Wednesday, October 8, 2008

Hospital Hound

We're in the hospital because The Boy had a fever last night that showed up gradually over the course of the day. Musical Daddy is glad that I'm able to tell by touch whether The Boy "feels warm" or not. I wasn't able to do that before. And some of the little pediatric hospital gowns have a picture of "Hospital Hound" on them, which is immensely cute.

During the day it was a high temperature but still within the normal range, sort of, in the afternoon it was a little higher, dinnertime it was about 99.1 axillary which, adding a degree because the axillary temperature (underarm) is a degree lower than what the temp would be with the thermometer inserted elsewhere, is about 100.1, and then after 8:00 it was 100.3 axillary.

I didn't rush, necessarily, although I started packing stuff as soon as I had put in the call to the treatment center. I figured that we may as well pack up our stuff right then rather than make a second trip (which Musical Daddy ended up doing anyway, as he left his chorus rehearsal before we had even left the house).

I may have seen this coming although it did seem pretty sudden. One sign: The Boy did a LOT of sleeping today. I wrote that off because he had also had a CT scan done under anesthesia, and I remember the last time Musical Daddy had had surgery he was groggy and sleeping extra for days, so I have that in the back of my mind every time The Boy needs to be sedated (which seems to be pretty often, unfortunately, and will be so until he is old enough to lie still for CT Scans).

He didn't eat much yesterday, although I guess I attributed that to a combination of anesthesia and a holdover from last week's illness. That said, he did seem fine on Monday, as I mentioned.

After I placed the call and started packing up, I knew that something was wrong. I put The Boy on our bed to hang out and he was just...lying there. He wasn't asleep. He seemed tired, which would cause him to be less active, but he was just so complacent. That's the word for it, and it's an odd mannerism coming from this child who is SO opinionated. He didn't complain about the fact that I'd walk in and out of the room or that I didn't stop to play with him. He didn't get up and crawl around on the bed. He didn't even play with the TiVo remote that I had left on the bed. He just lay there for a good 20 minutes doing nothing.

I got a major headache last night and I was kicking myself for not just taking a Tylenol before we left the house. Fortunately I did get some Tylenol and it made me feel better, allowing me to get some sleep. A nice...4 hours or so. Now I'm awake and, fortunately, the headache is gone for now. I'm speculating that it was something I ate. Didn't particularly want to cook anything elaborate because I didn't want to overfill the fridge, so I made rice noodles for The Boy and me and ate some gefilte fish to get some protein. The Boy had leftovers from lunch that he didn't eat--a chicken and veggie dish that I had made en masse on Sunday night.

I'll echo Musical Daddy's sentiment--anyone want to bring us some dinner? It's Yom Kippur starting tonight and I'd love a good pre-fast meal (even though I'm not strictly fasting because I'm "still" breastfeeding The Boy).

Yom Kippur. Ah yes. One of the few Jewish holidays that doesn't fall under the umbrella of "They tried to kill us; we won; let's eat." Because first of all, you don't eat. And secondly, this is, instead, one of the holidays that stems from obligation. Sukkot, the feast of the harvest, starts next week and it also does not fall under that umbrella.

It's the Day of Atonement. And the last thing that I want to do is sit around bellyaching about how miserable my life is just because my kid is sick. Because really, life isn't too bad overall especially considering how much support we get from family and friends even when things are "normal." Furthermore, the fact that my kid is sick doesn't give me license to be a jerk, a slacker, or a whiner. I am hoping that I have been none of these things and have tried to make things right in situations where I feel that I may have wronged someone. Since the deadline is tomorrow, if I have wronged you, please forgive me.

The Boy is still sleeping, and good thing because he needs it, and I think I'm going to tap into my reserve of snacks. Or maybe take a shower...

Monday, October 6, 2008

Workin'

The Boy had a pretty good day today. He wasn't sick, he ate and drank reasonably well with Ms. R., and he was fun and playful when I arrived home. The doctors and nurses indicated that for him to show side effects for longer than a week after chemotherapy is rare.

