Friday, February 9, 2018

Hospital Stay





Nearly the entire month of January was spent living in hospital as Little A turned into a medical mystery.

Just after he resumed school, on our return from a trip to his favourite mountain retreat, Little A began vomiting. It was a Thursday evening, and I was at a meeting. Big A called me midway through to ask if I had fed Little A anything unusual when we did our errands after school, as he had vomited thrice in the past hour.

I rushed home, and by bedtime, he had thrown up again. The next day, everything we tried to feed him came back up, and by Friday evening he was vomiting dark green bile.

On Saturday morning, despite the pediatrician's instructions the day before to "just observe and keep him hydrated", I took Little A to the hospital. By this time, he was so weak he could barely walk. The paediatric emergency team gave each other looks, and told me he should have been admitted the previous day. While connected to the IVs in the Emergency ward, they got us ready to move into the paediatric wing.

Through the next day, the green vomiting continued, in varied quantities depending on what Little A had been able to consume. By Sunday evening, I demanded we be assigned a paediatric gastroenterologist as our regular paediatrician, antiemetics, and even GERD medication administered every few hours had no effect at all on the copious regurgitation that happened every few hours.

And so begun a battery of guesswork procedures from standard x-ray and CAT scans to sedated insertions of cameras into his digestive tract that took place over the next ten days. What was discovered was that part of Little A's intestinal tract narrowed so much that possibly this caused all food going in to come out again. But no one was really sure what exactly caused it and how it suddenly happened when until that Thursday, he was eating and digesting food normally. 

Midway through the week it was agreed that Little A needed nutrition, so he was put on a second IV that fed him the equivalent of extra nutritious milk. This  IV had to be changed every two or three days, otherwise the risk of infection to the puncture site was high, so the search for veins and replacement of the needles was something that happened about a dozen times over the 3.5 week stay.

By the end of week 1, Little A developed a fever out of the blue, one so high it caused intense shivering, and for him to repeatedly sign and type for blankets. Blood was drawn, and it was klebisella pneumoniae, contracted through someone or something in the hospital. This led to his first ever course of antibiotics, in addition to fever and other meds that were being injected into his IVs several times a day. Visitors were strictly banned. 

Throughout this all, Little A remained brave, and kept on asking to go home. He spent days in a recliner chair and nights on the window seat, absolutely refusing the hospital bed unless it was to take him to yet another procedure. I went home for an hour every 3-5 days to launder the blankets and pillowcases we took to hospital as well as our clothes, then rushed back after a shower with another bag filled with clothes for 4 more days. By week 2, my French press and a bag of good coffee had taken up residence on the side table.  

The paediatric gastroenterologist was married to a paediatric surgeon, who met with us at the end of week 2 to say he would cut our son open to see what might be going on. He outlined the Whipple procedure, one I knew from obsessive Grey's Anatomy watching to be THE most complicated digestive operation of them all, one that would leave our son with no more "normal" stomach functions for the rest of his life, assuming he got through the complications of the operation.

But first, Paedia Surgeon was scheduled for his annual holiday. We had 10 days' reprieve, enough time to offer prayers to every saint and deity there was, and ask those so inclined who cared about Little A to do the same. An abdominal ultrasound was carried out in his room, and no unusual masses were detected by the sonologist. During this time, the vomiting slowly stopped, and Little A started begging us for food. 

Big A spoke to the technicians who did all the tests and the nurses who managed Little A's round the clock care, and we discovered that his case was being studied by the medical students and heads of several departments ranging from radiology to gastroenterology, none of whom could figure it out. We made a decision, without official doctor's orders, to start feeding him in tiny increments to see if he could keep food down. 

From one spoonful thrice a day on the first day to half a cup by the fourth, Little A kept his food down, and his IV nutrition intake was decreased. Nurses cheered him on, and we were allowed to take him on daily half hour outings, in a wheelchair, to a courtyard one level below.

When Paedia Surgeon and Paedia Gastro came back and read the charts, they wanted to do another battery of tests to compare with the first set. We refused anything invasive, and within that week Little A was taken off nutrition IV, and we signed a waiver that we were going against medical orders and taking him home. 

Our apartment is a 10 minute walk from the hospital that had been our home for close to a month. Big A kept going to work, since like clockwork twice a week we would be given an updated hospital bill. By the end of week 1, he slept most nights at home, and walked over as soon as he had finished at the office. When Little A resumed solid food, the Au Pair, who spent every night and most days in Little A's hospital room with me when not running home to get us more clothes, crayons, blankets, and toys, started walking home twice a day to cook him fresh food. When the whole family was finally home, it was the best feeling ever.