You sure know how to attract a crowd

Dear Madeline,

You've had a hell of run these last 48 hours. So much so that I am once again struggling with where I should begin. With Doctor Obvious in your rear review mirror and the suite of medications to control your nausea and vomiting being administered, the oncology "A-Team" made their rounds this morning after your radiation treatment and expressed a little concern over your upset digestive system. In fact, their concern was great enough that they ordered up some diagnostic X-rays to get a better idea of what was going on. Unfortunately, it turned out to be nothing good.

Later in the day, your results came back, and a member of the surgical team came up to explain what they were seeing - essentially that your large intestine was swallowing up your small intestine. Instead of jumping to a corrective set of actions, the surgical team member thought it best (as did Mom and I) to order a quick ultrasound. We were assured that your condition was not altogether uncommon in kids in your age group, and that certain subgroups (like kids who recently had abdominal surgery) were slightly more at risk for developing the condition. At this point, I left you in the tender care of Mom and I went home to spend the night with your sister and your grandmother. This is apparently when all the fun started happening.

Late last night, the ultrasound tech showed up and started doing her job. And then she started blurting out commentary about what she was seeing. This was a problem. See, Maddie, you had quite a few ultrasounds before your surgery. Mom and I were curious about what the other ultrasound techs were seeing, but we were told each time that it was against strict hospital policy to divulge any of that information - good or bad - to the patient directly, that it all had to be routed to the doctors for interpretation etc., etc.  This was a problem because she was only noting her surprise at what she was seeing.

The ultrasound tech raced out to make a phone call. Our nurse - thank God for her - saw this and asked if everything was okay.  She was told things were fine. When the tech made another phone call, our nurse asked what was going on and was given no response. And when more radiology staff began to arrive and poke and prod at you, our nurse ran to find a doctor to intervene and find out what in the world was going on. Before long, there were 10 people at your bedside. All the commentary, all the curiosity, and such little concern or consideration for Mom. It was as if you were a lab rat! Our nurse and the pediatric doctor on the floor helped Mom make great sense of things (along the lines of the earlier conversations), and hopefully they helped open a can of grief on the tech.

The result of all this commotion, though, was an ultrasound picture that caused a significant amount of worry - and debate - among the surgical and radiology teams. At this point, they agreed that if they didn't act quickly, there was a very real chance your intestines could die off. They disagreed on approach, though, because a surgical and a non-surgical approach each came with some unsettling but different, non-trivial risks. They eventually agreed to try a non-surgical approach, with the surgical team ready at a moment's notice to swoop in and run you to an open operating room if necessary.

I'll only briefly note the fear that Mom and I felt. There, that's about all I'll say. Mom was with you during the whole ordeal while I was made to wait outside the room. Our nurse - really an angel, Maddie - came back to keep me company and help calm my mind, knowing what I must have been thinking. She has quickly become one of our most favorite people in all the world, and we met her only Sunday night. What a skilled clinician, compassionate caregiver, and patient advocate she is!

I'll spare you the unpleasant details of the non-surgical approach, Maddie. Suffice it to say that whereas about a foot of your small intestine had telescoped into your large intestine before the procedure, only about 2 centimeters now remain in their improper place. Another member of the surgical team, along for the ride, noted to his colleagues that the procedure was "unsuccessful."  My baby, this must surely be but a technicality, because I'll rate keeping the surgeons at bay with alternative treatments a success any time.

They are going to try again later this morning to resolve the last 2 centimeters the same way the resolved the rest.  How this impacts the rest of your day remains to be seen.  You were already scheduled for an early morning abdominal X-ray, and you were also supposed to receive another radiation treatment this morning too.  Something likely needs to give, but after what we've just experienced, that's one change we'll gladly take in stride.  God is good, sweet pea, and so are all of those who have been praying for you.

Love,
   Daddy