The long story

I never quite got around to posting the entire, hellish story of Trystan's ER visit and surgery last week. We've been playing catch-up ever since. The weekend before the surgery, he got sick and started throwing up, but as Charlotte had acted sickish and had some loose bm's earleir in the week, we thought it was a stomach flu at first. We didn't get much sleep that weekend. By Sunday afternoon, he had stopped passing stool, which was a really bad sign--he didn't even have any gas. As all of his bm-related "emissions" are captured in a little bag glued to his tummy, it's exceedingly obvious just how gassy (or not) that he really is all day.

The ER visit was not fun. I took him myself, and my husband stayed home with Charlotte. That was not the best decision. We should have found a friend to watch or take Charlotte for the evening and gone together. The Children's ER is just not set up well for babies. The little exam room had a hospital bed, not a crib. In other words, there was no safe place to put down a rolly little baby. Also, I couldn't leave him for more than a scant minute or two with the nurses because they have other paitents they are responsible for. That made going tot he bathroom and getting dinner rather difficult. They were really nice and managed to order me some food from the cafeteria around 9pm.

Trystan's IV took 2 attempts. The first nurse checked both arms and dug around in one for a minute or so before giving up and going for help. Another nurse found a vein in his foot. That was fun. Then they had to put in a "NG" tube--a thin tube down his nose and into his stomach to suction out the contents. He screamed for 10 minutes straight after they put that in--he was so inconsolable that they did an extra X-ray to make sure it was positioned right and not hurting him more than it should have (it was fine...he was just MAD).

They did manage to find me a breastpump after I'd been there for several hours. I have a couple of pump kits at home from Charlotte's and Trystan's NICU stays, and I'd brought what I thought I needed with me. Unfortunately, they brought me the wrong kind of pump--they brought a "Lactina" and I'd brought parts for the "Symphony". I have Lactina parts (the kits they give you have stuff for both), but have never actually used one (the Lactina is an older model of hospital-grade pump, and I've only used the newer Symphony ones). The pump kits are mostly the same with a couple of extra parts to make the Lactina work, so I ended up with another set of pump parts (I've got quite a few sets now...). We finally got admitted around midnight and moved up to a real room with a real crib that could safely contain a baby.

There was a sort of daybed that I could sleep on, and I did get a little sleep. I got up once or twice to comfort Trystan between midnight and 5:30AM, when someone came in to draw labs (another needle stick--this one in the other foot from his IV). Around 6:30 we headed down to Radiology for the first set of X-rays. They put contrast dye down his NG tube to his stomach and took pictures. We headed back up stairs, then back downstairs again around maybe 7:30 or 8 to look at his intestines. More dye went down until Trystan threw it all up (along with what little stomach contents he had) all over me. Around then, my husband arrived after having taken Charlotte to daycare. We then got the pleasure of holding Trystan's hands while they put dye up through his stoma (the opening to his intestines where he normally passes waste). The shoved enough dye up that way that it eventually came shooting back out with force all over the table. The result of all of this baby torture was that they found a spot where his small intestine narrowed to almost nothing, where something was blocking it. Every time we would start going to X-ray again, someone would ask if there was any chance I could be pregnant--a necessary question since the X-ray would not be safe if I were, but after about half a dozen times, you start getting a little paranoid...

The surgeons were obviously seeing the results of the x-rays rather quickly, because when we got upstairs after the second (third?) set, we were told that they were on their way to get him to prep for surgery. Unfortunately, they had not yet told us just what surgery they were going to perform at this point. Communication was not their strong point--as evidenced by the phone call I'd received earlier that morning asking whether Trystan was coming in for his scheduled procedure ("Um, we were admitted through the ER last night and are in a patient room right now...I thought your group knew about that last night?").

The surgery went fast, and seemed to involve the least complicated of the possible outcomes. He just had scar tissue from his first surgery that needed to be removed--other possibilities had included removing dead intestine, more invasive things, etc. The rest of Monday was more peaceful. Trystan mostly slept. The nurses found me a Symphony pump (much much much better than the Lactina). I got to go home that night and sleep in my own bed (without interruption for the first time since Thursday night).

Tuesday Trystan was mostly just drugged and only a little fussy. At one point, he was acting like he was in some pain, and the nurse got pain medicine for him. She walks into the room with something in a pill cup and pulls out a pair of rubber gloves. "He's really not going to like me," she said. "It's a suppository." I almost laughed out loud before I asked whether it could go into his stoma. Heck, we wouldn't be going through so much drama if he had a place to put a suppository. The nurse got a kick out of it too when she realized what I meant--and the ordering doctor was a bit embarrassed. He got pain medicine in his IV instead.

