Last Monday night was a very different story. A story involving 2 hospitals, an ambulance, and one dried apricot.
Rebecca had woken up from her nap and seemed hungry so I offered her some dried apricots as a quick snack before we left to pick Daniel up from school. She ate the first few without incident but then seemed to choke on one. I heard her making choking sounds so I immediately laid her over my knees to hit her back to dislodge it. She immediately cried heartily and was breathing well but nothing had come up. I gave her some juice hoping that would help it go down, and she seemed okay but then threw it up. She was also drooling a lot. She was never a drooler even when she was teething so I knew this was a sign something was wrong.
By this point I was concerned enough to want to see a doctor so I called Kevin and told him I was taking Rebecca to the hospital so he'd probably need to get Daniel from school. Las Colinas Medical Center is only 5 minutes from the house but I debated whether it was safe to put her in her rear-facing car seat or if I should hold her in my lap instead. I have a mirror by her seat so I opted for the car seat but called her name every few seconds and was prepared to pull over and grab her if she seemed to have trouble or wouldn't look up.
Thankfully we made it to the hospital without incident and ran into the ER. As soon as I said I had a baby with a foreign object in her throat they brought us back to a room immediately...then we sat and waited. The first in what would be a series of "hurry up and wait" moments over the next 2 days.
Finally someone came in, checked her pulse, listened to her chest, and told us that this hospital wasn't well-suited for a pediatric emergency but that they were arranging for an ambulance to transport us to Medical City Dallas' pediatric ER. I called Kevin to update and ask him to pack a hospital bag for Rebecca and me, assuming we'd be there overnight. He packed the bag and he and Daniel headed to the hospital to meet us. During this time she soaked through several burp cloths from drooling and spitting up. Other than that she was in reasonably good spirits though.
After about 45 minutes of waiting the ambulance arrived, Rebecca was given a hep lock in her hand in case IV was needed (a process she thoroughly hated, understandably), and we said goodbye to the guys and embarked on what was the first ambulance ride for either of us.
As I looked out the back windows at the freeway behind us I thought "wow, traffic is better than I expected for 635 during rush hour." I knew we didn't have sirens on but thought maybe our lights were flashing. As we arrived at our hospital though I heard the paramedic tell the driver "you drove to the wrong hospital." What?! I looked out and sure enough, we were at Dallas Children's Hospital, not Medical City Dallas. The driver asked if I wanted to go on to to Medical City or just stay here. Um, my baby's got a foreign object in her throat, do you think I want to stay at the world-class pediatric hospital you accidentally drove me to or fight traffic to go across town to the other one? I told them we wanted to stay here so they wheeled her in and we were sent to the emergency room dedicated to kids with breathing issues. Which may not have been the best fit in hindsight but there we were, surrounded by kids going through asthma treatments.
And there we sat from about 7pm until almost 2am. An assortment of doctors and nurses came by and promised to be back soon with more information. From what I gather there was some confusion about whether Rebecca should be a surgery patient or a gastroenterology patient, because foreign object removal was usually the surgery team's job but when the foreign object in question was food, as in this case, GI took it. I'm not sure why that distinction or why it took so long to sort it out. They took several x-rays but couldn't see anything. Several nurses commented how her breathing seemed fine. I kept mentioning the drooling, though, as the main sign that something was wrong.
It was a long, frustrating night. Rebecca napped some in my arms but when she wasn't asleep she was fidgety and upset, as you'd imagine given that it was past her bedtime and she hadn't had any meaningful food since lunch. They started her on an IV line for fluids to prevent dehydration, which meant if I wasn't holding her I couldn't let her roam far for fear she'd pull the needle out of her hand. It's a sign of how tired she was that she didn't squirm to get away much and let me hold her. Also, we watched a lot of Daniel Tiger on Daniel's Leappad computer and my phone.
It felt like the ER staff was playing zone defense with us but no one really "owned" our case. I asked several times when we'd be admitted and given a room and was always told "soon."
After I posted on Facebook about it, several friends graciously offered help. We took our next-door neighbor Candice up on her offer and she stayed with Daniel for a few hours that night so Kevin could come to the hospital. We had planned on enjoying a good bottle of wine that night after the kids went to bed to celebrate our 7th anniversary. Instead, we dined on soggy Taco Bueno in ER waiting room chairs that stunk of BO. Then when it was getting late and we still didn't have a definite plan for moving forward, Kevin headed home to stay with Daniel.
Finally around 2am we were given a plan: GI would do an esophagram first thing in the morning then, if it showed a blockage, they'd schedule her for an endoscopy to remove it. In the meantime, we finally had a room on the GI floor so we could get some rest. The room had a big crib for Rebecca with collapsible rails, a recliner chair, and a foldout couch. Rebecca was still hooked up to the the IV pole and had another monitor taped to her toe so I had to set her in the crib just to use the bathroom. She hated that so I knew she would have no interest in sleeping in the crib.
So we passed the night sleeping together. We started out in the chair but it was horrible. It wouldn't recline all the way and kept trying to collapse in and my feet hung off the end, so after an hour or so of that we moved over to the couch. That went much better. With her wires she had to be on the edge so she started out sleeping in the crook of my right shoulder. Then when I woke up with nerve pain in the shoulder I rolled over a little more so I could wrap my left arm over her to hold her in the bed. I alternated between those positions every hour or so when the nurse check would wake us up.
