Kara's Appendectomy and our Experience with Children's National

On Monday, I came home from work to Kara saying she wasn't feeling well. She said her stomach was upset and she was very agitated. She said it started in the morning and got worse as the day went on. She didn't want to go to the nurse because she figured the nurse would just send her back to class. She threw up about 10 minutes later and kept throwing up. She sat on the couch moaning and couldn't even watch t.v. or play her kindle. I was worried, but figured it was just a bad stomach bug. She didn't have a fever and the pain was around her belly button. I promised her she would feel better in the morning. Kara had a lot of trouble falling asleep and when she woke up she was still in pain. I thought she was acting better, but she said she felt the same. Of most concern was she couldn't stand up fully. She was walking around hunched over. The pain was still in the middle of her stomach and she still didn't have a fever, but we decided to go to the ER anyway.

We got there around 9 and saw the doctor around 11. They immediately thought appendicitis. They gave her Zofran and some Tylenol and she finally felt better (she threw up 11 times from 4pm to 9am!). The poor kid was super hungry, but they wouldn't let her eat or drink anything, except for the CT contrast.  When we checked in, her temperature was 99.5. When she got to the back, it was 102.8. She was also really dehydrated. I called Thomas and he left work and met us at the hospital. But, then she got better. She could walk normally and said the pain was gone. We figured it was probably a virus made worse by the dehydration. We even talked about cancelling the CT, because why expose her to the radiation? But, her white blood cell count was elevated, so they strongly suggested we do it anyway. And, of course, we don't ignore medical advice when it comes to the kids. 

At 2, they had the results of the scan. Her appendix was 3x its normal size! They had already talked to the surgeon on duty and he wasn't comfortable operating on her, so they were trying to arrange transport to Children's in DC. They wouldn't let us drive her because they feared her appendix could rupture on the way. She was starving, but the nurse said she would have surgery that night so she couldn't eat or drink anything. We had a friend who had recently had the same situation and Children's didn't operate on her son until the following day (despite the local hospital telling her with certainty he would be operated on that night). Thomas called Children's, but all they would say is that they would have to evaluate her when she arrived. The staff at our hospital said they were confident that based on her CT scan, her operation would be that night.

Children's transport couldn't give our hospital a time when their ambulance could arrive, so we used an independent company. They got there around 6 (4 hours after diagnosis). Thomas rode with her and I followed right behind, I was afraid of getting car sick, and Kara was fine as long as one of us was with her. We got to the hospital at 7:30 and Kara checked into her room. They had the room ready for her and on the whiteboard, they had her listed for surgery the next day! Ugh!!! Apparently, that is the default if you arrive outside normal hours. We were kind of irritated. She was in pain again and super hungry. But, they couldn't tell us what time the surgery would happen, so they still wouldn't let her eat. We had arranged for a friend to spend the night with the other kids, figuring Kara would be having the surgery and we both wanted to be there for that part. But, instead, we just hung out all night. Had we known before we left St Mary's that the likely plan was surgery on Wednesday, one of us would have gone home to be with the other kids and come up the next day. 

In the CT scan (she wanted pictures to show her siblings, which is also handy for blogging).

Strapped in to begin her ambulance ride

It was a restless night. We saw a doctor around 8pm and he confirmed the surgery would be the next day.  He said the antibiotics bought them time and would keep her condition stable, so there was no hurry (again, information that would have been more useful when we called). Another doctor came in around 9pm and told us that the surgery times would be set in the morning and that when the doctors did their rounds at 7am, they could tell us when. He also said she could eat since it was before midnight. But, the 8pm doctor had said she couldn't have anything. After the nurse pointed out the discrepancy, they decided she could have ice chips only (I think the 8pm doctor outranked the 9pm). No doctor ever came in the morning. We asked the nurse repeatedly and she just kept saying a doctor would be in soon. Then, she told us the doctor said they had come by, but we weren't in the room. Not true! I left the room briefly at 6:30 to go for a little walk, but I saw they were in the hall, so I came right back. And, Thomas never left. I actually heard them outside her room at 6:45, discussing her. They didn't come in and I assumed they would return. 

