Thursday April 1
Nick has received platelets and red blood cells, he is poopy, has high blood pressure and nasty looking mouth sores. The docs tell me they worry about his continued weight loss. He doesn’t eat because he has constant nausea. This is Day 12.
A nasal jejunum (NJ) tube was inserted under a general anesthetic because he keeps puking up the NG tube. The NJ tube was inserted under a general anesthetic. It is put into place the same way as the NG tube: through his nose, and down his esophagus. The NG tube sits in his stomach, but the NJ tube is passed through his stomach and secured in his small intestine. That is why they use an anesthetic. It isn’t supposed to come up when he vomits.
Now, this kid’s whole body convulses when he heaves. It’s disturbing to see how violently he can expulse the contents, or in his case, non-contents of his stomach. Apparently his intestines are heaving too, because just one hour after insertion, and to the amazement of the staff, Nick puked up the NJ tube.
Backing up the bus for a minute I want to say that Nick is a bright kid. He’s curious, asks questions, and he makes friends easily. The nursing staff is drawn to talk with him.
“Your neighbor lets you drive his backhoe?” Allan is one of the male nurses. He’s a guy who chose to make a career as an acute care nurse on an oncology ward for children. Since this is a mostly female dominated profession I think he followed a calling in his heart to do this job. And I’m really thankful because he is a brilliant nurse.
Nick’s lounging back on a couple of pillows. “Yeah, our neighbor Gerry started teaching me when I was eight years old. But, we don’t call it “driving”, we say “operating.”
I’ve got to tell Gerry. He’s gonna love this.
Today, the exciting and unexpected arrival of the wrong end of the NJ tube created a group of milling adults in Nick’s room.
“His mouth sores are atrocious.” Someone says.
The look Nicholas shoots me means: what is ‘atrocious’?
“He isn’t tolerating the feeds.” Another person says.
“They make me puke.” The milling stops and five people, two in white coats, gather around his bed.
He’s a little guy, almost as white as his sheets with a shock of brown fuzz coating his head. But the look on his face shows his intent for being heard.
There is a collective shuffling of feet and someone glances my way, but I’ve got no inclination to say anything and keep my eyes on the child in the bed.
“Well…” A white coat speaks, “you need to eat.”
He gestures at the IV pole with the bag of caramel colored liquid hanging from it. “This stuff makes me sick.”
A familiar nurse says gently, “Nick, you’re as skinny as a toothpick. We can’t let you lose any more weight.”
Across his bed begins a discussion about his severe nausea and the amount of feeding tubes he has thrown up. Then, being candid with Nicholas proves to not be a good thing when it’s said they feel he should have a feeding tube inserted through the wall of his stomach.
“What? No way!” He declares in a strong voice to the group. Then he stamps his foot ineffectively under the sheets. Looking past their concerned faces he finds me now standing. His voice carries tears, and we all remember he is just eleven years old. “Mom, no! I’m not doing it! Please, don’t let them do that!”