Thursday, May 3, 2012

if you're appy and you know it...

The title of this post, while cheesy, refers to a few things of late:

The song sung many times a day around these parts for the benefit of this little guy (the son of our dear friends) who can clap and stomp and hooray with the best of them:

The cockney dialect of the most recent book I read, which was just wonderful and enlightening and makes me even more excited to pursue a career in nursing and/or midwifery (thanks for the recommendation, Karen!).

The abbreviated name of the organ of which dear Lucy was dispossessed during a 30 hour hospital stay two weeks ago.

It began one afternoon after rest time when Lucy woke up with a tummy ache. She was just not quite feeling like herself. Now this girl has a penchant for saying "my stomach hurts" then going on to play like nothings wrong until she hurls all over the place. There's just no knowing with her - she could be really sick, or she could just need a little extra fiber and a trip to the bathroom. This time it was the former, and saltines and gatorade did nothing to deter the onslaught of what I thought was a stomach bug. She went to bed early and I prayed it would be a 24 hour thing that would be over by morning.

The next thing I remember was being woken at 3:00 with a little face right next to mine saying "mommy, it hurts REALLY bad." My eyes weren't even open yet, but my momma radar must have been working over time because the first thought in my mind was "appendicitis." Lucy climbed into our bed, holding her right side. She was feverish, but apart from the stomach pain was surprisingly chipper considering the hour. The advice nurse checked her symptoms, asked a few questions (Does it hurt to walk? Does her abdomen feel tender to the touch? How high is her fever?) and Lucy and I were soon in the car on the way to the pediatric ER. Lucy talked the whole way there, and there was a little part of me that assumed we'd be sent home before too long. She just seemed too OK. She was even walking with me as we wound our way through the halls until someone took pity on us and walked me to the right wing.

We were sent for an ultrasound which the ER doctor said could be anywhere from 50-98% conclusive for diagnosing appendicitis. He was also concerned the pain could be related to an ovary as it was lower than usual appendix tenderness. I asked the technician if her appendix looked alright. "No, I wouldn't say that" was the response, and I made some calls in preparation for an overnight stay. A few hours and one IV later we were settled into a room upstairs at Doernbecher Children's Hospital - the same room we were in 4 years ago as little Lucy recovered from open heart surgery. Here is a photo of her before surgery, smiley as can be:
The entire procedure was less than 45 minutes long, and it took her longer to come out of anesthesia than it did to remove the angry appendix. It had not yet burst and the whole thing from onset to surgery was perfectly textbook. Lucy was home the very next day, with a tiny baind-aid over her belly button and was running around the backyard that afternoon. Modern medicine is amazing!

playing in the backyard with Eli - less than 24 hrs after surgery

A classic case of appendicitis starts with a stomach ache and low-grade fever and can mimic a stomach flu. Gradually (usually over 12 hours), pain localizes in the lower right quadrant of the belly and becomes quite acute. Symptoms in younger children are hard to read, mainly because they cannot articulate exactly how it feels or where it hurts. It is far better to be safe than sorry, and although appendicitis in youngsters (under 11 years old) is rare, the appendix can often rupture because treatment is sought so late. I have taken Maryn to urgent care in the past with possible appendicitis and was both relieved and chagrined to realize it was only constipation. But saving ourselves a Heaven is For Real ordeal is totally worth an extra copay and mild embarrassment.

The upside to all of this was getting to see the sweet bond that has developed between my girls. Lucy's one constant concern was that Maryn would miss her and would be lonely without a playmate. Hearing them talk on the phone to each other was priceless - I am so thankful to see that their friendship is deepening with age, and Maryn's sweet care for Lucy was precious to see. It cracked me up when seconds after waking up from anesthesia Lucy asked "where's Maryn?" She arrived back to the room in a stupor but instantly sat up in bed and rummaged around until she found the stuffed frog she wanted to give her sister. She promptly fell asleep again :)

Our friends and family were amazing as well and I felt almost silly for receiving dinner, flowers and gifts for the kids when Lucy was running around like crazy hours after arriving home. I am so thankful for family, great medical care, and friends who never fail to come through. And a little girl with a generous spirit and silliness to spare!