Wednesday, March 5, 2014

The "Million Dollar work up"

Just about 24 hours ago, our latest hellish tale began to unfold.

Callum woke up in a lot of pain last night, complaining of a stomach ache and then later that his knee/leg was hurting him.  We thought he might have bad gas (his stomach was rock hard and taut) and growing pains or a sprain (knee/leg). So we gave him some anti-gas drops and some ibuprofen to see if that would help. It was tough calming him down but I was able to finally get him (and me) to sleep (in our bed), and at some point, Jon transferred him to his own bed.

Around 4am he woke up moaning, and crying, and eventually screaming in pain again. I'm not quite sure how, but I did again eventually calm him down enough to go back to sleep. However, he woke up again about 6am, with the same thing (the last two wake ups he had stopped complaining about his stomach but continued to talk about his knee/leg and would refuse to walk on it). We had no idea where this was all coming from since he had been just fine hours before and no falls, etc. We were also both exhausted and beside ourselves as to what to do next, and poor Callum was inconsolable. So we finally made the call to take him to the ER since it didn't feel right.

Jon stayed home to take Logan to school while I drove Callum to the hospital. On the LONG 10 minute drive there, his pain and agony seemed to escalate to the point of hysteria by the time I got to the ER. Surprisingly, it was a ghost town, but given the screaming child in my arms, it didn't take long for a nurse to come straight to the door and usher me in as fast as he possibly could.

They were alarmed at how sick he appeared and how much pain he seemed to be in (he was screaming, writhing all over the bed and quite hysterical unfortunately). Our ER doctor later told me it's rare that they see a child in that much pain, so he was thinking it was something pretty serious.  I knew at the time they were all thinking that, based on how they were treating us, which made me wonder if I should be more worried than I was. :)

The doctor was pretty sure the leg/knee pain was referred pain and that what we were actually dealing with was a case of intussusception (essentially, an inverted intestine, which is extremely painful as you can imagine). They also thought it could be a case of appendicitis. Based on how Callum was presenting, either could have been a fit.

So, began the flurry of tests. We had blood work done. 3-4 vials worth. That was rough.

Callum could barely answer yes or no questions while in pain, yet the first and only thing he asked me when we arrived to the ER and he saw all the doctors and nurses surrounding him, was if he was going to get a shot. :(  Just a few minutes later, two nurses came in to let me know they needed to put in an IV.

I said uhhhh, that's not going to go so well. He's going to freak. We talked and agreed it would be best to wrap him in a "burrito" (with bed sheets) to help contain him. The nurses actually wanted to try without it but I encouraged them it would be better. As they were inserting the IV, Callum shrieked so loud I'm sure the entire first floor of the hospital heard us. One of the nurses looked at me and nodded, "Good call Mom."

After blood was drawn they gave him a small dose of morphine. We were all worried about his pain but we also needed to break the unbreakable hysteria that he was in. It, of course, calmed him down immediately. Phew.

Here's a quick peek at his "glowing toe" - a little sensor they taped to his toe to get his oxygen and heart rate readings. He asked me to take this pic since he loved his glowing toe so much. ;-)

From there, we were whisked off to run ultrasounds - many different angles and shots of his abdomen, as well as his testicles (the doctor also wanted to rule out twisted testicles). Callum did great, nodding off here and there, no doubt due to the morphine and sheer exhaustion.  The morphine caused a fair amount of chills/shakes (normal), which made him uncomfortable though, so he never truly fell asleep.  We also got a urine sample to run tests off - and they gave him some Tylenol (via suppository, poor guy!) to combat the fever he had developed.

After a bit of dozing back in his room, we were whisked off again, this time to run X-rays. The doctor was pretty certain nothing was wrong with his knee, leg or hips (I felt the same, you could move his knee and legs all around without any real change in his reaction), but he ran the X-rays anyway, just to be safe.

Fortunately, or unfortunately, depending on how you looked at it, the ultrasound results were inconclusive. And his X-rays came back looking great, without issue. His blood did show elevated white blood cells, a sign of infection, but at that point, it's all we knew.

