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When we arrived at the ER, Colin lay listlessly in my arms. He spoke in a whisper, and only a few words at a time. (Mostly "Mama?") His eyes were sunken into his face. When he cried - which he barely did; he mostly just lay there and stared - he didn't produce any tears.
When we left the ER two hours later, Colin was marching around the room singing "Seventy-Six Trombones."
That's the difference ten ounces of Pedialyte and half a Zofram (anti-nausea tablet) makes.
I don't know why he took Pedialyte in the hospital but not at home. They had the especially gross unflavored kind, even. But he guzzled the bottles down and asked for "more please" again and again - first in a whisper, and eventually with an indignant shout as he banged the empty bottle. Mercifully, it kept him IV-free. He produced the wet diaper necessary for discharge after the fifth two-ounce bottle.
He is sleeping peacefully now. We ought to be able to manage the rest of this at home: clear liquids and then bland foods, followed by a more normal diet tomorrow. They gave me an extra tab of Zofram if he needs it - or if Alex comes down with it next.
Every medical person we encountered in the last 18 hours has been fantastic.
Dr. Winkelstein, the doctor on call last night. We first spoke at 5:30. She told me to call back at 8 with an update, and after we'd checked in then she strongly encouraged me to call her in the middle of the night if I needed to. I did call her at 2:30am and she was awesome. Reassuring and not a bit tired-sounding. She helped me decide that it would be safe to wait until 6am to take him in to the ER. At 8, just as she was going off-shift, she called me to see how he was doing. When I didn't answer, she called the ER to see if we were there and if Colin was okay. The first three calls were just her doing her job, but that last one? Was the one that made her outstanding.
At the ER we didn't have to wait at all. There was a nurse at my side by the time we finished giving Colin's name and birthdate. Everyone went out of their way to greet Alex and say something friendly and supportive to her. (Mostly "wow, your mother is so lucky to have your help." Which I am.) They all listened to me very carefully. The doctor explained not only what we were going to try first, but also what we were going to try second and third, so that I had the whole protocol clear in my mind. Nobody made me feel like an idiot for not being able to get him rehydrated orally at home. The clerk didn't come to get the rest of our registration information (and proof of insurance, and copayment) until after Colin was markedly better. And - proof that they listened to me carefully - when they gave us our discharge instructions both the nurse and the doctor went out of their way to emphasize that breastmilk is considered a clear liquid and that Colin should nurse as much as he likes. Plenty of doctors don't keep that in mind for infants, let alone almost-two-year-olds.
I am so impressed with, and so grateful for, the care we received. Rehydration is pretty much a medical no-brainer, but to me that makes the good patient care even more impressive. They kept in mind that it wasn't a routine, worry-free procedure for us.
When we left the ER two hours later, Colin was marching around the room singing "Seventy-Six Trombones."
That's the difference ten ounces of Pedialyte and half a Zofram (anti-nausea tablet) makes.
I don't know why he took Pedialyte in the hospital but not at home. They had the especially gross unflavored kind, even. But he guzzled the bottles down and asked for "more please" again and again - first in a whisper, and eventually with an indignant shout as he banged the empty bottle. Mercifully, it kept him IV-free. He produced the wet diaper necessary for discharge after the fifth two-ounce bottle.
He is sleeping peacefully now. We ought to be able to manage the rest of this at home: clear liquids and then bland foods, followed by a more normal diet tomorrow. They gave me an extra tab of Zofram if he needs it - or if Alex comes down with it next.
Every medical person we encountered in the last 18 hours has been fantastic.
Dr. Winkelstein, the doctor on call last night. We first spoke at 5:30. She told me to call back at 8 with an update, and after we'd checked in then she strongly encouraged me to call her in the middle of the night if I needed to. I did call her at 2:30am and she was awesome. Reassuring and not a bit tired-sounding. She helped me decide that it would be safe to wait until 6am to take him in to the ER. At 8, just as she was going off-shift, she called me to see how he was doing. When I didn't answer, she called the ER to see if we were there and if Colin was okay. The first three calls were just her doing her job, but that last one? Was the one that made her outstanding.