Wednesday was worse, because Trystan felt better. He started passing gas and a little stool (or maybe it was X-ray dye!) into his ostomy bag. He wanted to be held, and was clearly hungry. He kept trying to suck on my arms and shoulders and was really mad if I tried to sit down with him or cradle him, because he wasn't supposed to breastfeed yet. I spent several hours holding him straight up and down against my heart and bouncing, because it was the only thing that he didn't scream about. Finally around 6 the surgery team decieded he could try eating--a single ounce of pedialyte, followed by another single ounce of pedialyte 3 hours later before any milk. My nurse that afternoon had seemingly vanished, and I got exceedingly irate trying to get help from the other nurses to bring the pedialyte so I could feed my starving baby. I was sorely tempted to just sit and nurse him, doctor's orders or no, since I had plenty of milk and he would have been willing.

He did, finally, get something to eat and his NG tube out. By Thursday morning, his IV was out, he could breastfeed, and they were ready with his discharge papers. He was in such a good mood all day Thursday--smiling at everything, and ectatic to be home and see his toys, and to eat. His appetite was still a little slow over the weekend, but mostly back to normal by Sunday afternoon. He was very fussy all weekend--probably a combination of lingering discomfort at the incision site, and all the new gas an stool passing through his tummy again.

They had told us that he was cleared to go to daycare "as tolerated", so he went and did fine on Monday and has been good all week. He is attempting to make up for lost time (and weight) by breastfeeding constantly the last two days while I was off week. The bandage covering his incision is still attached, but should come off within the next couple of days.

His next surgery (the one originally scheduled for a week ago) will be in another month or two. I just hope that we don't have a weekend full of drama before this one!

Home

We're home! Trystan was discharged this morning. The
surgeons had OK'd him to start on pedialyte and small
feeds last night, and he had no trouble keeping
anything down. In my opinion, he would have been fine
to start eating hours earlier--he was starving all day
and clearly mad at me for not feeding him :) This
morning he has been smiling and giggling and all
around feeling good for the first time since late last
week when he first got sick.
He was sent home with just tylenol for pain if needed,
and can go back to daycare next week if we think he's
up to it--If he's as good all weekend as he has been
all morning, he will do just fine.

His next surgery (the one originally scheduled for
this past Monday) will be in about 6 weeks, and we
have an appointment with the surgeon in 5. Hopefully
next time we won't have so much drama beforehand!

Update on Trystan

Sorry for the mass e-mail, but this seemed the
quickest way to update several people on what is going
on.
Trystan was scheduled for surgery Monday morning for
the next step to repairing (completing?) his GI tract.
Unfortunately, Friday night he started showing
symptoms of a stomach flu--throwing up, lack of
appetite. Charlotte had also been a bit cranky
earlier in the week, so we were afraid that he had
caught something from her or from Daycare. We talked
both to our regular pediatrician and the surgeon's
staff several times, and he appeared to be feeling
better Saturay. By Sunday, he was still not eating
much, still throwing up a bit, and hadn't acutally
passed any stool for over a day, so we brought him to
the Childrens' ER. He was admitted Saturday night,
and after a night of X-rays, having blood drawn
several times, a suction tube placed into his stomach,
IV, etc, it was determined that he had a bowel
obstruction. He had scar tissue from his first
surgery that was squeezing part of his lower intestine
so that nothing could pass. So, Monday afternoon he
had surgery after all, but to correct the bowel
obstruction by removing the scar tissue that was
blocking things. The surgery went quickly, and he was
doing well Monday night. He will stay for a couple of
days to maybe a week, waiting for his digestive system
to get moving again and to start eating and keeping
food down again. His previously scheduled surgery
will be postponed about 6 weeks.

How much do you spend on groceries?

How much do you spend a month on food (groceries and eating out)?  This morning I have figured out that we spend easily double what I would have thought.  We're talking about $1000 a month lately on food.  Yikes.

I started out with an exercise in budgeting.  With my newly reduced workweek comes a corresponding decrease in take home pay.  I went to our joint account online and downloaded the transactions for the last month to use as a baseline for figuring out what we spend.  I categorized things into Bills, Groceries, Dining out, Stuff, etc.  I was immediately shocked at how many times we've been to Schnucks lately and how much we've managed to spend there (over $700 in June).  I expected that we would have some extravagant amount spent on eating out, but it was actually not that bad (around $300).  When I pulled the numbers for the first half of this year, they weren't much better--dining out has been pretty steady around $300/month, and groceries from $600-750 (the higher end in May and June when I was home all the time).

