Friday, April 4, 2014

Former Floating Frat House Surgery and What Could Have Been

Current Location:  Sacramento, CA

A recent event at the Frat House seems to have warranted a blog entry and reminded Ben and I to be grateful for something we tend to take for granted; our children’s health. 
Although we navigated the waters of critical illness when Mickey was born, we have been fortunate to have nothing more than colds, flu, sprains and the occasional vomiting (the kids, not us….if you don’t count Ben and my college days…and mid 20’s….beer bongs will do that to you).  So as the hours progressed, we anxiously, watched our child become increasingly ill. At one point our eyes met and without uttering a word, we concurred on one simple notion.
“Dang, I’m glad this didn’t happen when we were cruising.”
Let me preface this with the fact that we would not have changed our mind about living on a sailboat and residing in foreign countries.  However, when something like this occurs, it does make us pause and reflect on the question, how would this all played out, if we were living on a sailboat?
The day began as any other, the boys woke up to their alarms, got dressed, made their breakfasts and were ready to go 30 minutes early, as their parents procrastinated, hit their snooze alarms and waited until the last possible moment to slide out of bed.  This is not an exaggeration and we have no idea how it happened, but our children are ready to go every morning before we can press the button on the coffee maker.  I know this does not present us in the best light as parents, but on this blog I try to always tell it like it is.
So the boys and I walked to their elementary school where I was teaching for the day and have been working regularly.  Apparently,  J.P. complained of a stomach ache to his big brother at morning recess, warranting the suggestion, “Go and see the nurse” (please note, their school does not actually have a nurse, but the boys don’t seem to be aware of this, since Mrs. Tracy and Mrs. Shelly are highly skilled band-aid administers).

J.P. decided to soldier on until the end of the school day, even gutting it out for his basketball practice.  Afterwards, we all walked home without incident, the Frat House mother still without any knowledge of a stomach ache. Upon entering the house, the boys found a bag of hidden Doritos in the pantry and celebrated the treasure by wolfing it down. It should be noted that the regular after school Frat House snack is blueberries, popcorn or edamame.  This is the honest truth and I’m not making it up because I sounded like a lazy mother at the beginning of this entry.

A couple of hours later those same Doritos propelled themselves out of J.P.’s stomach into our lovely stainless All-Clad stock pot. With concern and sympathy we watched the poor, young lad get sicker and sicker.  After interrogating the patient, I was concerned when he informed me that the stomach pain had now migrated to the lower right hand side of his abdomen.
Amongst his anguish and vomiting, J.P. looked over at me after I had cleaned out another pot full of orange regurgitated Doritos and said, “Thanks mom for cleaning up my puke.”

I took heart that if I had failed at all other aspects of mothering, my children turned out to be quite appreciative.
At this point, I decided to confirm my motherly intuition on Web MD and there it was in black and white, an acute appendicitis. Ugh! Ben called the advice nurse and ordered us to go to the Emergency Room where they would admit him to the hospital.  By this time it was 11:00 p.m. so we called our friend, Chris to stay with Mickey who was blissfully unaware of any drama, snoozing away in his bed. Into the night we drove with brave, J.P. in the backseat vomiting into my favorite stockpot. 

As some of you know, an ER can be a carnival ride-freak show on steroids, yet I had high hopes of some normalcy, it being Monday night and all. No such luck. However, they saw J.P. right away for which we were grateful. When the nurse asked him when the pain began J.P. answered in a serious tone, “At 7:50 this morning.”
She turned to us, winked and said, “Well, I guess that’s precise enough.”

He further entertained when he proclaimed to the nurse taking his blood pressure, “This is perfect for what we are studying in class. Medical history! I will learn a lot here.”  
James Patrick Doolittle….a patient AND a scholar!

They immediately put in an I.V., drew blood, performed an ultrasound and confirmed Dr. Molly’s diagnosis of ‘acute appendicitis’.  He was soon tucked into an ER hospital bed and given some pain medication. At this point he turned to us and asked, “Do you think I will miss school tomorrow?”

The curtain between J.P. and his new roommate, an inebriated 70 year old, provided a visual barrier, yet we were still privy to all of his verbal communication, mostly with himself.  One such conversation went like this:
Roommate sneezes loudly.

“Excuse me!”

“God Bless You”
“Thank you.”
“You're welcome!”

One would think there were multiple people on the other side, but it was just him enjoying his own company and being pleasantly polite to himself.  This got a silent chuckle from me, Ben and even J.P.
When we broke the news to our nine year old boy of the impending surgery, he cried quietly while processing his new reality. We explained that he would go to sleep and not remember the procedure and would eventually start to feel better. To this he responded, “But what if I wake up in the middle of it?”
Ooops! We neglected to inform him that it’s not like his nightly sleep! We quickly backtracked and let him know there was special medicine that keeps people unconscious until well after the surgery. Our bad!   

Middle of the night ER, waiting for the ambulance.
We brought his favorite blanket from home.

