It’s 7:50 pm on a school night. The Old Soul has, miraculously, finished her homework and is already in her jammies, and The Boys are in the bath. I am blissfully ahead of schedule… a very rare occurrence. When I finish the “work” of bathing The Boys, I give them their swim goggles, and a penny and a nickel. They are truly 2 chips off this old block–diving for deep-sea treasure… in the tub! This is our bath time ritual every other night.
I am officially “done” with my part of the bathing routine so I call my Mom who I haven’t seen since she babysat for my very successful and well-attended (80 professionals and parents) launch of the first meeting of the Nassau County Down Syndrome Support Group.
As Mom and I reminisce about days past, bathing 2 slippery babies at once (she raised 5 children), I recall the days when the 2 Little Men I was gifted needed lots of extra support even with the awesome, mounted-over-the-tub-wall bath rings. The constant diligence and real fear of babies slipping beneath the water is etched in both of our minds. As we laugh about how far The Boys have come and how I can momentarily leave the bathroom to grab their pajamas because they’re big enough and competent bathtub swimmers, I notice the bathroom has suddenly fallen quiet.
The deafening silence shatters our light-hearted conversation. Children’s silence — especially around water — is NEVER good. And, talking about how great things have gotten is like inviting disaster! A self-whammy. Bad Jou-Jou! I mean… I left them, just a moment ago, with their goggles donned and happily taking turns diving to the depths of the tub for the penny and nickel tossed by the other. A quick check reveals both boys covering their mouths (as in “uh-oh”) and a collective look of panic shrouding their faces. “What happened?” I ask — because they look fine to me. I’m looking for a little something extra — an accident in the bath maybe — but there is nothing! Pointing at Brian’s neck, both boys chime in together, “Brian/I ate money!”
Talking a mile a minute, they recount the tale: They were diving for treasure. Once recovered, they dropped their booty into a cup. And, my Big Little Man “drank money!!!!” I check the tub, the cups, the boats, the bathroom floor. Yes, the nickel is gone. Only the penny remains.
My Big Little Man is licking his lips and swallowing, and swallowing, and swallowing, and swallowing. “Money here, Mommy” as he points to his neck just below his chin. CR*P, it’s stuck in his throat! My Mom, still on the phone, is shouting, “What? What? Maggie, what did he eat?” I tell her. Deep down, we both know I’m about to spend the rest of the evening in the Emergency Room…. DARNIT! I was finally ahead of the bedtime curve for the first time in months. As always, Mom is offering support, “I can be there in 15 minutes!” I explain that I can call Daddy home. His departure from work is imminent anyway… I just have to tell him to skip his usual overtime tonight. “Call him and call me back,” she says.
I drag my Big Little Man out of the tub and stick my fingers down his throat…. DEEP… Tickling his tonsils (if he had any left)… But nothing — and I mean NOTHING — comes up. That’s odd in itself, don’t you agree? I’m thinking the nickel must be blocking the way. I give him juice and he drinks, swallows, and swallows, and swallows. The nickel is still stuck, right up there at the top of his throat. “Here Mommy” (pointing).
I call Sarge to come home right away as a trip to the ER is in my very near future. And I call Grandma back to let her know Daddy’s coming home. But Poppies tells me Grandma is already on her way. Finally, I call our beloved Pediatrician’s service (a number I know by heart LOL). Within a few minutes, the phone rings. After warning me NEVER to induce vomiting because the force could lodge the obstruction in the airway OR the object could be inhaled into the lungs in the process of coughing it up, he says what I knew was coming… definitive directions, “You KNOW you HAVE to go to the ER for an x-ray to find out where it is.” I do know. He continues, “With his narrower airway due to Down syndrome, you CAN’T take a chance. If he coughs it into the lung, we’re talking surgery.” I admit, “I knew you were going to say that” and we share a remorseful chuckle… You see, it’s not the first time he’s recommended a late night trip to the ER for us.
Out of the bath, towel-dried, hair combed, Angry Bird PJs on… times two.
My Big Little Man is breathing, but he’s swallowing, swallowing, swallowing. It’s still up high in his throat.
8:15 pm: Enter Grandma. Kisses all around and one little coat donned. He’s whining as I rush him to the car, “No Mommy. I tired. Go home now,” (he means “stay home”). Sorry Charlie, we are on our way.
8:20 pm: We quickly arrive at the hospital and, because it’s a child with a potential airway blockage, we jump the intake queue, skip triage and admissions, and are escorted straight through to an exam room. Seems like there are children asleep in gurnies all over the place, with worried and pacing parents hovering about. Then there’s me and My Big Little Man who is happily greeting and fist-bumping everyone we pass. We both know it’s not the end of the world. It’s not the first nickel ever digested. Still, the possibility exists — and is slightly greater for us because of the narrower airway — for some really undesirable outcomes.
8:50 pm: Admin comes in and quickly completes the paperwork necessary to get the Big Little Man officially admitted into the ER. Two student docs follow to get medical history and a better grasp of the situation. With my Big Little Man sitting there, looking like a perfect and freshly bathed little angel, I explain and educate regarding the narrower airway and, therefore, slightly higher potential for complication. Intake is officially completed, the “Pulse-Ox” is attached and we’re now officially in the emergency queue.
