Tuesday, August 28, 2012

Ultrasound for Will

I feel like Will's blog is turning in to his medical chart...

We have an MRI scheduled for next Thursday, but I found out that it is only looking at Will's abdomen, back, and pelvic area. I had thought that his right leg would be included to find out more about the huge vein in his foot, but it was not on there. I called Dr. Thomas to see if he would add it. After explaining to his office staff a million times that I was aware that he was a urologist and could care less about feet, he was the one that scheduled the MRI initially and he knew about this foot problem. Sure enough he called me right back (as he always does) and said that he would be glad to add it, but he didn't really think an MRI of his leg was really the test that needed to be done. His nurse called back and said that radiology couldn't add it on because the dye that they use wouldn't last long enough to look at all of these areas.

So I called his pediatrician Dr. Huss. He agreed that the leg needed to be looked at because he has a knot in his calf (which JT has always noticed, I didn't really think it was a big deal until recently). Will has been acting like it hurts him when we touch it lately. Dr. Huss agreed that MRI of the leg probably wasn't necessary, but an ultrasound should show us what we want to see. Sounds good to me because we wouldn't have to put Will to sleep for that. His nurse got it scheduled for me right away.

We went for the ultrasound and Will of course screamed his head off the majority of the time. When the tech turned on the sound to listen to blood flow, it got Will's attention and he started "ooh"-ing (his new favorite sound to make). He even started watching the ultrasound screen and seemed interested. Other times he watched TV. The rest of time he screamed. The radiologist reviewed it immediately and the tech told us that we needed to go back to the lobby and wait for Dr. Huss to call us. I told her that he had my cell and could call me later. She said the radiologist was calling him now and we didn't need to leave. Of course this couldn't mean anything good! JT and I tried to laugh it off, but we both were not excited about staying any longer than we had too.

I got to talk to Dr. Huss just a few minutes later. He said the ultrasound wasn't showing enough and JT and I were right...we need an MRI of the leg. Good grief! It looks like a vein malformation, but they can't see where it ends. They need to make sure it doesn't end in the muscle. I have no idea what this means. The radiologist added it to next week's test so that we don't have to put him to sleep twice. Wait a minute - how can they add it to the test when I was told that they couldn't do that just a few days before??? Dr. Huss said the radiologist said the test would take longer obviously, but there would be no issues with the anesthesia or the dye. Hmmm, I think that nurse lied to me. Oh well, we have a plan now and that is all that matters.

The plan: Thursday, Sept 6th
We will go for the MRI in the morning. Will is going to be put to sleep for it because he has to be perfectly still and there is no way that would happen otherwise! It will probably take a few hours. We are looking at the hemangioma (strawberry) on his back, fluid pockets in his abdomen, soft tissue and large veins in his pelvic area, and his calf to see if this vein is problematic.

I don't want anyone to get the wrong impression - Will is doing great!!! He is growing and developing just as he should. These are just all things that need to be checked out. Best case scenario is they tell us he will grow out of all of it without any interventions. If that is the case, I'll be sorry that we put him through all of this, but would be glad for no more procedures!

Wednesday, July 25, 2012

Lessons from Vandy

What we learned from our Vanderbilt hospital stay:

1. Careful what you wish for

  • All I have wanted was for a little time...just the 3 of us. A little vacation where we can just all be together. Well I got it! Nothing like 9 days of 24/7 togetherness in a hospital room. Not the vacation that I had in mind!
  • I just wanted Will to be cuddly again - I missed when Will was a little baby and would sleep on my chest and just snuggle up with me. Now he is always running around and will only sleep in his crib or car seat. He does NOT want to cuddle! The week leading up to this hospital stay and the week of, all he wanted to do was cuddle and be in our arms. I am mad at myself for wishing for this.

2. Stay positive, but be realistic - Never say never

  • When we first got to our actual hospital room from the ER, the nice transport man was telling us about the microfridge and how the couch pulls out to a bed. JT told him, "We'll be fine, we won't be here that long anyway." 
  • We also noticed at the time that Will's IV line said "change Tuesday". JT said, "I don't plan on being here long enough to see that get changed." - Yep, we were still there! And I think we even saw it get changed again before we left.
  • We went to get something to eat and the elevator stopped on the 3rd floor (surgery floor). I said, "Glad we won't be seeing that floor again!" - Of course we saw it again 2 days later.

3. Trust your instincts

  • There were so many times that JT and I just looked at each and asked if we were being crazy and should we just go home. We knew that this was not the normal actions of our child. But when no one can find an answer, how else are you supposed to feel? I am glad that we didn't give up. And I'm glad that Dr. Huss and Dr. Thomas didn't give up either.

4. Be thankful

  • Thankful for family and friends - There was so much love and support ranging from a simple text, to bringing dinner, to staying with Will so JT and I could escape for an hour every once in a while.
  • Thankful for Vanderbilt - We take it for granted that one of the best children's hospitals in 20 minutes from our house. The nurses and doctors were all wonderful!
  • Thankful for our jobs - I am so thankful that we have jobs that we can walk away from when something important like this comes up. There was a little boy not much older than Will down the hall, and I never once saw a family member there with him. His door was always open so the nurses could give him as much attention as possible. I finally asked what was going on because I couldn't believe a parent wouldn't be there. I was quickly put in my place when the nurse told me that the family was from out of state and had to work to keep the insurance so that their baby could be at Vandy getting the treatment he needed. Wow - I can't imagine and don't even want to think about what that must be like. 

