HSP – Part 2 – The Hospital

Sorry to break this up into pieces. I just don’t seem to have oodles of time to blog. Go figure!

Anyway, on Friday night the urgent care doctor put us on antibiotics for strep and told us LD had scarlet fever. I was a little worried because the rash looked nothing like the scarlet fever rash on the internet, and I couldn’t find any site anywhere that linked swollen joints to scarlet fever. But I had the antibiotics and I felt like at least we would get this out of his system.

Then on Saturday, LV woke up with a sore throat. I put in a call to our pediatrician and he called in antibiotics. Saturday afternoon, LW came down with a sore throat, but the pediatrician’s office was closed until Monday. She had to suffer with a sore throat until Monday morning when the doctor was able to call in an antibiotic for her. I also went into my doctor on Monday and got my own antibiotics for my sore throat. (Thank you, Publix, for free antibiotics!!!) We were dropping like flies…

While all this was going on, LD started new symptoms. He was totally lethargic, he complained that his stomach hurt, and he couldn’t get comfortable, constantly tossing and turning, tossing and turning. LD is a super tough kid. I mean super tough. He cried when he broke his collar bone when he was two. But after the first impact, he didn’t cry. When I took him to the pediatrician to have that checked, the pediatrician said, “No way it’s broken. He’s letting me push all over it. He would be screaming out in pain if it really hurt.” But sure enough, when I took him for an x-ray, broken collar bone. That’s how I knew this stomach pain was no mere tiny ache.

Then LD started vomiting. I knew strep throat could cause vomiting, so I figured that was what it was. But when he was still throwing up on Monday after 3 days of antibiotics, I took him to see the pediatrician. The pediatrician told me immediately that it wasn’t scarlet fever but HSP. He brought me a textbook which showed the rash and it looked exactly like it. He felt LD’s stomach, pushing it “to his spine,” as he said, and LD never flinched. When asked if it hurt, he said, “Yeah,” but quietly and calmly. So the pediatrician said he didn’t look hospital-sick, but we should just watch him. I also didn’t think he was hospital-sick (we’ve had Littles down with stomach flu before who looked worse than LD did). I was disappointed that there wasn’t anything else we could do except Tylenol, but home we went.

The vomiting and stomach pain did not stop. All evening Monday, and all morning Tuesday. But there were times in between the puking and stomach pain that LD seemed like he was getting better. On Tuesday morning, he was playing sticker books with the other Littles. But on Tuesday afternoon I called the pediatrician again. He said, “Take him to the hospital right now.” LD was on the couch watching TV, I was making lesson plans for the following day’s co-op, MM was still at work. What to do?? I called MM and he came home, I finished up my lessons, and we took him.

It was about 2 hours after I had called the pediatrician that we arrived at the hospital. LD vomited once in the car. MM asked me to bring in the “puke bucket,” but I was sure that LD would be fine because he had just thrown up, and he seemed to go 1-2 hours between vomiting. Of course, while I was checking us in, LD puked all over himself and MM. Worst mother and wife of the year award for me! Poor MM had to stay in his throw-up-laden shirt all night.

The brought him right back into the pediatric ER. No waiting room time for us. In the back room, the nurse informed me that they were going to need to do an IV. I had figured as much because both LD and LW have needed IV’s before due to stomach viruses. I figured this was the same thing.

Here is where my heart started to break for LD. The nurse tried one spot on his right arm, got a vein, but it “rolled.” Then she and another nurse proceeded to try 3 more times at different spots. For the first 2 times, LD had just sucked it up. But by the third try, he was screaming and thrashing. MM leaned over to me and said, “I’m going to ask them to let me try. This is ridiculous.” I was just praying, “Please, please, please let them find a vein that works. Please, Jesus.” I was also crying at this point.

They decided to give LD a rest and instead brought him in for a stomach x-ray and ultrasound. As soon as the x-ray tech left, she stopped over and spoke to the pediatrician on duty. The pediatrician came right over to us and told us, “LD has intussusception. He is going to need surgery right away. I’ve already called the surgeon and let him know.”

As you can imagine, this was a total shock to MM and me. We just looked at each other. The doctor proceeded to explain that HSP can cause intussusception in some children (a very small, small percentage of HSP sufferers, we’ve since learned). Pretty much, the bowel folds in on itself like a telescope, or like one of those kids’ light sabers. He would need surgery to stretch it back out.

Of course, they still had to find a vein for blood work, an IV, and the anesthesia. Another nurse came in and thankfully found the vein in LD’s right hand on her first try (his fifth). Then the doctor told us that before the surgery, they were going to try a procedure where they would give LD an enema of air and try to blow the telescoped bowel back out. If this worked, he wouldn’t need surgery. They wheeled us to the radiology department.

I had to hang back in the wings and watch while MM held LD down on the table with his knees pinned to his chest. They stuck a long tube you-know-where and started blowing air through his intestines. During the process, they continued to x-ray him to see if the intussusception was being fixed. Of course, LD was just screaming and crying during this whole procedure. After about 20 minutes, the radiologist told me that unfortunately the procedure was not successful and that LD would need surgery after all. He said he was able to move the intussusception down to where the bowel meets the small intestine, but that it wouldn’t blow out any further.

LD was brought back to surgery. The anesthesiologist told us LD would need a second IV but that he would wait until LD was out to install the new IV. The surgeon told us that he would be making a cut on LD’s right side below his belly button. He said he would open him up and determine how large the intussusception was. The surgeon said that if LD’s bowel had been without blood flow for a while due to the intussusception, that he might need to cut away part of LD’s bowel. The surgeon also told us that if the intussusception was anywhere near LD’s appendix, he would have to remove his appendix.

So, a mere 5 hours after we had arrived at the hospital, LD was wheeled into surgery.

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