Holy October!

Never has November been such a welcome sight for our family.  October was a difficult, joyous, crazy month for the Graffams.  Here's our month in a nutshell:

Sept. 28 - JD goes upstairs to get Nora ready for church.  He sets her down on the floor of her room, and she crumples over.  She stopped walking.  After talking to a nurse, we decide to take her to Methodist Germantown.  They run a bunch of tests and take x-rays and determined that they weren't equipped to handle her case.

After loading Nora into an ambulance, she is transferred to LeBonheur Children's hospital downtown.  For the record - seeing my sweet little 19 month old on a stretcher in an ambulance is about the worst thing I've had to witness so far in my adult life.  LeBonheur decides that Nora has toxic synovitis - a virus leftover from an ear infection is attacking her hip - and recommends a daily regimen of ibuprofen until it passes.  No big deal right?  We take her home and hope for the best.

A few days later, Nora is running around, back to normal.  The Methodist ER doctor calls to report that her blood culture was positive for a bacteria.  Based on the fact that Nora seems to have recovered, the doctors at Methodist and LeBonheur decide the bacteria must have been a skin contaminant and dismiss the idea that she was misdiagnosed.

For the next two weeks, Nora relapses and recovers every few days.  Her mobility varies from not being able to walk, to limping, to running.  JD takes her in to every pediatrician in the pediatric group - our regular pediatrician is on leave.  They all observe the limp but tell us to wait it out.

Oct. 14 - JD and I go to dinner and a movie.  My mother babysits Nora so we can have a date night.  I have trouble sleeping.  I can't stop coughing.  I've had this lingering chest congestion for a week, but it was worse.  All night, I pace the house because my back hurts from coughing so much (so I thought).  I have to empty my bladder every 5-7 minutes.  I knew I was sick but I didn't want to call my OB.  That week was my last week 'off' as the next week would start twice a week pre-natal visits for the twins.  The babies were moving like crazy.  By morning, I was exhausted.

Oct. 15 - I call my OB's nurse to see if he will call in a Z pack.  The nurse says that Dr. Mullenix wants to see me at 9 am.  I really don't want to waste my last week off going in, but I also want to stop coughing.  After listening to my lungs and hearing my symptoms, Dr. M asks if he can examine me.  Sure enough, I am 6 cm dilated and Baby A was already in the birth canal.  This is not a good thing as I have to deliver these babies by c section, which was initially scheduled for Nov. 1.  Baby A was complete breech, and the risk of a prolapsed cord was too great to attempt a natural delivery.  Less than an hour later, we meet our sons.  I'll do a longer post about this later.

A few hours after my c section while I am in recovery, the day care calls about Nora.  The director is worried about her leg again.  I call the pediatrician again to find out that Nora's regular doctor is finally back and wants to see her.

Oct. 17 - Nora finally sees her regular pediatrician.  On top of her leg issues, Nora's oxygen level is so low that it takes three breathing treatments in the office before Dr. Hussain will let her leave.  An appointment is set up with Nora's pediatric ortho to look at the leg.

Oct. 20 - We leave the hospital with James.  Simon must stay behind in the NICU.

Oct. 21 - Dr. Beaty at Campbell's Clinic observes Nora.  He says if six weeks passes of symptoms, they would step up her treatment.  He schedules a follow-up appointment for next week.  Nora's leg continues to get worse.

Oct. 25 - JD takes Nora in to Campbell's after hours clinic.  The ortho who observes her is sympathetic, but recommends waiting for our next check-up.  I get a call from the NICU - Simon is coming home!  We are so excited to have everyone home!

Oct. 26 - Nora's leg pain is so bad today that she can't stop crying.  This is the first time when she has had an episode where she won't let us touch her leg.  JD takes her back to LeBonheur.  He calls me close to midnight to say they have admitted Nora and have ordered an MRI for the next morning.  My mom quickly comes over to watch the boys so I can stay the night at the hospital.

Oct. 27 - When Nora is in recovery from the MRI, her nurse is the same nurse she had earlier in the summer for a different issue.  Unlike last time, the nurse isn't hinting around that Nora's MRI was normal, and keeps asking questions about hot spots, inflammation, etc.  She says to wait in Nora's room for the results from the radiologist.  She says if Nora is an emergency case, the radiologist will see us sooner rather than later in case they need to operate right away.  I take this as a bad sign.  When we get upstairs to her room, her floor nurse calls the radiologist to see if Nora can have a snack as she has been NPO since midnight.  The floor nurse quickly returns to say Nora can't have anything to eat or drink, and the radiologist was on his way.  Soon after, the radiologist, pediatrician, anesthesiologist and nurse practitioner come to Nora's room.  Two things popped up in her MRI - excessive fluid behind her left knee and a possible bone infection in her left shin.  They need to wash out her knee first and test the fluid, and put her on IV antibiotics for the bone infection.

As soon as the operation gets underway, the nurse calls JD to say that the fluid looked infected and they had to open up Nora's knee more than anticipated - but that was explained to us as a possibility beforehand.  Her white blood cell count confirmed the infection, and a few hours later we have a sweet, groggy toddler in the recovery room.  I stay a little longer, but then go home to be with the boys.  JD stays with Nora.

Oct. 29 - Nora was supposed to have a second surgery to washout her knee again, but the surgeons were confident that all the fluid is gone.  They still have no idea what type of infection she has in her knee, and this is causing a problem for treatment.  They send out for an infection diseases (ID) consult.

Oct. 30 - The ID doctors spend a lot of time interviewing JD and looking at Nora's chart, which leads them to diagnose her bacteria infection as Kingella Kingae bacteria - a bacteria that can grow out of mouth sores.  Nora has had hand, foot and mouth several times this year - and recently had mouth sores.  Once the ID doctors make this diagnosis, we are relieved because the treatment is easy.  Just oral antibiotics at home.

Oct. 31 - Nora finishes her IV antibiotics for the bone infection (not the bacteria infection), and they discharge our little girl.  We are finally all back together!

It was a hectic month with Nora's leg issues.  It was joyous with the birth of our sons.  Through it all, we felt incredibly supported, prayed over and well-fed (!) by our family, friends, neighbors and fellow church members.  'October' might be a dirty word in our house for a few years, but surely we will look back at the insanity one day and laugh, right???