We woke around 7:30 when one of the machines in the room started beeping loudly. A kind nurse brought me a cup of coffee (which tasted horrible but still, it was coffee) and we waited for the doctor to come get us for the esophagram. In the meantime one of the GI resident doctors who was rounding that morning came in to introduce herself. She was wearing a black cocktail dress and great heels with her white coat, the way Dr. Roman dresses on Nurse Jackie (but seemed imminently more competent). It crossed my mind that that was a curious wardrobe choice at 7:30am and I was tempted to ask if her day was ending or beginning. She said the esophagram would be around 9:30 and surgery, if needed, would be around noon.
By this point we were awake for the day and I wanted to keep Rebecca entertained to keep her mind off her surroundings and hunger. I was starving but didn't want to eat in front of her, so we turned on the iPad and watched another few episodes of Daniel Tiger. Every time the intro music started she got a big smile on her face.
After dropping Daniel off at school Kevin came to join us and brought coffee and breakfast for us.
When the time came for the esophagram we were brought down to radiology and they explained the procedure. Rebecca would be immobilized and drink a barium solution to coat the esophagram and enable an x-ray to see if there was an object in her esophagus. She was not a fan of being tied down and by this point she was deeply suspicious of any stranger who came at her.
Fortunately she took the barium solution easily and sure enough, it was immediately obvious on the screen that yes, there was a giant apricot lodged in her esophagus. Now it was just a matter of waiting for surgery. After a few hours and several more PBS Kids shows we were taken down to pre-surgery, where we met with the anesthesiologist and GI surgeon. And I think several other people. All the names and faces and titles were running together by this point. Finally the time came to part ways. Rebecca was wheeled away on a stretcher toward the OR and Kevin and I went to the surgery waiting room. I hadn't cried yet through all of this but watching that stretcher disappear and knowing my baby was scared and anxious and I wasn't there for her was enough to make me tear up.
We were told surgery should take around an hour so we grabbed lunch from the cafeteria and ate as we waited. After a little more than an hour we were told surgery was done and sent to a consultation room to meet with the surgeon. Once he arrived he told us the surgery was successful and showed us the swollen apricot in a bottle.
He explained that the surgery had been difficult because of the apricot's size. The scope they used had a grabber on the end to grab it but it was too big to pull out that way through her esophagus. He tried taking it in pieces but that wasn't working well either so they ended up pushing it into her stomach then going back in with a net on the end of the scope to grab it. (Apparently there was some reason why they didn't want to just leave it in her stomach but I'm not really clear on that). He showed us pictures of the irritation in her esophagus and warned her throat would be sore for awhile. He also prescribed 6 weeks of antacid use.
After awhile we got to go back to recovery to see her. She was still sleeping and looked quite peaceful. She woke up in good spirits and immediately sucked down a sippy cup of apple juice and wanted more.
We went back to her room (making sure to take her beloved blue Crocs that were in her crib!) and the nurses said to order her dinner from the room service menu. If she tolerated the food well, she could go home.
Usually I try to give my kids a healthy, nutritionally-balanced meals. This meal, however, I stacked the deck with things I knew she'd like: ice cream, applesauce, and a quesadilla. She wolfed it all down with a cup of milk, making up for the day's worth of meals she had missed.
She also figured out how to hold her cup with the hand with the IV and the padded board.
Besides her healthy appetite I was impressed with how much energy she had and the good mood she was in. The anesthesiologist definitely had a light touch, she had no lingering fogginess or confusion. It was like she woke up from a nap.
Kevin and Daniel came to pick us up and we headed home.
Since she's already had dinner and was exhausted I just gave her a quick bath and put her to bed. Funny, she'd spent much of the preceding 24 hours clinging to me tightly but now that she felt better when I tried to hold her she squirmed away to play. Well okay then ;)
She fell asleep almost immediately and while she woke a few times during the night she was easily soothed back to sleep. It was nice to see her sleeping soundly in her own bed...wearing her shoes, of course!
In the almost week since our return she's done pretty well but has choked on and spit up several foods so we know her throat is still pretty irritated. We've been sticking to a largely liquid diet as a result-lots of mashed sweet potatoes, yogurt, fruit pouches, oatmeal, and scrambled eggs. All things considered though she's in great spirits. Little ones are so amazingly resilient.
It was a scary adventure for our family and one I didn't see coming. Both of my kids have now visited the emergency room-one got injured sleeping, the other eating. No high-risk daredevil stuff. Needless to say we'll be more dilligent about cutting up food for both kids now. You worry about your kids choking on their food but I had never before considered the risk of food going down the right pipe and getting stuck. I'm the one who fed her the apricot so I felt terrible about inadvertently subjecting her to all of this.
I wondered if I was overreacting to take her to the hospital at all that night, especially when the ER team didn't seem to have much sense of urgency about it. The esophagram showing how her esophagus was completely blocked confirmed that my mommy instinct was right. I later read that the drooling was because her esophagus was so blocked that saliva couldn't pass through it.
So glad our sweet girl came through the experience okay and hoping her throat is better soon. In the meantime, aside from at the dinner table, it's not slowing her down any!
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