After the nurse called again, a doctor finally came in at 11:45 and said he wasn't sure how they had missed us. But, he had no information. He didn't know when her surgery would be. She was an add-on, so he figured they would put her at the end of the day, around 3. We explained we had 3 other kids at home that we needed to plan for, and told him the other doctor said she would be listed on the board in the OR, but he just held firm that he had no idea. 

Right after he left the nurse came in and told us the OR had just called and they were coming to get Kara. Yeah! We met her surgeon, who we liked and the operation started around 2. We saw lots of kids coming in for surgery. Most appeared to be scheduled surgeries. And, I am sure they had waited a long time for their surgery date. But, I couldn't help but feel that if you were going to push someone, it should be the kids who aren't in pain. Kara hadn't eaten in more than 48 hours and she was scared and in pain. I get that to them an appendectomy is pretty routine, but it was really hard to sit around with no real information. And, I feel like a lot of the frustration, actually all of the frustration, would have been eliminated with consistent communication. She could have at least eaten something the night before and we could have made advance arrangements for the other kids. 

While people were nice, they didn't seem to really care, if that makes sense. The nurses were better, but even they weren't great. It regularly took them a long time to come in to turn off her beeping IV (which seemed to go off every couple of hours).  At one point, she had to go to the bathroom and it took at least 20 minutes for them to come unhook her (they were pumping her with fluids). Another time, they just never came at all and Thomas finally wheeled everything in with her.  Although, in fairness, they definitely did their best to alleviate her pain. However, the nurses at St Mary's when I had my C-section with Luke were much more responsive.

But, back to the surgery, we finally decided that I would go home after she was out of recovery. We didn't want to leave the kids 2 nights in a row, especially since nothing was arranged at home. The guest room wasn't ready, the house was a mess. It just didn't feel right or fair. Of course, leaving Kara again didn't feel right or fair either. She came out of recovery and was shocked the surgery had happened. Before she went in, the anesthesiologist told us she would wake up and feel like only a minute had passed, and he was right. We told her she was done with surgery and her response was, "already, are you sure?". She quickly ate a popsicle, which she then threw up. She had a lot of pain, which seemed to surprise the nurse. They gave her more medicine and she felt better. I left shortly thereafter to go home to the others. The surgeon had said Kara could go home the next day. The surgery had gone really well and while the appendix definitely needed to come out, there had been no rupture. I got home around 5:30 and Thomas called and said another doctor had just come in and said she could go home that night! Ugh, again, information was not consistent! I was more than willing to go and pick them up, but I was nervous about her coming home when she had so recently thrown up and been in so much pain. Thomas agreed and we opted to have her spend the night.

I got there the next morning around 1000 and she was a new kid. She was sitting up, eating, could walk to the bathroom on her own and no longer had watery, sick eyes. It was such a relief. She actually walked all the way to the car! She had Motrin when we got home, but hasn't had anything since. She is already planning on returning to school Monday. Our kid is tough!

I realize this sounds like a lot of whining. At the end of the day, we fully recognize that the most important thing was she have a successful surgery, which she did. And, it isn't their fault we live almost 2 hours away (thanks to DC traffic). Yes, communication should have been better, but our childcare issues were the fault of distance, one huge drawback to where we live. I am grateful for skilled surgeons and nice nurses (even if they didn't come quickly, they were always nice). And, I am really grateful for the friends who helped us and those who checked in on us. Kara loved hearing the messages of well-wishes and it truly made a difference to know so many people were thinking of her. We received many text messages and phone calls and felt lots of love and support. My friend Kayce got the other kids off the bus on Tuesday and picked up Luke. She fed everyone dinner and kept them entertained. My friend Jennifer came over at 7 and took over. She put them to bed, spent the night, and got them off to school the next day. Another friend (Dana) drove Luke to Prep and Play. Then, Kayce did it all again until I got home on Wednesday. Yet another friend (Summer) was fully prepared to spend the night Wednesday, but as mentioned, I decided not to leave them 2 nights in a row. Many more were willing to help out and offered meals and anything else we needed. It meant so much to us! It is hard not living near family, so having friends willing to step in makes such a difference and we are so thankful!

One more cool story--the blanket was given to her at St Mary's Hospital. It is part of the Linus Project. People in the community make them for children in the hospital. She kept it every step of the way. Yet another thoughtful gesture, this one from a stranger!