Sunday, May 12, 2013

Intussusception

Alarik had quite the day last Tuesday.  And on into Wednesday I guess.  After visiting three hospitals in the span of 6 hours, and having an x-ray, an ultrasound, two sets of blood work and lots of monitoring, the doctors' best guess is that he had an intussusception that corrected itself.

It all started just before 3pm when Steph called from daycare and said Alarik very suddenly started holding his belly and screaming.  I brought him to the clinic where Dr. Korstad  ordered lab and x-ray which supported her suspicion that it was intussusception, though couldn't prove it beyond a doubt.  She got everything set up for us to go to the ER at Grand Itasca where a pediatrician and radiologist would meet us to do an ultrasound that would be able to see for sure if there was any "telescoping" in his intestines.  If there was, they could do a special type of enema that would hopefully correct it.  Otherwise, we'd need to go on to Duluth for surgery.  We were on the road to Grand Itasca within 45 minutes of Steph calling me to say something was wrong.  This small fact is important because, as you will soon see, the first 45 minutes of this ordeal was infinitely more productive than then next, extremely frustrating 7 1/2 hours!

Alarik threw up several times on the ride to Grand Itasca and his pain seemed to stop, though he was still very pale and wiped out.  After stripping off his dirty clothes and cleaning him up as best we could, we went into the ER and did not find things as Dr. Korstad has said they would be.  The pediatrician was not there.  After waiting for 10 minutes before anyone had time to check us in, and after having to ASK for a blanket for my cold, nearly naked, pale and sick son, we were told the radiologist was staying for us until 6pm. Then we got put in an ER bay and no one so much as looked our direction for 45 minutes!  Oh, except for Ty Hubbard who had seen Alarik's name on the ticker in the lab so he came to see what was up.  Finally a doctor came and said there had been some confusion and they were trying to get a hold of the pediatrician to come back in.  Apparently Dr. Korstad had called the ER to see if we made it and if things were going well with Alarik and she chewed some major butt when she found out nothing had been done yet.  The pediatrician eventually came back and met with us but by then the radiologist had left and they couldn't get a hold of them to come back.  Why would they leave when they KNEW there was someone in the ER waiting for an ultrasound???  Since it was just a rad tech left on call who had never done an ultrasound to look for intussusception before and also wouldn't be able to perform the enema, the pediatrician decided we better go on to Duluth where they could figure out if it was that or not.  She apologized for being an unnecessary delay on our route to Duluth.  I should think she should!  It's a good thing that Alarik was not in the same sort of pain he had been in Bigfork by that time or I'm certain Jesse or I would have strangled someone.  In fact, he looked so much like his old self by this time that we wondered why we needed to bother going to Duluth at all.  Turns out the pediatrician's son had intussusception when he was 3 and it presented the same way with intense pain at first, then appearing to go away.  She was sent home with him where he had a re-occurrence.  Whether because of that personal experience or her professional knowledge, she was pretty adamant that we figure out what had caused his pain in the first place.  She called ahead to St. Mary's in Duluth to tell them we were coming and why and to arrange for a direct admit to the pediatric floor.  That's another important fact to note because, while we had just wasted two hours (and who knows how much money) by stopping at the Grand Itasca ER, where miscommunication and disorganization abound, we were about to find out what REAL disorganization was all about.

As we pulled out of the parking lot and headed for Duluth, Dr. Korstad called and assured us that it was the right decision to go on and finish figuring out what was going on with Alarik.  He was still comfortable even if he was wrapped in a stolen ER blanket, riding in a puked on car seat that had been cleaned only so well with baby wipes.

Things at St. Mary's started out pretty good.  We were registered at the ER entrance with lightning quick speed and given perfect directions up to the pediatric floor.  Once up there, a total of three nurses participated in admitting Alarik.  And then we sat in his tiny hospital room for *****drum roll please ***** ONE HOUR AND FORTY FIVE MINUTES before the doctor came to talk to us.  Wow.  I expressed my frustration and was assured that progress would be made.  Some excuses were offered about how another peds had been admitted that also needed an ultrasound.  We just waited and waited and waited some more.  Dr. Erika was in Sandstone for the weekend but Dr. Thomas was scheduled to work in the ER at 10pm and he was nice enough to come in early and bring clean pajamas and clothes for Alarik.

Someone finally arrived to take us to radiology.  It was midnight.  You would never have known that it was five hours past his bedtime, Alarik was such a little trooper.  It was a "transport" employee that came to bring us down for the ultrasound.  He was almost as irritated as we were when told that Alarik's paperwork wasn't ready yet.  As if knowing since 7pm that we were on our way there for an ultrasound was not sufficient time to prepare the necessary paperwork.  Once the paperwork was in hand, the transport guy insisted that I sit in a wheelchair holding Alarik for the journey down three floors.  As we exited the peds unit, a nurse suddenly hollered for us to stop but, too late, Alarik's HUGS band that prevented someone from stealing him for the hospital hadn't been disabled by the nurse when she handed over his ultrasound paperwork and we triggered the alarm.  The transport guy seemed annoyed but acted as if this sort of thing was par for the course around there.  We were beginning to feel the same way.

The ultrasound itself went quick and smooth and the tech was super nice.  He said he was pretty sure there was no intussusception present.  But of course the official word had to come in the morning when the radiologist could read it.  We were told to wait for the transport people to come take us back up to Alarik's room.  We waited for 10 minutes and then made our own way back.  Then Jesse asked about his lab work which I had forgotten the pediatrician said would be done before the ultrasound.  A nurse looked into it and said the work had been ordered for morning which was a mistake but lab would be up soon.  Someone came from lab and was drawing blood for the test.  Before he was finished, someone else from lab came around the corner into the room, saw his colleague was already there, turned on his heel and left.  Jesse just started to laugh at that point and I was glad for it.  I didn't have the energy left to deal with Alarik plus bail Jesse out of jail for assaulting a healthcare worker!

We would have liked to take Alarik home and put him to sleep in his own bed at that point but the pediatrician insisted we stay and I'm sure she thought we were quite the parents, impatient and just wanted to take our kid out of there, but we didn't think too much of what had gone on so far so the feeling was mutual if it was there.  Alarik fell asleep in the kid-sized hospital bed with me rubbing his back as the doctor listed off all the other things that could have caused his sudden and severe pain, and then gave the reason why it wasn't those things.  Still without an official diagnosis, we were left alone and assured that we would be taken off the rounds list for the rest of the night so we could all try to sleep uninterrupted.  Good sleep is impossible in a hospital anyway, with streetlights and hall lights and noise and an uncomfortable bed.  Plus this uncomfortable bed was kid-sized and had a tossing and turning toddler in it.  I got to share that with Alarik and I made out better than Jesse who got the good old fashioned flip out "dad recliner".  Poor guy.

I actually slept pretty good, all things considered, and we all woke up at 6:30.  We let the nurses know Alarik was up and they did a quick check of him.  Our irritation of the night before must have helped us get an early discharge because the pediatrician had gone to get the radiology report and we were let go before they even did morning rounds.  Score one for St. Mary's. 
The nurse that discharged us wheeled Alarik out in a red wagon which I thought was pretty cool.

 We were home by noon on Wednesday and I gave Alarik a bath first thing.  After he was fresh and clean and moisturized, I snuggled him up in clean pajamas and put him down for a nap.  I tore apart the icky car seat and threw its cover in the wash along with the puked-on clothes, then lay down for a little catnap myself.  Alarik napped for over 4 hours.  He has been right back to his normal old self ever since then and we're keeping our fingers crossed that he stays that way.

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