A new era has dawned

It happened shortly after ‘Timan’ was released from the hospital. Every day we had to go to the ER in our local clinic, where the dressing was changed, the dressing that covered his still open incision from his appendicitis surgery and the emergency surgery afterwards. One morning we met this Indian doctor. And he did what I’ve tried so many times before but did not succeed at all.

I’m talking about the last step in toilet training, or should I say toilet learning. Since more than half a year ‘Timan’ was doing great concerning the pee issue, he could do it while sitting on his toilet seat (like every mom, girlfriend or wife should teach their male housemates), while lifting up the seat and nicely arranging his things (all three of them) on the rim of the bowl and also when he was playing outside. After a very short time of practice not a drop went awry, even though the wind was his biggest challenge when he was practicing outside. His little friend was showing him how to do it and several times I saw the two of them doing their business towards a wall. So cute.

But he flat-out refused plop a bowel movement into the toilet. The potty chair he refused from the beginning to use for anything else than as a chair to look at his little books. He insisted on doing his BM into the diapers. I’ve tried everything, I’ve tried it with many methods you may find online, nothing worked. I’ve told him he will not be able to go to pre-school in diapers, knowing he’s already so much looking forward to go next year. He did not care. So I gave up. In time he will come around I thought, eventually he has to. Isn’t there a saying that ‘nobody walks down the aisle in diapers’?

But back to the actual event, or person, that changed everything. The Indian doctor.

He was looking at ‘Timan’, the wound from the last surgery, he frowned and thoughtfully shook his head. To me he said than: ‘Madam, the boy has to go without diapers. Or there will be i n f e c t i o n.’ And to ‘Timan’ he said: ‘No more diapers little boy’. And ‘Timan’ looked at him, looked at me, swallowed hard, and said: ‘But … want diapers’. The doctor again: ‘Nooo, little one’, pulled the diapers away and threw them in the trash bin. ‘Timan’s mouth was quivering but he did not cry, just looked at the doctor. Was it his accent, his beard, I guess I will never know, my little one simply accepted what he was told.

We went home, without diapers, he took his nap after lunch, without diapers, slept through the night, without diapers and he stayed dry. You can imagine my surprise. I never expected it to be that easy.

Of course, we’ve had a couple of wet accidents in some of the nights since then and one BM in his undies at the very beginning but it took only a day or so until he told me he had to use the toilet for passing stuhl. And he is doing fine since then. I’m proud of him and I think he himself is as proud as he can be.

But ‘Timan’ gave me areal scare about two weeks into his diaperless life. After the operations he was eating normal, lots of fruits and foods with fibers but he was not drinking as much as he used to. I constantly had to force him, often by waving a syringe and from time to time I even had to use it.

So after two weeks doing absolutely fine he was complaining about pain in his belly. I was so afraid that again something was wrong related to the operations that I took him to the ER right away. By chance his former surgeon was on call. During the ultrasound he threw up and went limp. Again there was a small amount of some liquid visible in his abdominal cavity, but apparently nothing to worry. But to be on the safe side and I guess to cover himself, the surgeon admitted ‘Timan’ to the pediatric ward for observation. Next day CT scan and another ultrasound and these tests showed his intestines were slightly swollen, luckily the liquid appeared not to be the problem.

But gas and a full rectum were causing the pain, with other words, he had a constipation.

I think under normal circumstances this would have solved itself after a while but with ‘Timan’s history of belly pain I could not let it pass without having him checked by a surgeon.

The most important thing now is to make sure he’s drinking enough water and eating enough fibers so his stuhl is not getting compacted and he ends up being constipated again. And he will drink, this I’m going to take care of, the little one is on a drinking schedule now.

But fact is ‘Timan’ has entered another developmental stage, the baby and bubba days are over and a new era has dawned. Now ‘Timan’ is a little boy.

How did your little one master this developmental milestone? With your help, on his own, the help of somebody else, did he have an ‘authority’ figure like ‘Timan’ had? Please tell me about it.

‘Timan’s ruptured appendix with complications (emergency operation, surgery 2)

Continuation from ‘Timan’s ruptured appendix with complications (surgery 1)

8th of March:

My little son has spent the night moving from one side to the other, but otherwise without incident.  In the morning he wanted instant noodles again (for breakfast), and the sick ones are allowed to eat what they feel like whenever possible, aren’t they? He was drinking but he still did not wet his diapers. I told the nurse. They also took his drain out and in the bag was not much liquid. The male nurse on duty kept asking me about the state of his diapers and I kept telling him every hour or so. Still nothing around lunchtime and I was badly worried at this time and kept asking for the surgeon.

