So when Gary, the best male nurse on the 6th floor, came in with Memphis's walking papers, he was already in his going home PJs, ready to be strapped into his car seat, which was strapped to one of the wagons that CHM has for patients to use. See ya later, gator!
As to why Memphis and I spent 3 dyas at CHM, well that is a long story. Memphis had a seizure at 6:45 am on Tuesday. Memphis has not had a seizure since March when we tried to wean off the Keppra, so this one came as a surprice, but the sounds of Memphis's seizures are unmistakeable. Tuesday being my day off, I was sound asleep and Brad had already left to go clear snow. When I heard him yell I flew out of bed, across the hall and in the time it took me to do that, his seizure was over. So I took him back to bed with me and we both went back to some semblence of sleep. At 8:15 he had another seizure, again very short and no yelling this time, just stiffening and the head turn and rapid eye movement. Needless to say no more sleep that morning. We got up and attempted to do breakfast, which he promptly threw up. By that time it was 9 am and I could start calling doctors. I left a message at the neuro office and made an appointment to see the pediatrician that morning at 10:50. Memphis threw up another two times, had a loose stool and 3 more seizure by the time we got to the doctors office. The neuro nurse called back and said to let her know what the doctor thinks is going on, like an ear infection or something and then they would see about possibly adjusting meds.
While sitting in the peditricians waiting room Memphis had a sixth seizure, again very short in duration. By the time I could tell the receptionist and we got back to the exam room it was over. The doctor came right in and said he thought Memphis was Status Epilepticus, which is basically the brain remaining in a constant state of seizure, without becoming post ictal or fully recovering from the preceding seizure and I now know can be life threatening. The Dr said we should go to the emergency room, which is only a mile from his office and he would call and tell them we where coming.
When we arrived at the ER in Lapeer, they took us right in, faster than we have ever been served before, which should have clued me in on the seriousness of his condition. Upon getting into the exam room, the nurses started trying to get an IV going. The dr looked at Memphis's ears and throat and well as eyes. While trying to get an IV going Memphis threw up yet again, the fourth time and out his nose, whic really pisses him off and also had diarrhea right after we gave him rectal diastat, so of course that did not work. After several attempts and I mean several, to get an IV started they decided to do an IO, which is an intraosseous IV. I did not know what and I was and have since found out it is an IV that is inserted through bone into the marrow. Now when they brought out the gun that puts this thing in I asked the person who seemed to be the head nurse what it was. Keep in mind there is still a nurse trying to fish an IV into poor 
Memphis's little wrist and he had already been poked 4 other times. He was pissed and is being held down by three nurses and ER tech and his mommy. The nurse told me it was an IV that goes in his bone marrow. I must have gotten an awful look on my face and turned my head away. She continued in a very calm voice to tell me he had to have an IV and the was the best way right now. I was not arguing, I just was not going to watch while a Dr shot a needle that looks like a puch pin through my son's shin bone to get an IV started. In the mean time Brad had come into the room and I almost told him to leave when they did the IO, since I did not need him to pass out there. I know how he handles needles and if he had been any closer would have probably been in the bed next to Memphis. But after a loud pop and one yell, it was all done and Memphis had the IV he needed. They immediately started saline and then pushed some Ativan to break the seizure cluster. The dr ordered a dose of Rocephin to fight any infection that might be causing his seizure threshold to be lowered and said he thought he had slight ear infection. After a few fitful moments Memphis settled down and slept. At that point I could change him and get him cleaned up better from when he threw up. As he was laying there, he opened his eyes, looked at me, then turned his head to the right and his eyes started the rapid moevemnt again. I told the nurse who was in the room he was having another seizure and she immediately got the dr to order more Ativan. After the second dose my little man was pretty snowed.
