Monday, November 22, 2010

ER Fun

Our trip to the zoo today ended before it began when Will accidentally (need I even add that?) pulled his tube out while clamoring around in the back of my parents' old suburban.

I will interject into my story line here to just mention that I realize I have a very strong urge to blame other people when things like this happen (see Sweet Pickles Accusing Alligator). It was all just a terrible accident, but I couldn't help but think in a very non-torts-like fashion about how if only those boys had just gotten in the van like I had asked them to, if only Will would just listen when I say no, this would never have happened, if only I were able to keep them more under control blah blah blah. Yes, if Andrew had gotten in the van, Will would have done so, as well, and none of it would have happened. But Andrew could not reasonably foresee that hiding in the junky old suburban would lead ultimately to a trip to the emergency room. I do need to get the boys to submit better to my authority, but they are also little boys who like to play and climb and have fun and his tube should not come out from a little of the typical tumbling that boys do, and that he has done basically ever since he regained, as I like to say, psychological use of his legs again post-surgery.

But I digress. It was very surreal to hear him scream, "My tube came out!" and to look over and see that it really had, anchor and all. It must have been horribly painful, yet he stopped crying as soon as my dad backed my minivan out of the driveway on the way to the E.R. Porter screamed the whole way, but Will was calm.

The doctors did not seem terribly worried about the situation, saying that the site looked good (and I could see that the bleeding was minimal, though that hole pained me). Will was content so long as someone held the gauze onto his tummy while he watched endless episodes of Sponge Bob, the worst cartoon ever, at a range of literally 5 inches.

I began to feel like I was either not in America or in a Joseph Heller novel when the doctors reported to me that they could not do anything for Will because they did not have anyone with that expertise (in the entire hospital?), but that they would call around to other hospitals to see where to send us. That took several hours. All the while, Will's wound site was healing over. The doctors had informed us that repairing this type of situation is quite simple so long as it is attended to right away, but that by 24 hours the site is healed over and things get much more complicated (maybe another surgery would be needed). I was getting anxious as the hours ticked by and we started to reach closing times. DC Children's Hospital said they wouldn't fit us in but they would admit him overnight and do it the next day. We can't even get answers from the other hospitals and I am about ready to just leave and take Will to the ER at Fairfax, where I know there are pediatric GIs, having previously been treated by one for several months. I give a call over to the old office, talk to the wonderful nurse who had helped us all summer when we were still patients there and she was paving a path for us to be seen at the hospital. Meanwhile, the doctor in our ER got my old doctor on the phone, but she (ex-dr) said that she would not help Will because he was no longer her patient, thereby permanently wiping away any doubt I may have ever had about having left her service for Johns Hopkins.

Our nurse, who thought that she could replace the tube and that therefore there had to be a doctor who could do it, took some quick action and made the doctors brainstorm a solution that would not put Will in an ambulance headed for Baltimore (the Hopkins solution). The session of 6 doctors problem solving worked: why not have the Intervention Radiologist, who replaces displaced g-tubes in adult patients at least once a day, replace Will's? And a pediatrician can come in and prescribe the proper amount of sedative to relax him during the procedure.

Yes, why the heck not. I am not exaggerating when I say that putting in a new tube literally took fewer than 10 seconds. Truly. Then they wheeled in a little x-ray machine, snapped a shot, read the results and cleared us within 3 more minutes. It was the simplest thing in the world. It was like putting a straw through the lid of a soft drink cup. I was even more astounded after having seen its simplicity that the Arlington doctors wasted hours trying to send us elsewhere, denying having the capability of performing that simple little task. I would have felt some frustration, too, but whatever anger I have that seeks ventilation through blaming/accusing/criticizing was just overwhelmed with relief that everything was fixed and gratitude to the really great doctor who put off the video games calling to him at home (such were his plans) to help us out.

I learned a few good lessons but I will focus on one of them. Sometimes it pays to be a big fat semi-polite pain in the doctors' necks. I gave them some time to get things sorted, but as the hours went by and I got the sense that we were just getting pushed off because no one felt any responsibility, I started to become more proactive about questioning the doctors about who was doing what etc.

