Monday, January 24, 2011

Hospitals, Love, & Emunah

It's Tuesday. Yehuda Or and I are hanging out in bed in our pajamas. He's taking out the credit cards in my wallet with intense focus while I type away next to him. It's crazy that twenty four hours ago we were in the hospital, sleep deprived and scared, holding Yehuda Or down for his third blood test in 5 days.

Every two minutes or so he stops and turns his head to look at me, or reaches his hand over and grasps onto my shirt. If I get up to get my phone or if Eli needs to go into his office, he starts crying and reaching frantically. He has been through a tough week, and we're just doing our best to give him what he needs right now - lots of physical contact and reassurance that he's safe. I haven't totally processed the last week, but I know that writing about it, and giving myself the opportunity to put the experience into words will be very healing. I also know how worried all of you wonderful people were, and I want you to know what happened so that nothing's blown out of proportion and your minds are at ease.

Last Saturday night Yehuda Or woke up in the night with a fever. We gave him some tylenol and didn't think anything of it when the fever continued over the next couple of days. Babies get fevers and there are plenty of viruses going around right now. By Thursday morning we noticed that the fever was getting higher and more constant. He was also acting worse rather than better. All he wanted to do was sleep. It was the fifth day and I felt like it was time to check in with a doctor. We have two great pediatricians (Dr. Borjel and Dr. Godfree) that we see depending on who's available. Dr. Godfree (who calls himself Doctor Max with a very heavy British accent) was concerned at how long the fever was lasting and wanted him to get some tests done. He brought up a few possibilities, among them pneumonia, mono, and CMV. My heart dropped with the last one. I'm pregnant, and that virus can be extremely dangerous to an unborn fetus. Immediately all of the food I'd been sharing with Yehuda Or in the past few days popped into my head and I felt extreme guilt creeping up on me.
"But I'm pregnant!" I blurted out to the doctor. He took a deep breath and rubbed his forehead.
"Then you need to get a blood test."
"When does Yehuda Or need to get his tests. Should we go together on Sunday morning?"
"No. You need to go tonight. Now. If he has a bacterial infection and it's already been five days it is extremely important that he start treatment. He needs to be diagnosed now."

I called Eli on the walk back, my hands shaking and uncontrollable tears beginning to pour out of my eyes. I totally lost it. First time of many over the next few days. Eli calmed me down and told me to come home and we would cab to Terem all together. I felt so worried, so irresponsible, and like the situation was so beyond my control. Both of my little babies were potentially in danger.

Terem was the beginning of five days of tests, results, questions, and challenges. The doctor at Terem concluded that it must be a bacterial infection even though there were no signs of one, besides a slightly elevated white blood cell count (he had a blood test, a urine test, and two chest x-rays). Six hours later he prescribed amoxocilin and sent us home. The fever continued over night and through Friday. After almost 24 hours of being on the antibiotics his fever reached 104.2 while on tylenol. Shabbat was in 40 minutes and we didn't know what to do. The fever went down in about 10 minutes after giving him some ibuprofen and putting a cold cloth on his head. We decided to wait. Maybe he simply had not enough of the antibiotics yet. He woke us up at midnight hysterical. His body was scorching hot and he was shivering and moaning like he had the chills. We took his temperature and it was 104.5. We immediately jumped out of bed. A family friend who's a P.A. told us that if the fever went above 103.5 we should go to the hospital. Just as we were deciding what to do, Yehuda Or starting vomiting. A lot. He just continued to throw up until he collapsed crying on Eli's shoulder. We called an ambulance and grabbed a bag with diapers.

At Shaarei Tzedek hospital we were taken to the children's emergency ward and a crabby nurse began the entry tests. Yehuda Or was crying so hard that she couldn't get his accurate blood pressure. She told him to stop crying and told us that children always loved her and she was offended that he wouldn't stop crying. She was dead serious. For the sake of time I'm not going to go into how many doctors and nurses were rude, insensitive, and disrespectful during this whole experience. All I can say is, with a few exceptions, this experience made me feel even more distant and untrusting of the medical professionals in this country. Yehuda Or was either treated with frustration or indifference. We were treated as unintelligent first time parents that had no right to know what was being done to our child. I never missed my warm, reassuring family doctor in Denver more.

