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Let’s discuss a little intussusception

A funny thing happened while Lance was out of town on business last week…

 

It started as a normal day, except that Lance was traveling for his job to San Francisco.  Alex woke up at ~6:45 am and we went downstairs to get him some breakfast and start a cartoon, so that I could go upstairs and take a shower to get ready for work.  Sara was, thankfully, still sleeping.  Not long after his breakfast and his second or third (!?!) cartoon, he said his tummy hurt.  I suggested that he go to the bathroom, but he said he didn’t need to go.  He’s had little moments of complaining about tummy hurts now and again, I just thought it was one of these episodes.  When this has happened in the past, we have suggested that he probably ate too much and should just go poop.  The tummy hurts subside, they’re really not that bad, and life moves on. 

 

Well, this was different.

 

Alex with tummy hurties, hospital-1 blog

Alex at the pediatrician’s office

 

He kept complaining his tummy hurt, more than he’d ever done before.  He was moaning and groaning, and holding his stomach.  It hurt him so much that I told him to lay down and it would probably go away.  It was hurting him so much that I noticed he didn’t want to walk, move or bend his knees up towards his chest.  I had him laying back in his bed, on the couch, but nothing helped.  He kept calling for Daddy, but Daddy was not there.  He would call for me and I would come to him, rub his tummy for a bit, but then continue getting ready for work. 

 

We decided to call Daddy on the telephone, me thinking that he was just missing him and talking to him on the phone would make him feel better and get ready to go to preschool.  We called, he talked to him and told him that his tummy hurt, but it didn’t help. 

 

After a while, it was clear that I probably wasn’t going to work, for sure that morning.  By the time our Nanny arrived at ~9 AM he was full on laying on the couch, pale as a sheet, moaning in pain.  I called into work, saying I wasn’t going to be there that day, Alex was sick.  I called preschool and said Alex wasn’t going to be there, he was sick and asked if there were any tummy bugs going around.  They said there were no tummy bugs in preschool.  After trying to get a few things done, Alex was in so much pain that he wanted me by his side constantly.  We tried to get him to watch a movie, but it didn’t last long.  I knew I had to call the Doctor, something just wasn’t right.  My boy in so much pain that he couldn’t move?

 

My Mom was coming up that evening, to help since Lance was gone, so I wrote her an email saying that Alex was sick and I was taking him to he doctor, so come up early if she wanted.   I called the Doctor and made a sick child appointment for about 1 hour from then.  In the time waiting for the doctor appointment, my Mom called the house and said she was on her way.  She said that it wasn’t like Alex to not moving, she was sure something was not right either. 

 

We waited what seemed like a long time to get ready to go to the doctor, and by the time it was ready to go, he didn’t want to move.  I had to pick him up and carry him with straight legs since it hurt so much.  He didn’t want to change his clothes, he was still wearing pjs, it hurt so much.  So I carried him out to the car and carefully put him in the car seat.  I packed a couple of things and *thankfully* remembered his teddy bear, named “marshmallow”. 

 

I made sure to nurse Sara before I left, I didn’t know how long this day was going to be.  On the way out, he made a funny swallow.  I asked him if he needed to throw up.  He probably didn’t know what that was, he’d never done it before.  I took him quickly to the bathroom and he proceeded to throw up a few times and then it was over.  Our wonderful Nanny suggested we take a bag or a bowl in case he threw up in the car, good suggestion I thought.  Good thing we didn’t need it. 

 

On the way there he would shut his eyes and almost fall asleep, saying how tired he was.  He was so pale and not like his usual self.  While he would have his eyes shut, he would make a grimacing face every minute or so, in pain.  How horrible this was!

 

We got to the doctor and didn’t have to wait long.  We got him checked out by one of the doctors, and she agreed that he seemed pretty sick.  We could go home and just observe, maybe it was just a tummy bug.  But, I told her that my husband was out of town on business and I had a Nanny taking care of my other child at the moment – I would rather see what was going on during the day, instead of an emergency this evening or tonight.  She agreed and understood, thank goodness!  It could be appendicitis, that is what we were thinking.

 

We were on our way to an urgent ultrasound place, right near the hospital.  She had called ahead and we were expected.  I packed Alex up again, carrying him to the car.  He was SO tired.  So pale.  Again, he would almost fall asleep, but wince in pain.  It was getting worse and worse on the drive, and when I took the exit for the imaging center (take a right) and the hospital (to the left), I really considered going left to the hospital.  But, I chose right and went to the imaging center, they were expecting us and would get right in. 

 

I carried him into the place and he would be crying and screaming sometimes because he was scared and in so much pain.  We were taken back after 5-10 minutes and by this time Alex was in the most pain.  We tried to do the – “see – Mom gets an ultrasound on her tummy and it’s not scary” thing, but it wasn’t working.  I just told the technician to start.  It was just hurting him too much.  She did an OK job, Alex was screaming in pain and she had to put the wand thing on his tummy.  She wasn’t pressing hard, it’s just anything at that point was too much for him.  She did a quick exam of the region, lower right tummy area, and was out to “talk to the doctor”.   At this point, I knew it wasn’t good.  She came back about 5-10 minutes later with the Radiologist and did another exam with him there.  Again, I didn’t hear a thing since Alex was screaming, but I knew it wasn’t good.  The Radiologist talked with the original Pediatrician and told us to go to the ER.  His appendix was enlarged, ~6mm, which is (apparently?) above the cutoff for adult appendicitis. 