I've been tossing around the possibility of taking some time off from work to take care of The Boy, since it does seem like I miss a lot of work due to expected or unexpected doctor/hospital visits. I discussed it with my mother and my sister, who say that it isn't necessary. Musical Daddy likes the idea except that it would entail him taking on more outside work, meaning more time away from home, and leaving me with The Boy. And I talked about it with two of my colleagues, who pretty much said that while I ultimately need to do what's best for my family, there isn't a problem covering for me when I do need to be out.

If this is going to be the pattern, that The Boy will have 5 days to a week of sickness after chemo, then here's what we're looking at:

4 more chemo treatments (YAY!). Probably October 23 (Thursday) for DOX/VNC, November 13 (Thursday) for AMD/VNC, December 4 (Thursday) for DOX/VNC, and December 26 (Friday) for AMD/VNC. That's assuming that his counts are good enough to get chemo, which they may not be, but all that does is bump the dates back a bit. Scratching the last chemo because it takes place over Winter Break and we'll be home with him anyway, that makes 3 more weeks that could potentially be like the one that we just had, with the sickness and such. With one, possibly two, treatment center or hospital visits in addition to the ones that will be scheduled.

And of course, the surgery, which may take place next week.

It's a lot, but I guess when I think of it in those terms, it isn't too bad. The only thing that I need to do, that we need to do, is to go with my first instinct. If The Boy seems sick, I should just stay home with him, let him nurse all day, and that's that. Last week's hospital stay possibly could have been avoided had I either stayed home with him or brought him in to the center first thing in the morning. Because, you see, even though we usually have to wait for things at the center, they don't shut us in a room and ignore us, which is what wasted so much time in the ER last week.

Furthermore, I think that I'll go back to pumping if I have to but only during weeks when he is sick or is expected to be so. May not be necessary as I'll build up a stash while The Boy recovers from surgery. Don't forget that since he nurses all night, ounce-for-ounce he's getting as much milk as he would if he were sleeping through the night. He's just mostly schoolday-weaned.

Sunday, October 5, 2008

Funny how things change...

My parents are coming to visit this weekend, which we always love. Grandma loves The Boy!

Their kitchen was destroyed in a fire last week, rendering their house pretty much uninhabitable for now. Fortunately no one was hurt and nothing major was destroyed other than the entire kitchen.

I suggested that perhaps they'd want to bring all their laundry and get it done at my house, which my mom said might not be a bad idea. Funny, because usually it's the opposite--children come home with laundry for their parents, not parents coming home with laundry for their children!

I'd be glad to do the wash for them and give them a little break, but I doubt that they'd allow it. At least they have no choice but to let me cook for them.

Friday, October 3, 2008

Back to life...back to reality

We're home. Everything is "okay" and The Boy is himself again. Except that he's still not eating much. Today at lunchtime, he had carrots and that's pretty much it. I spooned him some broth, and he might have had a noodle and a bite of broccoli. Some carrot did come back up but I think that's because he tried to shove the whole thing in there. It just came up as chewed carrot.

I'm starting to wonder if maybe I would have been better off taking this semester off from work. Hindsight being 20/20 of course. We were not under the impression that things were going to be this time-intensive in terms of The Boy's various treatment-related battles. We just thought that he'd go for treatments or tests once a week and that would be that. I am starting to feel as though I am not giving 100% to my job, and my students and colleagues (and administrators) deserve better than what I'm giving them. As these are extraordinary circumstances, everyone understands. And my mediocre is still better than plenty of "bests" at the risk of tooting my own horn (figuratively speaking). But by the same token, maybe The Boy would be better off with Mommy at home.

On the other hand, our situation is pretty good, as Musical Daddy reminded me. The Boy goes to Ms. R, who lives very close by, and she rarely watches any other kids (just one school-aged girl on occasion for an hour or half-day here and there). Musical Daddy has a job that is close to home and close to Ms. R. We don't live terrifically far from the hospital, either. Musical Daddy's father is retired and has a flexible schedule and lives near the hospital (in the opposite direction from where we live), and his sister-in-law works in another department of the hospital, so she is sometimes able to help. Additionally, Aunt M. offers help and comes in from time to time, and my parents have made the effort to visit about once a month since The Boy was born. My mother stayed with us for two weeks, first to help while Musical Daddy was away, then for The Boy's birthday, and then because we thought that The Boy would be having his surgery.