After more blood tests, urine tests, and several exams the doctor on call told us that she was unsure of what was happening. Everything had come back normal and yet his fever remained dangerously high. She upped his dose of antibiotics and discharged us on the condition that we would go see our pediatrician Sunday morning. It was 6:15 AM Shabbat morning and we hadn't brought his stroller or coats in our panic. We were exhausted, traumatized, and starving. My pregnant body was begging me to lie down and sleep. We decided to walk home. We bundled Yehuda Or in blankets and started our hike to Rechavia. We got home around 8:00 AM and Eli took Yehuda Or while I collapsed and slept deeper than I've slept in months. They both soon joined me. We made sure to give Yehuda Or medicine every 4 to 6 hours to prevent his fever from spiking. But he remained miserable, lethargic, and after two scary nights with doctors, wouldn't let me change his diaper without screaming in fear. I felt like I had betrayed his trust. Even though I know we were doing what's best for him, I just felt like he was so confused as to why we were letting people hurt him.

Sunday morning Dr. Borjel said everything looked fine, and to keep giving him the antibiotics but he personally thought it was a virus and would go away within 48 hours. We were relieved but also unsatisfied since the fever continued and he seemed even worse. His coloring had started turning yellowish and he basically slept the entire day. That evening we got a call from Shaarei Tzedek. One of the blood tests had just come back and his CRP levels were extremely high. This indicated an infection or inflammation. We needed to come in immediately. She mumbled something about an ultrasound and E-coli and hung up. I started bawling. I just kept saying "I can't, I can't, I can't." I just couldn't do it to him again. I felt like they had no idea what they were looking for and with no regards for the fact that these tests were invasive and traumatic to a thirteen month old, they just wanted to keep going. I felt like screw protocol. Of course after speaking to our parents and being unable to get a hold of either of our pediatricians we knew we had to go.

Yehuda Or started crying as soon as we entered the hospital lobby. He started clinging to my neck and burying his head into my chest. I felt like he was begging me to leave. More exams. More blood tests. More running my fingers through my baby's sweaty hair singing the itsy bitsy spider while he screams "Ma!" with his eyes wide open in terror. Holding back my own tears was often impossible. It broke my heart to see him so scared, so confused. Between tests he would fall asleep, exhausted and heaving, only to be woken up again and held down for more. I had to keep going to the bathroom to splash water on my face, look myself in the mirror and say "You're the mother, you need to be calm. Snap out of it!" I just couldn't hold it together, I wanted my mom, I wanted a kind doctor to explain something to us, I wanted to take Yehuda Or and run home.

Monday morning Yehuda Or's fever was gone! We were so excited and I was determined to refuse any more testing and insist that it was over. Around 7:45 AM however the fever was back. Our case was passed on to a Infectious Disease specialist who spoke perfect English, was extremely gentle and kind, and was happy to explain everything to us with a soft smile on her face. She wanted us to rule out any heart problems, particularly a rare inflammation of the arteries that can indicate a high CRP level. We held Yehuda Or down for an in-depth 25 minute ultrasound of his heart and arteries. He never said "Ema" and "Abba" so clearly. The doctor said that although his arteries were "prominent" they were not inflamed. The heart disease was ruled out. He was sent for another x-ray session of his lungs. Normal. No sign of infection found. The doctor said to go home. If Tuesday at noon he still had any fever we needed to be indefinitely admitted into the hospital until diagnosis. If his fever was gone (without medication) then we could conclude it was a horrible case of the flu and it's over.

