Monday, June 25, 2012

Appendicitis, take 2

Almost 5 years ago, Micah woke me up in the middle of the night with a tummy ache that turned out to be appendicitis.  Now it is Josh's turn.

A couple weeks ago on Sunday morning, both Malachi and Josh (who will be 7 years old at the end of August) woke up vomiting.  We stayed home from church and they both recovered very quickly.  No one else ever got sick, and I attributed their illness to sun exposure.  Yesterday (Sunday) morning, Josh woke up again with a tummy ache and vomiting.  This time was different.  He was in a lot of pain.  He was in so much pain that I was immediately concerned and called the nurse hotline.  The nurse on the phone asked some great questions that I hadn't thought of, then gave me a recommendation to call the on-call doctor.  She seemed so calm and laid back, that I didn't call the on call doctor.  I don't really think he would have said anything different than "wait and see" at that point because Josh's symptoms were not unlike a normal stomach virus.  Oh, and also to keep up fluids.  Maybe I'm wrong, but it was my gut instinct. 

I watched Josh throughout the morning, encouraging him to rest as much as possible.  The last time he threw up was around noon.  He played xbox during the afternoon and was otherwise distracted.  He ate a little mac & cheese for supper.  He seemed like he was getting better, but I was wrong.  After supper, the tummy ache was back with a vengeance.  He was once again on the couch in tears asking if he could just take some tylenol or something.  He began running a low grade temp (100.6 orally).  I decided to take him to the hospital.  I got all the way to buckling him in the car and I was still second-guessing myself.  I said, "Josh you seem like you're feeling a bit better, maybe we should drink some water and get some rest...that's what the doctor will tell you."  He agreed, so we headed back inside to do just that. 

I had him sleep on the couch near our bedroom, and told him to come wake me if he needed me.  He woke me up 3 times during the night.  :(  Each time he was able to fall back asleep.  When he finally woke up this morning, he was STILL in pain, enough to have tears.  He didn't want to eat breakfast or drink any water.  He was dehydrated.  I quickly got ready for the day.  I was going to drop kids off at church for Vacation Bible School, then come back to get Josh and take him to the hospital, but decided that was too long to wait.  Mitch took the kids to VBS (this was a hard job, I am told, because he had to juggle a lot of little ones who did not get to go to VBS while he tried to get everyone to their right spots).

At the E.R., Josh was sent to a room right away.  There was no "waiting" like normal.  It seemed like every time I picked up my book to read, someone else would pop into the room to ask questions.  The doctor examined Josh, who had consistently been pointing to the left of his navel when people asked him to point to the one place it hurts the worst.  When the doctor pressed on Josh's tummy, however, it was VERY clear that he was most tender in that lower right quadrant where the appendix is.  The doctor ordered a urinalysis, complete blood count, chest x-ray, abdominal x-ray, and an ultrasound.  He wanted to avoid a CT scan.  The urine came back clean but concentrated.  His white blood count was high.  The chest x-ray was clear.  The abdominal x-ray showed a little bit of impacted stool, but not major constipation (Josh just had a "normal" bowel movement yesterday afternoon).  The ultrasound was the definitive moment though.  Before going in, I prayed that we would be able to see his appendix clearly and without obstruction.  They found it almost immediately.  Even I could tell what it was.  Magnified on the screen, it looked like a large carrot!  I know in reality it wasn't that large.  The tech sent for the radiologist to be able to see it in real time.  :)    It took the doctor about 10 min to get back to us and confirm that Josh indeed had appendicitis.

At this point when the doctor offered something for pain, I said yes.  They gave him a mg of morphine, which pretty much knocked him out for the rest of the day (such a lightweight)!  After that, he was more concerned/bothered by his dry mouth than he was about pain.  The nurses assured him he could have popsicles and ice cream when he woke up from surgery.

The surgeon on call happened to be Dr. Oakes, who is a friend of ours from a church we used to attend.  I felt blessed for the second time over (the surgeon who did Micah's appendectomy is also a church many surgeons are there, anyway?).  He was in a surgery when he was called to do Josh's, so we were scheduled for the afternoon.  When he came in the room, the first concern he mentioned is that appendices usually rupture within 18 hours.  It had already been 30 hours since symptoms first began.  He put Josh at the 2nd highest priority for an operating room...not life-threatening, but higher priority than others.  I was grateful.  My little man wouldn't have to wait much longer.  While we waited for the O.R. staff to finish another surgery, Josh and I chatted (though it was really funny since he was drugged up).  Josh said, "Doctors are so lucky."  I asked why.  He said, "Because they get to see all the cool stuff that's inside bodies."  When I told Dr. Oakes, he offered to let Josh stay awake and watch.  Josh shook his head no.  :)  By 2:15 or so Josh was in surgery, and by 2:45 pm I was meeting with the doc in the consult room.  It amazes me how fast they are!

Thankfully Josh's appendix did not rupture.  It was not even leaking.  But it looked NASTY.  The body was starting to wall it off (?).  The doctor wanted to keep Josh overnight for observation and two more doses of antibiotics.  It was almost 3:30 by the time I got to go back and see Josh, and I think waiting for that was the hardest.  He was SO sleepy.  It took him a good while to wake up and answer questions, but the first thing he asked for was a popsicle!  The nurse promised she would get him one when he got to his room, but it was a while to get him moved up to the peds floor and settled in his room.  True to their words, they got him a popsicle pretty quickly.  He finished it off in no time and sucked down a full glass of ice water.  He fell asleep again.  By 6 pm Josh was starting to really wake up and was ready to eat--yay!  He ordered a burger and fries and chocolate milk.  Since he really hadn't eaten since Saturday night (besides a little mac & cheese), I'm sure he was famished.  He perked right up and was quite talkative when Mitch came in around 7 p.m.  Mitch is staying the night with Josh and I'm pulling kid duty at home.  Tomorrow morning I'll get to have a turn at the whole VBS drop-off trick.  Yay!

I'm bummed because I asked Mitch to bring my camera up so I could get pictures of Josh...which he did, and I did get pictures...but then I forgot the camera at the hospital.  So they'll have to wait until Josh gets home.  I hope that Mitch and Josh are able to get some sleep tonight at the hospital.  I hope that Josh continues to improve rapidly and will be discharged in the morning.

I am so thankful that Josh is feeling better.  I feel so guilty that I didn't just take him in on Sunday.  But it could be that he wouldn't have been "sick enough" yet and we would have been sent home.  I feel bad for the pain that Josh had to endure all those long hours.  I'm so glad he is healing now, though.  Before I left I asked him, and I had already asked many times today (as a test of his pain level), "Do you feel like you're ready to go home and ride bikes now?"  And for the first time he said, "Maybe."  Such a trooper!  Josh was absolutely amazing today.  He was such a charmer, and everyone loved him.  Even though it was obvious he was very sick, he was very quiet and calm.  I'm thankful that God kept him safe and surrounded him with a caring and competent staff.  I'm thankful that God helped Mitch and the kids at home.  I'm sure it was crazy here.  It was sweet to come home and kiss all their faces tonight. 

1 comment:

  1. It can be so hard sometimes to determine if you child is sick, or SICK. I'm glad Josh is doing well, kids are so resilient. How nice that Dr. Oakes was able to do the surgery-something about knowing your child is in good, familiar hands is so reassuring.