So there's really no reason for me to leave my job (temporarily) other than a hefty dose of mommy-guilt. See, The Boy doesn't drink much most of the time. He nurses during the night and whenever he is around me. I do my best to send fruits and veggies with a high water content as part of his lunches. He does a better job of drinking water and juice with meals when he's with me as opposed to when he's not. He also does a better job of napping when he's with me or Musical Daddy. He's usually whiny and exhausted when I pick him up in the afternoon. Ms. R. just doesn't have much of a solution (and neither do we) to the problem of The Boy's refusal to sleep in any crib or playpen. Anyhow...if he were sleeping better and nursing during the day, would he be able to avoid the problems that he's had? Probably so.

In The Hospital

Today (although it's 2 AM the next day, the Tuesday rule says that the day doesn't change until you get your sleep) The Boy was sick in the morning once he got to Ms. R's house. As in, he threw up his lunch. He refused his food, had a bottle from the dwindling freezer stash, and threw up later.

I called the treatment center and we brought him in...only to be sent directly to the ER because of the time of day.

If I wanted to just sit on my behind and be ignored, we could have just stayed home. We checked in at 4; The Boy was finally brought to his room on the pediatric floor at 12AM.

I don't want to get all long-winded about this, mostly because I'm finally starting to regain the tired that I lost from having to talk to the doctors and nurses.

We should be out of here tomorrow. I hope.

Wednesday, October 1, 2008

History Lesson

From my Myspace Blog, dated September 22, 2007:

Over the past few days, The Boy had not been keeping his food down. And we're not just talking standard baby spit-up. At the risk of being graphic, if it comes up looking like milk, then it's still within the realm of spit-up even if it's coming out in larger volumes. If it looks like it's been in there for a little while...then we have problems.

After the third time in the span of 18 hours of this happening--because it did happen a few times in isolation last week--I called the doctor's office and they wanted to see him. Supposedly, he was down two ounces from last week, where he was a pound over birth weight at 2 weeks old. He was screaming his little head off and squirming, because he was hungry, and I ended up feeding him while the doctor examined him because nothing else would calm him down. That was pretty exciting.

The other doctor came in and talked with me, saying that he might have a condition called pyloric stenosis (or however it is spelled). If you haven't heard of it, you have now. I'll explain it as well as I understood it. There's a muscle in there, in the esophagus, that lets the food go down and helps it on its way. If it doesn't let food in, the food comes back up. He thought that it was this condition because he had lost a bit of weight, and the throwing up...this condition is most often seen in firstborn white males. So he sent us to the emergency room for an ultrasound of The Boy's abdomen and some bloodwork.

I called my mother and she told me that my cousin--a firstborn white male--had it. It requires surgery.

Hours later, we learned that The Boy did not have this condition and wouldn't require this surgery. He was so good at the hospital and only got upset at having blood drawn and making a little robo-hand to hold an IV port in place, and the ultrasound...then later on when we were waiting for results and he was hungry but I couldn't feed him until the results came back.

I spoke with the doctor yesterday morning (this morning according to the Tuesday rule, because I haven't had a full night's sleep yet) and he said that everything came back normal, the weight was still a concern but it was possible that the scale was wrong at the 2 week check. Frakking wonderful...since I'm nursing exclusively there's not really a good way to tell how much The Boy is getting at a feeding, so the doctor said he wanted me to pump and feed him bottles every 3 hours. He first asked about formula supplementation and I told him I'd rather not, and that I didn't think I had a milk supply problem. So he initially recommended 2 ounces per feeding, saying I could go up to 3 if he would take 3 ounces. I was a little nervous that he wouldn't take a bottle from me when I've got the real thing but that worked out fine.

I think I discovered the problem. I fed The Boy a 2 ounce serving of previously frozen breastmilk. Then, while he slept, I pumped for about 10-12 minutes. I have a fancy electric dual breast pump, because I'll be back at work soon and will continue to give The Boy only breastmilk. Anyhow, after 10 minutes I had about 8 ounces of milk. As I said, I don't have a supply problem. Thing is, milk production is largely guided by what the baby wants to eat. I'm very good at producing milk apparently, and he just kept drinking it because it was there, not realizing that he was eating way too much to handle. For subsequent pumpings, I stayed hooked up for 5-7 minutes and got 4 ounces.

