Margaret stopped writing for a moment and sat back reviewing her thoughts. During all of this she was so calm, and even now writing it all down her hand didn't shake, her eyes were dry, but her heart deep down ached. She shook her head and continued to write.
A security guard stepped out of the building, and began to saunter up to my vehicle asking the inane question of whether or not there was a problem here. I wanted to turn around and smack him, but instead I turned to him and said that yes, there was a problem. I told him I needed help and to get his butt over here with one of those wheelchairs parked up against the wall next to the ER entrance doors.
This guard ignored what I said to him, and walked up right behind me as I was trying to unbuckle Donnie from the seat, while keeping the bucket from spilling blood all over my car as I kept it under my son's chin while he continued to retch. Once again, this security guard drawled "What seems to be the problem ma'am?" At this point, I really had a strong urge to slap this idiot silly, but instead, I simply moved to the side so that he got a clear view of my six year old throwing up bright red blood into a three pound tub that was well over half full.
The man froze in his tracks and gasped, and I though he was going to faint. He began stammering "Oh my – Oh—Oh" I turned to face him directly and pointed over to the wheelchairs. I calmly told him to go and get a wheelchair while I got my son out of the car. He did respond to that and within a moment, Donnie was sitting in the chair and mercifully he finally stopped retching.
I looked up at the security guard, realizing that my vehicle was blocking the circle in front of the busy ER and told him that the lot was full and I didn't know what I should do about my car, but no matter what, I was going in with my child. The man seemed to have gathered himself somewhat by then and told me to just move it off to the side while he wheeled Donnie in and once he was settled I could come back out and move it. It turned out that the same security guard ended up moving my car for me once a spot in the ER lot opened up, which I was eternally grateful for.
As soon as I walked into the Pediatric ER entrance, I saw Donnie sitting in that wheel chair in front of the triage desk. He still had the bucket in his lap, but his head had dropped back against the back of the chair with his eyes rolled up and only the whites showing. His lips were the same color as his face, which at that moment had a dull gray pallor. In all honesty, my son looked dead. As his chest rose and fell slowly and his arms went limp, it was like watching the air seep out of a balloon. That was when I actually felt the first real stab of fear that I might lose my son.
Up until then I was worried for his health, but this… this mort couldn't be my child. His blood pressure reading was enough to make my blood run cold. I could see what the nurse wrote on her paper and while, as a lawyer, I had no idea what those numbers meant, I do know approximately what they should have been.
At my last physical my blood pressure was 112 / 70. Donnie is only six – well really almost seven years old, and I don't know how much different a child's blood pressure would be from an adult's. But he is a big boy. He stands 4'8" and weighs 80 pounds. He isn't that much smaller than some adults and that nurse wrote down that my son's blood pressure at that moment was 40 / 21.
He was taken into the room closest to the nurses' station and they got him up onto a stretcher. He was so out of it, that he hardly even stirred when they attempted to put an IV in his hand. This attempt was unsuccessful, because he was so dehydrated that his vein collapsed. They ended up using his other arm and had to strap a board to his arm to keep it straight, because the IV went into the crook of his elbow.
They took several vials of blood and hung a large bag of clear fluid that said sodium dextrose on it. They hooked him up to a monitor that told them what his pulse and oxygen levels were, and would take his blood pressure every fifteen minutes. I spoke with the nursing staff and two different residents and thus began the long eight hours we spent in that room.
She suggested that I try to wake him up and walk him down the hall to the bathroom once the IV bag was done and the machine that was controlling the flow beeped. So, I was resigned to try to get the sample they needed, even though I was not sure how I was going to accomplish this feat. By the time the IV machine beeped at me, another half hour had passed. He now had three full bags of IV fluids pumped into him and much to my relief, I was able to rouse him successfully.
He was cranky and confused, but he was able to walk with me down the hall to the only patient bathroom in the entire pediatric ER. It took some maneuvering and no small amount of irritation on Donnie's part to get this task accomplished. He couldn't use his left arm because it was strapped to a stiff board to keep his elbow straight, so I had to help him in the bathroom. This is NOT something that my son was at all happy with.
By the time we got the sample and returned to the room, he was much more alert which made me feel a lot better about the entire situation. I began to think that perhaps I was being over reactive and that he really was fine, just as everyone kept insisting. However, within five minutes, he once again fell into that deep and unnerving sleep, as if he were heavily drugged.
After five hours of watching my son sleep, Alan finally arrived. As soon as Donnie heard his father's voice, he cracked open his eyes and reached up for a hug before falling right back to sleep. Over the next hour, and another full bag of IV fluid, Donnie finally began to show some signs of recovery. The hospital staff kept insisting that his blood levels – his hematocrit- were fine and only slightly low. My logical mind simply refused to believe this, but what could I do? The on-call ENT wanted Donnie to stay and be observed for another two hours and he wanted him to gargle ice water every ten minutes. If, by the end of that time, Donnie didn't start bleeding again - they told us we would be able to take him home.
Once he was awake, Donnie began the non-stop angry crying that he wanted to go home. He hated being in that place and he was not going to be anything but cranky until he was allowed to leave. By the time those two hours of observation had occurred, Donnie and I had been at the hospital for eight hours and as much as I wanted to get the hell out of that ER and away from those people, I was still unsure that we should be taking our child home after what had happened.
Well, I was of course overruled and told repeatedly by the resident and the nurses that postoperative bleeding was a normal complication and that Donnie was fine. They did say that we should bring him back if he began to bleed again, but they all assured us that he was doing well and that he hadn't lost too much blood.