5. Believe in the power of prayer


What Will learned from our Vanderbilt hospital stay:

Sunday, July 15, 2012

Will - 15 Months

Weight - 24 pounds (back to his weight before he got sick)
Height - 31.25 inches

Food:
Will is pretty much off of baby food, except I sometimes give him the Sprout brand of veggies because it is the only way he will eat them. He loves carbs - definitely my kid! He eats pancakes and sandwiches almost every day. He likes chicken nuggets and turkey. He isn't into hot dogs so much anymore.  Bananas are still a favorite fruit, but sometimes he chooses to smush it up and play with it instead of eating it. He seems to only eat one thing off of his plate and refuses the rest. This is new for him because he used to eat anything. And it changes day to day of what his preferred food is. He is very polite and will hand you back the food he chooses not to eat.

Mobility:
He is walking everywhere! When we first got back from the hospital he went back to mostly crawling. After about a week he figured out walking again and now he is non-stop. All over the place! Poor Maggie can't get in a decent nap without Will closing in on her.

Language:
He continues to say "uh-oh".
At the hospital he learned the word "hi" and he says it all day long! He waves the correct direction now. He knows our routines and can figure out which one of us is leaving. When Hope comes in the morning and I grab my bag, he starts waving to me. When JT gets home at night, he waves "bye" to Hope.
Banana is "nananana". He will start yelling this in the grocery store when we walk by them.
"Gie" is every animal, including Maggie.

Toys:
Favorite thing is always Maggie!
He has learned to throw the ball and is getting pretty good at it. Maggie tries to be patient with him, but she eventually gives up and snatches it out of his hand.

We have been to the zoo a few times. He likes watching the monkeys swing, but he does NOT like hearing them yell. There are some clouded leopard cubs there that we like to watch climb trees and play with each other. Of course he calls them "gie". There is a great play area there that I am trying to get him to play more.

I apologize that this isn't a great update, but I feel like we lost an entire month with sickness. Next update will be at 18 months and I promise have to some pics!

Wednesday, July 4, 2012

Happy 4th of July!

We spent the morning with NeeNee and then went to Gram and Gramp's house for dinner. No fireworks this year because of the extreme dryness in the area. Will sure looked cute though!

Tuesday, July 3, 2012

WILLpower (Vandy 6/30 - 7/1)

Saturday:
Another restless night. JT and Will actually ended up sleeping together in the recliner most of the night. I hate that he can't get comfortable!
JT brought Will a pancake for breakfast, and he did pretty good eating it. He had some grilled cheese for lunch and a turkey sandwich for dinner. Eating was hit or miss, but we tried anything we could. MAO came today and Will ate his first ice cream cone - he loved it!
Will LOVED the ice cream cone!
Will really got into playing with his toys and getting back to his usual fun self.
The resident came in and took out Will's drain tube. I was up by his head and didn't really see it, but JT for some reason watched and I don't know how he didn't faint!
Saturday evening Dr. Thomas showed up and was excited to see Will sitting on the couch playing. We talked for a long time about how crazy this past week and half has been. He told us that we were good parents and should always continue to follow our instincts about Will, because no one will ever know him like we do. What if we had given up and just taken him home Sunday? What kind of condition would Will be in now? Scary to even think about! Dr. Thomas thanked us for being so patient and letting them find the problem and fix him. We thanked him for giving us our baby back.
And then the words we have been longing to hear...discharge in the morning! YAY!!!!!!
Will was CRAZY Saturday night! He didn't want to go to bed. He just wanted to laugh and play. I can't blame him, he has been so lethargic for past 2 weeks.


Sunday:
The resident came in around 7:00 for one last check on Will and then she told us she was getting his paperwork ready. Yay! JT started packing like a mad man. I don't know why the hurry, it takes hours to get discharge stuff together. He took a bunch of stuff to the car and I stayed in the room with Will. Will apparently  knew that we were going home and chose to scream at the top of his lungs in his room while pointing at the door. If I walked outside with him into the hall, he calmed down. The nurse came in and said everything was done. He took out Will's last IV and JT walked back in right after.
Goodbye Vandy! Will was wide-eyed the entire walk thru the hospital. When we got to the car he looked shocked. We are going home!

JT and I said that we could get through this because we had WILLpower! Our little boy is brave and tough and he can get through anything!
Our hospital board in the room. JT drew a pic of our family. Then Uncle Jon drew a pic of himself as a cartoon. And "WILLpower" is the most important thing!