It's been a pretty difficult process, to tell the truth. The great thing about nursing is that the food is always there for the baby. There's not any need to heat up the bottles or measure the milk/formula, nor wash anything in the sink, and bottles create more burps than breastmilk. No way would I ever feed The Boy formula, just because the bottle feeding is such a pain.

The Boy has been happy probably 2/3 of the time today. He's happy because he's eating and it's actually staying in him because it isn't too much. However, he seems to be hungry even after having 3 ounces of milk. I know that 4 ounces would be an acceptable feeding for a kid his age, but I'd like to just stick to what the doctor said. And, I'd like to get him a little more accustomed to this feeding size. Breastmilk does digest quickly though, much more so than formula, so he's hungry faster.

He had a bottle at 11AM, 2PM, 5PM and 8PM. At 10 or so, I took The Boy into my room to hang out and snuggle because he was fussy. We fell asleep and didn't wake up for the 11PM feeding. It was almost midnight. I pumped out the feeding for next time and got a bottle. I tried waking him, and he ate a little, but he really wasn't interested. The doctor had said to wake The Boy to eat every 3 hours...he normally doesn't eat that way. He will often sleep longer before a feeding, usually 4 hours or a little more. Thankfully, that happens a lot at night, giving us one later evening feeding, one 2AM or so, and one early in the morning. We're not at all accustomed to waking him up to eat. My grandfather said that he had a mutual non-aggression pact with the children--they don't bother him and he doesn't bother them. That's the way it has gone with feedings for The Boy--he eats when he wants to. He's on a pretty good schedule.

But I hate this bottle thing! I guess on the plus side, I can give my poor boobies a break for 2 days. And I guess it's good to know that he's taking bottles because he'll have to take 2 or 3 from Musical Daddy every day. I'm just hoping that when he goes back to feeding normally, there won't be any problems. And it's hard as anything to pump the feeding AND feed The Boy the bottle. Normally, if I'm actually there, I'm feeding him, and if I'm pumping, it's because I'm away from him.

Fortunately, we only have to do this nonsense through Monday morning.

Being a nursing mom is exhausting! It was so nice before this started happening...now we've got a little snag but we're fine...and someone might want to eat again.

Happy New Year

Although I am not very frum, apparently my blog is because it has taken a break for Rosh Hashanah. For those who are curious, frum means, roughly, " very religiously observant."

Anyhow, yesterday I attended services at my shul. There is a new student cantor who did a wonderful job (we have only student cantors in our congregation, and as far as I can tell, we get a new one every three years). I planned to bring The Boy this morning, but he had other ideas. Or rather, as much as he loves shul, his body was rebelling against chemo and whatever other nasties he had picked up from his schoolteacher parents.

This morning was a repeat of the events of a few weeks ago. I put him in his high chair, all set to serve him eggs and juice, and he started coughing and hacking. He brought up clear fluid which ended up in his bib pocket (making cleanup pretty easy), and he wouldn't even touch his food after that.

He also had a fever, up to 98.9 under the arm (which is about 99.9), but apparently it wasn't anything about which the doctor was concerned. I should mention that he received his chemo yesterday despite not having quite a high enough Absolute Neutrophil Count. I wish that, as long as he was going to receive it without having the numbers, that they had done it on Thursday of last week, because his numbers were actually better then. Anyhow, his temperature fell over the course of the day to about 98.4 under the arm but was back up to 98.8 as he was sleeping.

By the way, he did sleep a lot today, which is pretty normal for the day right after chemo.

He ate very little at lunchtime but had a strong enough stomach for dinner, thank goodness. And, thank goodness even more, he nursed every few hours.

Even with all of this, though, it's been a wonderful year, from one Rosh Hashanah to the next. I missed Yom Kippur last year, due to a separate issue that, I don't think, was ever related to this one. I'll post that story right after this one. But other than that...I had a great year at work last year and a wonderful year watching The Boy grow and turn into a little man.

As for myself, I have a few things to work on, as we all do. I'd like to do a little bit better about not pre-judging people before I know what's going on with them. Since most of the time, it's none of my business anyway. That said, if you ask for my advice, I'm always happy to share.