Not a great Monday - Vandy 6/25

After a wonderful Sunday with Will coming back to his old self, everything changed Monday morning. He was back to refusing to eat or drink. Blood cultures were negative. Fevers still going around the clock. Our pediatrician came in and we discussed the CT scan that had been mentioned earlier. JT and I just needed some convincing and education on what this would show that the ultrasound didn't show. We don't want to run any tests that aren't necessary. The CT scan is a much better picture and if there is something going on from previous surgery, this is how we will find it. Dr. Huss recommended that we do it, so we agreed.

JT and I questioned ourselves often about making the right decisions. Were we just first time parents being crazy about a fever? Do we need to just go home and stop torturing the poor kid? Tylenol and Motrin would eventually take care of it, right? What are we even looking for anymore?

Back to being lethargic

We went to the prep room because Will would have to be sedated. The plan was to give him pentobarbital by mouth. Within 20-30 minutes it should put him in a sleep where we could literally hold him upside down and he wouldn't notice. It worked pretty quickly so we took him to CT machine. As soon as we laid him down, he woke up. Back to prep room to see if he would sleep deeper, and then we tried again at machine. Guess who started moving! They gave him another half dose. Guess who still wouldn't go to sleep! After almost 2 hours of this nonsense, we moved on to plan B. We took him to the scan room, laid him on machine, and Will said "uh-oh". How appropriate! They gave him propofol through his IV. Nite, nite Will! While they had him under, they put in a larger IV so that we could start attempting to get blood out of it instead of pricking him in crazy places. He was brought back to our prep/recovery room sound asleep. First thing that I noticed was that he now had a "no-no" on each arm to keep him from pulling out IVs. He was not going to be very excited to wake up to that!

We were in the recovery room for a while because the sedative was apparently in full force now and Will was not waking up anytime soon. JT's phone rang; his mom was calling. (NeeNee came to the hospital during her lunch break and had taken off the rest of the afternoon. She was up in our room waiting for us to come back.) JT answered, but it was a resident in our room looking for us, not his mom. I could only hear JT's side of the conversation and watched him suddenly break down in to tears. Will was going back in to surgery and the doctor was on his way to talk to us.

 NUMB! There is no other word to describe what we were feeling. Surgery again? What was going on? On one hand I was thrilled that we finally had an answer, but on the other hand I was hoping for something simple like an ear infection. CT scan showed some bowel abnormalities so they were assuming bowel obstruction, but not 100% sure. No doubt there was something there that needed to be looked into. Dr. Thomas was as upset as we were. He was so confident that the hernia surgery went well, he couldn't believe this was happening. Since Dr. Thomas is a urologist, a general surgeon would have to perform this surgery since it was in abdomen. Dr. Thomas was going in too though to make sure that hernia was not back. We talked to different residents, but I honestly don't remember much. Basically we were hearing that "Will is going back to surgery and we're not exactly sure what we are even fixing". We were told the surgery would be as soon as an operating room was open. That could be a few hours though. We were taken back to our room and Gram and NeeNee were there. Our nurse Mary was as comforting to us as possible.

Finally surgery was planned for 7:00. We were taken down to pre-op then and stayed there for a while. Dr. Thomas came by often talking to us and even pulled up the CT scan and went through it with us. He explained why they weren't sure what exactly the problem was, but it was definitely evident that something was wrong that most likely involved the bowel. Anesthesia came by and we had the same doctor as from hernia surgery. This was good since he remembered the difficulty they had the first time. Then we met Dr. Blakely who was the general surgeon. He was very honest with us saying that he was hoping to fix whatever this was laparoscopically, but he wanted to prepare us that he would most likely have to make another incision. The plan was to take him back and put in a camera to see what they could, then they would call us with a plan. They finally got started about 8:30. We went to the waiting room and they called after about 20 minutes. They could not see enough with just the camera, so they were going to have to cut him open. We were expecting another call in an hour. It was almost 10:00 and we looked up to see both Dr. Thomas and Dr. Blakely had come out to meet with us. We went to a private room to talk. They started out saying that they were done and it was not a bowel obstruction. Over the next 3 seconds (felt like and hour) my mind was racing over all the other possibilities they could have found. They had found an abscess the size of a racquetball! Everything done from the hernia surgery was still in tact, this was just a fluid collection that may have been aggrevated during that surgery and bacteria was introduced to it and formed this abscess. Random! Even more random is why he even has the fluid pockets (another was found on his left side, just not infected), but that will be looked into at a later date. It was behind the intestines, so the intestines were pushed forward and that is why they looked so distorted on CT scan. No one is sure why the abscess didn't appear on the scan (or the ultrasound we have Friday night) and they are actually going to look in to that. (Will is going to be a case study I imagine.) What great news! He had to be cut open which is no good, but the outcome was better than expected. Dr. Thomas looked as happy and relieved as we did. We got to go to recovery to see him a little before 11:00 and he was still sleeping. He had an IV in his right leg. He also had a drain placed from his abdominal cavity. This will be removed in a week or so. We got back to our room and could not wait to get some sleep so this Monday would be over!

Oh, while in the waiting room I saw a table of children's books. The one that cause my eye was "Alexander's terrible, horrible, no good, very bad day". That just about sums up Will's day!