‘Timan’ has been drinking more than 1/2 liter but did not pass any urine since 5pm the day before. What goes in has to come out or something is badly wrong. The male nurse called the surgeon but the doctor played down the problem, 1/2 liter was not much liquid. Maybe not for an adult but for a toddler it’s a lot especially when no urine is being passed for a period of over 18 hr.

The nurse kept insisting ‘but doctor, doctor, listen …’ for several minutes until the surgeon ordered some tests to evaluate what was wrong. Looking back he probably saved ‘Timan’s live with this persistence. The urologist was called and an ultra sound performed. There was the full bladder visible and something more, but very diffuse. We rushed back to the ward, ‘Timan’ was given a sedative to put him to sleep, no reaction, double dose, no reaction. We went for the CT scan nevertheless and I managed to calm him down so it could be performed.

And back to the ward to put a catheter. When the surgeon tried to extract the urine by first squirting some saline liquid into the bladder, he felt a strong resistance, but suddenly it passed inside. Then he extracted 230 ml brown urine. Back for another ultrasound and I was told the final diagnose: ‘Timan’ was suspected to have a collection in his abdominal cavity.

The emergency surgery was scheduled to start immediately and lasted for more than 2 1/2 hours. 150 ml collection of liquid from his appendix wound on the colon was removed and the whole abdominal cavity was cleaned out. A difficult, dangerous and live threatening surgery for everyone, even more for a Toddler.

After the operation I inquired for the reason for it. Apparently a blood clot had blocked the drain of his ruptured appendix surgery and prevented the liquid to drain from the wound inside his abdomen. This collection became more and more and an inflammation developed inside his stomach cavity.

My little one was transferred to the Intensive Care Unit. He was more or less stable.

I’m not able to tell you the things going through my head during the operation and the first hours in ICU. But the only chance we have had, was putting our trust in the operating team that was trying to safe ‘Timan’s life.

9th of March:

The artificial respiratory unit was removed the morning after the operation but he stayed in ICU  for another day.

10th of March/11th of March

Back in the pediatric ward ‘Timan’ was given the ’emergency room’, a room where he was able to stay on his own and under close supervision.

12th march

He was taken off the machines and the drain from the wound was removed. And there was a blood clot inside, about 6 inch long. I was terrified when I saw this. The same complication could have easily happened again.

‘Timan’ got better and better from day-to-day. I think he recovered faster because we were able to move into one of the single rooms. And finally he was discharged from hospital on the 16th of March.

I hope this is not going to stay in his memory forever, maybe only the things we will tell him when he’s asking about his scars. And they are large for the size of his little body, a horizontal scar of  2 1/2 inch and a vertical scar of 4 inch starting 1 inch slightly towards the right above his belly button, running down towards his groin.

But what the hospital personnel did not tell me and I found out later was if this condition was not caught in time our little son would have died.

And I keep asking myself, are we talking here about a doctors error or negligence? Or is this just one of these complications that can happen after a difficult operation?

During the last couple of days I was finally able to search online and found horrible descriptions of complications occurred after a ruptured appendix surgery.

In the end I think we were most lucky still having our little son with us. He’s a tough little guy but somebody was watching over him.

Another thing I learned from this: Do trust your own gut feelings as a mother/father more than ever even when people try to appease.

Life goes on. This time my son is going to be all right. I know so.

‘Timan’s ruptured appendix with complications (surgery 1)

No parent wants his child to be sick and not really getting better but at one point you might realize it’s actually happening and there is not much you can do about it but trust the medical professionals. That’s what has happened to our family. These last months February and March 2011 were the worst months in Hubs’ and my live, by far, and certainly in ‘Timan’s young live.

These recent events were also the reason I did not write any posts or used the computer at all. But let me start from the beginning, how all begun:

‘Timan’ was sick with stomach problems off and on during the whole month of February and I already wrote about his belly pain, his focus on his belly and that something else there isn’t quite right. After the antibiotic course he finished towards the end of February he was doing really great and we all thought he’s cured and well again … until the late evening of March 2, when the pain came back with full force.

