Thursday, June 26, 2008

Wilms Tumor: Origins

Three weeks ago, The Boy had his 9-month checkup. No problems were found - and you know pediatricians. They root around the baby's body like they're giving an Oriental massage. Saturday night, you know that we put him in his crib - first time in about five months or so that he's spent the entire night there. It was a rough night on all of us, and when he woke up at his normal 5:30AM (when The Wife wakes for work), we brought him into bed with us to calm him down. She fed him, and said, "Why is his belly shaped like that?" There was a bump or a protrusion sticking out of his belly - like a hard nub underneath, the size of a baby's fist.

He hadn't pooped since Saturday afternoon - a long time, for him. We assumed it was constipation; the on-call doctor at our pediatricion's practice said to wait a day or two and see what happens. Sunday, he didn't poop at all, "confirming" our self-analysis. Monday morning, he had a little poop at 5:30 (actually, he slept in it for much of the night, leading to a little bit of irritating diaper rash). He had another little poop after his morning feeding, then fell asleep right soon after the feeding. I called the doctor's office at that point because the lump was still there; the nurse, when she called back, suggested buying a suppository. "Break the pill in half, stick it up there, and hold his little cheeks together."

Ah, the joys of being a father.

By the time he woke from his nap, it was really late - we drove to the drug store and bought the suppository, and my wife came home a little while later. As we drove home, The Boy had a HUGE poop - parents, you know the ones. I figured the constipation was better, even though the lump was still there. That night, we decided to take him to the doctor's office Tuesday morning.

Tuesday morning, we made an appointment and went in at 12:30. After they poked and prodded, the pediatrician sent us to get an ultrasound, to figure out if he a liquid mass - an intestinal blockage (aka poo) - or a solid mass (aka "Oh, f&ck"). They told us that the doctor wanted to see us again. Oh, f&ck, indeed.

We went back, and our pediatrician was almost in tears as he told us to check in to the hospital. He thought that it was a Wilms Tumor - he was right - because he had diagnosed a half-dozen or so during his 8 years in private practice. He said, "No rush - all the tests will be done tomorrow." We went home, quite distraught - I'm an emotional wreck, for obvious reasons - to gather our things and to snuggle a little bit with the baby.

Tuesday night, I cancelled my appointment with my chorus and drove to the hospital. We checked him in to pediatrics.

Here's where HELL started. The Boy is very young and very chubby - which means that he has little tiny veins that are difficult to find. The doctor putting in the first iv stabbed him about fifteen times before I freaked out on her. Not her fault - don't get me wrong - but immensely frustrating. To make matters worse, the blood pressure cuff machine (on his calf) wasn't working properly. The nurses, then, had to take his blood pressure four or five times to find the working machine / cuff, which was frustrating for the baby. This continued all night, until another freakout at 3PM (by the baby, not me) motivated them to get the working machine and leave it by our door.

The kidneys regulate blood pressure, you see. When the tumor is preventing the kidneys from functioning properly, his blood pressure shoots through the room. So, they had to take his blood pressure every hour or so and medicate him accordingly (hence the iv). To make things better, we had these uncomfortable fold-out chairs that were kind of flat beds to lie on - we couldn't snuggle the baby, we couldn't touch each other and we couldn't find a comfortable position to sit or lie.

That night, Molly got about 2.5 hours worth of sleep. I slept for one hour, give or take a few minutes. The next morning, he went for an ekg around 10, and he had an ultrasound an hour earlier (or so). I went home for a couple of hours, to do some travel work for the Big Apple Chorus' Nashville trip (to complete my commitment to them, because I am obviously not going to the barbershop international convention next week in Tennessee). I got back at 11:45, despite the best efforts of the combined resources of the AARP's Union County Driving Team, driving 15 miles an hour below the speed limit on every street.

At 11:45, he was taken down to the CT Scan and a deep sonar ultrasound of the kidneys, to confirm the initial estimate of a Wilms Tumor. The whole process necessitated drugs to knock The Boy out - you can't move around in a CT scan without ruining the process. He finished up and was taken back upstairs around 1:30, when he slowly woke up over an hour or two. He began moving and playing like normal while his parents sat around and cried.

The oncologist came in and told us the news - a Wilms tumor that has completely obliterated the left kidney, and 25% coverage on the second kidney. No indication that it's spread anywhere, but they won't know until they open him up and poke around a bit.

(The American way, isn't it? "Let me get A Look at it. I'll know what to do." Politicians go to disaster scenes so they can "get A Look" at it, not because they're going to pick up a shovel and start digging.)

Diagnosis - mostly favorable. We'll know in the morning. The Wife's parents arrived from Pittsburgh around 8:15 and stayed until 10:00 - the nurses very nicely let them stay a little bit extra because they came from Pittsburgh to see the cutest guy in the world. At 10:30, I literally passed out - told The Wife, "I have to sleep. I just can't stay awake any..." done. Woke up at 2:45AM because The Boy was standing in his crib yelling at us. The Wife had woken him up at 1 to feed (1 was the last call for solids / breastmilk), then they both went back to sleep, but he was hungry again.

I kicked her out of the room, because every time he looked at her, he thought "FOOD!" He wasn't calming down. She went to go read, and I walked The Boy around and soothed him. Forgot an important bit - the in-laws brought an inflatable matress that could expand to king size. So, we could snuggle with him a bit. He fell asleep on me after drinking some Pedialyte and apple juice, and we slept an hour. Then, he fell asleep on The Wife and slept another hour. All told, The Wife & I got about six, six and a half, hours of sleep last night. At 6:30, they came to bring him in to surgery.

1 comment:

Flossie Teacake said...

MD I am so sorry that your family and your little boy are having to go through this. I am sending all my prayers to you that treatment is as quick and painless as possible, and that your boy is back to his old self as soon as can be. Please be strong and update us when you can. With much love xx