9:00 pm: I’m happy that he’s breathing comfortably and swallowing a bit less frequently. I’m also amazed that he’s rocking his blood oxygen levels at 99 percent. (If you don’t have one, get a baseline blood O2 level, it’s good information if you ever get pneumonia. In 2010, the doctors at Cohen’s were erroneously certain that My Little Men’s pre-pneumonia O2 levels were likely no better than 80 percent given their Down syndrome. So they made that their release target. Could have been a BIG mistake but the Pedi spoke up and sent us home with 02, thankfully! DS, in and of itself, has NO BEARING on O2 levels (unless you’re talking about night-time levels and sleep apnea which is a bit more common in children with DS). Tonight I proved what I — and the Pedi — already knew: his baseline is “normal” at 99 percent!!!
9:35 pm: Enter the nurse who questions my Big Little Man about swallowing the nickel. He vehemently denies any such thing has happened because he figures, if swallowing the nickel got him in here, NOT swallowing the nickel could get him out. SMART BOY! She asks me whether I’m sure he swallowed the nickel… because he’s claiming he did NOT! Did I actually SEE him do it? How do I KNOW for sure? I explain that I gave them a penny and a nickel and the nickel was gone. I explain how both boys gave a highly detailed account of how “The Swallowing” occurred. She doubts me but I insist, “there’s DEFINITELY a nickel in this boy!” Still questioning his ability to accurately communicate, and ticking me off at the insinuation, I convince the Big Little Man to recount his tale directly. Finally, he does so in great–if not poorly articulated–detail, culminating with, “I ate money…. in here (pointing to his neck).” She’s now a believer!
10:00 pm: Just as the excessive swallowing has begun to subside — after all, it’s been an hour and a half since “The Swallowing” — one of the med students comes back with an adult-sized hospital gown. He has to be changed into official hospital garb. Wrapped like a toga-clad Roman, the x-ray technician escorts us through the halls of the ER. Again, my Big Little Man is fist-bumping with one hand and holding his toga in place with the other. He’s winning the hearts of everyone.
The machinery in an x-ray room is intimidating to the most seasoned, accident-prone person, so my Little Man is slightly taken aback. The nurse explains what’s going to happen, what he’s expected to do and that Mommy is going to be standing across the room. As she begins to wrap the miniature lead apron around his waist, I explain to him that it is meant to cover up and protect his “pee pee.” When the nurse continues, he wags his pointer finger at her and says, “No! Private!” Ooooh he makes a Mom proud! He’s a perfect x-ray model and stands still while a frontal and side shot are taken. The nurse explains to me that it usually takes several tries before they “find” the object in question. The first x-ray goes up on the light board and everyone hoots and hollers, “Yup! There it is!” And, there, at the entryway to his stomach is a bright and shiny (in the x-ray, anyway) nickel! It has successfully passed the airway! Pointing, they show my Big Little Man and tell him he should never EVER eat money again. “No eat money ‘more!” he paraphrases.
“So what now?” I ask.
“Call your pediatrician tomorrow and ask him for next steps.” is the reply.
Yes, we’re outa here! I ask at the desk if we can leave now but they tell me I have to wait for an official discharge from the treating ER Physician. Ugh!
10:30 pm: The ER Doc walks in and recognizes my Little Man from one of our past visits (I suspect the “identical twin with DS” on his chart might have given him a heads up). I remember him too! He’s the one who, just over a year ago, looked at our son in the ER bed and said with a whisper, “so how long has he had… autism? (FYI – My son doesn’t have autism, he has Down syndrome!) Ugh! He verbally releases us saying we should “see the money” in 24-t0-48 hours. If that doesn’t happen, and/or my Little Man shows signs of pain or rectal bleeding we should follow-up immediately with our Pediatrician. Ugh, again! I ask him, hopefully, “Can we go home now?” Nope, not until the discharge papers are signed.
10:45 pm: We are really and truly outa here…. Finally! All told, not an awful turn-around time for a trip to the ER.
Epilogue: We did not see that nickel 24 hours later. And not 48 hours or even 72 hours later either. With his Down syndrome, I expected things to move a little more slowly for my Big Little Man. We had two BMs early on but no nickel… And then, nothing! By day four I was beginning to think he might be stuck and vowed to call the pediatrician when his office opened on Monday. He’d called the proverbial “morning after” to check on the outcome and forewarned me that subsequent x-rays to track the nickel might be necessary if it didn’t come soon. Come on Little Man, show me the money! Just as I was contemplating the inevitable, acknowledging that I might have to make the dreaded call to the Pedi, it finally showed itself. 4 1/2 days later (the result of a slightly slower metabolism)!
Relieved, I cleaned up the nickel (BLACK from the stomach acid) and told the Old Soul I was going to get a copy of the x-ray and frame them both as a lesson NEVER to put your money where your mouth is! Her response, “that’s just GROSS Mom!” LOL
The Bonus Payoff: As we left the ER and crossed the parking lot holding hands, I saw it! The wooden cable spool I’ve been looking for for the past few months. I want to make a really cool french-stamped nautical end-table that I saw in a DIY magazine article. I searched Craigslist, Freecycle and Ebay, and asked electric and cable guys working in the streets and up on poles where I might find one, to no avail. Now, not 20 feet from the “trunk” of my minivan, there it is, beside a hospital DUMPSTER! Yes! I strapped my tired Little Man into the minivan and turned on “Night at the Museum 2” to entertain him while I squished the double stroller into the front street, dropped the third row of seats down and rolled that baby in.
Now to find the time to transform it. And, when I do — likely 6 months from now — I’ll take a pic to show you all (if I remember) what good came out of this episode. You see? Everything really does happen for a reason! ;-P