After a joyful day spent with Hubs who was off and eating lots of tasty food he was suffering again. We thought he simply had too much to eat but in the early morning hours, after a more or less restless night, I knew it was not the food, this was going to be really bad.

3rd of March:

I started to examine his lower tummy, first slightly pressed under his belly button than moving to the right and even though he said ‘no pain, mommy, no, no’ I saw his face twitching. When I applied the slight pressure on the left side, no reaction at all. At that point it was all clear to me. I woke up Hubs, made ‘Timan’ ready, called the doctor’s office, luckily they were open already and off we went.

This time the pediatrician came to the same result, suspected appendicitis, we left for the main hospital and asked for the surgeon on call. And we had to wait, and wait, and finally around lunchtime he got examined, his blood was taken for tests and his abdomen checked with ultra sound, the results were diffuse so ‘Timan’ got admitted to the pediatric ward for a 24hr monitoring.

4th of March:

The next morning, the main surgeon examined his stomach and set the operation for 12 noon (unfortunately another doctor had allowed ‘Timan’ to eat some breakfast early morning).

I was carrying him to the operating theater, we entered the main door (it does not look too reassuring, I can tell you, worse on the inside).

It was dark inside and a dark man in green with a cover over nose and mouth took ‘Timan’ away. I was not allowed to go any further and I heard his frantic screaming ‘Mommy, Mommy stay, Mommy, Mommy’ for several minutes as I made my way out to the waiting area, until it stopped. And my tears began to flow.

I told myself ‘hang in there, it’s just a minor operation, that’s been done thousands of times, he’s going to have 2 or 3 little marks and all will be over within half an hour. Just relax, all will be good.’

And time passed … 1/2 hour … 1 hour … Hubs got a break from work and joined me … 1 1/2 hours. I thought ‘don’t worry, it takes time for the anesthesia to work properly, to operate and to wake up. And more time passed … 2 hours … 2 1/2 hours … and finally a doctor came and told us that the operation is going to be finished, they were stitching now. But it has been a difficult surgery … after another 45 minutes the surgeon came and told us that ‘Timan’ is stable and slowly waking up. The appendix had been clogged by mucus and tissue and was perforated at the base. They had to clean out a big part around it. I was allowed to the recovering area and after a short while ‘Timan’ was brought back to the ward.

5th of March:

‘Timan’ was slowly recovering, but did not say much or move around much, he just lay in his bed and looked around. Maybe because of the paracetamol he was constantly given, to keep pain and fever in check.

6th of March:

‘Timan’ was allowed to drink clear liquid. The nurse emptied the drain bag full of blood tinted liquid from the wound inside his abdomen. But this night, around 2am he had a sudden fever peak of 40C (104F) after his temperature slowly has been going down, back to almost normal. But in the ward was a viral fever going around, I started to feel some symptoms and ‘Timan’ had a runny nose and was coughing, so I did not feel very worried about he sudden high fever, and apparently so didn’t the nurse.

7th of March:

‘Timan’ was allowed to eat soft food but did not feel like eating anything. But I got him to drink water and juice diluted with water and around 5pm I changed his last wet diaper. In the evening he wanted to eat instant noodles and I was happy he finally started eating.

I felt more relaxed, even tough the pediatric ward was overfull. In our room were 5 kids with 5 mothers and the room was 7m x 7m max. There were two beds in the ward’s main hallway and the only two single rooms were taken already.

Since ‘Timan’ is so young, just slightly older than 2 1/2 years, I know it’s difficult to diagnose appendicitis. Because I had to take him to the doctor so many times this February because of his stomach problems, I think he did not tell me all the time when he was in pain, because he knew I would take him to see the pediatrician again.

Could or should I have done something different? Maybe reacting earlier, so it would have been an easy appendix removal? Would it have been different if we were living in Europe? Or should I have listened to my gut feeling and insisted on thoroughly checking him through when we went to the doctor during his former stomach episodes? Was it a kind of rumbling appendix all this time? These thoughts kept coming and I will never know.

Did you already have a similar experience concerning a late or almost too late correct diagnose ? Please tell me about it.

But now ‘Timan’s ruptured appendix was taken out, he was still on strong antibiotic medicine administered by IV to fight bacteria and fungus and from now on it can only get better, so I thought. … (to be continued)

Belly matters – cute, annoying, painful and comforting.

