I've been gone from the blog for a while, but boy, I have a good reason. The past week seems like a month. Most of you know why I've been absent, but I thought I'd better go ahead and document the story on the blog. Just a warning, this is going to be long.
My youngest son, Ryan, has had a rough couple of months. He started having stomach cramps on Monday, May 16. Every day, at least once, but sometimes twice; he would lay on the floor moaning and groaning that his stomach hurt. Nothing helped it. When it quit hurting after 30 minutes or an hour, he would get up and go ride his bike, or go for a run, or whatever else he felt like doing...because he felt
completely fine when his stomach wasn't hurting. I was baffled. I didn't know how to help him. I offered multiple over-the-counter products, but nothing ever helped. He didn't seem sick and had no other symptoms. Trust me...I quizzed him about what was going on in the bathroom almost daily. I couldn't find a connection to any foods he was eating, and the stomach spasms were getting rather alarming.
After exactly one month, when we were finally done with all the senior party/graduation business for our oldest son, the girls' dance recital, college orientation, our 25th anniversary trip, and Ryan's week-long trip to Student Life Camp in Colorado, I took him to the doctor. Yes, I win "Mother of the Year" for getting my son to a doctor in a timely manner. But I've forgiven myself, so moving on...we saw a P.A. who ordered an x-ray of his abdomen. I got a call later in the afternoon telling me that Ryan was constipated. I was surprised, considering that he had communicated a different story almost every day for the prior 3-4 weeks. Regardless, x-rays don't lie, so we started 7 days of laxatives as instructed by the doctor.
After 7 days of laxatives, Ryan vomited the next day when his stomach was hurting. He was completely cleared out, but he had continued to have stomach cramps during the 7 days of laxatives. I was even more alarmed than before, because vomiting was a new symptom. He didn't vomit the next two days, but still had stomach cramps. By this time, it is the fourth weekend in June and my husband left for a work trip to South America. On Saturday, Ryan vomited and on Sunday he vomited a LOT of times. I took him to the emergency room in a bit of a panic Sunday afternoon, June 26. His stomach had been hurting daily for SIX WEEKS! The ER doctors were busy, but did blood work and assured me that he must have a flu bug. His blood work was completely normal, so they sent us home and Ryan continued to vomit through the night, but was better by Monday morning. I took him to another doctor, who is a family friend, on Tuesday morning. She ran bloodwork and did another x-ray. Everything checked out great. We had no idea what was wrong with him.
For the next week he had stomach cramps daily, but no vomiting. He thought they might be getting a bit less intense, so we were hopeful that things were going to improve ANY MINUTE, for Pete's sake!
We traveled to Missouri to celebrate July 4th weekend and had a great time with the relatives. Ryan swam and played, and of course, had stomach cramps at least once a day for about an hour.
We came home from Missouri the night of July 4th and were looking forward to leaving on a vacation to Wyoming on Friday, July 8th. We had some appointments and haircuts, etc. on Tuesday and Wednesday. Ellyn called me around 11:30, as I finished an appointment with my dermatologist on Wednesday and said Ryan had vomited a few times and seemed worse than usual. She told me I needed to get home. I called our doctor/friend who told me to take him straight to Blank Children's Hospital emergency room. She didn't need to tell me twice.
As I drove Ryan to Des Moines, he laid in the back seat moaning and writhing in pain, vomiting every 5-10 minutes. I drove really fast, and imagined what I would say if I got stopped for speeding. I felt ready to burst into tears but knew I had to hold it together.
When we walked into the ER, Ryan started vomiting again right at the check-in desk...and that gets you a room really fast.
We were in the ER from 1:00 pm until after 11:00 pm. Fortunately, Byron works two blocks away and had been able to join us during the afternoon. During the first 4 hours in the ER, Ryan almost climbed the walls in agony. He literally moaned, writhed, rocked, paced, pulled his hair, etc. They had an iv going very quickly, but had to try three different pain meds through the iv before he got relief and could lay down and relax. He had an allergic reaction to morphine and had to have benedryl through the iv, which complicated things even more. They also did another x-ray and bloodwork, which came back normal. Once his pain was under control around 5:00, they decided to do CT scan. Ryan drank the contrast/cherry flavored drink for the CT scan, and then we waited for 3 hours. He was somewhat comfortable and had the attention of a lot of ER staff. They started talking about admitting him, because his pain was not able to be controlled well.
