Keller and the $35,000 Poo

I ended my previous post with the details that led us to take Keller to Vidant with vomiting.  We have been taught that though Keller's bowels have been kind of stitched into a "good" place they are not where normal bowels are and that we should be on the lookout for signs that something has twisted.  Signs of that are no stool passing and vomiting bile.  On the Tuesday that took us to Vidant Keller had vomited everything, which was a big change because he had stopped vomiting in the two and a half weeks he had been on his new diet of blended food.   Phillip and I took him to ED in Greenville pretty certain that we would be headed back home in the wee hours of the morning.  But he threw up something that looked like bile to us on the way into the ED.

We waited a while to hear the results of his X-ray to find out that he was constipated and had air in this belly.  This was a shock because on his new diet he had been moving things like never before and had in fact pooped that morning. We were admitted in the early hours of the morning and so began our 10 day admission.  I have never seen my son in so much pain and that is saying something because we watched him recover from open heart surgery.  Over then next few days we would watch them try this thing and that with a myriad of consults to GI doctors, surgery and dietitians.  They tried a suppository and got some results they tried an enema, then another enema, then a suppository.....then I forget.  Overall Keller had 2 suppositories, 2 fleets enemas, 2 saline enemas, a half gallon of GoLytely.  On the first Thursday we were there he threw up something greenish with flecks in it, he had good timing too because a very fresh resident (we're talking like 4 days into being a resident) had just walked into the room.  He looked like he had seen a ghost.  We were confused, was it actually bile?  He had no answers for us.  I told him and the attending Dr. that I smelled poop on his breath.  But we had an eye witness to the event.  Keller was screaming in pain.  He would sit up from being asleep, scream in pain for several minutes and then fall over in exhaustion.  It was miserable to watch and we actually needed Phillip and I both there at all times to help manage him and the tubes and cords coming from him.  

On Friday we got a room upgrade and this was like being taken from the Palace Motel to the Ritz Carlton.  We had much more space to stretch out to sleep for a few minutes at a time.  Along with all of his other issues, Keller is notoriously terrible to try to get blood work and IVs on.  He was going through an IV every other day which meant 3-6 sticks on any sort of vein they could find to get another in place.  Saturday they placed a tube in his hiney and pumped saline in that way.  They also tried something called a hog's enema at some point.  On Sunday the attending Dr. said that we were now operating outside the world of science and had gotten into voodoo.  Explanation: no one knew what this little boy wasn't pooping. That afternoon he threw up that same greenish flecked fluid.  This time it was deemed poop, he was so backed up he was throwing up feces.  They hooked his g tube to a drain and were able to pull off ounces and ounces of poop through his stomach.  On the x-ray that followed his small bowels were so distended they looked like a dryer hose.  You could see all the lines (rugae) on x ray.  Shortly after that was when we heard about an obstruction which was later diagnosed as ileus.  They do not know what happened first, was he constipated so bad that the ileus happened or did the ileus cause the consitipation? We won't know.  Things slowly and we do mean slowly got better and by that Friday we were finally released.  June 30th-July10th we were in the hospital waiting for poop.  And just as a funny antidote: on Sunday the floodgates opened.  Keller had a very productive diaper, productive enough that I threw him in the shower.  He crawled out of the shower and out of the bathroom (thanks to big sister leaving the door open) and by the time I finished in the shower there was poop all over the carpet and down the hall.  I'm pretty sure that's Murphy's Law in action. :) Thank you for all the prayers regarding bowel movements.  They obviously worked it just took a little time. 

As a result of my last three years I am officially over the Fourth of July. Three years ago we found out I was having a miscarriage on the Fourth and the last two years we spent the holiday in the hospital with Keller.  Also, I have read articles about not going to teaching hospitals in July.  From my experiences these are true.  We have broken in a couple of residents now.  ;)