My family and I like to eat.  I really like to cook.  But should 4 of us (one who's 2 years old and one exclusively breastfeeding) really be spending that much money on food?  I have been congratulating myself recently on how much cooking-from-scratch I've been doing--buying more meant and produce and very little packaged stuff.  We don't eat many chips, few store-bought cookies (I make plenty of those myself), very little in the pre-packaged dinner mixes/sides.  So I assumed that I was doing well   I think that the main ways we get in trouble at the grocery store are:  #1 buying more expensive ingredients (nice steaks, "exotic" ingredients for one particular dish, etc) and #2 buying way more of things than we need.

 A good example of problem #1 is a couscous dish I made last week.  First off, I don't generally buy couscous, so I had none at home.  The recipe called for a 6-ounce "box" of couscous, but all I could find was either a larger package, or for the same amount as the large package, one with a spice packet that I'd end up throwing out.  I opted for the large package of plain couscous, and now have 3/4 of it still in the pantry.  The same recipe needed peanut oil, so I bought a small bottle, at a cost of $8 (ouch)--I used a tablespoon.  The dish was pretty good, but rather expensive in the end.

A good example of problem #2 is our cranberry juice stockpile.  I drink the stuff every morning for breakfast, but I'm kind of picky about what kinds I like (currently preferring cranberry-raspberry or cranberry-pomegranate, only 100% juice varieties).  My husband came home from the store about two weeks ago with like 6 bottles of the stuff--and none of them were the kind I like (he doesn't drink it..he's an orange juice guy).  I mentioned a couple of days later that we were out of the kind I liked, and he thought I meant we were completely out.  So he bought more.  We currently have 10 bottles of cranberry juice in our pantry.  For reference, I might finish a bottle over the course of a week.

Our pantry and our fridge are overflowing with stuff-we have probably every condiment known to man (3 or 4 kinds of mustard, 4+ kinds of vinegar, bbq sauce, DH's homemade bbq/hot sauce, ketchup, mustard, horseradish, soy sauce, teriyaki, sesame oil, olive oil, peanut oil, canola oil, wok oil, and on and on...).  For baking I have 3 kinds of flour (all purpose, whole wheat, and cake, plus cornmeal and masa harina), various forms of chocolate (regular cocoa powder, Dutch process cocoa powder, unsweetened chocolate, dark chocolate, white chocolate, chocolate chips), unsalted butter, salted butter, shortening, butter flavor shortening.  Our spices take an entire wide drawer plus a two-tier lazy-susan (I've got 3 kinds of cinnamon.  They're all different, and I couldn't cut back to 1...really.).  We use pretty much everything in the kitchen-at least occasionally.

I think a new goal is going to be to cut down our grocery bill over the next 6 months or so.  Cutting coupons won't help much-I already do that, but except around peak-baking season (i.e. Thanksgiving-Christmas) I don't really find a lot for the stuff we buy.  If there were more grocery stores close by, I could play the game of shopping the stuff on sale-but our 2 closest stores are both Schnucks (not counting a couple of "quick marts" that don't carry enough, and the tiny Walmart that carries mostly boxed junk food).  I don't have time to drive 20 minutes each way to find a discount grocery store to save $2 on the bill, so that's out.  I try occasionally to grow some of our own produce, but we have a small yard and lots of neighborhood bunnies, so I doubt we've ever come close to breaking even on the garden.  I guess the trick, then, is going to be to get smarter about how much food we're buying, and to use what we have.  That might help out with de-cluttering our pantry and our fridge, too.

So, know any good recipes for cranberry juice and peanut oil?

Rude people

We were involved in a hit and run accident this morning. Thankfully, it's not serious--very little damage to my husband's car, and definitely no injuries. In fact, the bump was light enough that the other driver told the police that he didn't realize that he even hit us (yeah, right).

