Thursday, January 25, 2007

Yet another two steps back

Not feeling so hot

Eli was having such a great last week; gaining weight like a champ, smiling up a storm and just being an adorable, content little guy. Eli was up to 7 lbs 5 oz last Saturday and then the fever hit.
I don't think I realized how sick Eli was getting until Monday morning. Sunday he was acting lethargic, but I assumed it was because he had a busy day visiting his Uncle on Saturday. Eli fell asleep on my bed while I was making dinner on Sunday, so I just let him sleep. Well, he didn't wake-up. I went to check on him 2 hours later and he was so hot. I took his temp on the stupid Celsius thermometer and it was 40 C. I couldn't do the conversion in my head (I later learned he had a temp of 104), but I figured he was warm b/c we have the space heater kicking out 85 degrees of heat, he was in a fleece blanket sleeper and swaddled in a fleece blanket. I unwrapped him, changed his diaper, and Eli fell back asleep w/ his little legs still sticking out of his sleeper. I assumed he would wake up soon & be pissed off that he wasn't swaddled. Well, he slept on my bed for another hour and a half until I woke him again. Eli's temp had dropped to 39 C w/o his eskimo dressings, so I knew he had a true fever. I gave him some Tylenol and he fell asleep in his swing and didn't wake up once during the night.
I woke Eli as soon as I woke up Monday morning and realized he had actually slept through the night. He still felt warm and didn't really wake up even when I undressed him. I could tell just by looking at him that something was very wrong. I went to weigh Eli and found that he had dropped 10 oz overnight! Eli was back to 6 lbs 11 oz and looking very, very frail. So, I packed up my sick little guy and headed back to the dreaded ER at Children's.
When we got to the ER at 1 pm I couldn't believe how crazy things were. There wasn't a spot to sit in the waiting room, there must have been over 30+ coughing, sneezing, and puking kids waiting. I begged the triage nurse to let us back into an ER room and luckily there was a room that they normally don't use for patients, but the nurse said it would be ok to let Eli wait there.
I told the triage nurse that Eli needed IV fluids ASAP and she said someone would be in shortly. So, we waited, and waited, and waited. 3 hours later I finally got to see a nurse. They hooked Eli up to an IV (not fun on a very dehydrated baby), but this time it only took two attempts. They also drew some labs and told us to wait until the labs came back to determine a game plan.
Another hour and a 1/2 later we finally saw a doctor for the first time. Eli's labs showed that he was dehydrated again. His BUN (measure of hydration) was up to 33 (last Sun when we were in the ER for dehydration it was 25). The good news was that his CBC (WBC count- indicator of an infection) and electrolytes were normal. The ER doctor wanted to admit Eli, but I really didn't think it was in his best interest to be around a ton of sick kids if he wasn't in fact sick. The doc said that she would give Eli two more hours of IV fluid and re-check his BUN. Well, 2 1/2 hours later the lab guy comes, takes three pokes to get his labs and we sit and wait again.
By this time we had been in the ER for 8 hours, long enough for the ER doctors to change shifts. The new ER doc came back and said that his BUN had only dropped to 31 and they wanted to admit him. I asked for them to call his ped or GI doc, hoping they would let us just go home. Well, 10-min later the new ER doc came back and said we were ok to go. I didn't hesitate to take our "get out of jail free" card. We made it out of the ER relatively quickly (45-min) and the only drama was the stupid d/c nurse hastily ripping out Eli's IV taking a good chunk of hair and eyebrow with it.
Eli and I made it home by 9 pm (we left for the ER at 11 am). Eli's temp had gone away and he was very happy to be home in his swing. I thought all was well until I got a panicked phone call at 7 am Tuesday morning. The original ER doc that saw us called and said I needed to bring Eli back into the ER right away. I called the ER and spoke w/ her and she demanded to know why we just left. Uhm, hello, Eli's ped gave us the ok to go home. Apparently one of his blood cultures showed had growth overnight and she wanted to have Eli admitted. I asked if we could just go the clinic to get a script for some antibiotics and she said "I don't think you understand, you have one sick little boy." I am of course in a huge panic now, so I asked if I would just go into the hospital and bring Eli through admitting. No, the ER doc said he had to be admitted through the ER. I asked how long it would be before we got up to the floor, and the ER doc said she couldn't tell me a time but they were very busy.
