Wednesday 9 August 2017

Pray for Josh

Hello all.

This is a 'fuller story' for those you have already heard about our current situation and an even fuller story for everyone else! 

A few weeks ago, we all had a brief but unpleasant stomach bug. We all recovered, but a couple of weeks later Josh was ill again. He recovered but was subsequently plagued with periodic stomach pains. This went on for a couple of weeks, and then last week he spent the whole week off school because the cramps were sufficiently bad. He also mostly lost his appetite. Libby took him to the doctor's two weeks ago and last week. He was given a couple of different kinds of medication and had blood tests taken done didn't seem to show anything untoward. 

On Friday evening he felt a bit better (we were all out watching Caleb being the lead in the school play - somewhat of a triumph, but a different story...) However on Saturday morning he still didn't have any appetite, and then had diarrhoea which was predominantly blood. 

This freaked us out a bit as you can imagine, but we were grateful to be able to get an appointment with the first doctor within half an hour. He suggested a few other possibilities of what could be wrong and recommended a stool sample and some more blood tests for those conditions. However, when Joshua continued to bleed while trying to obtain a sample, we pushed a bit (as we didn't want to have to go to A&E/ED/ER in the middle of the night) and the doctor agreed to give us some notes to take to the hospital.

I subsequently spent the rest of Saturday with Joshua in Accident & Emergency (the Emergency Department/Emergency Room, depending on where you are) while they ran multiple tests to try and determine the cause. To be specific:

* stool sample
* urine sample
* multiple blood tests
* x-ray
* ultrasound
* haemorrhoid check
* CT scan


Eventually, just before Libby and the kids came to visit, they diagnosed an 'intussusception'. If you haven't heard of that, don't be surprised. Although it apparently affects 56/100 children under 18 months, it is much rarer in people older than that. It is basically where a portion of the intestine telescopes in on itself. Something like this: 
After the doctor consulted with some paediatric colleagues, and they consulted with the surgeon, and the surgeon consulted with the Consultant Surgeon, and the consulted with his colleagues in Townsville and Brisbane (larger towns in the State) it was decided that they would need to do surgery to see the extent of the problem, sort what needed sorting if necessary and remove what needed removing (if anything). 

Libby stayed with him overnight in a room on the paediatric ward, and the next morning while waiting for an opening in the surgery schedule.


After going to church and feeding the kids, I was able to drop them off with friends and then join Libby. I managed to get there just before Josh went into surgery, and we were both able to go into theatre and I held his hand while they put him to sleep (around 14:45).


We were told the surgery should take between one and a half and two hours, and we probably wouldn't get any updates until he was in recovery and ready to be moved to the ward. 

We waited in the room he was expected to come to in the 'adolescent ward'. The plan was for Libby to stay with me until Joshua came out, but unfortunately, the surgery went on and on, and Libby had to go and collect the kids. Fortunately (at about the three and a quarter hour mark) I got an update saying that things were going well, but it had turned out more complex than they had first thought, but they expected to be done in a further 45 minutes. They also said he would be going to the surgical ward as they were better set up for post-op care. In the event, the surgery took four and half hours. 


Joshua has since done pretty well, getting up (with much assistance) for a shower on his first morning. However it is quite an uphill struggle to do anything, but he is keeping on with physio exercises he has been given.

On Tuesday he was able to move to 'clear liquids' (i.e. broth and jelly).

However, on Tuesday evening he started to feel nauseous, and despite the anti-emetics put through his canula started vomiting. The nurses had to get the surgical and 'pain team' registrars up, and around midnight we were sent down to radiography for an x-ray to confirm their suspicion that he had an ileus - basically his intestines had gone to sleep as a result of their treatment during the surgery and so everything that had gone in was just sitting fermenting in his stomach. Apparently this happens in 30-50% of such cases. 

The best solution to this problem was to insert a naso-gastric tube (i.e. a small tube inserted up the nose and down the throat into the stomach to drain everything out). This was done. It was a very unpleasant experience for Joshua, but he was as stoic as ever. However, the assurance that 'he would hardly notice it once it was in' didn't really come to pass, and he has found it fairly unpleasant. However, it did reduce the nausea and we managed to get 4-5 hours sleep. 

We have been rotating on and off with one of us staying with Joshua and one of us looking after the kids. 

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