Saturday, December 3, 2011

The beginning (continued)

The doc was so concerned about our boy that he called to check up on him from his home and we both decided it was time to go to the hospital.  So I pack Jacob up and take him to the local children's hospital's emergency department per his doctor's request.  Joe was at a conference so I kept him updated via text messages.  At this point we were still thinking a stomach bug and dehydration.  I really thought IV fluids overnight and we would be heading home.  Not so.

After an xray, labwork, and a CT scan, the docs came to report Jacob had acute renal failure and would need to be admitted.  What a surprise to us!  My husband and I had already decided that he would spend the night with Jacob and I would come back Sunday morning to spend the day with him.  We got him settled in for the night and IV fluids were started.

On Sunday, the labwork came back and his BUN was 140 and his creatinine was 7.7.  Just as a reference, the normal BUN is no more than 20 and the normal creatinine is no more than 1.4.  So, as you can see his kidneys were not functioning well at all.  The hospital we were at is a teaching hospital so the group of residents were asking us all sorts of questions about the previous week.  Being a nurse, I made sure I had committed to memory all what Jacob had been through the last week, including that he never once stopped making urine.  That was something I had been monitoring all week.  Luckily for us, I recognized one of the residents from the hospital I work at.  That was very nice as he kept us informed of every detail.  Since the hospital we were at did not have kidney specialists, they were consulting with the bigger teaching hospital.  The resident came back after ten minutes of telling me of the consult and said that as soon as the nephrologist heard the labs, they wanted Jacob at their hospital.  So after hanging out for most of the day, we packed up and took the 45 min trip to the other hospital. I rode in the ambulance with Jacob and Joe met us up there. 
By 6pm, we were pulling up to the ambulance doc at the new hospital...the hospital I work at.  We got Jacob settled in and Joe and I will begin our week of "shift work".  Joe spent the nights and I spent the days with Jacob. 

Monday morning after dropping off our daughter at school, I made the hour trip to the hospital.  I had no idea what to expect when I got there...good news or bad news.  I had an hour to reflect on the news we had received the night before. I think in that hour I went through every emotion there was.  I was happy we got him to the hospital.  I was mad that we waited a week, but who knew it would be kidney disease??  I was sad because my baby boy was sick.  I laughed with the radio; I yelled at other drivers; I cried, BUT I pulled it all together by the time I made it to the hospital.

That day we learned that just by pumping him through of IV fluids, his BUN was down to 77 and his creatinine was 5.5.  Dialysis was now off the table...whew!  Jacob was still vomiting, but able to keep some fluids down with the help of Zofran.

Tuesday, his labs had improved even more...BUN 55 and creatinine was 2.3.  Yay!!  Jacob was still vomiting so we needed to deal with that.  Plus he was still "spilling protein" into his urine.  This was concerning the doctors.  They wanted to know why.  They wanted to do a kidney biopsy to see what was going on and it was planned for Wednesday.

Wednesday.  Jacob is still vomiting so the biopsy is delayed a day.  The decided to give him around the clock Zofran to control his vomiting so the biopsy can be done on Thursday.  His spirits are not too bad.  He has been getting texts and a few phone calls from friends so he is happy.  He is a little bored though.  We do try to venture off the unit a few times.  This passes the time some. 

Joe and I are starting to get a little tired.  We live an hour away and the drive back and forth each day is getting to us.  Plus we had plans to move, but Jacob got sick so those were delayed as well.  Thankfully the other child we have at home is very understanding on our neglecting her.  We are also thankful for Facebook.  We were able to keep the our entire family up to date with one post rather than making a million phone calls!

Thursday.  Jacob had not vomited in about 24 hours!  YAY!!  So the biopsy was on!  Jacob's IV site had infiltrated the night before so the allowed him to go over night without a site.  The staff was so accomadating to him.  They gave him some Versed before they even began numbing the areas they were looking at starting an IV in.  Boy, does that medicine make him loopy!  (He was making us laugh!)  The IV got started and off we went to the biopsy.  It only took them about 15 minutes and we were heading back up to the floor.  Poor Jacob had to lay flat for about 4-6 hrs.  This did not make him happy AT ALL!  I tried to dim the lights and let him sleep most of it, but even the few hours he was awake, he was miserable! 

That afternoon, the doctor arrived and said that it would take some time to get all the results back as they examine the biopsy sample three different ways.  It could take days.  He did get some preliminary results quickly though.  His kidneys were very inflammed and he was now going to start three doses over three days of high dose steroids.  I believe he got 750mg Solumedrol each day.  Poor Jacob.  When we got the results, he was so scared.  He actually asked if he was "going to make it".  That about broke my heart.  To hear those words come from my child's mouth just about made me cry.  I gave him about as much reassurance as I could, but to tell the truth, I was scared.  I had no clue what the future held for him.

One thing we needed to deal with was his fear of needles.  Jacob is VERY afraid of needles.  After dealing with this fear all week, I finally sat with him and explained that the lab draws were going to happen and we needed to just find a way to cope with them.  I mentioned that sometimes people will use stuffed animals to divert their fear.  He had been eyeing a sock monkey in the gift shop.  I asked him if he thought he could use the sock monkey to distract him from the needle stick.  He agreed to try.

Friday.  The best morning text from my husband..."The sock monkey worked".  Praise the Lord!  Jacob completely gives all the credit to the sock monkey.  I think he is just stronger than he lets on.  We just let him think it is the sock monkey though.  Nothing else happened on this day. Just fluids and the daily steroid dose.  Joe stayed all day Friday so I could get some things done around the houses...like pack, paint, etc.  Then I spent the night Friday and stayed Saturday.  Jacob and Joe got to spend some quality time together.  Even though he was sick, he was still able to whip Joe's but at Monopoly.  The kid is the Monopoly king at our house.

Saturday.  The doctor comes in and asks Jacob what he wants to do today.  Jacob says, "Go home".  The doctor says, "Ok".  Jacob couldn't believe it.  "Really?" was his response.  Yep, after his daily dose of steroid, we got to go home.  By 6pm, we were pulling away from the hospital. 

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