There was some discussion as to whether they'd do a CT scan next, since they aren't crazy about CT scans on young children due to radiation exposure, but finally they decided to do a scan as well. This meant first poor Callum had to take down a cup of contrast liquid, which was absolutely awful to taste (I did taste it to see), and took FOREVER to finish (we technically didn't finish it all before the tech came to get us).

After the start of ingesting the liquid, you have to wait 2 hours before the scan, which I was actually fine with since Callum was super tired and kept asking to sleep. :(   The morphine and Tylenol were working and he was slowly feeling, looking, and responding better by the hour.

When it was time for the CT scan, we headed in. Callum was grumpy because we had woken him from a nap, and unfortunately, that grumpiness continued to spiral downward once he noticed the big rotating loud circular machine that I told him he'd be going into, so the doctors could take more pictures. The poor guy had had enough (can you blame him??)

On top of the scary machine and the crappy contrast fluid they had him drink beforehand, they also gave him an enema just before his scans AND THEN gave him several more doses of the contrast in between scans, via his IV.

When the techs had walked me through all this before we started, I explained to them that he hates the IV and is super sensitive about it. So good luck to them if they wanted to put more in him. Likewise with the enema, he wasn't going to like it (we've done one before on him at home and it was not fun). And finally, I asked if they had anything that could help keep him still because he wasn't going to be still for their scans. They said they did have a "papoose" like thing they could wrap him in, and I could then hold his arms/hands above his head as he went in and out of the CT.  Knowing my kiddo, without hesitation, I said yep, do it.

So we wrapped him up, I talked him through it and back and forth he went, in and out of that machine, with me holding his arms and hands as still as I could. He was crying and screaming and super afraid and upset by the whole ordeal, yelling to me to "get him off and out" and he wanted to stop. It was the most traumatic event, for the both of us, amongst it all. :(

It wasn't too long after, our doctor came to talk to us about the results.

The CT scan yielded nothing. Everything looked great and healthy and as it should. No appendicitis. No intussusception. No tumors, lesions, masses or anything else to explain it. This was discouraging for me because I wanted to know what was wrong. But the doctor said this was great because it could have been some really bad stuff.

But, given how sick he was when I brought him in and throughout most of the day, they wanted to admit him to the hospital and keep him under observation, just in case.

The ER doctor also called our pediatrician to let him know all that was going on and no more than 10 minutes later, Dr. Safir showed up to our room.

When he walked into the room, Callum immediately said "I've already had my shots" and showed Dr. Safir the IV in his arm. ;-)

The first thing Dr. Safir said to me when he walked in was, "Hi Bree, I see you've had the Million Dollar work up". Tell me about it!

We talked for a bit. He thought it was something viral affecting Callum's intestinal area, and believes it may be something going around since he's had three other patients, all with the same symptoms, in the last week. :(  But, thought this was best to keep him at the hospital overnight since they could help us get him hydrated, treat his pain quickly if need be and let him rest. And, he didn't want the same to happen again tonight and require us to make a U-turn back to the ER.

Once we moved to the pediatric unit, Callum was in such great spirits (go figure!). He was chatting with the nurses, walked a bit on his own and played in the toy room for awhile. I think the nurses were wondering why we were here. :)  I took a short break to go home and shower, pack an overnight bag, pickup Logan and grab dinner to eat back at the hospital.

When Logan and I got back, Callum had just woken up from a nap and was grumpy again. :(  So unfortunately, Logan's visit wasn't much fun and he didn't get much time with his brother before we decided it best to take him home (Jon is home with him while I stayed with Callum at the hospital).

Callum's pain and discomfort the rest of the evening has been up and down. He's had a few episodes of painful stomach cramps and diarrhea, but still nothing like before and overall he seems better. I'm hopeful he'll sleep through (most of) the night and is much better in the morning.

Speaking of sleep, I better get some myself, if I can. Here's my bed for the night, right next to my little buddy. :)

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