After a lovely birthday celebrating with my sweet little family, we woke up the next morning to find Clara and her bed covered in vomit. She continued to throw up every few minutes all morning long and was not able to keep the slightest thing down. We made an appointment to see our pediatrician around lunchtime and by the time we got there she was vomiting bile (think dark green, pea soup color, not the bright neon yellow stuff that we usually think of as "bile," but apparently is actually chyle?....my medical education continues...). Our wonderful pediatrician whom I love and adore didn't hesitate before calling the surgeon and sending us straight the the ER.
We had been told when Clara was discharged from the hospital initially that we were likely in the clear with the exception of: 1) catching a respiratory infection like RSV that compromised her already fragile lungs, 2) a bowel obstruction which is not uncommon any time there has been surgery involving the abdominal region, 3) a reoccurance of the hernia, which is slightly more likely for Clara than some other CDH kids because hers had to be closed with a gore-tex patch. You already know that we've done our best to protect Clara from #1 with our "winter hibernation" and zealous hand washing/sanitizing. But there's really nothing we can do to keep #2 or #3 from happening. And one of the main warning signs for those is vomiting that dark green bile. I will slip into some layman's medical explaining now. In a typical person, if that dark green stuff starts coming up, it's typically an indication that something has gone haywire because it shouldn't be able to reach the stomach.
So, once we got to the ER we had a series of x-rays done and Clara had blood taken and an IV placed for fluids. She was already severely dehydrated, but the vomiting had almost stopped by the time we arrived. Aside from those tests, it was a lot of hurry up and wait while we saw residents and fellows and whoever else wanted to stop in (ahh, a teaching hospital). Clara snuck in some naps here and there when she could. Early on, they were afraid that she might have had one of those complications because she was so dehydrated that the x-rays were a bit challenging to read. However, finally at about 8:00PM we saw a surgeon who said he thought this was just a wicked stomach bug and that the cause of that dark green bile was a malrotation of her bowel, from the initial surgery. This is no serious cause for concern in and of itself, but could result in a false "scare" like this one. They all affirmed that we were right to bring her in, and that anytime that dark green bile comes up again we will need to do the same thing to rule out one of those other complications. She would probably have needed the IV fluids regardless since it was such a violent virus. But we were finally discharged on the same day and sent home to wait it out. If there was any doubt left in our minds, the virus then made its rounds through the rest of our house. But, we've never been so thankful for a stomach bug....
It's amazing how emotional that experience was. We had anticipated and prepared for the potential of returning to the hospital at some point with Clara and I have watched many other families face multiple re-hospitalizations. It was just a few months ago that a sweet little girl, only a few months younger than Clara, returned to the hospital for a second hernia repair and ended up losing her life after surgery. But the longer Clara went without having any complications and the healthier and stronger she gets, the less likely it seems that we would have to revisit that kind of scenario. This jolted us right back to the terror of our first hospital stay. Even though it did not seem imminently life threatening, it was harder in so many ways. Clara is old enough to know what's happening and to feel fear and pain in a different way. My parental responsibility feels even deeper now than when she was a newborn and although the feelings of wanting to desperately fix her and comfort her were the same, they were also richer with two years of life and love. Likewise, the ways that our community of family and friends and church members and more rallied around us again with love and comfort and prayers of support and understanding reminded us of how fortunate we were (and are!) to have been joined by so many in this journey.