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Paging Dr. Hive... (posting this from the children's hospital)


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Hoping the specialist doesn't see anything concerning and that your daughter stays stable and vomit free. I still think you did the right thing by pushing for the MRI to rule out anything super serious.

 

Take care of yourself over the next several days, too - you have been through the wringer!

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I'm glad that they did the MRI.  

 

I wouldn't trust a resident as the final say, as mentioned before, they are dumb at this point in the year, so please follow up.  Request a copy of the specialists report and a disc of the MRI images for your records.

Edited by melmichigan
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Noooooo! Poor girl! :( 

 

Have they looked at gastroparesis? A friend's daughter was diagnosed with that after several years of misery. I think they went to CHOP.

 

 

 

She hasn't had any GI study. The gastroenterologist team never saw her at the hospital. We do still have a referral to the pediatric GI clinic, but they weren't taking appointments when I called two weeks ago to schedule.

 

It's a little thing, but right now while she is having motor skills symptoms GRAB a phone / camera and film it. Since they are sporadic, this way your concerns can't be written off.

 

That's a good idea.

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There aren't any other children's hospitals in the state and the one she was at is the top children's hospital for our region. I'm hoping to meet with our family doctor tomorrow instead of the nurse practitioner. Maybe she will have some new ideas. We haven't seen her at all during this illness (she got married and was out for part of it).

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Do you have a discharge plan for the current scenario?

Sort of. The attending ped said she might vomit again for a couple of days. This is her second day home. I'm supposed to take her back if she escalates back to multiple times per day/can't keep food down. She didn't eat much today because her stomach didn't feel good.

 

I don't know what outpatient treatment options are available to help her. Zofran, phenergan, and rizatriptan have not worked. The only thing that has worked is the toradol + compazine + Benadryl IV cocktail she got in the ER on Wednesday.

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Sort of. The attending ped said she might vomit again for a couple of days. This is her second day home. I'm supposed to take her back if she escalates back to multiple times per day/can't keep food down. She didn't eat much today because her stomach didn't feel good.

 

I don't know what outpatient treatment options are available to help her. Zofran, phenergan, and rizatriptan have not worked. The only thing that has worked is the toradol + compazine + Benadryl IV cocktail she got in the ER on Wednesday.

So they didn't send her home with anything?  Are they thinking she won't keep meds down?  Toradol and Benadryl can be given orally, compazine can be given by suppository.  Obviously IV is the most effective, but there are other options.  That is very poor outpatient management, especially on a weekend.

Edited by melmichigan
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So they didn't send her home with anything? Are they thinking she won't keep meds down? Toradol and Benadryl can be given orally, compazine can be given by suppository. Obviously IV is the most effective, but there are other options. That is very poor outpatient management, especially on a weekend.

This whole illness has been horribly managed. She's been to the emergency room three times and her regular provider three times, and she spent two nights in the hospital. We still don't have this under control or really know what we are dealing with.

 

She threw up again. 2x in four hours. Her head hurts and we don't have something that works. I can't give her more Zofran (which didn't work anyway). I gave her Benadryl.

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(hugs).  I'm sorry.  I'd take her to a different, non-Childrens hospital.  Do you have a Catholic hospital nearby?  I'm not Catholic, but  I've worked at a lot of places (I did some travel nursing), and they always seemed the most thorough with rare and complicated situations.  And frankly, they seemed a lot more likely to listen to the concerns and instincts of parents, especially if they are either a non-teaching hospital or where nuns still have a heavy presence in management. Also, the ER has always been able to bump others for imaging studies at every one I've floated to.  I wasn't an ER nurse, but sometimes covered there, especially during flu season.

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Day 23: We are back to where we started. She threw up four times between 5pm - 6am. Her head hurts, too.

 

There are three hospital systems in our area. One is owned by our insurance. The other two systems aren't covered (including the Catholic hospital and the non-children's hospital on the university campus). The only other children's hospital is for orthopedic needs, nothing else. The hospital local to us sent us home after ruling out appendicitis and without investigating anything else, so I'm not hopeful they'd be more proactive.

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When you go back to the children's hospital, can you bypass the residents and insist on seeing only experienced physicians?

 

Get that patient advocate helping you navigate right from the beginning.

 

Many hugs to your daughter, yourself, and the rest of your family who I'm sure have been stressed by this whole situation as well. Do you have help locally--family or friends to smooth things over at home while you're busy with the sick child?

Edited by maize
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DDs BFF has Cyclical Vomiting. It happens every 20-30 days for her. EACH time it is a hospital admit.  She gets severely dehydrated.  If it isn't under control with IV RIGHT AWAY she is sick for WEEKS.  I wonder if that has been investigated?  Her drs are in Chicago.  Her parents are very happy with her care.  Her drs are hopeful she will grow out of them. She's 15 now.

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Do you have Kaiser?

 

 

No, but it's a similar system.

 

 

DDs BFF has Cyclical Vomiting. It happens every 20-30 days for her. EACH time it is a hospital admit.  She gets severely dehydrated.  If it isn't under control with IV RIGHT AWAY she is sick for WEEKS.  I wonder if that has been investigated?  Her drs are in Chicago.  Her parents are very happy with her care.  Her drs are hopeful she will grow out of them. She's 15 now.

I've read about Cyclical Vomiting and that doesn't seem to fit what's happening with dd.

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Yes, that's how she got the MRI before we were discharged. We don't have the results from the MRI, yet, though. I'm hoping our regular doctor can exert pressure to get those.

 

Okay, so  I came on this morning (busy day today LOL) for this....

 

I have two thoughts for you. 

 

1) MR Images

 

I've become a master at getting images from different places. (I hate saying that, on multiple levels.) Forget waiting for your doctor. Different hospitals have different policies at getting the discs, with or without the rad's report. Call the hospital and ask for two different things: a) I need a copy of my minor daughter's recent images and the radiologist's report accompanying them for both MY records and for the Doctor's records. What do I need to do to get these images?

 

Most of the time, they will tell you to have the doctor's office contact to request. One of our local hospitals are *really* bad about allowing patients to access their own stuff. But, press the issue. 

 

If they tell you, you can have them now, come pick them up (with a wait in the waiting area). GO GET THEM. A disc in hand is of value....more value with a rad's report. 

 

If they tell you that you must wait X amount of time and the doctor must request their own, call your Primary's office and tell them you are going to call two to three times a day until you get a verbal report of the radiologist's report. And, then follow through.

 

 

2) I'm hating this, but what were the protocols followed when they did the MR? Did they do the MR with contrast? Did she hold still? Does she have braces? You may not know the answer to the first one. You should know if she had contrast, or ask her. 

 

I'm worried about your daughter and have been thinking about her.

 

Kris, who has to stop off at the Imaging Dept. of the local AFB clinic to get the rad's report from my daughter's MR from Friday. {{Hugs}} I really do understand.

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We are going to try compazine at home to control the vomiting. She has a heart murmur now (no one caught that at the hospital, maybe it's new). It's most likely benign, but at this point we are going to investigate everything. She's going to get an echo this week. Her blood test last week showed elevated histamine, which perhaps is a factor in all of this. We are going to do antihistamines around the clock to see if that helps.

 

Her provider had MRI results, which were read by a radiologist over the weekend. Everything is normal. No Chiari malformation, no growths, no bleeds, no sign of MS. The MRI did not have contrast as far as I know. I wasn't allowed to stay the whole time she was at imaging on Friday.

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