Readmitted.

My fear of seeing Peter readmitted to the hospital finally came true.  Thankfully, our stay wasn’t long or stressful.  Peter ate French toast while the pediatrics staff rolled their eyes, wondering why the ER doctor had bothered to have Peter admitted.  (At least that’s what I believe they were thinking.  It was all so casual compared to our NICU experience.  Peter didn’t even need EKG monitoring!)

Our little ordeal started Sunday evening.  As I was getting Peter ready for bed, he threw up his dinner.  I put him in the bath tub, where he played happily in the water for a few minutes.  And then he puked again.  I had Son take care of Peter while I cleaned up the mess.  Son gave him a bottle of milk, and then Peter vomited everything he had taken.  After that, Peter refused to take anything more by mouth.  Son made a run to the pharmacy, and I tried to settle Peter down for bed.  After I laid him in his crib, he puked again.  So I removed the soiled blanket, snuggled with him for a few minutes, and laid him down to sleep again.  A couple minutes later, Peter was having dry heaves.  Son returned, I made one last attempt to settle Peter into his crib, and… you guessed it: more dry heaves.  Son snuggled with Peter for about fifteen minutes.  Dry heaves again.  Son started imploring upon me to take Peter to the hospital; I told him to call the on-call nurse, not believing that they would do anything other than give Peter IV fluids if we took him to the hospital.  Only a couple hours had passed since Peter started vomiting, so I was skeptical that Peter needed IV re-hydration just yet.  The nurse told Son to take Peter to the ER if he didn’t stop vomiting in an hour.  As I was holding Peter, he again had dry heaves, and I decided that Son was probably right.  Why wait another hour?  Peter didn’t look like he was going to get well any time soon.

Peter’s stomach did seem to settle a bit after we left for the ER.  He went a whole hour without vomiting.  When he finally vomited for the ninth time in triage, he produced bile-tinted mucus for the doctor to observe.  The doctor ordered a CBC, urinanalysis, IV fluids, and Zofran.  Peter had to be catheterized to get the urine sample, poor baby. It was quite traumatic for him… he has screamed every time a doctor or nurse has come near him since then.  Can’t say I blame him.  Peter also vehemently objected to the IV placement, but everything became better when he got his Zofran.  His nausea quickly subsided, and he settled down to sleep.  It was about 2 a.m., and he was exhausted.

Lab results came back: no UTI, elevated white blood cell count (30,000/mcL when normal would have been 15,000/mcL).  The doctor said that based on this, he couldn’t tell what was wrong with Peter, so he would be admitted to pediatrics.

Peter woke up and asked for something to drink.  I had the nurse bring him some Pedialyte.  Peter took 4 oz and fell asleep again.  We waited for a room to become available in pediatrics.

We were finally transferred at about 6 a.m.  I had driven to the UMass Memorial ER our of habit… the NICU was on the Memorial campus.  However, pediatrics was on the University campus, so Peter got an ambulance ride.  He objected while the EMTs were strapping him into his car seat on their gurney, but once it was clear that no one was going to stick a catheter into any of his orifices, Peter looked around with interest as his surroundings passed by.  He was definitely feeling better.

Peter’s IV infusion ended shortly after we settled into our room in the pediatrics department, we all snoozed for a couple hours, and then breakfast arrived.  To my surprise and delight, Peter was interested in eating.  He ate a piece of French toast and some Cheerios.  I couldn’t tempt him to try the applesauce or yogurt, but I was happy to eat these myself.  The doctors came in and told us that they thought Peter had viral gastroenteritis; they had seen a lot of similar cases recently.  Since Peter was taking fluids and wetting his diapers, we could go home in a few hours. A nice gentleman brought some toys for Peter, and we watched cartoons on PBS.  Peter got bored and started trying to run out of the room.  Since we were under quarantine, though, we couldn’t go out.  I gave him a bath, and by the time we were done, the doctors were ready with his discharge orders.

We left at noon, and Peter slept all afternoon while I watched video recordings of the classes I had missed.  Son went to work.  I thought it was remarkable how easily we had been admitted and discharged.  There was no requirement that Peter gain weight for two consecutive days prior to discharge; no five-day brady watch; no car seat test.  The doctors were not concerned that Peter would randomly stop breathing or choke on his food, and they expected him to make a full recovery in a few days.  All so different from the stress of a NICU stay.

The next day, Peter started having diarrhea, and I started feeling nauseous.  Son took the afternoon off so that I could go to my shadowing site, the Target pharmacy in Leominster.  Unfortunately, I grew increasingly nauseous as I was driving to Leominster and could hardly focus when I arrived at the pharmacy.  To make another gross story short, I lasted an hour before puking in the hallway of the “Team Members Only” area.  Then I took advantage of the relief from my nausea to drive home.

Son fell ill that night.  We all stayed home the next day.  I took Peter with me to an appointment with my PCP, and the poor baby screamed when the doctor approached us with a stethoscope.  There was a similar scene when Son took Peter to his pediatrician on Thursday… I hope that this doctor-phobia will subside before his next check up on the 24th.  We’ll see.

Now for the happy ending: I started feeling better the day after my Target incident; Son was feeling better on Friday; and Peter started producing feces of a normal consistency on Saturday.  Hopefully, we’ve made it through the worst of this winter’s cold and flu season.

For any healthcare professionals who may stumble across this post, I leave you a word advice: It is never appropriate to make a funny face at a mother holding her sick toddler and ask, “And how old are YOU?”  You will either embarrass a mother who gave birth before the culturally-accepted childbearing years or you will embarrass yourself when you learn that a woman who you thought was “fresh out of high school” is, in fact, in her mid- to late-twenties.  (Yes, the ER physician was an old fart.)

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