Tuesday, December 1, 2009
I was told that the details of Thomas's experience went all the way up to the Director of Anesthesiology as well as the Director of Residency. The individual resident and anesthesiologist were spoken to about the incident and Thomas's case will be used as an example in their teaching of what *not* to do.
That's all we ever hoped for -- to avoid something similar happening to another kid.
Thursday, November 5, 2009
We've taken a few trips since I last posted. PNW was gorgeous. I can definitely understand the "pull" people feel toward the area. Mike would never survive the cold, the rain and the liberals, though. :) I would love the cold and the rain. And I'm much more tolerant of liberalism than my husband. :)
Our last trip was to the Midwest again. Visiting family and going to Cincinnati Children's for Thomas's medical stuff. Thomas got to spend Halloween with his cousins and trick-or-treated in the neighborhood I grew up in. Talk about a trip down memory lane. I even ran into a childhood pal roving through the old 'hood. Good times.
Remember Thomas's 'flowchart' for his Halloween costume last year? I couldn't talk him into being anything really new this year. I swear the kid is 8 going on 38. The *only* thing he mentioned other than re-vamping last year's costume was wearing all black and being a spy. So I jumped online and started the search for a trenchcoat and maybe a fedora. He saw me and said "Nooooooooo. I just want to wear REGULAR black clothes and be a spy." I nixed the idea for safety reasons. I knew he'd have a hissy about using reflective tape or something so he'd be able to be seen. So, no spy. In the end, we used last year's jetpack (glad I saved that!), and changed the front. Last year he fell down and could not get up because his 'armor' would not let him bend at the waist. So we found a catcher's chest guard and spray painted it silver. Added some starburst glitter Christmas ornaments to be "gravity grenades", some duct tape and the letters S.P. and voila -- Space Police costume.
The trip to Cincinnati Children's was more eventful than usual. Long story. We've been taking Thomas there for over 4 years now and feel like old pros when it comes to routine endoscopies there. We don't really feel anxious about it now. Thomas doesn't get nervous or upset. We've really become comfortable with the whole thing and have come to trust the staff there. So I have to say, we were utterly shocked when something did not go well. It is minor in the grand scheme of things and no lasting harm was done. Here's the e-mail I felt compelled to send to the hospital's Patient Advocates after the incident. I did take the Dr's names out. I don't want my blog coming up if someone googles them.
Yesterday (Tuesday, October 27, 2009) my son, Thomas, was seen by Dr. "X" for an upper endoscopy in Same Day Surgery and Dr. "Y" was the anesthesiologist. After going over Thomas's history with us, an anesthesia assistant or student (I’m not sure which) named Sean (?) asked Thomas if he would rather be induced by mask or IV and Thomas chose IV.
As I discussed with Dr. "Y" in the PACU, if I had been in earshot of the conversation, that would not have happened. From prior experience I know that Thomas's veins are difficult, and prone to "blowing out." I had stepped away from the bedside momentarily (to the section of the room right outside of where the endoscopy takes place, but still inside the doors of the endoscopy room) to get a consent form for research that had accidentally been left in the pre-op room. Though my husband was standing nearby, he could not hear this conversation and did not realize Thomas was being asked this question, or that any decision had been made to do things differently than usual. (Thomas has undergone numerous upper endoscopies at Cincinnati Children's, all with a relatively smooth induction of anesthesia and without incident.) Neither his nor my opinion/input/permission was sought. By the time I returned to the bedside, the IV was being started. It did not go well. Thomas got upset and felt pain when the IV was inserted. It was difficult to get it inserted, but Thomas was "talked through it", being told that it would only hurt for a minute and that it was like "just a bee sting." I regret that I did not stop the induction via IV at this point, but felt torn, thinking that it would be over soon and that Thomas would be "out" in just a moment. The vein blew. Dr. "Y" told the student that the vein had blown, but the student insisted, "No, he's getting it." The propofol was causing him pain and a new IV had to be started after anesthesia was partially induced. At some point, I said "I'm going to step in here and say let's use the mask." The student put a mask on Thomas and said "It's only oxygen." Though Thomas was "out", I could clearly see that he was in physical pain and clearly not completely anesthetized. He moaned, grimaced, pulled his arm away, his entire body stiffened and he lifted his body off of the table as the second IV was started.
I understand that "things happen" and I appreciate Dr. "Y" taking the time to come speak with us in the PACU. Upon further reflection on yesterday's events, I find myself still angry about Thomas being caused needless pain. I am also frustrated that I did not get a chance to speak with the student who made the decision to induce via IV.
I simply cannot believe that it is Cincinnati Childrens' procedure to ask an 8 year-old, without any parental involvement, to make the decision as to how anesthesia will be induced. Thomas has, thankfully, forgotten the experiences he has had with IV placement prior to yesterday and had no idea what that decision would involve. I know that he does not like the mask and would likely have chosen any alternative offered to that. On previous occasions, I have helped hold him still so that the mask could be held in place. Many times, with great success, the mask has been forgone in favor of holding the anesthesia tube close to his face. What I am getting at is this: though I know that he may not "like" the mask, I know that it causes him no physical pain. Based upon prior experience, I would not have opted for an IV induction. I would have guided Thomas toward choosing to be induced via gas. I feel as though my opportunity to advocate for my child was taken away in yesterday's situation.
