Twyla Goes to the Hospital. (Now With Conclusion!)

by Alexa on April 21, 2014

The party line, of course, is that daycare is a boon to women. But has anyone investigated the possibility that daycare is an invention of the patriarchy aimed at killing off working mothers altogether?

We’ve all been sick more or less continuously since Twyla started in February. The weekend of April 5th, she got a nasty case of croup, and was home sick for a few days. Mostly recovered (little cough, slight snorfles, but no fever) she returned to daycare for two days at the end of the next week. I’d been feeling sicker myself and on Saturday morning I went to the doctor to see whether my pneumonia had returned, because I have nothing better to do with my limited free time than get chest x-rays. My pneumonia was NOT back, but there was a lot of frowning while listening to my chest, where the air was apparently “really slow” and “swirling,” which sounds very elegant and all but it turned out to be a very elegant case of bronchitis. I was given a stern talking to about “resting,” and how I should start doing it. That night, Twyla threw up twice (extremely restful). I thought it was probably snot-related. Sunday morning she was not very hungry (which is not a thing that happens to Twyla), and sat around holding a banana for a while before eating a third of it. I mentioned to Scott how odd this was—usually we don’t keep bananas in the house because Twyla has a Banana Problem and becomes unhinged when not allowed to eat the entire bunch, one after another in quick succession—and Twyla promptly threw up what little banana she’d consumed.

So all day last Sunday I sat in bed, trying to “rest” (I do not know how to sleep in the day), and Twyla slept next to me. Occasionally she’d stir and I’d give her a sip of water, and at one point after this she gagged again, and then fell back asleep. By three in the afternoon I was a concerned that something was amiss. Twyla was still sleeping. She sounded congested, and I wondered whether her cold from the previous week could have turned into pneumonia. No fever, though. I Googled “toddler sick sleeping all day.” At some point Twyla opened her eyes. I tried to keep her up. She sat up and drooped over again, falling asleep on her face. I carried her out to the living room. She seemed blank and not quite there, and kept drifting off. I took her into the kitchen and made her drink a little ginger ale. Then Scott and I noticed that her fingers and toes were dusky. We decided she needed to be seen and he took her to the ER.

The ER, by the way, is also our clinic’s after-hours care venue. We go to the primary care clinic at the Children’s hospital, which dates back to Simone’s NICU stay, when they asked for a pediatrician as we neared discharge, and I didn’t have one because I hadn’t believed I would get to take home a live baby, and if you don’t have a live baby you have little use for a pediatrician. So the NICU nurses suggested the clinic one floor above, and one of the doctors came down to meet Simone, and we have been very happy there ever since. It makes referrals to specialists easy, they are used to ex-preemies, and they also cover parts of the hospital service, like newborn checks, which was nice right after I had Twyla. The downside is that if something happens after office hours and they decide you need to be seen before Monday, they send you to the ER downstairs. For a long time this made me feel guilty, like I was abusing the system, but that’s just the way it is.

So I sent Scott and Twyla off, worried but also feeling like maybe I had overreacted (maybe her fingers and toes were purple with cold!), only it became clear pretty quickly, via the texts Scott sent to keep me updated, that I hadn’t. The triage nurse must not have liked what she saw, because when Scott and Twyla got back to the room a doctor and two nurses were waiting for them. If you have ever been to an ER for something that does not involve screaming or obvious continuing blood loss, you know that this is not usually the speed at which events proceed. They kept asking if Twyla could have gotten into any drugs or medicines. I knew she couldn’t have, but I ran around the apartment checking every prescription bottle anyway, panicking and having visions of CPS coming to investigate and taking the girls away because our apartment was Too Messy (I was not in the very most logical frame of mind). Twyla’s oxygen saturation was normal. They took blood, and urine via catheter, and placed an IV. Twyla barely cared about any of this, and went straight back to sleep after they finished, which I think we can all agree is not Standard Operating Procedure for toddlers, and by now I was a wreck. The doctors were worried and moving quickly.

Simone and I played UNO and I tried to keep the both of us calm. She was still running a fever from her own version of whatever pestilence Twyla had been fighting off the week before, so I didn’t want to take her to the hospital if I could help it. I could have taken her to my mother’s and gone to the hospital myself, but at this point, as scary as everything was, there wasn’t the sense that it was time sensitive in a way that meant I needed to be there, which is my euphemistic way of saying no one thought Twyla was going to die in the next few hours, and I was having some severe PTSD-type reaction and every time I thought about going to the hospital I also thought I might throw up. I felt like I should go—god knows I’d be getting more complete information if I were the one talking to the doctors—and more than that, I felt like I should want to go, to race to Twyla’s side. But I was paralyzed with fear while also suspecting that I was making more of this than it really was, and I knew Scott would be able to keep it together in the ER, and I figured I could do more good at home than there, especially considering that if Twyla rebounded quickly with fluids—they knew by this point that she was dehydrated—there would be work and school in the morning for most of us.