Well, it was going to be a cold day in you know where before I took Eli back into the ER for 8 hours around several dozen kids w/ flu, RSV, you name the bug. So, I called his ped's office instead. I got a hold of his ped and she agreed that it wasn't in Eli's best interest to be in the hospital if he didn't need to be. By the way the ER doc made it sound was that Eli definitely needed to be in the hospital for several days for IV antibiotics, but his ped said she was ok w/ him coming into clinic for them. So, his ped said she would call the ER doc back and tell her we weren't coming and I packed up Eli to bring him to the clinic.
Eli had repeat blood cultures done at the clinic and he got a shot of antibiotics. He wasn't a happy camper about either, but at least we didn't have to spend days in the hospital. Eli had gained weight since being in the ER, so it was a good sign that he hadn't depleted all the IV fluids he had just got. His fever was down and other then being cranky from everyone bugging him, Eli looked fairly good. His ped felt he was healthy enough to go home and gave me her direct line in case something changed.
It was quite funny actually talking to his ped about the ER doc. I definitely got the sense that she did not like the ER doc at all. Eli's ped said she was very upset that we weren't taking his "medical condition" seriously. Uhm, he has short bowel, he poops, alot. We already know those things. Eli's GI doc called his ped back Tues morning and said, a BUN of 31, heck that's great for Eli! The ER doc made it sound like he was turning into a baby prune or something. Well, Eli's ped and I agreed that we would not be bringing Eli through the ER at Children's anytime soon. The best thing about going into his ped vs. the ER is we got a plan worked out for when Eli get dehydrated. His ped gave me her direct line and pager and told me to call an hour before we go to Children's. She said either her or a partner would meet us in the ER, so Eli doesn't have to be seen by any doctors that don't know him. Hopefully this should decrease all the drama of medical prof. freaking out b/c he's a little guy who just poops a lot.
Tuesday and Wednesday were really no fun w/ Eli being super cranky. I got a good call back on Wednesday afternoon and his ped said the lab draw at Children's was a contaminate and Eli was not in fact septic. His draw at Children's grew Steptococcus, but his lab draw Tues at the clinic was negative (before any antibiotics). So, someone at Children's lab messed up and didn't get a clean draw. Just makes me even more glad that I followed my gut instinct and didn't haul my fragile little guy into the hospital again.
It hasn't been much fun the past few days taking care of crabby Eli. He is in a lot of pain from whatever bug he was and he isn't shy about letting me know it. The ped gave us the ok to add Motrin every 6 hours in addition to Tylenol every 4 hrs. It helped a little, but Eli still screams in dire pain every 1-1.5 hrs. It's as if he knows I have his drugs and just won't give them to him. Hmm, wonder where he got that from (for those family members that remember me after my c/s with Eli). I am going to bring Eli in to the ped on Friday for another follow-up, and if he is still inconsolable, his ped said she would prescribe some prescription pain meds to help make Eli a little happier and more comfortable.
A very long drawn out story to describe Eli's terrible, horrible, no good, very bad week, AGAIN. I really hope that Eli is starting to turn the corner on this latest illness. His weight today was much better, 3260 grams (7 lbs 3 oz). He still hasn't truly gained any weight since the middle of December, but my poor little guy keeps getting sick :(
Please pray that Elijah can get healthy and get back to growing more baby. Also, pray his pain can be managed, Eli can maintain his fluid levels, and he can stay out of the ER/hospital.
Keeping busy

Can't a little guy ever get a break?

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