Monday, September 14, 2009

Listing, continued

What did I say for 2, 3, and 4? Jaundice, bus, and itchy, right?

Okay, so, true to my word:

1. Jaundice

Anyone who's been reading this blog for a long time (anyone?) may remember that we have a chazaka around here of jaundiced newborns. Barak had jaundice, which was taken care of in the NICU with an IV, but which probably contributed to the feeding issues that lasted well into his first year. Iyyar had to go back to the hospital for another three days to go under bililights; although he never needed to be in the NICU, this was scarier in a way because the bilirubin level that would have indicated he needed to be readmitted was lost by the lab, erev Shabbos, and we came frighteningly close to not hearing about it until it was too late. Newborn jaundice tends to be thought of rather casually because it's very well understood and usually easy to treat--but if it isn't caught in time, it can lead to brain damage and death. B"H we never went even close to that, but even that brush with it was too close for me.

By Avtalyon, you'd think we'd all have been on the lookout, especially since he had every single risk factor on the list: he was orange, he'd had a difficult delivery, he was a boy, he'd had siblings with jaundice, and he was early. Oh, and by the time he was discharged, he had an elevated bilirubin and was starting to get listless. Two days later, his morning bilirubin--I was taking him in twice a day for blood levels, in addition to using the bililight blanket at home--was 16. He was readmitted. Like Iyyar, his bilirubin shot straight through the ceiling by day four, and his level when he was admitted--around 3 PM--was 26. Not. A. Joke.

Time from lab test to time arriving in hospital and getting him under lights was about eight hours. What if that level had been taken at night? And I'd been called at, say, 10 am? And the doctor had left the same totally uninformative message ("This is Plony. Call me back." Thud.) followed by another game of phone tag? It would have been very bad news. And as it was, I was back in the hospital with a very sick four-day-old baby, in a highly contagious floor full of flu and RSV, with everybody who came in the room telling me how we had to get him out of there as fast as possible before he picked something else up. They hardly even let me nurse. He ended up losing a full pound, forgetting how to nurse, and... yeah. It wasn't fun.

So, hello! Here I am, pregnant with baby #4! And I went to my pediatrician with a simple request. "Do you think this time, if I have a baby with an elevated bilirubin at two days, we could skip the two days at home/peds admission thing and just PUT THE BABY UNDER LIGHTS already in the mother-baby unit? Lower infection risk, lower screw-up risk, less stress?" No. No, no, and no; insurance would never approve it. I asked pediatrician #2. Nope. He got angry just at the suggestion that he should take it up with insurance.

Pediatrician #3 was the pediatrician I haven't seen for a while, since he was the one who dropped the ball with Iyyar's lab results. It wasn't just him, obviously, but I haven't felt comfortable with him since. But I hoped he at least remembered it, and scheduled Avtalyon's 18-month checkup with him for yesterday. I reminded him of Avtalyon's history. And Iyyar's. And Barak's. I may possibly have gotten slightly emotional--not on purpose, but when I get stressed my voice shakes (this is why I write the speeches! and do not deliver them!) and it probably helped. I made my request. Two-day bilirubin of, let's say, ten. Will you have them keep the baby under lights instead of sending him/her home for monitoring?

"Well, usually you wouldn't even consider that. But obviously there's something going on with your kids that isn't normal. I think that'd be very reasonable."


"Yeah, I think that would be appropriate. I can't promise the insurance company's reaction but I'd call it medically necessary."

Wow! Wasn't expecting that.

2. Bus

Barak takes the schoolbus to and from school, with (like) the big kids. Barak loves the schoolbus. I love the convenience of the schoolbus, but I find it scary. He is very little to be riding the bus alone; there is no monitor on the bus; the kids on the bus have been in school from 8-something till 3:45 and are uniformly off the wall. And adding to this is that there seems to be a different bus driver every day, who does not know the kids, doesn't pay attention to the kids, and just drives. Which is his job. But stopping is also his job. Stopping at the RIGHT STOP.

On Friday, when I saw a bus stop opposite from Barak's bus stop, I hardly paid attention to it; three privately chartered school buses come that way at the same time, and I assumed it was one of them. Until I saw the fourth-grade boy entrusted with making sure Barak is OK on the bus get off it. Without Barak.

"Where's Barak?" I shouted across the intersection.

"I didn't see him!" he shouted back.

Oh. No. I looked up and saw the bus rumble past. Is Barak on that bus? Or not? I hesitated for about a second and then went into a full sprint after the bus. I am, let us not forget, in my seventh month. I was wearing crocs. And carrying shopping bags, which for some crazy reason I did not drop. I raced to the corner, where the bus slowed down for the intersection but did not stop, while screaming "Wait! Wait! Wait!" as loudly as I could. I got closer. The bus pulled away again. I kept running, as fast as I possibly could, while screaming, until after another block and a half the bus stopped and I slowed down and trotted the rest of the way, gasping. The bus waited, door open.

