The Thick Of It

On Thursday night, somewhere around 8 pm, Satch complained of abdominal pain, then vomited. He continued to vomit every 30-40 min...all night long. I asked Robert, who goes to bed later than I, to sit with Satch until he's ready to go to bed so that I could get a couple hours of sleep. At around 5 am we decide to take him to the ER for fear of him becoming dehydrated. They started an IV and took labs. The labs showed dehydration, of course, and a slightly elevated WBC. All preliminary cultures were reported out normal i.e. strep, flu etc. They inserted a catheter to collect urine which, as you can imagine, was very traumatic. The doc palpated his abdomen (extremely hard in my opinion) and stated concern for appendicitis. He insisted that we get an abdominal x-ray which showed nothing except moderate stool and some sediment in the bladder. He insisted on an abdominal u/s which showed mild inflammation in the area, an enlarged bladder w/ sediment (I don't think it occurred to them that my son was now afraid to pee after getting a catheter inserted for a urine sample so he was holding all fluid being pumped into him). Then the doc insisted on a ct scan and said, verbatim SEVERAL times, "sometimes you can be totally fine with appendicitis and sometimes you can be on your death bed"...so not only did this scare us into going forward with the scan, but it scared Satch too. Satch began asking questions about death and dying, having already experienced the death of our elderly cat. I knew that he was trying to process what the doctor so carelessly said. The u/s came back inconclusive, not showing anything suggestive of appendicitis. They then concluded that the moderate stool was pushing on the bladder and blocking flow of urine and thus causing vomiting.

I'm not a doctor, but I knew this was unlikely because it wasn't as if he had gone for days without evacuating. My feeling was that he had some sort of nasty virus. They wouldn't discharge us until satch voided urine. I wouldn't let them catheterize him again. They wanted give him an enema and I refused saying, "Satch has already been through a lot of very traumatic and inconclusive procedures...we will give him miralax when his stomach settles". SO, we sat his bum in a bucket of warm water. He urinated. We were discharged. As we were being discharged there was another mindless remark on the part of a well meaning nurse. She said, "He's such a good patient, he doesn't even cry". This was oddly confusing for Satch because he did cry when he was being hurt, and I feel that he is entitled to his feelings. I replied, "Satch cries when he needs to and it is good to cry when you need to and Satch is indeed a very good patient". Then two nurses agreed in unison. I didn't want that statement to imprint anything on my son. I didn't want him to think that if he cried, he wasn't "good".

We arrived home at 3pm after spending 10 hours in the ER. Once home again, Satch vomited 2 more times. I tended to him all night, only allowing him sips of water every 2 hrs to be certain he kept it down. He didn't vomit again. Saturday I gave him dry toast, apple juice, some noodles cooked in veg stock and he did fine. However, he began complaining of a sore throat and a cough and periodic abdominal pain. I checked his throat and did not detect a strep odor or any white gunk, but his tonsils looked very enlarged. He developed a low grade fever which I did not treat with hope that it would kill the virus. He had no energy and slept on and off for most of the day. I sat beside him the entire time.

On Sunday, although the vomiting had ceased, he was clearly getting worse. He had no appetite, just a bit of light grazing. He was sleeping a lot and his fever went up to 102+ so I gave him some Tylenol. He also confessed that he was now afraid to urinate and said, "the tube hurted me" and he added that he did not like the potty. That night he woke frequently to sip water and began complaining about his throat.

In a fog of fatigue, my mind wandered to melt down that he had last week in which he, completely out of the blue, began crying. He told me that he was feeling sad because when he goes to school he will miss me. I told him that school was still a long way off and that he didn't have to go to school until he wanted to. I was suddenly overcome by guilt because we had started a very casual potty training routine with Satch after he expressed interest in going to school. We explained to him that schools want the children to potty trained and that when he was no longer using diapers, he could go to school. So, we used that as a way to encourage him to give up his diapers and he seemed to be on track. Now after the melt down conversation, I wonder if he's been afraid to void because he was harboring fears of separation.

Yesterday Satch appeared to get worse still so I called our family doc at 8:30 AM and arranged an appointment for 11. I told them the entire story and asked them to get the hospital records faxed over so that we weren't wasting the doctor's time. When the doctor examined Satch, we discovered that his staff had not called for the records. The doctor took another culture and although I was unable to see it myself, he was certain that he had a faintly positive strep test. He decided to give Satch Augmentin. Since that antibiotic is very harsh on the stomach and it was gastro symptoms that landed us in the ER, I asked if a different medication could be prescribed. The doctor stated that there is also a chance that Satch may have a urinary tract infection due to the sediment seen in the scan, but there was no way to be sure since he didn't have all the results from the hospital. We decided that since the Augmentin would knock out both strep and the possible UTI, that it was the way to go. This is the first time he's ever been on antibiotics. As we left the doctor's office, the receptionist casually asked me to get the hospital records. I said, "when I called the office at 830 this morning, I requested that your staff acquire the records so that they would be here for this visit. I was told it would be done and it was not. Therefore, the doctor didn't have all the information he needed for this examination. I will sign a release form for you if you need one, but I am requesting that you get the records".

When Robert got home, he made us dinner because I was exhausted. Satch was still not eating more than a few bites of toast and crackers. Right now, I'm not worried about nutrition, I just want him to get some calories. Robert asked if I wanted him to come home early today to help, but I told him not to. I felt that leaving early would only require him to make up the time...time that could be better spent when Satch is well and wanting to play. I asked him if he could, once again, do part of the night watch, so I could sleep for a few hours.

While I was sleeping, Satchel's fever went up again and Robert medicated him. After the fever broke in a sweat, he carried Satch up to bed. In my confused state of fatigue, I awoke startled when I heard Satch coughing, and because he wasn't next to me I called out urgently, "where are you...where are you". "I'm here, mama", he said in a froggy tone. And I was able to gather my wits and remember that he had been sleeping on the sofa next to Robert and was now coming back to bed.

This morning, there is no fever yet. He is still quite miserable and crying and coughing and arguing about taking the medication. We are hoping that we have an accurate diagnosis and that the medication does the trick.