Tuesday, March 17, 2009

One Renal Calculi, Morphine On The Side, Please

Today I am thankful for smart doctors, good drugs, and healthy children.

A few days before Christmas in 2006 (it's late, so in case you don't feel like doing the math, that's nearly 2.5 years ago) Savannah got really sick and spent a night in the hospital. Stomach cramps, vomiting, blah blah...

Lab work, xrays, CT and ultrasound of the abdomen and pelvis, and about $8,000 later, the gist of the story was: "Yes, Savannah has gastroenteritis. It also appears that she may have a slight problem with her right ureter being enlarged and having a possible blockage, but we can't define the problem."

Her symptoms went away, and so did the testing. We were told the problem must have resolved itself, if indeed there even was a problem.

Several times over the next nearly-2.5 years, she would experience episodes of severe stomach pain, but it would only last for a short while and I would think "Well, she's getting close to being a teenager. All kinds of things are gonna start happening around here."

Last month, the pain returned more forcefully, so I scheduled an appointment to see a new doctor to whom we're in the process of switching all of our family care. He ordered several lab tests and more ultrasounds, upon seeing her past history. Only one test was abnormal - the urinalysis. And still the pain persisted, intermittently.

Last Tuesday, Savannah was in such bad pain I took her to the emergency room at around 10:30 PM. Now when I say "bad pain", you'd think an 11 year old girl would be visibly crying, making at least a small scene. Not my daughter. She curled up in the middle of the gurney and, barely audible, just whimpered occasionally. Lab work. CTs of the abdomen and pelvis. IV fluids. Pain medicine. Puke medicine. Infection medicine. Because, you see, she was still having issues with the urinalysis.

After whipping through seven or eight lovely little airsick bags, and naturally receiving no help whatsoever with any type of oral medication, and waiting for the results to be sent from the radiologist-we-never-saw, lo and behold....

My 11 year old daughter was diagnosed with a kidney stone of 5.5 millimeters.

Go get a measuring device.


Stop what you are doing and go find something that has that "Everybody's going to be using this someday! You'll be glad you learned it!!!" metric measurement system on it, and look at how big 5.5 millimeters actually is! Grown men scream and roll around on the floor for lesser stones than that! (I know - I'm related to one! As my sister says, "He never will let me forget that I had to wash my hair before I took him to the emergency room. He wasn't dying! He could wait a couple more minutes.") - Did I just digress, there?

Being 50 miles from the nearest pediatric urologist, Savannah and Mama were treated to an ambulance ride to this wonderful place called St. Vincent Mercy Children's Hospital.

Now, let me point out - my husband works at our local hospital. Has for over 17 years. Our boys were born there. I've had surgery there. I was there following my car accident. I worked there for a few years as a unit secretary. Our community is small. Not Mayberry-small, but close. When you go to the emergency room on the right night, you almost expect fellow patrons to call out "Norm!" So needless to say, but because it's me I'm gonna anyway, everybody pretty much knows who we are. If the kids are admitted, the nurses that pop into the room aren't always there to push drugs. They just know us, and they're stopping in to see what's new with our family. I like that.

St. V's is not so small. While we had one nurse for each twelve hour shift, there were no extras dropping in to check on Savannah's progress or ask if Gabe still has his little yellow blankie at home. But by golly, did we see doctors! Right off the bat, 3 students and/or residents barged into the room to begin bombarding us with questions. They were all writing. One had no clipboard. (Huh? No wonder President Obama is pushing for bigger Pell Grants!) I don't know if they planned to coordinate their papers once they left the room or not. One of them was never seen in Savannah's room again. Just as quickly as it came in, the whirlwind left. Apparently kidney stones in children are somewhat rare, so perhaps Savannah was a little like the albino rhino you hear about but never see, and they wanted their chance to say they saw history. Who knows. She slept through the whole interview process, anyway.

Surgery was scheduled for later that day, but because of emergencies, was postponed until the following late-afternoon. In that waiting time, her pain again completely disappeared. While I slept the morning away trying to recuperate from having NO sleep the night before, Savannah ate breakfast, cleaned the room, rearranged furniture, and watched some movies. Funny kid, that girl.

She is funny, too. Especially when she's been doped up with Demerol and Phenergan. Not only is she comical, but she's quite bossy. I was told to "Sit down!" and "Drink it yourself!" and given several stern looks by a normally fairly docile young lady. She vaguely remembers stating some of these orders, but she does not remember relaying to me her thoughts on her pain level. It is common practice in medical settings to ask people to rate their pain on a scale of 1 to 10. I think it's completely arbitrary, and rather stupid, because honestly, HOW in the world can you recall what childbirth feels like 11 years after the fact? Sure, you know it hurt back then, but you aren't in the throes of labor, so to reply to "Considering the WORST pain you've EVER had in your LIFE, how would you rate THIS pain?" is basically pointless. However, to remain politically correct and insure that this medical bill would actually BE insured, I was encouraging Savannah to "rate her pain".

"Now Sis, you told the nurse that it was 7 a while ago, and after your medicine, you said it was 5. What would you say it is now?"

Savannah very groggily muttered, "I don't know what time it is."

Folks, this is why Deanna isn't a nurse.

Deanna would love to collect a paycheck by picking herself up from the floor after a rousing round of raucous laughter, but she wouldn't want to find an NG tube shoved up one side of her nose and out her left ear by an angry patient who doesn't find the humor in his temporary drug-induced insanity, so hence Deanna remains a non-paid working mother who blogs, for no pay, about people's pain. And when my daughter flung her head back and glared at me because I told her "Ya know...this is GONNA find it's way onto my blog one way or another." ... Deanna was glad the real nurse had stepped out of the room momentarily, because Deanna was beginning to feel like the nurse thought Deanna was a bit heartless. Maybe it was the tears running down my face.

So to sum this whole episode up the best I can, Savannah is now down one kidney stone. Unfortunately, a second one was found on the opposite side, so she must return for further surgery in the next few weeks. She's much more comfortable, she's feeling much better, and she got to ride in an ambulance, although she doesn't remember much about that. Except she loves to say that every time she woke up and looked for me, I was happily chatting away to the ambulance driver, flinging my hands and yakking about something. When I laughed at her and asked her if I really talk that much with my hands, she raised her eyebrows and smirked. I'm not sure what that means.

I just can hardly stand the suspense of how much this excursion is going to cost. Yeah for health insurance. And I'm trying not to be overly angry at the doctors who, two years ago, didn't further investigate the suspicious evidence on her CT, even though the surgeon told us last week that this stone has probably been there the whole time...


Grandy said...

Oh my what a dilemma. I'm so sorry she had to go through all that (and you of course). At least you now know what the issue is. ;)

The Mother said...

I'm glad your daughter is feeling better.

BTW: Since you will be going through this again, you should become familiar with the terminology. The singular of calculi is calculus. Just like the math.

Does that say something about the math? I never did get calculus. Maybe because I wasn't stoned?

Deanna said...

Ya know, I do believe that I knew that shouldn't be ONE calculi somewhere in the back of my mind.
Should it be a surprise that I was too lazy to go to dictionary dot com and check the spelling out? NO - I rarely take time to read the rules to a new game, which is somewhat important for success.

I never even considered calculus - I would have preferred being stoned.