But the stuff that I really want to remember consists of anecdotes about the kids. Some of it is funny and some heartbreaking. In the case of Will it is both since everything that little boy does and says breaks my heart.

On the ride over to the ER, Will was mostly quiet. But he did look at me and say sadly, "I wish I only had my nose tube. I wish I never got a tummy tube."

At the hospital, Will received a sticker which at some point somehow got lost (I don't know how since he never left the little bed). When asked my one of the many passing medical professionals about whether he liked stickers, he responded in the affirmative and reported that he had one, in fact. When he saw that it was no longer on his shirt, he said, "But where the hick is my sticker? Where the hick is it?"

When they gave him a sedative, Will proved himself to truly be beyond the reach of typical human frailty. They gave him 1 cc of sedative. We waited. Will watched tv and acted totally normal. The doctor remarked that he himself would be knocked out by 1 cc. They have him anouther 1/2. Nothing. Another 1/2. The nurse expresses her anxiety about giving such a little guy that much. Will continues to interact iwth us and respond to Sponge Bob. Another 1/2. Will is in a wonderful, mellow mood. He smiles and talks with us. I consider how handy it would be to have emergency access to this medication from time to time. It is at this point they decide that the underweight three year old who has not napped is not going to fall asleep and they do the procedure. Will is nice and mellow for it. I begin thinking about the ways in which adults self-medicate, as those who unwind with a glass of wine at the end of a long day. I feel deprived. If it is true that women in Utah have higher rates of anti-depressants/anxiety meds use than women in other states, it has got to be because they don't drink.

We get back to my parents' house and Will retires to my parents' bedroom with a bowl of popcorn. My mom tells me that Andrew had a great day. After dinner she asked him whether he was ready to go up and take a bath. "Yep!" When she turned toward him she saw that he had spilled chocolate milk all over the table. "Andrew! You said you were ready to go up but you spilled milk all over the place! Why didn't you tell me?"
"Mmmmm. Scared, I guess," he replied. I love Andrew.

Brigham was offered (and accepted) a new job. We have been very excitedly anticipating the future and looking into buying a house of our own. I have felt really lucky. But today, after Will's accident, I realized just how lucky I really am and it has nothing to do with Brigham. Just kidding. With Brigham's new job.


Allie said...

This sounds like just about the worst day ever. Here is what I did like about it: that you guys were on your way on an outing to the zoo with your parents. Awesome! You guys do such fun things together and your kids are going to have such special memories of all of it. The spilled milk story was funny and the nose tube vs tummy tube story was heart-breaking and the news about Brigham's job was exciting. I hope that life is a little more low key for you guys tomorrow!

Ashley said...

This is so sad, I feel some sort of vicarious love/heartbreak for Will and it makes me sad that he has to deal with this. What a brave and sweet little boy! All that waiting around must have nearly driven you crazy. You are a good mom to stay on them until they got the job done. I'm glad Will has you. BTW, it was an intervention radiologist who gave me a chest tube when my lung collapsed. And I can't believe that woman said she wouldn't help since Will is no longer her patient! How horrible!

I want details on Brigham's new job and your new house!

And truly, you are so so lucky to have those three (four) boys.

Jenny said...

I'm sorry to hear about all this--and so glad to hear that Will is alright. I was starting to feel so anxious and claustrophobic just reading your description of how horribly you and poor sweet Will were treated at the hospital! Maybe if you guys had come to Music Time yesterday instead it wouldn't have happened--I'm just saying... :)

Sarah said...

Congrats on the new job and house! I am so sorry about the incident with Will's tube. Good for you for being proactive and finding someone to do the simple procedure. That is horrible that the ER was so unresponsive. I hope you guys have a happy Thanksgiving!

Troy and Nancee Tegeder said...

You sound so calm in your post, but as a parent, I know you couldn't have been that calm when it was actually happening. What a terrible adventure, but I'm glad he is doing better. Where is the new job at? Congrats.

Erin said...

I am just so sad after reading that. I love that little guy so much. We will keep him in our prayers. You are so strong Alex and such an example to me.

Isn't it sad that you have to be that way to get something done? I've been in that situation and it is ridiculous to say the least.

I laughed out loud at, "where the hick is it?" Too cute.

Congratulations on the new job and can't wait to see what you end up with!