If Little Red hadn’t come down for a glass of water at 11pm, we wouldn’t have known until morning that Boy Blue had thrown up. We’re pretty sure it was the vomiting that woke up the older brother, but he was too tired to know what woke him.
As we’ve already learned with our little guy, once the vomiting starts, it won’t stop for three or four days. This was no different.
Thursday was a very wet day. I left a message with our pediatrician asking if there was another virus going around or should I come in to test for a food intolerance? A nurse called me by noon and set me up with an appointment for first thing on Friday morning. I watched my lethargic boy doze on the couch between bouts of vomiting, and counted his ribs to pass the long afternoon. I thought if I watched him long enough my mind would suddenly discern what it is inside of him that causes these episodes. I knew it was more than just a virus. That night I went online and did some research.
Friday morning Little Red stayed home with Paul and I loaded Boy Blue and his Daytime Brother into the stroller for the 8:30 appointment. We were there to check in at 8:15, and everything seemed normal. I explained to our pediatrician the history of this being what I thought to be the sixth episode, without a regular timetable between episodes, but the episodes themselves had a very predictable pattern.
I told her that although we don’t know anyone who is sick, we do play at the park a lot and I was hoping she’d say there is a virus going around and to just hang in there. She said she wasn’t convinced that was the case, as she hadn’t been seeing a higher than normal number of cases.
I explained that my second thought was that he had developped a food intolerance. We hadn’t added anything new to the diet, so I was pretty sure he didn’t have a full-blown allergy, but as food allergies and intolerances are in my husband’s side of the family, maybe something like that was going on. She said she’d run a food panel in our blood work.
I prefaced my third idea by saying, “Now, you know I’m not a hypochondriac, but do you think it could be Cyclic Vomiting Syndrome?” It was an outside shot, but when I did my research I could see it had merit. She agreed with me that it was an outside shot, especially as she’d never had any abdominal migraine patients so young (early research suggests a link between cyclic vomiting and migraines.)
She was concerned that he had lost weight again, and was back down to 22 pounds and 7 ounces, although he grew another inch and a half since the end of March and is 34.5 inches tall. His weight used to hover around the 40th percentile mark, and has now fallen off the charts. She sent us downstairs to the lab for bloodwork, including a food panel, and also for an x-ray (in case the vomitting was caused by some sort of blockage or malformation on the inside.) She apologized to Daytime Brother that he would have to wait longer before we left the medical office buildings, and presented us with a handful of stickers and a couple of lollipops. (I thought when you took the Hyppocratic Oath there was something in there about not giving candy to babies? I was surprised, but grateful, and felt incredibly strange when later I was saying, “here, Aiden, would you like a candy?”)
The line for the lab was long, it being Friday and in the middle of the morning, but Boy Blue dozed and Daytime Brother was content to be pushed in the stroller and play with stickers. (and flirt with anyone who’d make eye contact.) Boy Blue gave me the “you’ve got to be kidding” look when I asked him if he’d pee in a cup, puked on the shoes of one of the lab assistants, but didn’t cry at all when we took seven (or nine?) vials of blood from him for all our tests. He was likewise pathetically docile during the x-ray, a stark contrast to when we x-rayed his leg during his failed attempt to break his ankle.
The x-ray was clear, and the food panel didn’t flag anything, although some of those tests have still not come back, but Boy Blue’s electrolytes were very low so the doctor hooked the little guy up to an IV for an hour while I nursed him (the only food he would take, and the most likely food to stay down.) It was lunchtime and I hadn’t planned to be there that long. Our pediatrician found a fruit bar in her drawer for Daytime Brother, and the nurses asked if they could take him while I held my sick baby. Dr. Waldron offered to pick me up some lunch as she zipped out, and although I declined, she brought me a smoothie anyway.
After an hour of fluids we did another blood draw (this time he did cry a little) and his CO2 levels, which had been abnormally low at 15 had dropped to 11. This kind of acidosis doesn’t make sense in someone who had been vomiting acid (if you expell acid shouldn’t you have less and not more?) Also, although he was clearly sick, he did not appear to be sick enough for such acute acidosis — an adult with a CO2 level of 11 would have needed several monitors and would have been pretty close to catatonic!) A red flag went up in Dr. Waldron who immediately tried to figure out why his kidneys were not holding on to what they needed to. It was then that she said she needed to admit Boy Blue to the hospital. The fluids he needed were not available at the clinic and he needed to be checked out by a nephrologist. I called Paul to pick up Daytime Brother (who had been on his absolute best behaviour all day and he had been there for over seven hours!!!) and pack my toothbrush, and we put the little guy on some more fluids while we waited for all the dominos to be put in place.
Because Boy Blue had an IV in the inside of his elbow (not an ideal place, but the veins on his hands were not cooperating) they called transport instead of allowing me to drive him to the hospital. When the paramedics showed up with the guerney (and our sweet pediatrician retrieved the carseat from her own car so we wouldn’t have to wait for the next ambulance, she repeated several times “this isn’t something I’d do for just anyone…” to the incredulous paramedics) Boy Blue lost it. He knew we weren’t going home. The guerney was scary. The men were strangers. Everything was unknown. We left the medical office building 8 hours after we had entered.
He was too sick to realize the coolness of being in an ambulance (albeit buckled into a car seat strapped to a guerney, and vomiting again before he went to sleep.) He was scared. He wanted me to unbuckle him and hold him. He wanted to go home. He cried half the way there. But he did settle down, and the paramedic that sat in the back with us kept me in conversation, which helped me stay on top of things.
(Funny note: as we crawled along Los Feliz Blvd -during rush hour on a Friday!- a woman walked up to the ambulance and asked the driver if he could pick up the man two car-lengths ahead who had just been in an accident on his motorcycle. He politely explained that he already had a patient in transport and that she needed to call 9-1-1. When we passed he remarked to us that he had seen that motorcyclist speed past us on the right only a couple of minutes ago and he thought, “that guy is going to get into an accident.”)
Boy Blue awoke as we were getting him out of the ambulance at the hospital, and started crying again. It was a very scary thing, and to further the insult I could still only walk beside him and not hold him. Another paramedic who watched us disembark asked the driver if he knew the lights were on. Some day, when Boy Blue is older, he will love to hear the story of how he went to the hospital in an ambulance with the lights flashing.
The Kaiser hospital on Sunset has been completely re-built since the little guy was born and his room in pediatrics, as it was in a corner, was especially palatial. The crib was a hospital crib, which terrified him, but as long as the nurses weren’t checking him out or attaching him to things I held him in the chair which helped a lot. We settled in for what we hoped to be an overnight stay wherein we found some answers and solutions quickly. We met several nurses and not only the resident doctors but also the attending physician (for whom Boy Blue displayed his vomiting prowess.)
After Paul dropped off Little Red for his pajama party (it was date night) he brought me some fast food. His brother soon joined us and the two of them gave Boy Blue a blessing. Paul was very nervous about the uncertainty of things, but I felt very comforted. Having had a blessing and being admitted to the hospital, I knew that the little guy was in the best hands of both Heaven and Earth. He was even calm enough that by the time Paul left and we settled in for bed that he slept in the crib with me on the pull-out beside him.
Thus endeth Friday.