Once we got home and got him settled in his pajamas and on the couch to watch a movie, it was after nine o'clock at night. He had slept so much at the hospital that I figured if he wanted to watch a movie it was all right with me, since I had no intention of letting him go to school the next day.
Around nine thirty we got a call from Doctor Harrington asking how he was doing. At that point, he was simply zoned out and lying across his father's lap staring at the television. This was when I started quizzing the doctor about how it was possible that my son had lost so much blood and still be just fine. Doctor Harrington told me that his hematocrit was 34, which is only one point down from normal. I then said that I couldn't see how that was possible. I also wanted to know why it was okay for him to have been essentially unresponsive for five hours and still be considered all right.
Doctor Harrington said that he did not know that Donnie was unresponsive and asked if I understood what the term meant. He said it means that Donnie was unconscious. I told him that he was acting as though he had been heavily sedated. He would only rouse to vigorous shaking and only for a moment. I told him that I even lifted my son's eyelids and shined lights into his eyes and got no response. I told him in my book that is 'essentially unresponsive'.
Once again, I was assured that since his blood labs were okay that he was going to be fine as long as he didn't start bleeding again and that this was a normal postoperative complication.
Well, let me tell you I was simply not convinced. So, once I had him settled in bed – our bed – I pulled out the Mayo Clinics Medical Encyclopedia, which I had purchased for a court case, and began to look for information on this blood test that they were all holding so much stock in.
I did find that if this test is done on a person who is seriously dehydrated, the reading can be falsely high. Now as a reasonable and intelligent person, that made sense. If this test shows the concentration of red blood cells in the body, but the volume of body fluid is very low, then the count will seem higher than it really was. As soon as that volume is replaced, in order to get an accurate reading, a new test should be taken. What I would like to know is WHY they didn't do that in the hospital after they put four bags of fluid into my son.
I called the ENT's office the next morning as soon as I got Charlie settled with my day care provider for the day. I talked with them about what had happened the previous day and the woman I was speaking with told me that she had already spoken with Doctor Harrington. She once again assured me that the situation was fine and that Donnie's blood work was within acceptable range. I asked about the test being skewed because Donnie was so dehydrated and she said that I could get another test done, but the numbers would probably only change by a small margin.
I asked when I should bring him in to be seen, and she told me that they would see him at his two week follow-up appointment on the ninth. Well, by this time I was fed up with these people because none of them were willing to listen to the fact that my child had lost a significant amount of blood and that he wasn't "FINE". I hung up and called Doctor Holt. He told me to bring Donnie in a little later that morning and he would run a new hematocrit on him and examine his throat to evaluate his surgical site.
Donnie was not interested in food at all and he even bucked drinking anything, but I had to insist. I didn't want him to become dehydrated again because I knew how important it was to get an accurate test. Doctor Holt examined him and confirmed that the bleeding had indeed stopped and that his throat didn't look too bad, but he noted a large clot on the right side. He did another blood test and we got the results back in less than five minutes, rather than three to four hours.
He told me that even though they got a reading of 34 in the ER his actual hematocrit was 26 and his hemoglobin was 8.9. Not having the necessary background to understand what those numbers meant, I asked him for some clarification. When Donnie was two, they did these same tests to get what is called a 'normal baseline'. So, at age two his hemoglobin was 12.9 and his hematocrit was 35. The difference between his normal reading at age two and now showed that my child had lost 25 percent of his blood volume, which for a child his size equaled almost three pints of blood.
Doctor Holt assured me that this was NOT a normal postoperative complication. If I had gotten Donnie to the hospital even fifteen minutes later than I did, he very well could have gone into heart failure due to extreme blood loss. In short, my child nearly bled to death - all the while I am being assured that he is just fine!
I wanted to know what we should do to take care of him and Doctor Holt told me that since he is stable and not bleeding, that we should keep him quiet and put him back on soft foods until the risk of another occurrence had passed.
Once his throat is healed up there is a special supplement that we need to put him on for three months. That is how long it will take for his body to make new blood to replace the blood he lost. Until Donnie can replace all of this blood, he is going to be weak and tire easily. He will miss most of little league this summer, which has him very upset and angry. When it is all right to allow him to run and play again, he will have to be very careful. Even a simple nosebleed could be serious enough to land him in the hospital because he simply doesn't have enough blood left in his body to spare for injuries like that.
So, here I sit...writing in this diary...wondering what is wrong with me. My child came very close to dying yesterday and I don't feel scared or panicked. I haven't cried or broken down in any way. Every one of my friends and family keep saying to me "I don't know how you are doing it – keeping so calm and collected. I would be a mess!"
So what's wrong with me? Why don't I have the emotional response that every other human being around me is having. Donnie and Charlie's day care provider cried when I told her what had happened to him. Both of the firm's partners contacted me and told me to take as much time at home with Donnie as I needed and not to worry about my cases, both of them marveling at how collected I was.
I just don't understand how I'm not falling apart after all of this. I am glad that I am not – I think.
A/N – I have not forgotten about my two other stories but I had to get this out of my system. This story actually happened this past holiday weekend. Emily, my six year old, is home and recuperating. She is mad at the world because she can't do the things she wants to do or even eat the things she wants to eat. She told me earlier today through huge tears that the world just isn't fair anymore.
I held her close and told her:
"Oh sweetie, it never was and it never will be, but it's what you make of it that counts."