So, not to dwell on last week too much because it really WAS totally sucktacular, but there was this other thing also going on that put the stress level to somewhere in the Barely Tolerable For Humans range.
Charlotte turned into The Incredible No Sleeping Baby. Really. It went like this:
Did you catch that? TWELVE HOURS without the baby sleeping.
And then this, the next day:
That was SIX HOURS! The next day:
Four days after that:
Two days later:
The pattern was pretty clear. She'd cry and cry and cry for two days and then crash out and sleep for the next one because (big surprise!) when you don't sleep for two days you get really, really tired.
Throughout the whole thing I was remarkably nonplussed by it. The daytime non-sleeping bothered me more than the evening non-sleeping. She's crying, but all of her needs have been met and I know she's okay so...just cry and I'll hold you and rock you but that's really all I can do, Charlotte. Please go to sleep. But after a few cycles of this it became pretty clear that it wasn't random jags of irritability or a growth spurt that lasted forever, it was a legit pattern (thanks to Emily for pointing it out) and she was also appearing more and more like she was in pain. She was arching her back and stiffening her legs and refusing to be laid down flat or slouchy. The car seat was her worst enemy. She was unpredictable and just plain angry, which is normal for a baby but not ALL THE DAMN TIME. Babies should be happy for some of the time.
No big surprise that on Day Nine I was so done with this situation. Having obtained medical degrees from University of Google AND University of Twitter AND University of Mommy Bloggers, I knew it was reflux. I KNEW IT. She had all the classic symptoms. I even cut dairy from my diet, and it didn't help, which only left reflux and then Jonna used the word "reflux" and that's all I needed to see since she has a Ph.D on the topic.
REFLUX! AM MEDICAL SOOTHSAYER!
Unfortunately, my three medical degrees do not qualify me to write prescriptions for medication (HARRUMPH) so we had to go visit the pediatrician. Our pediatrician was not there that day and while I do not like seeing OTHER doctors very much, I was willing to in this case. There was a lot of crying and I was very interested in making it stop. It seemed so cut and dry. I'll get the RX for Zantac, she'll be medicated by lunch and things will get back to normal by dinner.
But you know what? Doctors hate it when you go in and say, "This is the problem and this is the drug I want." I think it makes them feel like all of those loans aren't worthwhile if they don't get to play Socratic Method with their patients.
The doctor we ended up with, I like her, but she intimidates me. (Not many people intimidate me, even fewer that I will admit to in a public space.) She only gets to me because she is the doctor that diagnosed Claire with bronchiolitis when I was utterly convinced she only had a cold and it was nothing at all to worry about. But this doctor brings in a nebulizer and tells me that she has this condition that comes with a pre-printed handout and added respiratory risks for the rest of her life and I pretty much crumpled in that room.
This doctor, I respect her a great deal because she is very thoughtful and astute and kind, but I am always scared she's going to tell me something awful that I've completely overlooked or thought less of.
I am not kidding about her Socratic Method line of questions. What is the problem? Describe it to me. Does she do this? That? What about this other thing? I can never tell what answer I am supposed to give her to get what I want (an obvious error on my part, I KNOW), so I found myself, ah, padding my answers a bit in the hopes that they were leading to Zantac in a weird kind of "Choose Your Own Adventure" line of questioning. I wasn't lying or making anything up but I was trying to communicate that there was an actual PROBLEM here and that it wasn't normal by any stretch because the last thing I wanted her to tell me was something asinine like "Babies cry. Just roll with it." I know that babies cry and I can handle that but what Charlotte was doing was absolutely not normal.
When she asked me if she was projectile vomiting I said, "Maybe? I don't know?" I said that sometimes it comes out with force and lands at the edge of the burp rag (true). In my head I knew it was not CLASSIC projectile vomit but I wasn't sure if she thought there should be SOME projectile vomit to merit the Zantac. And really it did sort of...fly out of her mouth so, I don't know.. MAYBE? JUST GIVE ME THE DAMN ZANTAC. This doctor, she has an incredible poker face. I could not tell what she thought. Then she asked when it started and to be honest I could not remember the exact day. I felt like it had been about a week (upon looking at Twitter much later, it had been about ten days). I guessed 5-7.
With the relatively fast onset (according to me) and the maybe projectile vomit she thought it MIGHT be pyloric stenosis and we should ultrasound her to make sure before we tried Zantac. I was really unhappy when she said that because I knew it would be a separate trip to another facility and it would cost a bunch of money and, most of all, I thought she didn't need it. But this doctor had found something serious before in symptoms that I thought were innocuous so I went with it even though I knew in my gut that it was not necessary and it was most definitely not the economically efficient way to treat these symptoms. Wouldn't the smart, economic way to go about this be to try the Zantac and if that's not it, THEN ultrasound for the more serious condition? She was eating, keeping most of it down and she was not exhibiting any signs even CLOSE to failure to thrive. She weighed 11 pounds, 10 ounces at this visit. (Birth weight, 7 weeks prior was about 8 pounds. Girl is putting on deliciously kissable fat.)
But, whatever! This is the game! I want the Zantac, this is the route to it. LET ME WASTE MY DAY WITH THIS FIRST WORLD PROBLEM. We got to Children's Imaging that afternoon and they didn't see us until FORTY MINUTES after our appointment. The entire time I am stewing about this whole damn thing and how much it costs and what a waste of time and effort and resources it is. Also, they told me I could not feed Charlotte for three hours prior to our appointment. So, now it has been three hours, forty minutes and to a 7-week-old? That is too damn long between meals. She is screaming in the waiting room, but I feel zero guilt about subjecting everyone to this lovely serenade because it is actually all their fault in the first place. I actually stand next to the check-in window while she is screaming for this exact reason. You can't run your appointments on time? I will give you a screaming baby in your face for a half hour.
