Wednesday, October 22, 2014

Hospitals: a love hate relationship

     I do love hospitals in some weird way, I mean, I do work at one. Hospitals are typically full of extreme ups and extreme downs--we were fortunate to experience that tiny gray area in the middle--mostly. Some have been asking about Madison's recent visit to the hospital so I thought I'd just start from the beginning. (It's a long read but I like to print my blog when related to Madie and put it in her baby book :-))
     On a Tuesday morning Madison woke up with a 102 fever--odd for a morning. Typically fevers are highest in the evenings so I knew something was up. She had zero other symptoms like runny nose, cough, ear tugging. Motrin and Tylenol seemed to have little effect on the fever which was odd for her.
     After several days and one trip to the doctor to be sure this wasn't an ear infection she woke up Saturday morning . . .  never, never, never ignore your mother/nurse gut feelings! Something was wrong. She would hardly put any weight on her left leg and at one point wouldn't even get off the ground from a sitting position. We had the Lord's mercy this entire weekend starting with the fact that her pediatrician was the one on call this day. We took her in around 12:45 p.m. to be seen again. After watching her limp around and testing range of motion on her hip, she decided this was not normal and required blood work and x-rays to check for infection. We headed to the hospital to be directly admitted to the pedi floor for tests. Dr. Daniel Gebhart was truly an answer to prayers for God's provision for an intelligent, well spoken physician to take care of my daughter.
     We spent the next several hours being admitted and then starting an IV. On the 3rd try (YUCK) the IV was in and blood was sent--after having to poke again because "we didn't get enough blood". Hello, I watched them do it and they got enough--a.k.a. the lab lost it or something happened once it left my sight. Perks of being an ER nurse. X-rays were done shortly thereafter which looked normal.
(excuse the baby tear stains on my shirt)

   Okay, so option A is the best option (toxic synovitis) indicating a viral infection of the joint. Somehow a bug makes it's way to the joint and camps out causing pain and swelling only lasting a week or so which then usually clears up on its own. Option B is much more serious (septic arthritis) in which there is a bacteria causing infection of the joint and blood stream. We were told that option B won us a trip to Lubbock where there are pediatric orthopedists--something Midland doesn't have--and requires a long course of IV antibiotics and can potentially cause permanent joint damage. Go option A! Go option A!
    Blood work came back: all 3 important tests (WBC's, CRP and ESR, for my nurse friends) were out of the normal limits for option A--crap. Next step is a biopsy of the hip joint. At this point were beginning to get physically, mentally and emotionally exhausted--and it was about 8:30 p.m.--with no nap. So after wiring her up with all the monitors we were wheeled to the procedure room where they would perform an ultra-sound guided synovial biopsy while she was moderately sedated.
     The lowest point of this whole ordeal was being stuck in a stupid room away from the procedure not knowing how anything was going--not the norm for me! 8,928,857 thoughts run through your mind while you pace the dumb room waiting. After 20 minutes, which felt like 3 hours, the radiologist came out of the room with a bad look on his face and shook his head. Normal joint fluid should be clear, hers was cloudy indicating puss/infection. My mind: "Okay Lord! Let's get ready to get ourselves to Lubbock. Let's see, we have family there but we'll still have to pack. Will they ambulance her or fly her?".
     After waiting for her to wake up from sedation--hilarious--we got GREAT news from the amazing Dr. Gebhart: even though it looked like puss, the white blood cell count from the joint fluid was low enough to be considered toxic synovitis, not septic arthritis! Praise God. They also didn't see any bacteria in the fluid. Unfortunately, because of the abnormal blood work the doc thought it best to start some IV antibiotics just in case.
     Now it's about 12:45 a.m. After finishing one dose of IV antibiotics and working on another one Madie said "momma, my arm hurts". At this point she had been demanding to have her arms safely tucked into her blanket because "If they can't see my arms they can't poke me again!" Poor worn out, tortured, yet intelligent child. So I dig her arm out of the blanket and turn the light on to see her nearly two year old arm and big as mine! The IV infiltrated/pulled out. NO! All the medicine and fluids beginning at who knows when were just hanging out in the tissues. Of course the first thing that crossed my mind was "great, we get to start another IV!"
 Don't let those arms get out!

     5 unsuccessful IV attempts later I finally said STOP! I am not an ER nurse for nothing! I made one phone call down stairs to my amazing group of ER night shift nurses and asked to talk to the great and wonderful Jose who came upstairs and started the IV on the FIRST TRY. Have I mentioned that ER nurses are amazing?
     The pedi nurse restarted the antibiotic that was running when we noticed the infiltration and we attempted to settle in for the night--because now it's 2:30 a.m. A few minutes later, Madie, after demanding both Tim and I lay in the bed with her (just do what she says and maybe she'll sleep--totally didn't know this was a God plan) said "mommy my head itchy. Itch it momma." So I itched it. Of course I'm thinking this is just soothing to her--all lights were off in an attempt to get her to sleep. But then, I notice her eye in the dim light and said "Tim, it looks like her eye has a bag under it?" I knew we had been up a while but not that long. Then she licked her lips several times. ER nurse brain flew into high gear and I nearly flew to the light switch and turned it on. My beautiful baby girl was a PUFF BALL. Her eyes, lips and face were so swollen that she was looking at me through slits, and her heart rate was 171 bpm. I immediately turn off the IV pump and yell for the nurse. Textbook anaphylactic allergic reaction. No more Vancomycin for Madison Hird!
     After IV benadryl she finally fell asleep at 3:15 a.m. Of course I didn't sleep a wink while constantly checking the monitor for her heart rate and pulse ox.
8 hours post-allergic reaction and 2 doses of benadryl. Also note the still-puffy left arm from the infiltration--looks like Popeye!

     The next few days passed in a blur while waiting for blood cultures to be negative receive a few more doses antibiotics to treat the bug.

We were all worn and insanely excited to get home Tuesday evening with a clear report and no more limping!
     How did we make it through? Jesus. He sustains. I will never know how people walk through trials greater than that and have no hope because they don't know our Father. I don't have words for how many times it was 100% evident that God had intervened and was working His perfect plan for us while going through this.
     Hope I didn't bore you! It was an exciting time! Ha.


Friday, January 3, 2014

Growing up with a Doberman

I often get odd looks when I'm out walking with a stroller and a dog who's head is as tall as the stroller. I'm sure we do look like a circus sometimes when the dog hits the brakes to sniff the weed I didn't see. I won't even begin to paint the picture of what it's like to take the dog to the vet . . . by myself . . . with the baby . . . Deciding to bring a baby into the world with a Doberman never crossed my mind until my mom told me my grandmother was concerned about the the combo. He did weigh 90 more pounds than her when we brought her home. You're concerned about that?!
So here I am ready to show you how bad life really is with a Doberman and a baby. They fight often. The Doberman is SO aggressive. This may not be suitable for your children to watch.

Don't listen to prejudiced ideas about this breed. He is one of a kind and more than family to us.