Memphis's little wrist and he had already been poked 4 other times. He was pissed and is being held down by three nurses and ER tech and his mommy. The nurse told me it was an IV that goes in his bone marrow. I must have gotten an awful look on my face and turned my head away. She continued in a very calm voice to tell me he had to have an IV and the was the best way right now. I was not arguing, I just was not going to watch while a Dr shot a needle that looks like a puch pin through my son's shin bone to get an IV started. In the mean time Brad had come into the room and I almost told him to leave when they did the IO, since I did not need him to pass out there. I know how he handles needles and if he had been any closer would have probably been in the bed next to Memphis. But after a loud pop and one yell, it was all done and Memphis had the IV he needed. They immediately started saline and then pushed some Ativan to break the seizure cluster. The dr ordered a dose of Rocephin to fight any infection that might be causing his seizure threshold to be lowered and said he thought he had slight ear infection. After a few fitful moments Memphis settled down and slept. At that point I could change him and get him cleaned up better from when he threw up. As he was laying there, he opened his eyes, looked at me, then turned his head to the right and his eyes started the rapid moevemnt again. I told the nurse who was in the room he was having another seizure and she immediately got the dr to order more Ativan. After the second dose my little man was pretty snowed. After what seemed like an enternity the dr came back in the room and said that he wanted Memphis to be observed overnight, which I figured. And since we live in a rural area and Lapeer hospital does not have a peds unit it was off to Hurley, Mott at U 0f M or CHildren's, my choice. So my accomidations of choice was Children's since that is were Memphis's other doctors are at and if more testing had to be done I wanted his neuro in on the decision. When the ambulance arrived, we decided to give Memphis another dose of Ativan, since he was fighting to wake up and was extremely agitated. For those of you who have had a child strapped into a car seat who did not want to be in there, think about three times as bad, but half high as well. Not so much fun for the 90 minute ride to Detroit. So off to Ativan lala land again it was for the little man. When they went to load him into the ambulance, I went to side door, found my seat and buckled myself in. The EMT said, looks like you know what to do. I said I ridden in the amublance more times than I ever wanted to.
After arriving at CHM it was like a freak show, having a child with an IO IV. Seems as though those are not that common. Again, the ER nurses tried to get another IV started in his foot. Ever wonder how many times you can stick the foot of a poor two year old. Evidently 5 is the limit for one foot. By this time he was half waking from him Ativan land and was again agitated and pissed. So the ER doc decided to give him yet more Ativan, evidently you can give a little person Ativan each hour, because believe me, I asked. Back to be in lala land again. Then the IV team came in and actually got an IV started in his arm. The dr came in and said that she has spoken with neuro and they said to up his Keppra to 4ml 2x daily and to admit him to the 6th floor as a pediatric patient with neuro consult. Ok, sounds fine, but when I had talked to the neruo nurse that morning she said he was close to the top dose of Keppra and I again confirmed the dose was OK and was told yup, good to go with 4mL for Memphis's weight.
By this time I had told our story to the pediatrician, the neuro nurse over the phone, the ER nurses, the ER doc in Lapeer, the EMT, the intake nurse at CHM, the ER nurse at CHM, the physician's assistant at CHM and then the ER doc at CHM. And I would tell it again to a new nurse and doc ever tweleve hours while staying at our chosen accomidations. I was also forced to tell nurses, docs and nurses assitants what his seizures look like and to explain that he was not have seizures when they would take his temp and BP every 2 hours, he just does not like to be messed with when he is sleeping. He gets that from his dad.
While waiting to go to our room, the nurse came in to check Memphis's sugar level, since I mentioned that he had not eaten all day and had thrown up what little he had eaten that morning. It was a little low, so they gave him a glucose solution. The nurse came in and was saying over she shoulder to have another nurse note in his chart that he was getting 500mL for 21 kilos of body weight. I stopped the nurse and said how much did you say he weighs? She said 21 kilos. Now I am not good at metric conversion but I do know there are 2.2 pounds in a kilo and I KNOW Memphis does not weight 42 pounds, he weighs 28-29 pounds. I told her this and told her that he would not be getting a higher dose of Keppra until someone checked with Neuro again on the dosage level for his correct weight, because I know there is a fine line between the upper doses and toxicity, which is very bad. Evidently there was a miscommunication between the EMT and the admitting nurse in the CHM ER and the wring weight got written down. The dose of his Keppra was double checked with Neuro and adjusted to the correct weight.