From the waiting room at Children's Imaging, I call the doctor because I'm really over this whole charade. I ask if we can try the Zantac first because this does not seem like an economically efficient way to treat this. I say that exactly: ECONOMICALLY EFFICIENT. I wonder if she was approaching it from that angle to begin with. I should have said this to her hours ago, should have had this conversation face-to-face the moment she suggested the ultrasound. I tell the nurse (because you can never talk to the doctor, of course) that it costs $225 and I think this is ridiculous. She comes back and says that the Doctor says it is "absolutely necessary!" And I am like, Dr. M. isn't PAYING for this or wasting her entire damn day chasing something fictitious and just when I am about to lose my shit to her on the phone we are finally called back for the ultrasound.
We did the ultrasound. There was no pyloric stenosis. (OF COURSE.) She phoned in the prescription for Zantac and heaven opened up its gates me. $265 (the ultrasound was $225, $35 co-pay, $5 for the Zantac) and eight hours later, we had solved the problem.
We're on day 6 of Zantac and it's like I have my old baby back. She's happy and predictable and she sleeps in nice, big several-hours chunks like babies should.
I could make a lot of snotty, first-worldy, ranty, American comments about how this all went down and I DO have some concrete thoughts, but my reality tonight is that I just wanted to get this all down in the permanent record and come back to the ethics and policy and fiscal responsibility of it later. I'm going to eat a cupcake and watch Deadliest Catch with my husband. Later, ya'll.
ugh - you poor thing. i am glad that the zantac is working! hugs!
Posted by: Meredith | June 29, 2011 at 08:17 PM
I'm so glad that she's so much better. I also look forward to hearing the rest of your thoughts!
I actually nearly got into a flame war on Twitter when this was going down. I said that because of economic reasons (and with no other counter indicators) we'd treat with a scrip first and do ultrasound as a 2nd resort here in Canada. Someone who I *think* has lived in Canada as a child went off on how Canadian care sucks and how we pay 50% income tax (untrue), etc. and blah blah blah. It was odd, and 140 characters isn't enough to refute the bogus claims of random strangers. That'll teach me - all I wanted to do was sympathize with your frustrations. Those things I look forward to hearing more about in future.
Posted by: Sarah in Ottawa | June 29, 2011 at 08:26 PM
Is it normal for reflux to hit at about that age? I've always thought it was there from the start, but between Charlotte and Arwen's twins, I'm guessing it's not. So if I end up with a non-sleeping, in-pain baby around six/seven weeks, I should head straight to the ped?
Posted by: Jessica | June 29, 2011 at 08:40 PM
Firstly, YAY! So glad that you found a solution and that you and your sweet baby are doing so much better.
Secondly, the Socratic questioning thing is SO MADDENING. My husband and my dad do it when I am sure - SURE - that something is wrong, and they are so poker faced about it that I have no idea if I'm giving them the "right" answers. Of course, they always end up on "you're fine." But it would be nice if they would say, once in a while, "I'm asking you this because of XYZ." Or, "ABC isn't bad, it's just an indication of such-and-such. But XYZ is worrisome because of whatsit."
People are not dumb. I think we ALL "pad" our answers a little bit. And sometimes I think it would be better (for ALL of us) if doctors would simply be transparent about what they're looking for, and what certain things look like. "Do you have a cough?" is one of those questions that can have so many different answers. But if you know that they are trying to rule out one specific kind of cough with a specific sound/duration/intensity/whatever in order to rule out a specific diagnosis... Well, how can more communication be a bad thing? (Okay, I acknowledge there are issues with this method, too. Leading questions and all that. But I would prefer it.)
Posted by: Life of a Doctor's Wife | June 29, 2011 at 09:20 PM
Been there. Done that. Sorry you're going through it. We're in the process of weaning her off the stuff now. By Monday she'll be free and clear. I'm glad Charlotte responded so well and things are back to normal. :)
Posted by: Vanessa Napolitano | June 29, 2011 at 09:51 PM
Oh, and isn't zantac amazing? A gift from baby Jesus!
Posted by: Vanessa Napolitano | June 29, 2011 at 10:05 PM
For serious, how do parents do it when they do not know of the wonder of the internet?
Posted by: HereWeGoAJen | June 30, 2011 at 08:00 AM
You might enjoy this bit. She's a doula and a midwife in training. Two of her four kids had acid reflux. This is what they did when meds didn't work for one of them.
http://gbbcwellnessblog.com/?p=175
Posted by: Margaret Turner | June 30, 2011 at 03:23 PM
Wow, this makes me love my GP even more. When my second baby was all stiff and board-like after eating, but wanted to eat all the time, and screamed and cried when we laid him down, I said to my husband, "This is reflux. Ima gonna get us some damn medicine." I went to our GP and described the symptoms, and God bless my GP, he said, "Let's try some Pepcid and see if that works."
LO AND BEHOLD. It worked. Turns out he had silent reflux, we took to calling the Pepcid "Normal Baby Medicine," because it turned our unhappy little guy into a happy, normal baby.
I'm glad that in the end you got the meds you needed. If it's any consolation, my refluxy guy grew out of needing the meds by his first birthday, and ironically is my best eater of all three kids.
Posted by: Karen | June 30, 2011 at 03:33 PM
Well. . . maybe next time, don't lie to the doctor. Then you might not need to do the "unnecessary" tests. She recommended that test based on what YOU told her (lied to her) was going on with your daughter. In this case, I'm afraid you must blame yourself for wasting your own time. Lesson learned: be honest.
Posted by: Capn Obvious | July 01, 2011 at 09:45 PM