What a week this turned out to be. After rallying on Sunday and feeling slightly better then he did on Friday and Saturday last week, Munchkin crashed again on Monday morning with vomiting and the addition of swelling to his sore right eye, so the decision was made to return to the hospital, but this time Sydney Children's Hospital in hopes of getting some answers.
This is what his eye looked like on Monday but the doctor who saw him at hospital thought that it was viral conjunctivitis. They thought the headaches he was continuing to have were part of his migraine he had Friday morning, and they believed the vomiting and stomach pain were likely gastro. So, after being in hospital since approximately 11am, at about 6pm, after blood tests and some Hydrolyte to make sure he wasn't dehydrated, they sent us home - with instructions to come back if he got worse. I've included my nightly sleep app reports in this blog post to show you just how much Munchkin and I suffered through the nights of this momentous week. The orange blocks indicate time I was awake, while the blue, green and purple are my various stages of sleep.
Tuesday morning he woke up with his eye looking worse so I phoned our family doctor and scheduled a teleconference appointment with him to review everything that had happened since I spoke to him on Saturday. Once I spoke to the doctor and sent him two photos of Munchkin's eye via text message, he immediately diagnosed the eye problem as periorbital cellulitis and sent me an e-script for oral antibiotics. Then he also decided that it was time to order an ultrasound to check what was going on with the tummy. He didn't think it was the appendix playing up because Munchkin could jump, didn't have lower right rebound pain, and instead had wide spread general pain across his abdomen, but wanted to rule it out definitively. Sadly, because our phone call wasn't until after lunch, we had to delay the ultrasound until the next morning because Munchkin was required to fast for a minimum of six hours. We quickly scheduled an 8am ultrasound for Wednesday morning and limped our way through the night. As you can see from my sleep app above, we were awake more than we were asleep. The yellow/orange blocks are the time we spent awake. Poor Munchkin spent most of the night laying on the lounge while waves of stomach and headache pain came and went.
Wednesday morning my husband took Munchkin off for his ultrasound, while I stayed home to take a teleconference follow-up phone call from one of the doctors from Sydney Children's Hospital in regards to our visit on Monday. It was while I was speaking to her that I got the text message from my husband saying that the ultrasound did indeed show appendicitis and we needed to head back to Sydney Children's Hospital for surgery. The lovely doctor I was speaking to said she would alert the emergency department in hopes of speeding things up for us - which it did because they literally triaged us and took us straight back into the emergency ward. This was at approximately 11am. While we waited for various tests to be done and things to be organised, Munchkin kept busy watching "Empire Strikes Back" on a portable DVD player that was brought to his bed. It was a long afternoon of waiting but finally at about 5:30pm he went into the operating room for the surgery and I headed to the waiting room. I half watched the news and a game show while enjoying a cup of tea and some sandwiches. I actually felt calm for the first time in days because we FINALLY knew what was going on and were fixing it.
This is a photo of Munchkin in recovery. Whilst the surgery went smoothly (textbook according to the surgeon) coming out of the general anesthesia didn't go quite as well. I could hear Daniel crying from the waiting room and he was pretty hysterical. He was so upset that they sedated him a second time and just let him sleep for another 30 minutes or so before waking him up again and assuring him that he was fine, it was all over, and he would feel much better soon. He said his stomach pain was exactly the same as it was before the surgery, but the anesthesiologist told me what pain meds were in his IV and it is a wonder he was feeling anything at all. At any rate, once he was calm it was time to take him to the ward and get him settled in a room.
Though he is only nine years old, Munchkin was taken to the adolescent ward, so that we wouldn't have to worry about disturbing sick and injured babies, or being disturbed by babies who aren't sleeping through the night. We were in a four person room but there were only three boys in the room once we moved in. We were settled in our room by about 8pm and Munchkin was thrilled to see that he had his own personal TV - loaded with movies along with free-to-air channels, and a tablet loaded with lots of games. The worst thing about the night of his surgery was the fact that he didn't fall asleep until 10:30pm and woke up at 4:30am. I thought perhaps with his IV pain medications he would fall asleep, but no such luck. Thankfully he was still and quiet enough that I was able to doze in my bed until morning rounds began at 7:30am.
This was my view from our room. I had a small chair that folded out to be a single bed at night and during the day I could look out the window and enjoy what little view there was considering the weather. The black arrow in the middle left of the photo is pointing to the skyscrapers of the CBD (downtown Sydney) that were visible when the cloud cover wasn't too thick.
