First of all, the kid who had his appendix taken out the other day is doing great. Everything went well with his surgery and he came back to NPH today. He's going to stay in the clinic for a week just so we can keep an eye on things, but he's in good spirits and his wound looks clean, so hopefully everything will be routine with him. He won't be lonely because right now the clinic is filled to capacity. We have a couple girls with fevers, a boy with a sprained ankle and another boy who had his appendix taken out at the same hospital on Friday. This is a story about that boy.
So this kid ALSO had his appendix taken out last week, only his had already perforated (popped) and spilled the infection into his abdomen. They took out the appendix and put him on antibiotics. Things looked good for the first few days here except that he was complaining about an unusually high amount of pain. We thought he was just trying to milk the attention, so we spent a little extra time with him and just kept a close eye. Well, today after I worked a bit, I went to say hello to him. He tells me that he has more swelling around his incision site so I tell him to lift his shirt. It looked like this kid swallowed a ferret. There was so much swelling behind his incision site that it was pushing his skin out a good two inches. The swelling went down past the length of the incision, in total a length of about six inches. I knew that he had one hell of an infection brewing back there. I noticed his stitched had been taken out and he told me that the doctor had seen him this morning to remove the stitches and knew about the swelling. The doctors have already left for the day, so I figure I can talk the doctor in the morning to see what the game plan is for him.
I always feel bad when the kids are in the clinic since it's painfully boring there, so I bring in my computer and we all pile onto the beds to watch a movie. Felipe is sitting next to me when all of a sudden I hear him say "Uh oh." I look over. His hand is clutching his side and blood is pouring out of him. There was so much pressure behind the wound that it popped open the incision. The whole bottom of his shirt is already saturated in blood. I grab his hands and walk him to the examination room. By the time we get there, puss and blood is streaming down his legs onto the floor. I lay him down and the other nurse comes in to help me. The poor kid was freaking out so we had to try to calm him down while we drained the wound. The nurse would put a gauze underneath the wound, push on his abdomen and a quarter cup of vanilla custard would come out. It was without a doubt the most disturbing thing I've seen as a nurse so far.
After about ten gauzes, we were finally getting only blood back. This is usually a good sign, the only problem was we couldn't get the bleeding to stop. We both looked at each other and went to the other room to discuss our options. We both felt that he might have popped his internal stitches and needed to go back to the emergency room, but when he heard this he started getting really scared and upset. We called Doctor Nicole who is actually a surgeon in Germany. She came to check on him right away and decided that he didn't need to go back to the hospital (much to all of our relief). She had to tear open his skin a bit to let the wound drain (which looked really really fucking painful) but he was feeling much better in a few hours.
Ok, so it wasn't technically a disembowelment, but it was still pretty cool. By cool, I of course mean educational and interesting, not cool that the poor kid's stomach exploded. And I had to explain to the other poor kid afterwards that that was NOT going to happen to him, so he didn't have to worry. But it looks like that other kid just bought himself an extra week in the clinic :/
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