Wednesday, June 30, 2010
Kanga & Little Roo, part 4
Early Easter morning, Roo's blood was drawn again. I didn't know it yet, but that would become a regular occurrence—getting his blood drawn early so that the residents could get the results and give them to the attending during morning rounds. An hour or so after the blood draw, my hubby wasn't back yet, but the resident was. She did not have good news. Roo's bilirubin was still pretty high, and he would need more time under the lights.
But that wasn't all. He was dehydrated and wasn't gaining weight. She needed to talk the course of treatment over with her attending physician, but they may want to put in a feeding tube.
And that is the moment that I completely lost it. Also the moment that this particular resident forever cemented herself in my mind. With a look of sheer terror on her face, she said, "Don't cry—what can I do to help you stop crying?" It wasn't the words so much as the tone… the tone that said, "Holy crap, they didn't prepare us for this in med school. Why the heck is she crying?" Let me tell you, Sweetheart, it's because my baby is in the hospital, I am filled with post-baby hormones, and you seem about as sure of his treatment options as you do about how to achieve world peace!
I explained to her that I did recognize the fact that this was likely not one of the more serious charts on her plate, but it was my baby and it was all new to me, and my body was still full of hormones, so I couldn't help but cry. The jaundice was enough to make the tears stream down, and the addition of the news that I was starving my child (No, that's not what she said, but that's how I felt!) was just too much.
As if she hadn't already done enough, the resident then felt the need to add, "So………. with a regular newborn… how do you know if they're eating enough?" I was speechless. Actually, "speechless" implies that I didn't know what to say. I knew exactly what I wanted to say—I just felt that saying, "You are walking around here masquerading as a doctor at CHILDREN'S HOSPITAL. What is wrong with you? Why on earth would you ask a sobbing hormonal mother that question???" would not be helpful to the situation at hand. So I stammered through an unsarcastic-as-possible explanation about how you feed them when they are hungry… and then they don't cry as much… and then they grow… and then you know they're eating enough.
She left then. In a hurry.
Fortunately, my husband had arrived by the time she came back. This time she told us that she and her attending wanted to proceed with putting in a feeding tube to be sure that he got the amount of nutrition that he needed. My husband and I couldn't wrap our minds around a tube going down our tiny little boy's throat. Have I mentioned that my hubby likes to ask questions? Lots of them? Well, combine that with the fact that he was in full Papa Bear mode, and he was just about unstoppable. He convinced her to tell us how much Roo should be eating and give us 12 hours to try to feed it to him orally. After all, I had been feeding him until he stopped, but hadn't really pushed him to wake back up and eat, etc. It was worth a shot.
Throughout the day, we were all-out cheerleaders for our little guy as we encouraged and prodded him to eat. And he did it! He ate every last milliliter that I gave him. We were thrilled.
I should mention that I did run home that afternoon for a bit. My husband and mother-in-law came in the morning with the Lamb & Monkey, all dressed up for Easter. My parents—who no longer knew what to do with the whole Easter dinner they had prepared—came in too. Not exactly how we had planned to spend the holiday. But that afternoon, my hubby stayed with the baby so that I could go home for a while. I don't think I really followed his plan, though. I think he had wanted me to grab a shower, take a nap, etc, etc, and come back later that evening… but I just couldn't stay away. I rushed through a quick shower, put on clean clothes, threw together a bag with some clean PJs and clothes for the next day, and went back in. As much as I missed my big kids already, I was still hopeful that we would be coming home the next day, so I wasn't worried at that point about spending time at home.
But nothing was as easy as it seemed during our hospital stay. The attending physician came to see us that evening, and he was still concerned. (He was great, by the way. Both of the attending physicians we had during our stay were wonderful.) He suggested that we put in a feeding tube right away. I could feel the tears welling up in my eyes as I protested that Roo had eaten what the resident had asked, and he explained that the number she had quoted us was just what he needed to survive, but he needed at least 50% more to grow and thrive. "But she never told us that!" I cried miserably. This girl was lucky that I never had to see her again. The attending gave us the new numbers that Roo needed to reach and encouraged us to try feeding it to him orally—but he warned us that as soon as Roo had one feeding that fell short, we needed to put the tube in. He was also insistent that we could spend only 15 minutes feeding the baby each time. After that, he explained, Roo was actually expending more calories than he was taking in.
It only took one feeding. I tearfully called for my nurse and told them he would need a tube. Honestly, the tube itself really wasn't that bad. It was quick to put in and very small. The sad part was what it represented… Another problem. Another issue to keep us at Children's. Another symptom that could point to something bigger. I was scared.
And so a new step was added to our routine… Every three hours I would measure out 35 milliliters of breast milk (That's just a tiny bit more than an ounce.), attempt to feed it to him, then page the nurse to come and give him the rest via the tube, then pump. The schedule was rigid—the nurses would come in and tell me when it was time for him to eat. If he got off schedule because of bloodwork being done (which was now happening several times a day), they would quickly adjust his feedings until he was back to "normal." Throughout the night I would set the alarm on my watch so that I could wake up and get a bottle started before the nurse came in… at least I did at first. I quickly realized that they were quite happy to feed him for me, and I was glad to get a little extra sleep.
On Monday morning he was still taking only half of his feedings by mouth, and I knew we weren't headed home any time soon. But I didn't know that there were more hits coming.