Some time ago ‘Timan’ and I had a talk about where he was coming from. I kept it very simple and just told him when he was very very little, he was living in my belly, until he grew too big and wanted to come out to play. And of course he understood that neither his beloved tricycle nor the blocks he’s playing with all the time would  have fit inside my belly . He was fine with this explanation, and dropped the matter. Remember he’s just 2 1/2 years old and I was very surprised he showed some interest in this.

But since that day he’s having a somewhat strange and funny love for my belly. He likes to cover it with little kisses (cute :-)) and pat it and he’s telling me that the belly button is the eye, the belly is talking (of course my stomach is grumbling once in a while), smiling (??) and has to eat (mangos and apples, his favorite fruits at the moment).

But anyway, a short while later Hubs was joking about the ‘big’ belly ‘Timan’ has. Especially after a meal he really likes, he looks like he has swallowed a little ball in whole. One word led to another and Hubs ended up being the one with the ‘big’ one  ;-). But he did not agree with this at all (aren’t they all a bit vain sometimes, the husbands?) and kept telling ‘my belly is medium (size)’. I myself reinforced the message to ‘Timan’ that Mommy has a ‘flat’ belly. Well, even if that’s not entirely true, it does makes you feel good when somebody is telling you that your belly is flat, doesn’t it?

But back to the subject: very often babies and toddlers have a comfort object they take with them wherever they go. ‘Timan’ never had one. Oh no, that’s not true, he did and does have one, a very big one, and this would be me. Snuggling in my arms turned into pressing his face onto my belly. Whenever he wants some special snuggling time, it has to be with my belly. At the beginning I thought this is very cute. But now, several weeks later, it’s getting a little annoying. ‘Timans’ love, or should I say admiration, for my belly goes so far that he’s even trying to do the kissing thing in public, and I don’t like that, not at all.

But during the last couple of days, the belly became the main focus in ‘Timans’ life. For good and bad (painful). He’s sick in his own (stomach flu, I guess) and needs mine for comfort even more than ever.

Sometimes he’s telling me that he’s not a ‘bubba boy’, no, he’s still a ‘tipti bubba’ (tiny baby). Maybe this is just a developmental stage when the tots are trying to become independent but are too scared of the things they encounter once in while and are looking back to the ‘carefree’ days of babyhood when the only things that mattered were the nipple (food) and a good sleep.

And  I believe it definitely has to do with the belly talk we’ve had in the past. It’s his way of staying in touch with his roots, so to speak.

Be honest, deep down aren’t we all back to this stage once in a while when we would really need the special care and comfort of someone?

It’s giving me pain to see him in pain.

‘Timan’ is sick. Since yesterday afternoon. It hurts my heart. He’s so vulnerable and week, sometimes he has this high-pitched crying and sometimes he’s just softly moaning. He want’s to hold me, he wats me to hold him, he wants to be carried around, be cuddled, he’s in pain and he does not want to be by himself. And I’m helpless. I try to make it more comfortable for him and he keeps moaning. And it’s weekend, everything is closed, the doctor’s office and the clinic too.

After a couple of hours we went to the ER yesterday. And finally, there he could vomit, all over the room. A little bit I was relieved, he was trying to get rid of whatever it is, that’s causing the pain. I’m not the one who goes to the doctor because of every little thing, certainly not because of me, but for ‘Timan’ it’s different. He’s so little and vulnerable and he’s my son.

It was the first time we went to see a doctor because he is sick. Upset stomach, reason unknown,  we got medicine for the pain, for oral rehydration and a medicine for roundworm infestation. But I’m wondering what could have caused it. If it was something he ate, it must have been on Saturday morning. But I can’t remember anything different from other days. We were not even outside. Or maybe some bacteria in the soil he has put in his mouth while playing outside during the days before , and I did not see it?

Now it’s Sunday afternoon. After a restless night he woke up with a  fever this morning, the pain still there. A little while ago he finally ate half an apple and now he’s resting on the couch, he’s sleeping.

I know, toddlers are sick all the time because of things they put in their mouth, lick from their fingers. He’s had several episodes before, but they were different. And ‘Timan’ is different. He’s my son.  And it’s giving me pain to see him in pain.