So after a long day, we settled into our room on the 6th floor. I would be remiss if I did not mention how impressed I am of the nursing staff at CHM every time we are there, which thankfully has not been too often. We got transferred from the ER to our room at around 7:30 p.m. We had arrived at CHM at around 3:00 but did not get upstairs until late because the floor nurses do not like it when the ER nurses send a patient up to them who is in lala land from all the Ativan. Imagine that. We spent a pretty uneventful night in room 606, a private room no less, since so many kids at CHM had the flu and Memphis's nasal swabs said he did not. Which is good, better for sleeping when you do not have room mates.
On Wednesday morning he woke up groggy but happy. We snuggled in the chair for a while, until he threw up stomach bile. Yuck, what a way to start a morning. Then it was meds time, which he kept down. After the meds had settle I tried to get him to take a sippy of Pediasure, which he drank 6 ounces. After about 45 minutes I tried some peaches and cereal, which he took three spoonfuls and firmly closed his lips. About 5 minutes later he gave it all back, peaches, cereal and most of the Pediasure. Over the next hour he gave more of the Pediasure back. I told the nurse, who was surprised. I said, he threw up four times yesterday, I have been telling everyone that since we went to the ER in Lapeer. The doctors made rounds and the neuro doctors said they thought it was combo of him having an ear infection and outgrowing his med dosage. They would leave it up to peds to discharge us if they thought it was OK. The peds doctors came in and said that they would leave it up to neuro to discharge us. OK, who get to make the call?! Then I told them that he was still throwing up. What, throwing up? Yes, puking, vomiting, barfing, whatever you want to call it, he was giving back all of his stomach contents. I told everyone this yesterday. Was he having diarrhea? He had some yesterday, but when you don't eat for over 24 hours then throw up whatever you do eat it is hard to have diahhrea isn't it? By this time I am getting a little frustrated. So the peds doctors say, maybe he has a stomach bug and that helped to casue the seizures as well as the med dosage. I ask about the ear infection that all the ER docs have talked about. Ear infection they ask? OMG I am going to murder the next doctor who asks a stupid question. So again I explian what three doctors and nurses say they have seen in his right ear and that he had a swollen lymph node. Oh, maybe they should take a look. Ya think. Now I should tell you that I have the utmost respect for the doctors at CHM, but as a parent I am the advocate for my child and I know that something caused these seizures and I will push the doctors until I am satisfied with their explaination and diagnosis. I know that their major concern was getting the seizures stopped but my major concern is making sure they do not come back and if something besides Memphis growing is causing them that I want that treated and I mean right now.
So all the doctors leave, saying that if Memphis can keep down some fluids today then we can go home late in the afternoon. Well about an hour later, around noonish Memphis throws up again and this time there is some red bloody looking mucus in the puke. I tell the nurse and then when the resident comes back to check Memphis's ears. Yeah, his ears, which she says the right one is pretty red but not bulging so maybe the antibiotics administered in Lapeer have begun to work on the infection. Oh, ear infection huh. Amazing I said that yesterday and I did not go to school for a million years to become an MD or DO. I tell her he threw up again and that there was some blood in it. Of course this requires another night in room 606 to make sure he can keep food down and that he does not have a torn esphogus or stomach. Well, I think he threw up 8 times in 2 days, maybe his throat is irritated but I would rather stay than go home and have it be something serious and take this roller coaster ride all over again. I must say that the docs at CHM are not afraid to keep a kid an extra day if they are not completey sure he is ready to go home, unlike some other hospitals I have dealth with who just want to open up the bed for someone else. So because he kept throwing up they give him something to settle his stomach, Zofran, which worked great. We started feeding him 2-3 ounces of Pedialyte and had to practically pry the sippy from his mouth. After he kept that down he got another 4 ounces and all was well. So that evening he got 8 ounces of Pediaure over a three hour period and kept it all down. He was one hungry little bugger.
The next morning we started with meds, then 8 ounces Pediasure and 3/4 cup cereal and applesauce, which he devored all of it. I have never seen Memphis open his mouth for food like that. It was like as soon as I said open he opened his mouth and kept it open until he was sure the spoon was in there. He drank another 16 ounces Pediaure before they came with our discharge papers and we wheeled our way out of the hospital to celebrate New Year's Eve by going home and going to bed early.
(I do have some photos of Memphis at CHM, since Grandma had her camera in her purse. The camera is not one of the things I thought to grab when left the house Tuesday morning.)
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