It is a week exactly from when this all happened. It is also 8 days after I last saw Isla’s pediatrician. We had a well check today to make sure that she is thriving and putting on weight. She is not yet back up to birth weight, but she did put on 8 ounces in 8 days – 1 ounce per day is what doctor’s are looking for. She should be back at birth weight by early next week, 3 weeks after birth…not bad at all for a wee peanut. Today I gave the pediatrician the details of what led us to the emergency room. He didn’t ask if I used the formula for top ups or not, he just commended me for having to have gone through what we did and still managing the weight gain. I don’t tell him that I only used the formula last Tuesday, the day this all happened, otherwise the weight gain is thanks to exclusive breastfeeding.
Dr G, the emergency room doctor is a lovely man with a good bed side manner. At times over the next few hours he is prone to overstating the facts as a way of creating fear, as well as not being completely clear on what is going on. Emotions are running high and his wishy-washiness and over dramatization do not help Chris and I as we decide how to do the best for our daughter.
Sometime around 3AM Dr G tells us he advises a full sepsis workup for Isla. This includes taking bloods, urine, and a spinal tap as well as administering antibiotics while they rule out the presence of a virus like meningitis and RSV (Respiratory Syncytial Virus) which could be the cause for her stopping breathing. The doctor wants to err on the side of super cautious even though she does not have a fever or any other symptoms that warrant this work up. Neither of us are keen on introducing antibiotics into her system. We just want to get her home, wasn’t this just a freak occurence? I’m shuddering at the thought of a big needle going in her tiny body, she’s only 11 days old. Dr G tells us to discuss and he’ll be back soon.
After discussing wether we should subject her to these procedures, we realize that it was not really up for discussion. Dr G will not discharge her unless we have another doctor willing to take over her case at 4AM. Chris takes Preston home, there is no use them staying. Though big brother Preston is only 4 he has not slept this entire time – they need to go home.
I am dead on my feet, it is 4:30AM and I have been holding Isla since we arrived at the emergency department sometime around 10:30. Dr G starts the procedures with the help of a nurse. Putting in the line for the IV is painful to watch. Isla howls and shutters, she is so small on the bed and they have to strap a board to her hand so that it all stays in place. The pain must be so new for her that she scratches her face with the other hand. All the while I am not doing too well at consoling her, all I can do is sing “You are my sunshine” softly into her ear and let her grasp my finger for comfort.
Dr G edges me out from the side of the bed and starts to lay out a tray next to her with several needles and vials. He’s actually trying to get me to leave the side of the bed, I realize he is about to do the spinal. He tells me to sit down, I suppose he doesn’t want me to watch. She cries out so loudly that she actually swallows the sound.
I clothe and cuddle her. I’m sitting in the corner of the room on the only other piece of furniture in the room, a hard chair. I’m thankful that Chris has left me Preston’s blanket as I am cold and shivering. I’m not sure if the room is really cold, if I am in shock, tired or all three.
Around 8AM the staff is getting ready to change over. Dr G comes in one last time looking very grave. He says he’s happy he made us stay as her results for the spinal are showing a high white blood cell count, which happens when the body is trying to fight an infection. This is the last time I see him. I ask the new nurses who come on duty to clarify what that statement means. No one will tell me anything.
My eyelids are starting to flutter open and shut and I am actually worried that I will drop Isla. I’ve been sitting and holding her around 10 hours. Desperate to close my eyes, I swaddle her and place her on the narrow bed in the room. I place one hand on her, she won’t go anywhere, but just in case. Then I place my head on the bed, my head feels so heavy with all the medical terms I’ve been introduced to and all the tears I’ve cried. A few minutes later a new nurse comes in and asks how I’m doing. Finally I say, ‘not good. I’m tired and I’ve been told my baby may be fighting an infection.’ Thinking back now I must have looked horrendous because she rushed out to get a doctor to give me an update as well as returned with a wheelchair so that we could finally be transferred to a room in the pediatric ward with a warm cot for Isla and a recliner seat/bed for me.
The new doctor in emergency stops me as I am being wheeled away , ‘don’t worry mama. It looks like it’s just a case of pneumonia.’ She smiles sweetly and walks away, not before saying, ‘you should go home.’ I’m in a daze. Did she just tell me my little baby girl has pneumonia and I should just go home to let her be by herself for 48 hours? For people who are meant to be supporting mothers in their effort to breastfeed, she hasn’t really thought that flippant comment through.
Upstairs in pediatrics I can’t say enough good about the nursing staff and the doctor looking after Isla. She explains that the doctors in emergency jumped the gun. She does not see any sign of pneumonia, she’s not sure why I would have been told that. I ask about the elevated white blood cell count and she gives a simple explanation, this is common in newborns. A high count not only shows up when fighting an infection, but also when having experienced a trauma, in this case the shock of childbirth less than 2 weeks earlier. Why the scare tactics in emergency then? I don’t think it was intentional, I think they just weren’t child specialists, and so they got it wrong. I just wish they would have held their tongues instead of scaring me for no good reason.
We spend the next 48 hours in hospital waiting for all the tests to come back. Every few hours a test comes back negative, and with each result I am relieved. Meanwhile I am setup on the recliner chair breast feeding and trying to get some sleep in between her temperature and lung function checks and all the other interruptions of being in hospital. These always come back stable as well.
Apart from the rough start at the beginning, the nurses in the ward were a tremendous support. At first their were questions about my milk – had it come in? How did I know how much I was producing, had I ever pumped it? Could I put Isla’s nappies aside so that they could see how much pee and poo she was producing. Could they get me some formula so I could go home and they would feed her over the 48 hours? Again, all the questions about milk, as if this in some way was my fault and somehow related to my milk production. After a night in emergency and a full 24 hours plus without sleeping, I lost it on one nurse and squirted my breast milk at her after a repeated question about if my milk had come in or not. It was not my finest hour, but it made her stop and listen to me, ‘yes, my milk had come in and the only way I would continue to produce enough milk for her is if I kept on breastfeeding’. That story must have made the rounds at the nurses’ station as everyone seemed to understand my position from then on. Looking back I understand that they were only looking out for her best interest, but their needed to be some support for me wanting to breastfeed as well.
Alot happened over those couple of days. I got really tired and my sister came down from Ottawa, which was a great comfort. Chris and Preston visited every day and Isla continued being the same baby she always was. The final results came back negative and we were discharged asap. The doctor agreed that a hospital full of children with hacking coughs was the worst place our completely healthy little girl should be so we were out of there as soon as the last test came back and our 48 hours was up.
Over 600,000 infants a year in the United States go through the same sepsis workup that Isla did. It is standard for a child less than a month old who has a fever. If you google “full sepsis workup” you will see it is a controversial procedure, as it is extremely extensive considering that only 1% of children will actually have something that needs treating. The upside to doing these tests is that if the symptoms of that 1% were not caught, something like meningitis could spread through their body and be fatal in less than 48 hours.
Has your child ever been in emergency for a similar situation or some other ailment that mainly affects children? A part from the obvious hell of being in hospital with your child, did you feel helpless?