All four of us were loaded in the car on the way to get haircuts for my husband and daughter. Hubby first stopped for a carwash--one of those tunnel types where a conveyor belt carries your car through all the brushes and soaping. We'd just pulled onto the track and put the car in neutral, and saw the car behind us pull up really close and stop suddenly. I shouldn't call it a car, as it was a very large, newer looking beige truck--the kind that might be practical if you actually hauled things in it, but had way too nice of a paint job to be doing any real heavy work that I could see. The carwash started pulling us in, and suddenly we felt another bump--much too hard to be the jerking of the carwash belt, but since we were in neutral, not hard enough to really smash the car. We were already in the soap at this point, so the attendants let us continue through. I fished in my bag for paper and pen to write down insurance info on. We pulled out of the carwash and off to the side so my husband could get out and check for damage. I was already watching for the truck to emerge from the wash, ready to write down the license plate number--I think I had a hunch that the guy would drive off. Sure enough, he left the carwash and drove away without so much as a backwards glance--even though my husband was standing right there trying to get his attention.

We called the police and put in a report. The carwash attendant had the same story that we did--that he "gunned it" and stopped suddenly once, and then did it again and hit us. They were really nice and helpful, giving a report to the police, and had also written down the license number. They had an incident report form where they wrote everything up very quickly. The police immediately went to the truck's house and talked to the other driver, who claimed that he didn't know he hit us. We heard back from the carwash manager a couple of hours later that the truck's driver then came back to the carwash and tried to complain that the accident was the attendant's fault.

I'm trying to refrain from calling this driver a variety of unpleasant names. Clearly, he knew that he hit us, or he would have been complaining to the insurance that we were trying to pass off old damage as a new accident. He realizes that there were multiple witnesses: at least one attendant--there were 2 + the manager working at the time--plus my husband and I, and a security camera. So, now he's going to try blaiming the carwash. I don't care what he claimes the attendant was telling him--he should have been able to clearly see the car sitting practically motionless in front of him, and been competent enough to know that he should not hit it. I just hope his insurance company (and ours, and the carwash's) straighten him out about that.

Formatting

Sorry for the strange formatting. I've been experimenting with emailing my blog posts instead of logging into the website...either Outlook adds some very explicit formatting (down to font, etc), or blogger interprets my email that way. In the mean time, if you're seeing large spaces in my posts, well, just enjoy the breathing room....

Back to Work

Friday I started back to work. So far, things are going pretty well. Then again, today is only day #3.

I brought Trystan into daycare in the middle of last week for a sort of “show and tell” to train the daycare workers on how to care for his ostomy. I also wrote up a multi-page, step-by-step guide, complete with photos, should they need to apply a new pouch. I’m glad that none of them are squeamish (how can you be when you deal with poop for a living?), and they all were very optimistic about the whole thing. After Friday, they were even more confident that his care is not really much harder than any other baby. Monday, they got to change the bag (in addition to the normal emptying). Twice. Those things are a little touchy—either they last for days at a time, or they come off within hours. Their second attempt was still on strong this morning, so I think it’s a winner. And now, they’re even more comfortable about his care (as am I).

Work for me has been fine. It only took me about two hours to clean the 1100+ email messages I’d accrued from one account. I had a couple of other computer accounts and pin numbers/passwords that had to be re-set. Everyone was friendly and happy to see me. I found the mother’s room with no problem—I am in a different building than when I was still breastfeeding Charlotte. I also got lucky and ran into one of the other moms on her way into the room, so I got the door code from her. My first set of tasks is to run a series of automated tests against the newest build of our software—tests that I originally wrote. It’s not too bad, and I have breaks of up to 10-30 minutes while waiting for tests to complete (or fail) to finish doing the rest of the back-to-work cleanup, and to pump without feeling like I’m taking too much personal time.

The pumping itself has been going great. I was VERY stressed by the whole thing after Charlotte was born, but this time I have several advantages. First, I have several hundred ounces of milk in our deep freezer from Trystan’s first hospital stay (a typical bottle is around 4oz, so we’re talking about weeks worth of food here). With Charlotte, I was able to just barely keep up with her demand—this time there is no problem if I run a little short. I do, however, have to make sure the old stuff gets cycled out, as it only has a shelf life of several months (6+ in a deep freeze, according to LLL, but we’re already at 3 on most of it). Second, I already have all the equipment I need, and then some: electric double-pump, backup hand pump (one that works really well on clogged ducts—just too slow to do at work), hands free band, extra parts, tons of bottles (not to mention all of the ones already in the freezer), etc. Finally, though my supply has dropped off a bit from my initial post-birth pumping (when I think my body was convinced it was feeding twins), my supply seems ample and is taking less time than before (pump running for 10-15 minutes a time instead of 25+).

I think the hardest part is getting up in the morning and getting out the door. It’s much harder with 2 kids, and when getting up some nights to nurse Trystan. Then again, I always felt hurried to get out the door *before* Trystan was born, so I guess that’s not too bad all in all.