Tuesday, September 14, 2010

Days don't get worse than that...Day 1

Although it wasn't a typical weekend, at wasn't unusual either.  "Mommy" had left for a Creative Memories conference Friday afternoon which was in Baltimore.  The little guy, Joshua, had been "teething" pretty bad and was out of sorts.  That's pretty typical for an 11 month old, right?  Big brother Jackson was doing a great job of playing with the little guy, and helping me straighten up.  We made it through dinner, the boys took a joint bath, and on came the pajamas.  Joshua had been even more fussy than usual, which had made it very difficult for "Mommy" to leave.  I gave him some Tylenol, rocked him to sleep, and put him in his bed.  As I was getting Jackson ready for bed, Joshua woke up and started screaming.  So Jackson got some water, got kissed, and tucked in.  As I was shutting the door, I heard "THUD", followed by louder screaming.

I ran in to Joshua's room, and sure enough, he had climbed out of the crib.  He had never attempted to climb before, so it was a shock.  I have a background as an EMT for the Virginia Beach rescue squad so I immediately started a trauma assessment.  Eyes were reactive, no red marks or bruising, not guarding anything.  Ok, I decided to call the nurse on call anyway.  She agreed with me, to keep an eye on him, check on him in a few hours, and see how it goes.

I walked in at 3:00 am to find that he had thrown up.  Not good.  That is one of the signs of head trauma.  I called the nurse again, and she said that they only get worried after throwing up multiple times.  She assured me that he was probably fine, but to still stay aware.  I felt better, so I rocked him for a while, enjoyed some cuddles, and put him back in bed.

At 7:00 am I went in to check on him, because he had been waking up pretty regularly at 6:30 am.  I went to the crib, and gave him a little shake.  Then I saw that he had thrown up again.  He grunted, but didn't open his eyes.  I picked him up to get his diaper changed, and he was very lethargic.  My boys are always full of energy, so I was starting to get concerned.  I took another look at his eyes, and they were rolling back into his head.

The next ten minutes are a blur, but I one handedly got the diaper changed, 4 year old dressed and into the van, and we were rolling.  We are blessed to have a great Children's hospital 20 minutes away.  I made it in 15.  On the way I called my wife, my parents, and my in-laws.  My in-laws live close, so they agreed to meet me so they could take care of Jackson.

We made it through check in and into a room in about 10 minutes.  With the knowledge we had, the doctors (Residents) started with the possible head injury.  Initial assessment ruled that unlikely, so they moved on to think it was just a virus wreaking havok.  They wanted to observe and see how he did.  Well, I will tell you, he did not do well.  To see your little 11 month old lying on a hospital bed, not moving, and moaning was not an experience I ever need again.  My in-laws took Jackson to their house and kept him busy and happy.  They wanted me to give Joshua liquids, because they thought he was dehydrated, and then they decided to put in an IV.  Only they couldn't get access.  They called the special team that just puts in IV's and guess what?  They couldn't do it either.  Then they paged the woman with the golden touch, and told me she was on her way. 

At this point, he had not really seen the attending, but she had been supervising.  She came in to see the cute little guy she had been hearing about, and I gave her the run down.  She got that look on her face that you get when you are trying to solve a puzzle.  Then I saw her lean over and smell his breath.  Tears welled up in my eyes as alarms started screaming in my head.  I thought back to my EMT class where we had learned that a fruity smell on the breath is a sign of ketoacidosis which occurs as the body attempts to get rid of excess acetone through the breathing.  This is a major concern for diabetics, but my 11 month old wasn't diabetic, right?  I instantly said "is this when I remind everyone that I am a type-1 diabetic".  She stood still for a second, and then the room was another whirlwind.

The lady with the golden touch got the line started.  They did a quicky blood test that just came back as "high", and sent us straight to the PICU.  He wasn't moving around a lot, and they had put him on several medications for pain and because all of his levels were "off".  Once in the PICU he was attached to several monitors and drips.  He had tubes everywhere, and would occasionally scream for 2-3 seconds and then go back to sleep.  "Mommy" got her very good friend to leave the conference right after I had first called her.  They drove her straight to the hospital (they got a speeding ticket on the way), but she was there. 

I don't know what would have happened if the attending hadn't stopped in to see the "cute boy".  I firmly believe that she saved his life.  I also thank God for sending the angel that pushed him out of his crib. There is no other explanation because he was not a climber and the sides were up!  Bloodwork revealed that his blood sugar level was over 1200.  We spent several days in the PICU, and several more in the hospital recovering.  We had some great nurses.  It was also scary too because they kept saying "it's different because were not really sure what to do since he is so young."  I got really tired of hearing that one.  In the end, we acquired a great Endo team for Joshua, and I got my little boy back.  He had not been acting right, and then we knew that it was Diabetes, and not just teething.  We still beat ourselves up about missing the signs, but I think most people would have.  He was so much happier when we got home.  Our lives had changed for ever, but at least my little guy felt better.


  1. ...wow... i have tears coming down my cheeks...there are no words to describe what you felt and saw in those early hours, but thank you for sharing his story with us. thank you for writing it down for him.

  2. WOW, that is quite a diagnosis story. And so lucky that the physician came when she did. I used to be a PICU RN for 12 years...up until Joe's diagnosis. I remember hanging up the insulin drips, IV fluids with dextrose, the postassium...EVERYTHING is WAY off and you have to correct very, very, very slowly and cautiously...

  3. OMGsh....

    I'm an after hours telephone triage nurse...I keep wondering if our protocols would have sent you in?????

    THANK GOODNESS someone thought outside the box - beyond the head injury!!!!!!

    And thank goodness for a dad who was quick to rush for help!

  4. Brian, after reading this post I have tears dripping down my cheeks just remembering how scared we all were that day in the ER and how grateful this grandmother is that Joshua is so lucky to have such a wonderful Dad. I'm so glad you have started writing again. You guys didn't miss the signs, they are all things that 11 month old babies exhibit or can't be measured. Love ya

  5. Brian, I am so thankful for many things that day. You being the amazing father you are being the number 1 thing. I know you say all the time any one would have taken him into the hospital but truth be told, not everyone would have pushed the doctors to do more then wait it out as you did. Your EMT and Father Skills told you something else was wrong. You didnt just think it was a virus. We have had amazing friends and family support us through this journey but we both know as the doctors told us. Joshua was with in 3 hours of dying. If you had waited at all it could have been so much worse. I thank God everyday that you did what you did and responded the way you did. We are lucky Joshua had his angels pushing him out of the crib that night for sure... but we are more lucky he has you as a dad. I am a firm believer YOU saved his life. I LOVE YOU