Tuesday, December 05, 2006

Like Father, Like Son - Pyloric Stenosis

What a day!

Ok, let me backtrack once again.

I have been up for over 40 hours watching this little one. He has been vomiting every time we feed him. The first tip was that it was projectile vomiting. However, he was hungry after he vomited. I followed the same pattern at his age as well. Our first thought, or the top of our list in our differential diagnosis was pyloric stenosis. Pyloric stenosis is a blockage between the stomach and the small intestines - the muscle gets so thick that it does not let food pass through it.

We saw the pattern and knew we had to go in to the hospital - even if it were not pyloric stenosis - the little one was only 13 days old and could get dehydrated pretty quickly (then it would be even harder to get an IV in or anything).

So I drove him to the hospital in the morning. Summer drove Sarah (now 15 years old) to school. Quickly we agreed we needed to go back to Lucille Packard's Children's Hospital where he was born for an ultrasound to confirm (or rule out) the diagnosis.

They were great in the Emergency Department. I remember evaluating it a million years ago. They confirmed the diagnosis and the decision was simple - surgery. Surgery at only 13 days - this kid has gone through a lot in a short life-time - but this was going to be life saving. Luckily we had moved fast before he had gotten dehydrated or worse.

Like Father, Like Son

When I had it, they fooled around with adjusting the formula for a few days and I lost 3 pounds that I could not afford at the age. My father said "the heck with this" and wrapped me up and drove through the snow to Children's Hospital in Boston - another great hospital.

I was so small at that point, they simply put a flashlight to my abdomen in a dark room and confirmed the diagnosis. So like father, like son. I wrapped my little one off to run to the hospital (but this time around I had a pretty good guess about the diagnosis). And like father, like son - my little one had the same condition I had. We had followed a tradition (but this time with somewhat less stress and some forewarning or insight into the problem). Here are my son's scars (very tiny scars in the making) and mine (which has grown along with me) - now is that sharing or what at an early age?

In any case, back to my son's story. We entered the emergency room. They finally found a vein - hard with these little ones. The are small and curve around so quickly.

Neonatal Intensive Care Unit

Then off to the NICU - neonatal intensive care unit.

It was packed with other little babies - I mean really little babies (premies). Some of their problems made you really appreciate how lucky you were. Some had heart conditions, others were as small as my fist. One couple next to us were waiting for a heart donor. Our life condition (although life and death if untreated and somewhat complex 50 years ago), was doable and considered in some ways routine in comparison.

So, we met the anesthesiologist - Dr. Elliot Krane. He was our neighbor - what a surprise. Great guy. He agreed to take some of the pictures for us during the operation. Here is a picture of Little David getting ready for the operation.

Amazingly, a little (very little) incision was all he needed. Here is what it actually looks like with a bit of magnification. Karl Sylvester was his surgeon and you can see the quality of his work below:

Now a days, it is laproscopic. They go in there without disturbing everything and make the cut. In my day, they pulled everything out a bit to work on it which created more stress on all the neighboring organs. Today, the operation takes about an hour including prep and recovery. The little ones can eat the same day and go home the next.

All is Well

Little David was a text book case. He ate already and tomorrow - home he goes. What a journey life is with little ones? It takes you to a whole new world - once again. There are moments when nothing else matters, all appointments are cancelled and are less important. You are reminded of what your primary responsibilities are all about - watching over them (even if it is literally watching over them for 40 hours straight). In any case, all is well and he will not remember a thing (except I will remind him endlessly with a copy of this blog when he is older).


For now, all I can say is - many thanks to everyone who helped us at every stage and one more thing: Good Night (at 3:55 am).


At 5:41 PM, Anonymous Anonymous said...

Good evening Summer and David and "little David",
What a great job you did on the blog page! And at 3:55 AM!!
You certainly "sprang into action" - just like your father did.
I am so happy that they have changed the procedure from when you were born.
You are so fortunate to be so close to a wonderful hospital. Dad had to drive 90 miles each way from Danielson.
Love, Mom

At 6:08 PM, Anonymous Anonymous said...

I'm glad it all worked out okay! Yay to the baby being home again =)
~Laura Lynn

At 9:16 AM, Blogger David Fetterman said...

And David,
I'm so glad everything is ok with little David. Thanks for the blog update!
Once Jen told me, I thought, I bet there's something on the blog. Genetics
is fascinating - hard to believe you two have the same scars now.

At 9:19 AM, Blogger David Fetterman said...

glad to hear that you came through and helped rescue little david. he
certainly is a chip off the old block.


At 2:36 PM, Anonymous Anonymous said...

What a miracle this little baby is. The two of you have come through for him twice already in only 13 days! David Mark is so lucky to have you two as parents! He is so handsome too. lots of love, Judy

At 10:06 AM, Blogger David Fetterman said...

DF: This email is from the doctor who brought David Senior into this world.

Dear Elsie,
We have been meaning, for some time, to write you about the truly
remarkable and unique document we received about the birth of your newest
I really think that there are few, if any, other families that could have
produced such a gesichte. In the first place, the two pyloric stenoses and the
fact that by virtue of his own experience, David was able to recognize the
condition early and get such advantageous early treatment. And then, the calm
acceptance of the bris, the beautiful pictures,, including the arrival of the
youthful-looking grandmother. Finally, the list of David's impressive
achievements and international recognition. Tell me, is
his company totally private and separate from Stanford?
We think the Fettermans are a remarkable family.

Will we be seeing you soon in Florida? much love,

Gert and Moe


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