Feeding the Appendix Monster

Just before our 10-year-old son, Tommy, was wheeled into surgery, he was asked by the nurse if he had any more questions. He did.

“What will happen to my appendix?”

The nurse said they feed it to the Appendix Monster who lives in the hospital’s basement. Tommy laughed, which made him wince in pain. Then she told the boring truth: It would be put in a small container with a blue lid. It would be sent to a pathologist, who would look at it and agree it was, indeed, an appendix. Would he like a photo of his appendix? His face lit up like a disco ball. Of course he would! The nurse asked another nurse to help her remember to make two copies—one for the chart, one for Tommy to keep forever.

They gave Tommy a drug through his IV that relaxed him immediately. He’d have no memory of being wheeled into the OR. We kissed him goodbye. I went back for seconds. My baby. His bed was steered out of surgical prep and through double doors. Goodbye, we called.

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The surgical waiting area was quiet. Nothing is scheduled for 9:00 pm, so everything that time of night is an emergency. There was only one other family in the room designed to hold dozens of furrowed brows. I tried to distract myself with my phone, but it was hard. I thought about the 24 hours that passed in a blur of sudden acute sickness and growing exhaustion. How did he end up there?

Last Wednesday began like our other summer break mornings: Purely lazy, slow to start, with thoughts and schemes about how it should unfold. I’m a big believer in daily park and playground trips, usually in the morning before it gets too hot. That day, however, I decided we were going to add a picnic lunch to the mix. After breakfast and getting dressed, the kids made sandwiches, washed grapes, and packed chips and drinks. It was already hot, so we’d concentrate on lunch first, some play time, then we’d shop for Fathers Day presents.

Everyone had a great time at the park. Archie went around introducing himself to kids, saying, “I’m Archie and I like nachos.” Teddy sat in the caboose of a play train for 90% of the time like a Robber Baron holding court. The park we visited has giant rock climbing structures. Tommy and the big kids spent most of their time climbing and leaping off. There was no hint anything was wrong with Tommy.

After eating and jumping and shopping, we headed home. As the afternoon passed, he seemed more quiet and subdued. Shortly before 5, he announced he wasn’t feeling well and hadn’t for a couple of hours. I asked where. He said he felt like he was going to throw up. I assumed he was overheated from the park. He hadn’t eaten much lunch because he was excited to play. I had him drink water and eat a banana, which he nibbled as he laid on the couch. I lectured him on drinking water. We brought drinks to the park, plus they had a drinking fountain. How many times did I tell him to drink? I did, he insisted.

Then, he did throw up. I asked if he felt better. He said he did, but he returned to his spot on the couch, this time with a big bowl just in case. Again and again, he returned to the bathroom. My husband came home from work. We told him to let his stomach rest. No food or liquid for an hour or two, then try again. He waited, sipped a tiny bit of water, and immediately lost it. I began to think it wasn’t a wild playground hangover—it was probably a tummy bug. Yuck. Archie had developed a bit of a runny tummy, too, but from the other end of the digestive system. He was pooping like a duck. I silently prayed it would be short and they’d keep it to themselves.

Tommy kept throwing up, even when he had no water to sip. Then he said something which worried me. His stomach hurt. He pointed to the location: Lower right side. We quizzed him about constipation. No, he said. We asked if, when he was throwing up, did he pull a muscle? Didn’t think so. It just hurt. I felt his forehead to see if he was warm. He was fine. It was bed time. We had him sleep in Beatrix’s room, in her bed, so he’d be close to our room. (Beatrix moved in with Aidan.) We gave him a bowl and told him to yell or come to us if he needed anything. All night, we heard him up and down, in the bathroom. I talked to him nearly every hour, asking about pain, telling him I’d call the doctor in the morning. He slept a little and so did I.

He seemed to be doing better in the morning. I had him sip some more water and told him if he kept it down, in an hour or two he could try a little applesauce. We were optimistic. But the water was too much—we are talking drops of water. He was now throwing up bile. I was mostly worried about dehydration, so I called the pediatrician’s office. Of course, they wanted to see him. I told my husband, who was already at work, to head home. In the meantime, Aidan would have to babysit everyone for a short while.