Comforted by this fact and a dose of morphine, he dozed off, however 15 minutes later his big, sweet, beautiful eyes blinked opened, looking up at me hopefully.  He then asked me a question that broke my heart, “Did they cut it out yet? Is it over?”

As night evolved into early morning, the staff informed us that he would need to be transferred to Sutter Memorial Hospital where there was a pediatric surgeon on staff.  The EMTs arrived about an hour later and were very sweet with the patient asking him questions about himself and being very kind. As they conversed with J.P., he divulged that we had lived on a sailboat and traveled for two years. This warranted a comment from one of them that made all of us chuckle, "I don't think I've ever said this to a nine year old before, but I'm so jealous of you!!"

With that, J.P. was loaded into an ambulance and taken the 2.2 miles to the facility where he would have surgery.  Ben rode with him and asked the EMT’s if they could turn on the sirens and lights to which they obliged. Oh, boys and their toys!

As I followed in the car, appreciating a moment of solitude, thoughts blazed through my brain.  Would J.P. be ok? What if there were complications with the surgery? Could he have an allergic reaction to the medicine and anesthesia?  The damn broke and I was soon in tears driving through the empty streets of Midtown Sacramento.  Noticing that the hysteria was building, I said a prayer and calmed myself down. Sailing 10,000 miles taught me many invaluable things. Perhaps the most significant was that hysteria is not a great strategy when all hell breaks loose.

As a side note, we received a call a couple of days later from the ambulance company who informed us that the 2.2 miles ambulance ride cost $2,000. We are covered for it, but WOW!! For that amount of money, shouldn’t it have been tricked out with gold rims and staffed with a butler serving cocktails???

After arriving at 3:00 am, J.P. was brought to the pediatric ward where we awaited confirmation of his surgery time. When the pediatric nurse came in and informed us that the surgeon was on call and would be in at 6:00 am, I wasn’t concerned. However, she then proceeded to tell me, “The hospital will fit him in sometime later today because the schedule is quite full”.

I couldn’t believe my ears. Mama Bear had been awakened from hibernation and she was NOT happy!  <Enter GROWL here>

Ben had returned home to get some sleep and stay with Mickey, so I’m sure he was concerned when I texted him at 5:30 am. Before I print below the text exchange, please note a few things about Ben and myself as husband and wife.

Molly -  The Irish one, tends to be easy going until pushed too far, turning quite hot headed (especially when someone messes with her children).  In addition, she has an endless desire to get things out in the open and tends to express every emotion as it bubbles to the surface. Let’s just say I’m not a woman who says to her husband, “No, I’m fine” when I’m upset. This can be a blessing and a curse.

Ben – the ultimate example of an easy-going guy and truly lives by the philosophy, “It’s all good!” . He tends to avoid confrontation if possible, but will put up a good fight when needed.  The text exchange went like this:

 Molly: How r u guys doing? I’m ready to start kicking some butt here if they don’t get him in there (surgery) soon. He’s been awake off and on and keeps asking me when. What’s your plan?

Ben: No plan here. Explain to JP that they will need to fit him into a full schedule.

Molly: Yes, but I’m not ok w/ that. It’s been 7 hours since diagnosis and really don’t think we should be waiting any longer. U may want to get down here to play peacekeeper.

Molly (cont.): Scratch that, get down here and be my back up. I think it would be good if u were here sooner rather than later. I can send Kathy if u want (to take care of Mickey).

Ben:  You tell me. Shall I check w/ chris or is Kathy on her way? Or I can b there in about one hour just dropping him off a little early….whatever you like.

This is where I terminated texting and made an actual phone call to my husband. With the conversation that ensued, I came to realize that I was looking for Ben to be at the hospital to make sure I didn’t get hysterical with the medical staff. With no sleep and a stressful night behind us, I was feeling extremely emotional, tired and anxious.  We were also at a difference of opinion, in that Ben was not seeing the urgency about getting J.P. into surgery, and I was. So if that was my deal, why the heck was I waiting for him? It was time to put on my big girl pants and take care of business.

So I hailed the amazing, nurturing, kind night nurse to our room and asked her to meet me outside in the hall. As I expressed my concerns about the timeline of the surgery, she was an attentive and active listener (Honestly, I really don’t know how these people do this job…it takes a strong and wonderful person).

When she reached out her hand and rubbed my arm, telling me everything would be alright, Mama Bear stormed out of her lair and this nurse now became my prey.

It went something like this….

Molly:  Thank you for your kindness, but this is what I want you to do (pointing a finger… I know soooo bad, but I couldn’t help it).  Pick up the phone, call the pediatric surgeon and tell her that I am NOT ok with this timeline of fitting him in where they can. I don’t know if this is a communication thing, but I want it to be known he needs to be in surgery ASAP. Here’s my point, if they have diagnosed him with appendicitis…the only next step in this scenario is that it will burst and we all know that’s NOT good.

I looked into the nurse’s eyes to see the horror of “Oh, crap this mom is seriously on the brink of an emotional breakdown”…which made me even more angry.

