelia by giving it to her with a syringe, but she threw it back up. So with the doctor called the local ER to let them know we were on the way, and I called Dean, and off we went.

Amelia again slept on the way to the ER. There was valet parking so I could take her right in, and it was very calm when we got there, so we were taken right back to a room. While I was talking to the ER pediatrician, Dean and his mom arrived. (Dean's parents has just arrived for a week's visit. Great timing.)

Then began the process of getting an IV in Amelia's tiny veins. She was much more dehydrated than we had realized, and it took the doctors and nurses at least 10 or 12 tries before they got one in (in her foot). It was awful. Amelia was scared and in pain and being stuck repeatedly with a needle. Plus every so often she would throw up, and her vomit was taking on a rusty color, looking more and more bloody each time. All I could think was "something is very wrong," but I kept trying to soothe Amelia and tell her everything was okay.

Just a side note to say I almost feel like I somehow became a real mother sometime during our experience in that emergency room. Despite all that was still to come, I think our time in the first ER was the worst part of this whole experience because Amelia was in so much pain and we had no idea what was wrong. She was so upset and we were so scared. It was truly the worst part of the worst night of the worst week of my life. I felt like I was going to faint. All I wanted to do when they were trying to get the IV in her, and later when they were drawing spinal fluid to test for meningitis, was to leave the room so I didn't have to watch these things happen to my baby. But I couldn't. And there was no way I actually would have. I realized that my job was to stand there and tell Amelia that she was brave and strong and that everything was going to be okay. And for that to happen I could not be upset. I had to be calm and strong myself. And so I was--or I tried very hard to be.

Anyway they finally got the IV in. They did the spinal tap. (Random memory--after the procedure the ER doctor was taking the tape off Amelia's back and he said, "I think getting the tape off is the worst part." Um, no, I think the part where you stuck a huge long needle into my baby's spine was the worst part.)

It's hard to remember the timing of things after that but we got the good news that Amelia did not have meningitis and then they told us that they had gotten the results from her earlier blood tests. Her white cell count was very very high. The ER doctor told us Dr. Staerz wanted up to go to the nearby Children's Hospital so they could do more evaluation. Then he told us one of the things that they would be looking into was leukemia.

That might have in fact been the worst moment in all of this. It was the most terrifying thing I have ever heard. The ER doctor kind of wound his speech back around to saying that odds were she had a stomach virus, but it was too late for that kind of talk. We were in a black hole of terror and Amelia was still throwing up blood.

We must have waited quite awhile for a team of ambulance people to come move Amelia. In the meantime the ER doctor had talked to an oncologist at Children's, who told him that based on what she could see of the blood test and what we were describing, it was likely not leukemia. So that was reassuring but in the way that pouring a teaspoon of hot water into an icy bathtub might be warming. Finally the ambulance people arrived, got Amelia strapped into to a stretcher, and off we went.

I rode in the ambulance with Amelia while Dean drove the car. When we got to Children's Hospital they had a room in the ER waiting for us. A doctor came right in and the first thing he said was, "So what did you hear at [the first hospital]? A lot of people come in from there freaked out."

I said we were had heard leukemia as well as some other horrible-sounding diseases. After telling us that leukemia was a scary word but that the survival rate for it was over 95% these days, he went over the reasons he did not think that Amelia had it. He did the same for the other diseases they had thrown out at the other hospital. He also drew some more blood so that he could have a very good hematologist there take a look at the blood just to be sure.

Another side note--this experience has shown us how subjective a lot of medicine is. For example different doctors might read a high count of white blood cells in different ways depending on how the cells look and how old they are. Dean and I both realized we tended to think of medical diagnoses and treatment as very exact and scientific but that is not always the case. It underscored in my mind how hard it must be to be a doctor. I am a million times more impressed with doctors than I already was.

Again, I can't remember the timing, but we were in the Children's ER from about midnight to 6AM. A kind nurse brought in a cot for Dean and me to share. I also spent some time lying with Amelia on her bed. Every now and then she was still waking up, looking miserable, and throwing up blood. Her little lips were parched and rimmed with red. The hematologist came in and confirmed that Amelia's blood looked nothing like leukemia. The ER doctors kept coming in and checking. Finally he told us he wanted to admit her but he was not sure whether to send her to a room or to get a CT scan. He eventually decided that because her symptoms where not really in line with appendicitis and because it is so very rare for such a young child to get it, he would send us up to a room to let the hospital doctors continue to evaluate Amelia. Dean and I agreed that that seemed like the best thing to do at that point.

As we were wheeled up the our room, the sun was rising. It was the first time ever that I have stayed awake all night.

When we got to our room, we were greeted my our kind nurse Leesa, who would actually be our nurse for 5 of the 7 nights we would be there. Again, my memory is fuzzy at this point. Doctors came in and out. Amelia kept throwing up. The took a stool sample. Everyone was still leaning toward virus at this point. Apparently Dr. Staerz called around 8 or 9 AM and ordered an x-ray, and that's when things began to move along.

The x-ray showed that there were some issues with Amelia's bowels being blocked and I think they also showed that she had an infection in her abdomen as well. We were told the surgeons would come up and look at Amelia and either order a CT scan or do surgery right away. The surgeons came up. They said it was not a case in which we needed to rush to do surgery and ordered the CT scan. We got the CT scan. It confirmed what the x-rays showed: obstructed bowel, infection, possible ruptured appendix. She was going to need surgery to fix it.

By the time all this happened it was maybe 1 or 2 in the afternoon. Amelia was clearly in pain. We fully expected her surgery to happen very soon, but at that point the doctors began to speak of putting in a catheter and seeing how she did. I began to be suspicious that they were thinking of not doing the surgery that day. The doctor we were talking to, who was not a surgeon, was being vague on what the plans actually were. The fact that some emergency surgeries had come up was mentioned. At this point, trying hard not to be tearful, I made it very clear to everyone that I wanted Amelia's surgery to be done that day. Maybe she wasn't a life-threatening emergency, but she was in pain and we had already spend more than half the day waiting for decisions and test results and doctors to arrive and etc. Hospital time is very slow.

After that things started to move along. A surgeon came up to tell us she was scheduled for 6 PM. He talked about the surgery, the procedure, benefits and risks. We signed some papers.

We were still scared but relieved that things were moving in the right direction as far as fixing poor Amelia. I really don't know what we did all afternoon, but at 5 PM, a nurse came and told us they were ready for Amelia. Some people came and wheeled her crib to the surgery floor. We waited awhile and then talked to some anesthesiologists, then to Amelia's surgeon, Dr. Bruny. She was extremely reassuring. She seemed very calm, cool and collected, which was the case with most of the surgeons we spoke too, but she was also plain nice. Not that the other surgeons were mean--they were just direct to the point of being curt. I am not criticizing them--they have a very intense job. But Dr. Bruny made us feel very good. She told us her plan was to do the incision, clear out the infection and then remove the appendix. She answered our questions, and then wet to get ready for the surgery. They gave Amelia the first medicine that would put her to sleep, we kissed and told her we loved her, and the nurses, while playing with the stuffed animals in Amelia's crib, wheeled her away.

Whew. That's all I can do at this point. Spoiler alert: Amelia is home now, happy and playing, so don't worry about the ending. But I will have to write about the surgery and the days after ASAP.