In the parking lot at the ped’s, we walked slowly. He carried a small plastic storage container, not caring that he had to use it around strangers coming and going into the building. I rubbed his back. An older lady said he was a poor, poor baby and gave me a worried look. We were taken back to a room pretty quickly. A little plastic container is a one-way ticket to get out of waiting room exile.

He was examined. The physician’s assistant manipulated his legs. She bent his knees and hit his heel. She watched him get off the table and walk. He was hobbled over to the right side. She pressed all over his belly, saving the lower right quadrant for last. She pressed. He howled, especially when she let go. A final test would check his urine. It was fine, except for ketones. He had the symptoms of appendicitis, but it would have to be confirmed at Children’s Hospital. She called the ER and told them we were on our way.

Thankfully, he slept a little on the trip across Denver. I helped him walk inside, where he laid on a couch. The nurse offered a wheelchair to him, which he happily took. After going over his recent history, we were told he’d have blood work to check for elevated white blood count and an ultrasound to look at his appendix. They had him in an ultrasound room quickly. The tech snapped on the Disney channel for him to watch. I watched the ultrasound screen, trying to discern what I was seeing. Black pockets, white objects, squishing, pushing down, apologizing, yelping. She excused herself to show the images to the radiologist. She returned and wheeled him back to his room in the ER. I told her I needed to use the restroom, could she stay with him for a minute? She said, “It’s a good idea to use it now because a lot of people would be in to see him soon.”

I took this as a bad sign.

It was. He had acute appendicitis. It needed to be removed. Surgeons would visit and they’d get him in as soon as possible—but be warned, it was busy. Tommy was the third appendix that day (and we found out he wasn’t the last.) They had a full OR board already. We were in for a bit of a wait. I took this as a good sign. If they were worried about imminent bursting, they’d bump him up. Thankfully, he was given strong pain killers, which helped him relax. When asked to sign a paper, he wrote: “Thomamamam.”

My husband arrived with Aidan, Ryley, and Joel. Sam stayed home with Beatrix, Archie, and Teddy. My in-laws dropped everything to watch them. At first, I was a little irritated the other kids came, mostly because I wanted to concentrate on Tommy, but they soon proved to be a great distraction for him and cheered him up a lot. It was good to have them there, but it was funny seeing the reactions of everyone who came in the room. They all said something about how the “whole family” was there. The kids would laugh and say no. Only half!

After a long afternoon, he was wheeled upstairs to surgical prep where there was more waiting. And waiting. Tommy was brave, patient, and maintained his sense of humor. When asked, for the zillionth time, to rate his pain on a scale of 1-10, he said “5 and 81/154s.” Soon after, he was wheeled away.

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Tommy ended up spending two nights in the hospital. He needed IV antibiotics and pain management. I was glad he had a chance to finally sleep. I spent the first night, my husband spent the second. Tommy came home on Saturday to a very happy family. Everyone marveled at the photo of his appendix. Luckily, it hadn’t perforated. We caught it in time. Against his pale pink intestines, it looked like a bright red, swollen, angry sausage. He proudly shows his three scars to everyone, even if they don’t ask to see them. We will work on that.

Post-surgery special visitor

It happened so fast. Hours before he started feeling bad, he was tearing around a park, climbing, being a boy enjoying a wild sunshiny summer. He will be back to normal soon. Kids bounce back fast. I’ve been in awe of how well he handled the news, the hospital, the needles, the pain. I told him this experience will make him into an even stronger kid in all sorts of ways. He was puzzled by that, but someday he’ll know.

Appendix monster? Consider yourself fed.

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I thought I’d include some information about appendicitis. Have it on your radar, just in case. Abdominal pain in the lower right side should always be noted, especially when vomiting is present.

Appendicitis Symptoms, Causes, Treatment (WebMD)

Appendicitis (Mayo Clinic)