People make snide comments about other people who post to Twitter when their children are ill, but being able to ask for support and receive it was amazing, and my friends on Twitter (and Jonna, who allowed me to text her about all of this as it was happening) were a great help to me, just by being there. 

I suppose around this point is when Twyla’s bloodwork came back. Most of it was fine, but her sugar was low and her lactic acid was high. They gave her some sugar in her IV and told Scott they would retest the lactic acid. I worried for a moment that she might be diabetic, but it wasn’t long before I hit upon another possibility—and this soon took on the feeling of an inevitable truth—namely that she had the rare metabolic disease that immediately comes up when you begin Googling Twyla’s symptoms and high lactic acid, a rare metabolic disease that often means death in early childhood. This had the ring of truth to me, because I have at times felt very superstitious about Twyla, because I am an absolute moron. Twyla, you see, was conceived so effortlessly, and then she LIVED, and the pregnancy chugged along* until she was born at term, and apart from dreadful colic and reflux in her earliest weeks she has been a dream baby. She is so lovely and has such a constant, goony smile that other people smile back at her everywhere she goes; she is happy and sweet and EASY, even during toddlerhood. So it seemed only natural to me, because of my previously referenced moronism, that something would go terribly wrong while she was still very young and she would die. Thus, even though the differential for Twyla’s symptoms and bloodwork was full of ordinary things, the most likely being “virus of unknown stripe,” I seized on to the rarest and deadliest and then, realizing how absolutely insane this was, didn’t trust myself to have any opinion on the seriousness of her condition at all. Twyla woke up. Her circulation was better. She ate part of a popsicle. The ER doctor decided to “leave it up to us” whether she should be admitted. If we lived further away, he said, they would definitely admit her, but since we lived so close to the hospital (about four blocks), it was our call.

Doctors, do not do this. Please, I beg of you. Maybe you think you are doing families a favor, giving us a place behind the wheel, but it feels as if you are asking us to make a decision above our pay grade and then live with the consequences. I will ALWAYS wonder if Ames would be alive if I had chosen differently when my OB gave me a choice of prednisone or lovenox, even though he made it clear that he didn’t think I needed either (and that he thought prednisone might cover some possibilities lovenox would leave unaddressed). I was tormented when the perinatologist on call the night of Simone’s birth asked me to decide whether to deliver at 25 weeks or wait to see if the contractions stopped on their own. And I was NOT thrilled at the idea of taking Twyla home only to watch her all night in case she became unresponsive (in…her sleep??) and needed to return to the hospital.

Luckily (?), I’d no sooner told Scott as much than Twyla threw up her popsicle, despite IV Zofran, and leaving was off the table. She was admitted.

I ordered a pizza for Simone and myself as I had been doing such an excellent job of parenting that I had forgotten about dinner and it was now 8 o’clock. We washed our hair and got into our jammies and ate. Simone was worried about Twyla. Most kids Simone’s age have a faith that doctors can fix things, and a distance from the possibility of death, that she doesn’t have because of Ames. She has asked, many times, why the doctors couldn’t fix what was wrong with him, and obviously this was different in a million ways (Twyla not being a 22-week-old fetus, for starters), but the possibility of Twyla dying felt real to Simone, which is not how it should be for a six-year-old. I was glad to be there with her. I reassured and cuddled and let her sleep in my bed. After Simone was out, Scott and Twyla Facetimed me from Twyla’s new room on the Peds Floor. She still didn’t look great, but she was awake, which was an improvement. I slept with my phone under my pillow.

*Typing this, I am realizing that my pregnancy with Twyla was awful–I had hyperemesis, gestational diabetes, polyhydramnios, was on daily blood thinner and weekly progesterone injections, started contracting at 15 weeks, needed terbutaline, etc.–and yet apparently all that need happen for me to regard a pregnancy as suspiciously easy is for no one to die during it.

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I am not trying to be coy or create drama—Twyla is fine!—but I really am out of writing time. I am not even sure why I bothered to write all of this out, as it is no doubt EXTREMELY BORING, but now that I have, I might as well post it and keep going. I will finish up the rest tomorrow.*

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*By which I meant a month later. Click here for the thrilling, belated conclusion!

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