Friday, June 29, 2012

Vandy 6/26-6/29

Tuesday:
Will didn't fully wake up until almost the afternoon. He had so much anesthesia Monday that it took him a while to sleep it off. Overnight was pretty uneventful. Fevers continued as expected; they weren't going away immediately. His pain was being controlled with morphine.
Will says, "What in the world happened to me?"
Realizing that we weren't leaving the hospital for a while, JT and I decided to go home and pack some more stuff because we were out of clothes. Gram and Gramps came to sit with him while we were gone. We got home, washed 1 load of clothes that we absolutely needed, took showers, and repacked. I called to check in and Gramps said that Will had vomited a bunch of green stuff. Will has NEVER thrown up. This must have scared him to death. We couldn't leave right away because we we're waiting on clothes to dry. It was so frustrating that the one time we leave together for a long amount of time (and it was only about 2 hours) something bad happens. We finally got back to hospital and Will was looking pretty comfy in Gram's lap. He obviously felt better after getting that stuff out of him. The residents showed up not long after we did. The nurse had paged them when Will got sick. Gram was trying to explain the color and quantity to them, but Will didn't think they were getting the picture, so he chose to demonstrate again for them. It was so much and such a horrible color! The residents said it was a product of an empty stomach (he hadn't eaten in several days), pain meds, and anesthesia. The nurse gave him some nausea medicine and we were just going to watch him. He seemed to feel better again after he was sick. An x-ray was done that night to make sure the was no bowel obstruction (seriously, bowel obstruction even being considered is just a horrible thought).

Wednesday:
Vomiting happened again at midnight and about 7:30 in the morning. The x-ray showed that his intestines were essentially asleep. Congrats Will - you just earned yourself a NG tube! This tube goes through the nose down to the stomach and can be used for suction or to give tube feedings. We were using it for suction in this case. It was recommended that we leave the room for the placement, so we did, and walked far enough away to not hear the screaming. Dr. Thomas said he actually did pretty well with it and he seemed to have instant relief as soon as it was placed.
It wasn't very easy to hold Will at this point. He had so many tubes attached to machines and the wall that it was nearly impossible to get him situated. We stayed like this most of Wednesday morning. 
JT went to the auction this morning and Gram came to stay with me. We just hung out in the recliner all morning taking turns holding him. With the tube in place, he still couldn't eat or drink. Because it had been so long since Will had anything to eat or drink, we began discussing a PICC line with the doctors. This is a more permanent IV that would be a way to give nutrition through the veins since his gut wasn't working. It would involve another sedation. How could we avoid this? Will's intestines had to wake-up, so we were waiting for him to pass gas. So we waited, and waited, and waited. Nothing!
Our good progress for today, no fever in past 24 hours. Yippee!

Thursday:
No fevers overnight. We did another x-ray that showed some improvement in intestines, but not significant enough. We were scheduling PICC line for 1:30. We signed the consent form around 11:00 and then Will and I were chilling out in the recliner. I felt some rumbling and sure enough he had a dirty diaper. Yay! Never in my life did I think I would be excited about a dirty diaper, or be posting about it! The nurse paged Dr. Thomas and he came up to the room as excited as we were. Now the dilemma...get the PICC or assume we are good to go and skip the PICC and possibly wait another couple of days for nutrition for Will if this was just a fluke? Our choice was no PICC unless we absolutely had to. We didn't need it for IV antibiotics because we could go home on oral antibiotics. Dr. Thomas felt like Will could improve on his own so we cancelled the PICC. Fingers crossed that we made the right decision! Will is in control now.
Pops and Nonna finally got here this afternoon. Will had been pretty fussy today. He was really acting hungry but we couldn't feed him yet. He sneezed and his NG tube came out a little bit. The nurse came to tape it back which required us to hold him down. This time Will decided he wasn't going down without a fight. I was on the verge of a breakdown anyway, and I just couldn't hold him down for torture anymore. Luckily sweet Lauren showed up right then and we escaped downstairs to cry, laugh, and just get away for a minute
Dr. Thomas came by this evening and decided to get the tube out so we could try to get him to eat on his own. That all went smoothly (tube was out in just a second). Will ate a few ice chips. Yay! 

Friday: 
Restless night. Will can't seem to get comfortable or maybe he is just starving and having hunger pains. I hate giving him narcotics, but I don't want him to be in pain either, so I usually give in to the pain meds. 
Today's goal is to feed Will! He refused water this morning as always, wouldn't eat jello, but ate one or two ice chips. Then he was done; back to refusal. JT got him a Popsicle and crushed it up. Will ate half of it. Yay, finally progress! 
Pops and Nonna came back by before they headed back to Chattanooga. NeeNee came by and we walked around the hospital for a bit. Will was too tired to pay attention to much so we came back to the room and he went to sleep. Gram and Gramps came by and Will became playful. JT and I left hoping he may eat for them, but no luck. Then a stroke of brilliance (from someone other than me of course), try an actual bottle, not sippy cup. Will hasn't used a bottle in over a month, but he of course couldn't get it fast enough. Can't wait to break him of this habit again! But honestly, I don't care what it takes, I am just glad that we are eating and drinking. He has had some Cheerios and piece of banana too. I think it is safe to say that we are on the mend! Possible discharge Sunday or Monday is all continues to go well!

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!