Well, here’s a parenting milestone we weren’t expecting to cross off our list so fast: rushing our child to the emergency room in the middle of the night.
The short version: totally common circumcision complication causes lots of bleeding. ER visit turns long and disorganized, IV fluids are required, and a tiny problem turns into a full night in the hospital.
The long version:
After a joyous bris, a long nap, some gift-opening, and a leisurely stroll to Welles Park and back (my first real trip with Ezra outside the house), we settled in to watch a movie. At around 9:30, Sandy passed me a wet Ezra to change. As I walked him down the hall, I noticed that the edges of his onesie were not just wet, but also tinged pink.
I opened his diaper to find a good amount of fresh blood. We’d been changing his diaper all day and hadn’t encountered this before. In fact, we were coming up on the time when it should have been all clotted up and ready for us to change the gauze dressing.
I was a little taken aback, but not too shaken up. I called Sandy in, more because I noticed I was standing topless (these boobs, they need a break from the nursing bra sometimes) with the lights on in front of a huge bank of open windows 15 feet from a neighboring building. I figured he could come in, lower the shades for me, I’d mop up the blood, put on a new diaper, and we’d go back to the movie.
But the blood kept flowing, a steady ooze of thick red. After a few tries, we finally got the mohel on the phone, who talked us through pulling off the top layer of gauze. Unfortunately, the under-layer, a ring of gauze that was applying blood-stopping pressure to the incision, pulled right off with it.
As we did all this, Ezra, who had been remarkably calm, finally started squalling – mostly because we were holding his legs down. This was when I discovered my magical secret power. I leaned over his wailing mouth and popped my boob right in.
With the mohel 45 minutes away, we all decided it would be best to go the ER. The mohel offered to meet us there.
We pulled up and I ran in while Sandy parked. I looked a little crazy in my blood-stained t-shirt, and at one point, while explaining the situation to the desk clerk he paused me to ask, “um…where’s the baby?” Like maybe the crazy lady forgot him at home.
An hour passed in the waiting area. The mohel arrived and started applying pressure using some gauze the clerk lifted for us out of a cabinet in the ER because he felt so bad that nobody would triage our bleeding baby. Finally we were triaged and placed in a room, where we basically waited for another hour.
It felt like each time a doctor or nurse would pop in, they could see the mohel was competent at applying pressure, so they’d lose their sense of urgency. Can’t help but wonder if it had just been me, covered in blood and crying, would we have gotten more help earlier?
In any case, eventually a doctor came by, examined the area, and suggested applying Surgicel to stop the bleeding. The mohel thought that sounded great, the two other doctors who dropped in thought that sounded great, we thought it sounded great. And then another half hour later, we were still waiting.
Sandy and I both went out to plead with the doctor to just stop the bleeding already. He got testy and said that he’d decided to upgrade the whole case to the pediatric hospitalist, a specialist from Children’s who floats around the hospital. A few minutes later he apologized for snapping at us, and agreed to apply the Surgicel while we waited for the hospitalist to arrive, which he estimated would be another hour.
Meanwhile, Ezra was a trooper. In between gauze changes, he would remain calm and alert. When the mohel changed the gauze or a doctor or nurse poked at him, he would start crying, and I would lean over the table and insert the magical boob into his mouth. I had one tool at my disposal, and I intended to use it. There is no modesty, and no deference to the modesty of your religious professional, when your baby is screaming and covered in blood.
About this time, after 3+ hours in the ER, we finally asked the mohel to go home. He’d been a huge help during the bleeding, and we deeply respected his commitment to making sure Ezra was doing OK, but we were exhausted, running out of emotional resources, and couldn’t handle having a stranger in the room with us any longer.
After he left, when everything seemed totally under control, suddenly it spun out again.
The phlebotomist could barely get enough blood out of Ezra for the tests that needed to be done, probably because dehydration was shrinking his veins. Then the hospitalist came back and said she was increasingly worried about his color (paler), affect (increasingly sleepy and unresponsive), and heart rate (fast), and wanted to admit him overnight for IV fluids.
Sandy was furious, and rightly so. Here’s a perfect example of why healthcare costs in America are spiraling out of control. If they’d stopped the bleeding at 10:30, we would have been headed home safe and sound by midnight. Instead, it was 2 am, and they were about to admit us for an overnight stay. The hospitalist was understanding but firm. It sucked that it happened this way, but she wasn’t backing down from her recommendation.
We decided that I would stay with Ezra and Sandy would head home to get some sleep. We still had family in town from the bris visiting the next day, and besides it seemed like one of us should have some coping resources in the morning.
After Sandy left, an awesome gay nurse who apparently specializes in starting infant IVs dropped in, surrounded by nurses who wanted to learn his secret tricks. “You’re never going to believe this, but the same thing happened to my nephew!” he told me, as he expertly threaded in the IV apparatus.
After he left, I curled up on the bed with Ezra and dozed off. A guy came in and I sat up. “Free ride!” he said. “Lay back down!” He didn’t actually look like a hospital employee, but I wasn’t in the mood to worry. I lay back down and rode that way all the way to the peds ward.
The doctor who came to see us first was a tired-looking Eastern European guy who introduced himself as Greg. He asked for the whole story, checked Ezra over, and then wandered out. He came back a few minutes later, suspicious. “I don’t understand something,” he said. “You had the circumcision done at 9:30 on a Sunday morning? How is that possible? The offices are all closed.” He stared me down, as if I’d somehow procured an illegal back-alley circumcision. I was so tired, I think I managed to spit out, “Jewish ceremony. Home. Mohel.” A few minutes later, he came back with more questions, calling the mohel a “yimmel.”
There was no sleep for me. First I was worried that the IV hadn’t been hung yet, not realizing he’d been giving a good dose of fluids when the nurse put in the IV in the ER. Then, once the fluids were hung, I couldn’t sleep because I was terrified something would happen to Ezra and I wouldn’t notice.
Dawn turned into morning, and I was pretty delirious. More blood tests were taken. More nurses and doctors stopped by. Our pediatrician came to visit, and in my exhausted paranoia, I was overjoyed that she seemed sympathetic instead of angry.
Sandy came back to the hospital with some desperately needed food for me, and we waited. Caught in a shift change between hospitalists, we were stuck there until 12:30, despite the fact that Ezra’s blood tests all came back normal by 9:30.
Finally, carrying a calm, healthy Ezra in a hospital blanket we’d stolen because we’d brought him to the hospital in nothing but a diaper and a bloody swaddling cloth, we joyously left the hospital and went home. After 14 hours of feeling like everything was spiraling out of control into a vortex of terribleness, it took a moment to realize that in fact our baby was perfectly healthy, and was actually in better condition, with a hospital-grade bandage and a prognosis to heal faster than before.
It’s can be hard as a new parent to know what kind of job you’re doing. The afternoon after the bris, Sandy and I had tried grading ourselves on our first week. I think we settled on a B+. Late that night, in the ER, we felt ourselves slipping a letter grade, maybe two. But in the morning we began to realize that we’d done nothing wrong, and in fact we’d actually taken pretty good care of our boy, given the stress and novelty of the situation. It’s not a test we’d planned to take this early, or one we want to take again anytime soon, but all things considered, I think we did all right.