What I would like to see happen is that today's incident be used as a teaching point to the student (Sean??) in regards to what age it is /is not appropriate for a child to make healthcare decisions without parental input and about making sure parents are at least aware of healthcare decisions their child is being asked to make.
So, what say you, people of the internet? Am I asking too much to think that my 8 year-old should not get to make that kind of a decision without my input?? I was just stunned. And downright pissed!
OTHERWISE, everything went really smoothly as far as the endoscopy goes. Though Thomas did fail his wheat trial rather spectacularly. Dr. X's first words to us in the conference room were "NO MORE WHEAT!" Well, that's pretty emphatic. His esophagus was in bad shape with exudates & furrowing showing up again. It was so bad that Dr. X said "I'm not even going to call you with the biopsy results. Unless, of course, they are not what I expect. If you don't hear from me by the end of Thursday, just go ahead with our plan." Honestly, it is easier if he fails, that it is a clear failure. No having to continue trials to see what happens. No notion that his next few trials may be colored by continuing a food that is "iffy". So now we wait 6 weeks for his esophagus to have time to heal and then we move on to new food trials. That means that our next trip to Cincinnati will be a ways out. Maybe that will prove to be some incentive for my parents to come visit.
Dr. X did lay out a plan for the next several food trials. If Thomas passes foods on the next 3 or 4 endoscopies, he should have a pretty healthy dietary variety. And then we'll start moving toward getting rid of his feeding tube. Which is a good thing. But it is also slightly unnerving. Thomas started out life below 3rd percentile in size (preemie). He moved up to around 25th %ile in his first year. Then in his 2nd year, he dropped back to 3rd %ile because he was so sick with (what turned out to be) eosinophilic esophagitis. Since he got his feeding tube and we've been able to get him nutrition even when he can't or won't eat well, he's moved up to 50th %ile. Possibly that's still below where his genes would take him without a medical condition, since Mike is 6'5" and no small fry and I'm *not* a petite flower myself. But, plain old average is GOOD. He's healthy because he is getting proper and adequate nutrition. I'm just concerned about what his growth might do when we drop the tube. I'm sure it will be a gradual thing. I'm sure we'll keep it in for a time even if we don't use it just to keep an eye on his growth. But it is still something that gives me a case of the "what ifs".
In other news . . . my best friend has set a wedding date!! WooHoo! I am so excited for her and her future hubs. Congratulations, Carrie!
Tuesday, August 11, 2009
Due to a great promotion Albertson's had been running, we are majorly stocked up. I will be able to go months without buying many things like shampoo, q-tips, spaghetti sauce, cereal, granola bars, laundry detergent, etc. Therefore, there was only going to be one coupon we would really want/use in Sunday's paper. Instead of buying the paper, I headed to eBay and got 20 of them for less than the price of 2 papers. While there I found some tearpad coupons that will work well with the Albertson's/Kraft promo that starts tomorrow, so I got those, too. Score!
Monday, August 10, 2009
and friends in Indiana
hanging with friends
It's enough to wear a person out.
Public school starts here this week, so I figured we should at least try to get rolling. We need to get a bit of book learnin' in before we head off on another trip. This time the PNW beckons! I've never been . . . only drooled over t a c k y b u z z e r ' s photos. On tap for this trip: Cascades NP, Olympic NP & Mt. Ranier NP. That'll be educational, though, right?
Thomas did have an unusual amount of focus today. I hope that bodes well for our homeschooling journey this year. We finished early enough to have some free time, run our errands and still get home before public school let out. SaWeet! To celebrate, I'm making the Thomas-friendly version of chicken & dumplings tonight.
Saturday, July 18, 2009
- frozen (Albertson's in the slash pocket)
- snack foods (Target in the slash pocket)
- beverages/condiments/pb&j (misc. in the slash pocket)
- boxed/canned (more misc. in the slash pocket)
- baking/cereal/granola (nothing yet for this pocket)
- meat/dairy/produce/bread (misc. store coupons in the pocket)
- paper/cleansers (rebates in the pocket)
- perconal care (restaurant coupons in this pocket)
Within each section I added pages that each hold 3 4x6 photos to hold the coupons. I took some blue painter's tape and a sharpie to label the pockets. So for instance in the personal care section there are pockets for the following:
- razors/shave gel
- oral care
- styling products
- feminine hygiene
- skin care
- OTC meds
- first aid supplies
You get the idea. I also started using the old canceled check file to save my receipts. Sometimes a good rebate will come along that I already qualify for if I could just find the receipt. This should solve that problem. I've been saving tons and getting sweet deals. I need to lay of the cereal deals for awhile, though. I think I have probably 10 boxes stockpiled. And I am the only one in the house who really eats cereal!
I remember some friends' moms growing up who did the couponing and rebating thing seriously. My mom never did. So at least I'm not turning into my mother yet, right?
Friday, July 17, 2009
- tire change (take off shoes, turn socks inside out and replace shoes)
- refuel (drink a box of apple juice)
- clean windshield (spray water on face and wipe off)