On May 12th at 2:50 am, I woke up because Niki was crying hysterically. Once my eyes adjusted to the light, I saw blood everywhere! We co-sleep and our bedsheets were covered in so much blood that I initially thought Niki got injured somehow. My eyes adjusted a little more and I saw that Niki was thrashing about because she had blood all over her. She was frantically using her hands to wipe her face and then promptly vomited a large amount of bright red blood on the sheets. Twice.
It looked like something out of a horror scene. :(
A nosebleed I can deal with, but vomiting blood could indicate a GI bleed. And we all know she's had plenty of those before! John woke up in a flash and immediately sprung into action. He started mixing and administering her factor while I was on the phone waiting to be connected to the on-call Hematologist. Meanwhile, Niki was crying and still gushing blood everywhere.
It was hard to tell where the blood was coming from because there was SO much in her mouth too.
Dr. Awesome turned out to be the on-call Hematologist which made me feel instantly guilty for calling her so late/early. I know that she has a son around Niki's age and as a mother I felt bad for contributing to her early morning exhaustion. Niki was still actively bleeding so John tried to apply pressure as best as he could. The Nosebudd is too large to pinch her tiny nose so applying constant pressure is tough and involves holding her down. (Which we both hate to do because it feels like we're violating her trust.) After a brief discussion, Dr. Awesome and I were pretty sure that the bloody vomit was more than likely a large amount of swallowed postnasal drip. However, given the large quantity of blood and Niki's hysteric behavior, she felt that we should take Niki to the ER.
With Niki's prior history of GI bleeding, it was important that we made sure that there was absolutely no GI issue going on.
The NovoSeven was starting to kick in and Niki finally calmed down after John stopped applying pressure to her nose. Given what happened the last time she had a nosebleed, we figured that it would be best (and less traumatic) if we left her nose alone so any forming clots wouldn't be dislodged. As we waited for the bleeding to completely stop, we provided "hygiene control" by using baby wipes to clean up the drips before they went into her mouth. We changed her, packed some factor, grabbed her lucky ladybug blanket, and off to the ER we went. There's something about being surrounded by ladybugs that makes me feel like everything will be okay.
(I saw them everywhere after Ethan passed away and Niki is a Ladybug too.)
It was a completely different staff that was on that night. No Nurse Stat or Dr. Daddy, but I swear it felt like I stepped onto the set of Grey's Anatomy. I'm used to Niki's nurses being pretty (it's statistically easier to find hot nurses than doctors), but this time Niki's nurse and doctor were H-O-T.
Niki had her very own Dr. McDreamy for a change. (And I half-heartedly wished that I looked less 3am-esque.)
Dr. McDreamy was a very efficient doctor which was an added plus. He was already in the exam room waiting for Niki and knew her history too. He won my heart when he started to do the exam. He worked his magic and calmed her down. Niki just let him do his exam (all the while staring at his beautiful face) and then he was off to do whatever it is doctors do while their patients wait for hours and hours.
He concluded that Niki wasn't having a GI bleed. (Thank goodness!)
Nurse Beautiful (that's my nickname for her in case you didn't figure that out by now) did the customary blood draw from Niki's Broviac. There was no Ceftriaxone (abx) infusion this time around because Niki didn't have a fever. A line infection wasn't a concern. By that time, Niki's bleeding had completely stopped so we turned down the lights so she could rest. John and I took turns nodding off so we could catch up on some sleep too. A few hours later her test results came in and Dr. McDreamy said we could go home.
It was 7:00 am, painfully bright outside, and I was supposed to start work at 8:15.
I was exhausted, but I need to preserve my FMLA. So, off to work I went instead of staying home (like I wanted to) so I could comfort my baby. As always, John stayed home with Niki so he could monitor her status and play "Mommy". Meanwhile, Nurse Richard called me at work and advised me that Niki should stay on factor every day for the next three days. (Then we could go back to every other day.) After a long 8 hour shift, I went home, cuddled with my crusty-nosed daughter, and crashed. I didn't even eat dinner.
Flash forward to 2am and Niki jarred us from deep sleep with her hysteric crying.
Her nose was bleeding...again. Our bedsheets looked like something out of a murder scene...again. And John and I scrambled to give her factor...again. We didn't contact the on-call Hematologist this time. Even though Nurse Richard reassured me during our afternoon discussion that we should call for everything, I was hesitant and embarrassed to call for such a "trivial" thing. I know that it's their job to advise us in the wee hours of the morning, but still...I felt bad. I'm working on these internal issues of mine.
I often wonder if any other hemo-Moms feel guilty like I do.
Seeing that much blood is unnerving for me as her Mom, but Niki was tolerating the bleed well. I need to learn how to avoid getting emotionally charged in these situations. Niki wasn't vomiting this time so that helped me keep my emotions in check. Besides, she didn't cry as long as we left her nose alone (the down side was there was blood everywhere) and the bleeding started to slow after about 30 minutes.
Her nosebleed was completely resolved (and she was back to bloody-booger status) after about an hour.
The following morning Niki had a follow up appointment with her Pediatrician, Dr. Sweetheart. John called in sick the day before so it was my turn to take time off from work. I called in sick (using my FMLA) just for the morning. I have to be very conscious about how much time I have FMLA left before I put my job on the line.
It sucks, but what can I do?
Dr. Sweetheart is the best! Her exam was thorough and despite her little nose being plugged with clotted blood, she determined that Niki had a sinus infection. So, Dr. Sweetheart sent down a 10-day course of Amoxicillin down to the pharmacy.
"At least she looks good in red!"
She was right. Indeed, my daughter looks beautiful in red. :)