At the ER we didn't have to wait at all. There was a nurse at my side by the time we finished giving Colin's name and birthdate. Everyone went out of their way to greet Alex and say something friendly and supportive to her. (Mostly "wow, your mother is so lucky to have your help." Which I am.) They all listened to me very carefully. The doctor explained not only what we were going to try first, but also what we were going to try second and third, so that I had the whole protocol clear in my mind. Nobody made me feel like an idiot for not being able to get him rehydrated orally at home. The clerk didn't come to get the rest of our registration information (and proof of insurance, and copayment) until after Colin was markedly better. And - proof that they listened to me carefully - when they gave us our discharge instructions both the nurse and the doctor went out of their way to emphasize that breastmilk is considered a clear liquid and that Colin should nurse as much as he likes. Plenty of doctors don't keep that in mind for infants, let alone almost-two-year-olds.
I am so impressed with, and so grateful for, the care we received. Rehydration is pretty much a medical no-brainer, but to me that makes the good patient care even more impressive. They kept in mind that it wasn't a routine, worry-free procedure for us.
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I bet this made the nurses and docs smile and laugh! How scary for you! Glad to hear the positive outcome.
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I think once they hit a certain point of dehydration, it's virtually impossible. I looked back, and Henry was 20 months when he ended up with IV fluids. I'm glad they got Colin going without getting poked!
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I hate flavoured Dioralyte and much prefer the unflavoured kind, but it's hard to get. I don't like the taste of things pretending to be other things. But it's also possible that he likes things which taste like other things, as long as he's not fighting the urge to heave his toenails up, poor little mite.
I'm so glad you got good, supportive, respectful care. It makes such a difference.
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You worked so so so hard at it by the sounds. How heartbreaking that he got so sick; it's the nature of the beast with gastrointestinal stuff and kids. (And not just kids. My father-in-law, who is a reasonably healthy 60yo guy, got rehospitalised 2 times with it recently despite being able-bodied, extensively trained in first aid, and attempting very seriously to keep hydrated in the recommended manner with a spouse to help out. It just got on top of him.)
I'm glad the ER made a big difference to Colin somehow and of course, that had it not made a difference that there would have been so many backup plans.
Yay Colin.
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"Seventy-Six Trombones" level of wellness!
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So amazingly glad that poor fella is doing better. Hope you are soon!
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Dr. Winkelstein was the one who came to see us when Max was in the NICU and she was so amazing. So professional, calm and positive, but also totally pleasant and down-to-earth. I honestly think talking with her was the first time I really thought he would be okay.
We are forever in your debt for recommending the practice. I just can't get over how much I love them all.
I hope Colin's recovery is as swift and sure as it sounds and that this little chapter is over and done with at your house!
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I love Dr. Fragetta, but I have it in mind that Alex may prefer a female doctor as she gets older. If she does, it's wonderful to have Dr. Winkelstein (and Dr. Brinkman, who is also great) in the same practice.
It really is such a massive relief to feel like you can absolutely, positively trust your kids' doctors. I'm glad your kids are there too.
breast milk is a clear liquid
Back in the early-mid 80's, I worked the pediatric oncology unit at Roswell Park (major cancer research center in Buffalo, NY, much like Sloan-Kettering only not as well known). We had a 19-month old girl with a rare form of leukemia who had horrendous GI ulcers from her chemo. (Think of multitudes of canker or cold sores, from the mouth all the way through to the anus.) I had an amazingly difficult time in convincing my nursing colleagues that breast milk was absotively, posilutely the very best thing this baby could be drinking and that it *did* count as a clear liquid. I worked night shift so I didn't see the docs all that often unless there was a problem, so I'm not sure what they were telling the mom, but she was on the same page I was and the baby got nursed as much as she would/could.
Clarissa, using Ken's account
taste and rehydration
(Anonymous) 2010-11-30 09:47 am (UTC)(link)Emma
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