Blood Brothers

Word of warning: today's entry is all about poop. So, if you're eating, you may want to come back later.

We took Matthew to his first non-routine pediatrician visit today. (Don't worry; he's fine.) Friday night (of course! the weekend!) we noticed that he had some blood smears on the poop in his diaper. He'd been having some diarrhea, so we thought maybe it was just some irritation, but this is one of those "need to see the doctor" kind of things. When we looked online, it turns out that most of the causes of bleeding like that are relatively minor, except one (intussusception, where part of the intestine telescopes in on another part), which is very serious (but also involves more severe bleeding than Matthew had). Since he was acting perfectly fine otherwise (no fever, no vomiting, etc.), we figured it probably wasn't anything too terrible.

The advice nurse said that although her computer system said that he should be seen within 24 hours, she thought it would be fine to wait until Monday (today). We took him to an urgent care place on Sunday anyhow for peace of mind, but they said they couldn't do any tests to figure out what it was, and said we'd need to go the E.R. for that. Well, since going to the ER would be likely to expose him to unpleasant germs, and because with our insurance the visit would cost a minimum of $200, we decided to wait. But it's really frustrating that just because this happened on a weekend, we have such limited options for getting him seen. Once the boys are a little older, I think we're going to switch to a pediatrician with better after-hours and weekend-hours availability.

Anyhow, we got a same-day appointment for today, and the doctor thinks he just has some kind of viral or bacterial infection that led to both the diarrhea and the bleeding, and either way, they don't treat those -- they just let them clear up on their own. And indeed, Matthew seems to be having less diarrhea, so hopefully he's on the upswing. The only thing she told us to do differently was to give him unfortified milk for the next week, to make things a little easier on his digestion (and of course, to come back again if anything seemed to be getting worse).

Then, when we called in to check on James this afternoon, they told us that they had stopped his feedings because he'd had some dark-colored blood coming out of his ostomy. However, he wasn't showing any other symptoms of anything being wrong -- all his vital signs were fine (except for his usual high blood pressure), he wasn't overly fussy or lethargic, his bowel sounds were okay, and so on. (I visited him for an hour and a half or so after Matthew's appointment, and he didn't seem to be in any distress.) So, they didn't seem particularly worried about it being something serious, but they don't really know what's causing it. When we just called to check in, the surgeons had been in to look at him, and they seem to think it might just be some irritation to his ostomy. He'd had some red blood yesterday that they thought was ostomy irritation, but it seems like it would be a little strange for that to cause darker blood. But the last time they checked his output, there didn't seem to be blood there, so the surgeons are recommending restarting his feedings. Hopefully it's just something minor that will go away; we'll see.

UPDATED 10 PM: They're planning to restart James's feedings at 10 PM, at the same level he was at (16 ml/hour). We'll keep our fingers crossed!

Also, at the appointment today, Matthew weighed 9 lbs, 4 oz! (That's a little inflated because he had his outfit and diaper on, but still -- over 9 pounds!) The pediatrician who saw him had done a rotation in the NICU when he was there. She was on the "other side" (Pods A, B, & C), but she had taken care of him a few times and remembered him. She was very happy with how big he'd gotten. :)