The CT scan came back showing something abnormal in his small intestine. I felt optimism for the first time in weeks. The ER doctor then called a pediatric surgeon. At 10:00 pm the surgeon decided to try a procedure that he thought might correct the problem the radiologist had seen on the CT scan. I'm not going to describe the procedure, but I will say that watching Ryan go through it was like watching someone give birth. It lasted about an hour and did NOT work. Ryan was then admitted.
Byron headed home to be with the other kids, who had been alone since noon. (Glad they aren't little anymore.) Ryan and I got to his hospital room around midnight. Wow, what an unbelievably looooong day it had been. I was exhausted and Ryan had been through hell. And I don't say that lightly.
The next morning (Thursday) we met with the surgeon who asked us to relay the whole story again...when the cramps started, other symptoms, what had transpired in the 7 weeks, every detail we could think of. He had talked with the radiologist who read the CT scan and he thought he knew what the problem was: a Meckel's diverticulum. (keep reading...I will describe what it is a bit later.)
Ryan spent Thursday in a hospital bed with iv fluids and pain meds, but did not have any stomach cramps. He could eat or drink NOTHING, in case of surgery. In the afternoon, he had something like dye put through his iv to work its way through his entire system. I don't know what it was called, but he went to nuclear radiology for the "dye imaging" which required him to lay still for 75 minutes. No problem, he fell asleep watching a movie.
His siblings visited and provided entertainment and a much needed distraction from hunger. Ryan hadn't eaten anything on Wednesday, since he'd been sick. He was feeling hungry by Thursday afternoon.
The surgeon was hoping the dye image would show the Meckel's diverticulum. He warned us ahead of time that it could be in Ryan's intestine, but not show up on the image. This dye image/test was a possible way of confirming it without cutting into Ryan to find out.
disclaimer: I am not a doctor, but I will try to explain the problem
A Meckel's diverticulum is a remnant of the yolk sack/umbilical cord that is supposed to dissolve shortly after birth. In two percent of the population it doesn't dissolve. It usually makes itself known within months of birth, by causing bleeding and extreme pain in infants, due to the fact that it produces acid. (The intestines are non-acidic.) Very rarely, they go undetected if they do NOT produce acid. The surgeon quizzed me about Ryan as a newborn: did he cry a lot, did he have bloody diapers, was he premature. No, no, and no. The dye image came back inconclusive for a Meckel's diverticulum. It didn't show anything wrong. Ryan was scheduled for exploratory surgery for first thing Friday morning. (The same Friday we were supposed to leave for Wyoming.)
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| Ryan--looking relaxed as he heads for surgery |
Ryan had surgery at 9:00 am and by 10:00 we learned that it was indeed a Mickel's diverticulum, with a major complication: intussusception. The Mickel's diverticulum would normally be like a 1-inch pocket in the small intestine wall. Ryan's had inverted, so it was sticking up into his intestine and causing things to catch on it as they passed through. As things caught on it, it began to telescope his small intestine into itself: imagine reaching into the end of a tube sock and pulling to turn it wrong side out...that's what was showing up on the CT scan. It was the cause of Ryan's extreme pain--his small intestine was starting to turn wrong side out.
funny sidenote story--Throughout the 7 weeks of stomach cramps, Ryan would say that he thought he had a twisted gut. Sweet little sister Meggan told him he had a demon in his liver, something she picked up on some tv show called Untold Stories of the ER. The surgeon told them they were both right, only the demon wasn't in Ryan's liver, it was in the small intestine and he cut it out.
Ryan had two very small incisions and one a little larger, and he had the problem corrected and his appendix removed (preventative measure that is very common). They took pictures of his "guts", so we have been able to see the entire problem with our own eyes. We were elated to know that the diagnosis was correct and that the surgery fixed the problem!!! Meckel's diverticulum with intussusception in a 12 yr. old is considered rare, and we are so grateful that it was found and corrected. The surgeon told us that he was planning to mention Ryan's case in his next lecture.
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| Ryan -- ready to go home |
The doctor encouraged us to continue with our vacation plans and just leave a couple of days later. he gave us instructions for Ryan and his cell number in case of a problem. Ryan was dismissed at 2:00 on Saturday. We left for vacation at 7:30 Sunday morning. My brain was just a tiny bit fried. Being gone from home for 3-4 days prior to leaving had made it very difficult to get anything ready. I packed in a hurry, and we are now relaxing as a family in the beautiful Grand Tetons!