He took a little cat nap sometime Thursday but nothing of any substance and certainly not long enough for me to get any sleep. I just spent the few minutes drinking more tea and sending text messages to update everyone on the situation.
The clown doctors came to visit our room and gifted Munchkin with a Lego set which he immediately got to work building. For those of you who have seen the movie Patch Adams, you'll know roughly what clown doctors are. Essentially they are volunteers who dress up and visit the children to cheer them up.
We visited the Starlight Room twice on Thursday and Munchkin LOVED playing the retro arcade games. We also enjoyed some banana bread and some hot chocolate. Finally when they were about to close for the day at 5pm they sent us back to our room with a craft bag full of Fimo clay which Munchkin has been wanting for ages (you can bake it), and two small Lego sets, so he was a very happy little boy.
Anything to do with needles in the hospital was a drama. Wednesday morning when we arrived they tried to put his IV (called a cannula here) into his right hand but he was dehydrated and his veins were flat so it took three people working together to get it in him (while he screamed) only to have it develop a clot and refuse to work. So they took that out and a different doctor put this cannula into his left arm and it was much more effective. However, through the process of all the blood drawn previously in the week, we discovered that Munchkin is allergic to the numbing cream they apply, and much of the skin tape they use as well. So everything was itchy.
Thursday evening Munchkin enjoyed putting together his additional Lego sets he received while visiting the Starlight room and we got a pretty decent night sleep as well, so I thought the worst was behind us and we would go home on Friday.
However, Friday arrived and it was clear he was not a well boy. His headaches, stomach ache and nausea had returned and he was vomiting as well. No one was quite sure what was going on. So it was arranged that we would stay Friday night while the doctors and nurses tried to work out what was wrong. On top of everything, his blood work had come back gram positive so they ran another set of bloods to see if it was an infection or just a contaminant in the original sample. Additionally there was some concern that his periorbital cellulitis was actually orbital cellulitis (which is much more serious and requires IV antibiotics) so they arranged for a paediatric eye doctor to check him out as well.
He finally crashed in the afternoon and slept for at least three hours which is really what he should have done Thursday after his surgery and I had hoped that he would wake up from the sleep with all the pain resolved.
Sadly we spent a good portion of the night awake with Munchkin still complaining of headache, tummy ache, and he vomited in the middle of the night as well. Ultimately though, the doctors and nurses felt that the stress and trauma of the surgery and the noise and chaos of the hospital in general, were contributing to the problem. His eye exam was normal, his infection was periorbital cellulitis which meant that oral antibiotics were the proper treatment, and his follow up blood work was normal so they suggested we try gate leave Saturday afternoon. Essentially this would mean we would go home and if he relaxed and improved we could stay home - we just had to ring the hospital to inform them - and if he got worse it meant we were able to come straight back to the ward and bypass the emergency room. So we got home about 4pm Saturday afternoon, and by 10pm that night he was doing well so we rang the hospital and informed them they could formally discharge us as we were staying home.
More scars... chicks dig scars... and Munchkin has the largest collection of scars of the three boys so far. He has a scar on his eye from crashing into the Lego table, he has a scar on his head from crashing into the edge of the kitchen cupboard, and now he has three scars on his tummy from his laproscopic appendectomy.
Munchkin thoroughly enjoyed playing with all his new Legos in the comfort of his own home.
And while our sleep wasn't perfect Saturday night, it was much better than previous nights in the hospital and I really believe the nurses and doctors are on to something when they say that hospital and everything that goes on there is stressful for kids.
Though both Munchkin and I took two books each to hospital with us, neither one of us did any reading. Munchkin was either busy watching movies or in pain, and I have to have near silence to read so why I bothered to even take books is beyond my comprehension in hindsight. So all of these books are ones that Munchkin read from Sunday until Wednesday morning when we left for the hospital.
One final note... the two older boys were rock stars through all of this. They had to stay alone whenever my husband took Munchkin and I to the hospital, and they adapted to the disruption in their lives quite well. During the four days we were in hospital they behaved well, completed what school work they could independently, did anything extra asked of them by daddy, did their regular cleaning chores on Saturday, and generally showed us just what mature boys they have grown up to be. I was really pleased to hear how they managed themselves through the week.