 

My Mom had picked up Sara from our house, with the help of our Nanny getting the car seat in her car, brought her to me and met us a the imaging center.  I didn’t have my pump as it was at work, and at some point, I would need to pump or nurse her.  Thank goodness for my Mom!

 

I could choose Children’s Hospital, which obviously specializes in pediatrics.  Or Evergreen Hospital, only ~ one mile away, but if it was appendicitis, some surgeons operate on children and some do not and I might be sent to Children’s anyways.  I chose Evergreen – my kid was in extreme pain and I needed help now.  I second guessed myself, and thought I should’ve taken a left to the ER instead of the right to the imaging center.  Darn it!

 

We got to the ER and I once again carried Alex.  They got us right into triage, but had to wait for a room in the ER.  Another 5-10 minutes.  I texted Lance, while holding Alex in the waiting room.  He said he was busy between 2-3pm, so I didn’t call.  I’m not a good “text”er so I just wrote “appendicitis, ER, call when you can”.  Not long after that, they took us back to a room.  Little did I know, when in the ER they shut off all cell phone service, none, nada, zip.  Lance was not able to get a hold of me.

 

I explained what was happening to the nurse, they were getting ready to start an IV, and the ER doc was in quickly.  He had been laying down for about 5 minutes and by the time the ER doc was there, he wasn’t screaming in pain much anymore.  He was feeling a little better.  I thought, this is crazy!  What is happening?  She talked to me and felt his tummy.  She asked him to stand up and stand on one foot, jump around.  He did it!  Without much problem?!?  What is going on?

 

All this while, my mind is going ALL the way.  Alex is going to have emergency appendix surgery, Lance is out of town, I’m going to have to make life-and-death decisions by myself and on and on… 

 

Things calmed down a bit from there, since he wasn’t in the extreme pain.  They started the IV, he was pretty dehydrated from throwing up and not eating/drinking anything since that morning.  They were going to take some blood to see if they could tell what was going on. It was now 2:30ish.  I was able to nurse Sara, she was hungry and I was ready to nurse her.   After making sure Alex was doing OK, nursing Sara, I finally went out of the ER quickly to call Lance and tell him what was going on.  It was almost 3 pm.  At that point, I realized that he had been trying to call me but the calls wouldn’t go through, I had no reception.  Uh Oh!  

 

He asked – do you want me to come home right now (as in – go to the airport, take the next flight home and be there at some unknown hour)?  I told him to wait, we were waiting for blood results first, he was seeming to get better. Let’s just wait for the blood results and go from there.  I told him I would call when they came in and we would decide what to do. 

 

The results came back after a bit and showed no infection signs, increased white blood cells (or something like that).  It probably wasn’t appendicitis, since the blood results didn’t show an infection and with appendicitis – the pain doesn’t just go away, like his did. 

 

We waited a bit more, I was so confused by what was happening.  Was Alex just pretending, was I going crazy, would his tummy hurt if he forgot the doctors were there?  I would be talking to him about something and casually ask about his tummy.  Does it hurt now?  Did it stop hurting really bad, but still hurt a little bit?  All signs showed his tummy was feeling much better. 

 

Alex started to get a *tiny* fever, so they gave him so tylenol.  They started with some anti-nausea medication, perhaps since he might have to have surgery, I’m assuming.

 

The ER doc told us that the on-call pediatrician and on-call surgeon would be by later, but if we wanted him to stay, if my instincts were telling me that he needed to stay (she also knew that Lance was out of town because I told her), then she would admit him to the hospital.  But, if my instincts were telling me that he was fine, then we could go home later.  We decided to have the on-call pediatrician visit before we made a decision. 

 

He was great – the on-call Pediatrician.  We started by explaining what was happening that day and he did an exam.  He told me that it wasn’t appendicitis, since the blood work didn’t show it and the pain from appendicitis doesn’t go away.  He thought it was intussusception – a telescoping of the small intestine into the large intestine.  It causes all the symptoms that Alex had, pain, vomiting, and then can subside when the intestines get straight again. 

 

This diagnosis seemed to really fit what we had experienced.  I, for sure, didn’t want anyone to cut into my boy Alex if they didn’t have to!

 

He was getting better and better, and was soon into everything in the ER room.  He put on a mask and “glubes”.  He wanted to use the stethoscope that the doctor was wearing, he wanted Sara to lay on the bed with him.  He wanted to listen to my heart and be “the doctor”.

 

It was clear – he was better.  We decided to go home.  By the time we got home, it was around 7 pm and I was so tired.  What a day!  I started the day off thinking I was going to work, getting both kids ready by myself.  It ended up in the ER, thankfully with no surgeries. 

 

ER visit for Alex # 3, check.

 

Alex with tummy hurties, hospital-9 blogAlex with tummy hurties, hospital-12 blogAlex with tummy hurties, hospital-2 blog

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