Tuesday, June 7, 2011

The Appendix Files

Six days ago, I was going to Iceland on a romantic getaway with my husband. The bags were packed, the passports were prepped, we’d made turkey and cheese sandwiches for the flight and I’d typed up a list of instructions for my parents who were staying at my house to take care of the kids, full of details about pickup and drop off and bedtime, and how to work the thermostat. David and I got into our traveling clothes and waited for the car service to call to say it was downstairs and ready for pickup. But when it called, instead of taking it to the airport we went to the emergency room.

Primo was having stomach pain. Had been since around lunchtime, he informed me when I picked him up from school at 3.

“I have a bellyache,” he moaned.

“Ok,” I said, “I’ll take you home and you can go to the bathroom.”

You think you’ll stop blaming gas for all your child’s physical maladies when they stop being a baby, but in fact, gas is a perfectly viable culprit up until adulthood. Its gas, I assured him, reading a text from a friend who told me that there was a tornado watch in effect for the Tristate area covering the exact expanse of time I was supposed to be traveling to the airport and taking off for Iceland.

So when Primo did indeed go to the bathroom but felt no better and continued to complain of a stomachache, I thought, come on kid, I have bigger problems here. We may be caught in a tornado and not be able to go to Iceland.

"My belly . . ." groaned Primo.

“Try going to the bathroom again, “ I said. “Gas can be very persistent.”

My parents and sister arrived with their stuff and I showed them where I kept the Children’s Tylenol and how to use the air purifier and what Primo likes in his lunchbox. We sat down to dinner.

“Primo says his stomach hurts,” my mother said.

“I know,” I said, urging him to eat some chicken soup from his prone position on the couch. Then I mouthed to her: “He’s worried. About us leaving.”

Because when gas doesn’t work as a scapegoat, there’s always anxiety.

"I’ll call the doctor to make sure,” I said, and did so promptly. I was so unconcerned, however, that I left my cell phone in my purse and didn’t hear her call when he phoned me back.

Primo ate his soup and lay down to read Harry Potter with my mother while I double checked all our important documents.

“Did I show you where the will is?” I asked my mother, “We got our last will and testament made up.”

“He says his stomach still hurts,” my mother said, “It’s been hours now.”

“Mommy!” moaned Primo, “I just want it to stop hurting. Can you get some medicine?”

It was when he told me that he wanted it to stop hurting that I got that unmistakable dread feeling, that bulls-eye mother intuition which said, “Yeah, something’s up here. You need to investigate further.”

I asked my dad, who’s a cardiologist, to take a look at him and for the first time that day, someone asked Primo where it hurt. He pointed to his lower right abdomen, below his ribs. Not his stomach at all. My father pressed there. He winced and pulled away. My father pressed on the other side. No response.

“Has he been vomiting?” asked my dad.

“No,” I replied, “But he did say it felt like he had to, once or twice. He was nauseous.”

My father was silent but thinking. That never bodes well.

“You need to call the pediatrician back,” he instructed.

At that moment, the car service called to say they were downstairs. I told them to come back in fifteen minutes and paged the doctor again. This time, I was waiting by the phone. In the three minutes of so it took her to call me back, Primo went into his room and feel asleep.

And that’s when we knew we weren’t going to Iceland. Primo has had scarlet fever and roseola and rotavirus and he has never, NOT ONCE, never gone to sleep in three minutes. Clearly, the kid was sick in a needs-immediate-attention way.

I explained the situation to the doctor and she confirmed that it did sound like it could be appendicitis. Maybe not, but definitely worth checking out. She sent me to NYU Hospital, where there was a fantastic team of pediatric surgeons, just in case.

Ten minutes later, my mother, father, David and I were driving over the Brooklyn Bridge, with half-asleep, half-moaning Primo in the backseat, on our way back to the hospital where he was born. Very quickly, we were brought to a stretcher, he was given a blood test and IV and we were off to radiology for an ultrasound. The blood test and IV, while terrifying, had been fast and he’d weathered that trauma well, but the ultrasound was a different story.

To get a good picture, they had to press directly on the spot that hurt him and, of course, the more they pressed, the more it hurt. No matter how much they pressed or how many people attempted the ultrasound, they couldn’t find his appendix, the which they assured me was not uncommon.

Appendixes are assholes. Besides being unnecessary and prone to infection, they are also difficult to find on a sonogram because they’re inside your guts, and obscured by all your other organs like the colon and bladder and stuff. But that didn’t stop these radiologist from trying to find it and hurting Primo like a mofo in the process. The more they pressed, the more he cried out and tensed his abdomen and the more he tensed his abdomen the harder they had to press.

“One more picture,” the technician said, pressing hard.

“YOU SAID THAT AN HOUR AGO!” Primo protested.

He wasn’t wrong. It was a never ending, inferno-esque trial. I frantically asked questions about Harry Potter and the Fantastic Four to distract him, but to no avail.

“I can’t TALK when it HURTS THIS MUCH!” he exclaimed, “Make them stop!”

Then, apropos of nothing, he announced very firmly to the room: “One thing is for sure. I am NOT having my appendix taken out.” He said it like all this was trying enough but to have someone suggest that his organ be removed was just TOO MUCH and he wouldn’t stand for that.

Finally, they gave up. What did them in was when yet another technician came in to give it a shot and asked Primo to point where it was hurting and he said: “No, I won’t! Because whenever I tell you where it hurts, that’s EXACTLY where you press and I told you that hurts much worse and you’re not listening to me so I won’t tell you where it hurts anymore.”

You couldn’t argue with the kid. They’d worn out their welcome. In my opinion, if you can’t find an internal organ within an hour, you give up and try another time or call in the big guns.

So they wheeled him in his wheelchair back to the ER where the pediatric surgeon n call told us she’d like to admit him because they couldn’t confirm it was appendicitis without the ultrasound but it certainly might be and warranted monitoring.

“Can you give him something for the pain?” I asked.

“Unfortunately not. “ she said, “Because the pain is the only thing we’ve got right not to diagnose him. If it gets better, it’s not appendicitis, if it gets worse, it probably is. So we’ll set you up in the pediatric ward and check on him in a few hours.”

And that's when our hospital adventure got started in earnest.

You didn’t think I was going to blow my wad all in one post, did you? This is what they call a good, old-fashioned saga, readers. Check in tomorrow for the continuation of . . . the Appendix Files.