Molly (in a hauntingly calm, quiet voice): Look, I know you think I’m being emotional and I’m telling you not make that mistake. Let me be very clear with you. This is what I want you to do:

(Molly holding up 1 finger)  “One. Call the pediatric surgeon.”

(Holding up 2 fingers)  “Two. Tell her the mother of this patient has serious concerns about the timeline for this surgery due to the decline of this child’s health which includes a high fever and increasing pain. Also there is the growing anxiety by the 9 year old patient about the impending surgery. He is waking up every 30 minutes asking me ‘When mom? When?’.” 

(Holding up 3 fingers)  “Three. Then take a pen and write down in the file my concerns,  that you made this call and the surgeon’s response”

(Holding up 4 fingers)  “Four And if there is no response, I want some doctor down here to explain to me the health benefits of waiting.….understand….me?”

To her credit, the nurse squeaked, “Yes.”

Awaiting surgery. Who wouldn't fight for this bear cub?
Jon bravely stood by J.P! The nurses even gave him his very own hospital bracelet.
I felt momentarily guilty that I had just shot the messenger, but was proud that I didn’t go all “Shirley Maclaine” from Terms of Endearment on the woman.  BUT-if I had to, I would have!!  The movie clip actually played through my head as I talked to the nurse.

The scene I am referring to, takes place in a hospital, where a daughter is dying of cancer and receiving pain meds to keep her comfortable until her impending death. Her mother is quite persuasive when the nurses are late administering the medication. If you haven’t seen it, here you go:

I remember watching the movie with my mother when I was in high school. The scene moved my mother to tears and at the time I did not understanding why. Now having my own children, it is crystal clear.

A few minutes later the nurse returned and reported that J.P. was scheduled for surgery at 7:00 a.m.  With her duty done, growling Mama Bear now retreated back to her lair.

Ben returned to the hospital just as the surgeon arrived to explain the procedure to both us and J.P., answering all of our questions patiently. She chuckled when the charming patient informed her in a morphine induced haze, that he had a medical research report due in a couple of weeks. He hoped to choose appendicitis as his topic. Much to his surprise, Dr. Graf offered to take a photograph of his appendix during surgery.

They soon prepped him for surgery and he was whisked off to the operating room. Unlike 35+ years ago when I had my appendix out, they catered to J.P.’s emotional needs quite beautifully. For instance, they allowed him to have his beloved teddy bear, Jon with him during surgery and put him to sleep while we were still by his side. I remember crying hysterically when they told my parents to leave the room while they prepared me for surgery.

They were able to do laparoscopic surgery and all went well much to our relief. Later, as J.P. recovered back in his hospital room, the surgeon dropped by to check on him and delivered the photograph of his now defunct appendix. We were tickled by the gesture and J.P. proclaimed, “I’m totally going to get a good grade on this!”

Yep, we took photos in the recovery room. Don't judge, the nurse suggested we take them!

Now that's a selfie!

He spend the next two days recovering in his private hospital room complete with his own television, adjustable bed, food delivery and people catering to his every need. J.P. was in heaven!!  When they informed him he could go home the following day he said, “Do I have to? I really like it here.”

Who would want to leave this place??

As we posted updates on Facebook on his recovery, we were thankful for all of our family and friends well wishes. One such comment made me chuckle and to again ponder the question, “What if this happened while we were cruising?”

Our fellow cruising friend, Heather, posted a comment which makes me laugh because of the truth in it!  Background; the “Perlas” are the Las Perlas Islands. They are a series of small islands a day sail away from Panama City, Panama.  A “head” is the toilet on a boat.

“Can you imagine if this had happened 10 months ago, while in the Perlas? We ALL would have been looking at him like a boat project, similar to taking the head apart. This way is MUCH better. Speedy recovery!”

I know it may not make sense to you land living mothers, but every time I read this it still cracks me up! A ‘normal’ mom may feel terror or shame, but when I reflected on this, I felt relief!  We would have figured it out and while it would have been challenging to get him to a hospital and communicate in a foreign language, I have no doubt we would have received the necessary care. 
There would have been a community of cruisers milling around figuring out if we could take care of this ourselves. After reaching the conclusion it was outside our expertise, we would have banded together and got him to a hospital. That’s what I learned while cruising, the balancing of self sufficiency and not hesitate to get the help when you need it.

And now another edition of the…..


Part #1: 
While recovering from surgery, J.P. was complaining of increasing pain. The nurse suggested going pee since a full bladder can create pressure on the wound.
He then urinated into the bedpan, filling it to the top.

J.P. (clearly relieved):  Oh God! That was my second most favorite thing so far.
Nurse: What was your first?
J.P.: The I.V.
Nurse:  Why the I.V.?

J.P.: Because you can give me all sorts of medicine and I don’t have to get a shot or take that nasty tasting stuff through my mouth.

Part #2:

After learning about our sailing trip, a nurse asked J.P., “So do you like to travel?”
The nine year old J.P. replied, “Yeah, but I think I’ve had my fill of it.”