The Appointment

We had to wait two months, but we finally got in to see a doctor that would do something for LM's fissure.  The appointment was at the surgery clinic at the local children's hospital, and I have to admit, the thought of surgery made me a little bit anxious.  LM would NOT take the idea of surgery well; I knew it, and I hoped there would be a quick answer; diet changes, not a big deal, yadda, yadda, yadda.

Well, that is not quite how it went.  We arrived for our appointment at 10:15 in the morning.  They had asked me if I preferred a morning or afternoon appointment and since my sweet hubby was working evenings this week, I figured a 10:15 appointment would give me plenty of time to talk to the doctor, stop at the drug store and get home to feed all the kids lunch.

We sat in the exam room and I explained to LM that he would have to show the doctor his bum.  He asked if the door would be closed.  Yes.  He asked how many people would be in the room.  I told him it would be us and the doctor and maybe one nurse.  He said he was okay and that he didn't have any more questions.

LM is a shy boy and when he didn't talk to the resident that came in first, I answered her questions for him.  After a few minutes, he warmed up to her.  Then she said he'd have to pull down his pants, just a little, for her to take a peek.

Yeah, there was no way he was going to do that.  He started to cry.  The resident said she'd go to get the doctor right now so that he only had to drop trou once.  She left the room and I wrestled his pants off him while he screamed like I was removing a limb and not just some fabric.

The doctor and resident came back and took a peek at his anus.  The doctor said that the fissure is healed right now (sounds like he heals fast like his daddy!).  She put on a glove and stuck in a finger {insert blood-curdling scream here}and commented that there were balls of hard stool just inside.

And I thought that would be it.  Alter diet, be on our way, right?

Wrong.

Just after 11:00 we were headed to the x-ray department for an abdominal picture.  We got in there quickly, much to LM's dismay.  They had a very fun video game there that he wanted to get back to after he was done his x-ray.  We had to pass it by though.

We returned to the surgery clinic to see the doctors again.  They put us back into an exam room where we sat, listening to their excited conversation in the hall outside.  In just a moment, they called me out.  They wanted me to see the x-ray.

"I don't know if you see x-rays very often," the doctor started, looking at me.

"Nope," I replied.  I hadn't seen an x-ray in quite awhile, thank goodness.

And they started explaining it to me.  First of all, all my interest in medical books did not teach me that the bowels went up and across and back down.  I thought that was something else, like a large intestine.  But I guess that doesn't make sense for the large intestine to come after the small intestine...

He was full.  PACKED full.  All the way from his rectum, up and across and back down.  Full of poop.  The doctors marveled at this.  They commented that this was one of the fullest kids they'd seen.  I started thinking that LM could be the poster child for full-of-poop.  And then I started wondering how the heck he is still so skinny with all that crap (literally) lodged in his abdomen.  THEN I started worrying about how skinny he'll be when it all comes out...

The doctor snapped me away from my thoughts by mentioning that they would have to do something about this today.  He was just too full.  I didn't really grasp what she meant until a nurse came along with a box in her hand.  It read Fleet Pediatric Enema.

Oh crap.  LM is NOT going to like this.  And I'm going to have to get his pants off again, seriously? 

They called the nurse that specializes in bowels.  She took LM and I into the treatment room and went over about nine pages of instructions, meds, diets and fibre - twice.  Another nurse came in and they suited up.  I lifted (wrestled?) LM up onto the bed...and he screamed while the nurse held him and I tried to get his pants and underwear off.

And he screamed while the nurse cradled him on his side on the bed, patting his head and offering reassurance to him while the other nurse inserted the tube.  They wanted to do a deep enema just because he was so full.  I tried to hug him and show him love while paying attention to how the enema was administered; I'd have to do it twice more at home and this was something that I did NOT want to mess up.

He screamed while they held him on the bed, waiting for the enema to take effect and begin the contractions that would push out the stool.

He screamed as I carried him to the bathroom and set him on the toilet.  He screamed that he wanted to go home.  I hugged him until he told me to stop because he didn't want me to hug him while he was on the toilet.  The nurses shut the door and left us alone in the bathroom, saying we could take as long as we wanted - as long as LM wanted - then we were free to go.

He pooped.  And there was blood.  And mucous.

It was quite alarming to me, and I'd been seeing this stuff for a couple months now.  One of the nurses came back to check on us and I got her to peek into the toilet.  "All normal," she said.

LM recovered his emotions and I helped him get dressed.  We walked out to the treatment room and were handed a bag with all of the paperwork that the nurse had gone over with me.  And a lab requisition.

My stomach dropped.

LM asked if we could please just go home now.  I told him that we had to make one more stop, and his groan almost broke my heart.

I opened the lollipop that the nurses had given him before the treatment had begun and gave it to him.  And we walked to the lab.

"What are we doing here, Mommy?" LM asked.

"Well," I started, trying to find the least scary words (I didn't find any).  "They need to take some of your blood."

This started the howling up again.  LM cried and cried.  I held him and rocked him and kissed his forehead.  This was agonizing and my child wasn't even really sick.  My heart went out to all the parents that were actually in the hospital because their children were patients there.

When LM's sobs subsided I told him I was going to call his daddy and he could come with me or stay on the couch where he sat.  I went to the phone on the wall that would allow me to dial out (no cell phones allowed) and phoned my husband to let him know where we were and that we'd be awhile.  And I almost lost it.  My eyes filled with tears and I recounted the morning that we'd had and all the stress that LM had been faced with.  But I didn't let them fall...this was not the time nor place.

After about 45 excruciating minutes of waiting in the crowded lab, LM was called back to the room to have his blood drawn.  More screaming.  More crying.  The nurse felt for him and told him to take as many stickers as he'd like.  He didn't take any.  I picked out a bandaid for him and another nurse came in to hold down his arm.  As he cried, they took his blood and I could not get him to look away from the needle.  The nurses thanked him for turning his arm the right way in his struggle to get away (I guess lots of kids turn their arm the wrong way and the nurses have to re-insert the needle).  They told me that there'd be a bruise there later because he was so tense.  I nodded but barely heard them.  I was busy telling LM that it was time to go HOME!

"Can we still get ice cream?" he asked.

"Of course," I said, throwing out the window the deal we had about him being brave and us getting ice cream for that.

We did get ice cream - for everyone in the family.  And I got him a kids meal for lunch too (since we didn't get out of there until almost 2:00 pm) because we never let our kids get kids meals.

As I write this, my emotions are still right below the surface.  They are made even stronger by the memory of a nine year old girl who struggled through a blood test herself.  Her mom had to sit on her.  It was the same hospital, different location, almost 23 years ago.  That mother had promised the girl a special cassette tape for her Cricket doll, if she was brave for her blood test.  That little girl wasn't brave.  Her mom had to hold her down.  She got her reward anyway too.  The girl was me.

The blood was collected to test LM's CBC, electrolytes, glucose (I wonder how that will come up with two lollipops and no water in his system!), calcium, phosphate, urea, TSH, and Free Thyroxine.  They will also test for Celiac disease.  I need to make an appointment to return for a sweat test which will rule out Cystic Fibrosis.  The doctor wants to make sure that they cover everything that could cause constipation before just jumping to a conclusion that LM's problem is his diet.

We'll return for a follow-up appointment in six weeks.  I'm hoping to hear "case closed" then.

And now I start working to make that happen!