"My... kindergartner... is... on... this... bus!" I gasped. "You stopped at the wrong corner!" The bus driver just kind of looked at me, waiting for someone to get off the bus. Every kid on the bus, it seemed, was piled into the front of the bus, standing on the seats or in the aisle. "What's his name?" they--not the driver--asked me. I told them and they took up the chorus, and a few moments later Barak, face blotchy with tears, was produced.

"The stop is at the northwest corner, not the northeast!"I told him. "Please, stop at the right stop next time!" The bus driver looked unconcerned. "He should have known his stop."


"He is FIVE YEARS OLD! He's in kindergarten! He knows HIS stop. You are also supposed to know where the stop is and stop there. He's not going to know to get off at the wrong corner just because you've stopped there! He's too little to even see out the window to the other side of the street! He doesn't see me standing there, he's not going to get off!" Especially not since I have pounded this into his head. And, I did not point out--but should have--he couldn't even tell that the bus was stopping to let kids off, because there were so many kids jumping around in the aisle he couldn't see to the door.

The bus rolled off and I tried to calm Barak down, all the time thinking, seriously, what would have happened if I hadn't caught the bus? What would he have done? Gotten off at the next stop, after the bus had turned, over a few streets, where I wouldn't have seen him or known where he was? Gotten off at the stop after, or the stop after that, or a stop a mile away? Hoped for a kind adult? He knows his address, but not when he's that upset. What if the adult that found him wasn't kind? What if he tried to find his house by himself? What then? Best case, maybe he would have gone home with another kid--whose mother would have looked up his last name, called out house, and found no one home, because I would have been trailing after the bus searching for him. Or maybe stayed on the bus till the end, when the driver would have done... what, exactly?

This morning I called the principal, who, to his credit, took it seriously, apologized, gave me his cell phone number, and told me that he, personally, stayed in the office until the buses finished their routes. He made sure he got the whole story and wanted to know exactly where the bus was supposed to stop and where it had stopped. He said he would talk to the bus company about the stop and to the boy entrusted with Barak to be extra-sure that Barak gets off where he's supposed to--not that this should really be his responsibility, but I have heard it from every mother that you have to have an older kid looking out for the little ones, so he's been enlisted. About the kids jumping around on the buses, though, he seemed to have no solution--apparently this has been a problem since busing started, three years ago now.

Friday night, by the way, my husband had run into one of the mothers who witnessed my Olympic performance chasing Barak's bus. "She said she'd never seen anyone run that fast." Pause. "Definitely not while pregnant, anyway."

3. Itchy

When I was pregnant with Barak, lo these six years, I had a Most Unpleasant Rash. It started as a few itchy bumps around my ankles at around 16 weeks, and slowly spread up my calves, getting itchier and itchier. By around my fifth month patches had appeared on my arms, and by my third trimester it was almost everywhere. By my eighth month it was all over my legs, including the tops of my feet; my arms, down to the wrists; and my shoulders and entire torso--dense patches of red bumps that itched indescribably. It was HORRIBLE. My OB had no idea what it was and called it eczema, telling me to cover myself with moisturizer; I hate lotions at the best of times but trying to cover your entire body with cream when you can't reach half of it... yeah. And anyway the cream didn't help. By a couple of weeks before Barak was born it was a disaster. I couldn't sleep or think straight or do anything but try not to scratch; I was bruised and bleeding and beyond miserable. At one point I even woke my husband up at 5 am crying, not that I thought he could do anything about it, but... I was SO ITCHY! And it was Pesach, so I couldn't even do oatmeal baths. Awful.

By the time Barak was a week old, it was almost gone; I had scabs, but no new bumps came out. A week or two later it was like it had never happened. When I got pregnant with Iyyar, I waited nervously for the first bumps, but they never came. With Avtalyon, I had a few itchy spots but they never turned into anything. I thought I was off the hook.

Until a couple of months ago, when I noticed itchy spots on my ankles. And they started to spread. I mentioned it to Shanna, who recommended this soap. (Which, by the way, smells exactly like Wrigley's Spearmint Gum.) I bought three bars and a jar of the lotion; I think it's helped, but it hasn't yet wrought miracles. (See the woman in the "before" picture? That was me, except without any of those clear patches she's got.) Right now I'm at 29 weeks, and so far the itchiness is limited to my ankles and calves and one patch on my left arm. If it doesn't get any worse, I can deal. It had better not.


Carolyn said...

The bus situation sounds really scary. Even though we have a bus hostess, I think tonight I will put a card with our address and all our phone numbers in Robbie's backpack.

Also, I had the same extreme itching during the last part of my pregnancy. The most annoying thing was that the doctor did not see it as anything serious.

Anonymous said...

i heard a firsthand report from an eyewitness. they felt really bad for you!!!

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