It's currently 1:00 and he has been fever free for 24 hours! I am relieved, still nervous, shaken up, and SO THANKFUL all at the same time. This experience made me feel SO empathetic for parents who have children with serious illnesses and conditions that force them to live in and out of the hospital. I would go through child birth a million times rather than feel the horrendous dread of my child's life being in danger. I have never asked for anything with my entire being until now. I thought I had, but now I realize that I hadn't. As I am coming out of this experience I also feel incredibly grateful for such wonderful friends and family who called and texted and facebooked and davened for us. When I asked for friends to pray and spread the word I wish that I had been more specific about what was happening and made sure that people knew he was in the hospital for tests due to a FEVER. I only realized after that the facts were unclear and people thought there had been an accident or a fatal diagnosis. THANK G-D this was a teeny tiny NOTHING of an incident compared to what happens. I really want to do my best to integrate this experience as a lesson. I'm not sure yet what I learned. I do in a way feel stronger. And more protective of my decisions. I feel disillusioned by doctors. I really felt like most of the tests were redundant and based on protocol rather than brain power. But maybe that's just anger that will subside with time. I am sure of one thing - holding my child close and doing everything that I can to protect him (and my unborn little bean in there) is the most important thing in the world to me.

I'm sorry that there's no uplifting or inspirational conclusion to this post. I'm just not there yet. But I feel positive, not at all depressed. I really want to thank everyone for being there for us and I wish a huge REFUAH SHELEMAH to all of the children and adults out there that are sick. Please Hashem, we should all be healthy so that we can enjoy this wonderful world and do our unique part in making it a better place.

Wednesday, January 19, 2011

When it Rains it Pours

I have always felt aware of the cycles of life - the ebb and flow of events and emotions. In the past few weeks there has been a down-pour of change.

In terms of our family, Yehuda Or has entered a stage of serious "separation anxiety." I am no longer able to give him to a friend for a minute while I go to the bathroom without desperate cries of "Ma! Ma!" He's also been sick for a while with a bad cold/flu thing which has made bed time and our weaning process very difficult. Eli and I just have to keep reminding each other that this is but a phase, and we may as well keep our sense of humor during the more trying stages of parenthood. Fortunately, every time I see Yehuda Or's little face or hear him proudly exclaim "Gluck!" as he points to a clock, I feel so full of love that the bed time drama just doesn't seem like such a big deal. I've started feeling the new little baby in there kicking and rolling around, which is such a wonderful feeling that I can't help but stop what I'm doing and smile every time I feel it. I'm getting so excited to meet this new little person and find out who he or she is.

We spent a Shabbat in Efrat (the Zayit neighborhood) and loved it! We're really excited to finally have found somewhere that seems like the right fit. We're in the midst of apartment hunting while also trying to get someone to take over our lease here in Jerusalem. Zayit seems to have all of the qualities we're looking for in a community: laid back & nice people, plenty of Anglos, religious diversity, and young families in our stage of life. We've met several GREAT couples and close friends of ours just moved there this week. So that's an exciting development...

We also just booked tickets to Denver! I'm missing my parents and home town so much. Tickets in March were SO cheap, so we're going to the Rocky Mountains! Can't wait to see family and friends and enjoy Target and Starbucks.

I'm feeling very blessed right now - the flexibility in our lives is really something to be thankful for. We keep realizing how amazing it is that Eli is his own boss and we can just decide when we want to go to Denver without needing to check in with someone or fear losing a paycheck. With the handy dandy MacBook Pro, Eli will be able to work through our entire vacation! (Yipee.)

Love from Jerusalem!
Leah

Tuesday, January 4, 2011

Bedside Manner = Not Yet Imported to Israel

[WARNING: This post contains details about being a woman... body/pregnancy related things]

Just got back from a doctors appointment and I'm fuming. With my last pregnancy I had a doctor that never made eye contact with me or even faked a smile, and half-way through I switched. Well the new doctor told me that she didn't want to hear me speak English because it was pathetic that three years after making Aliyah I couldn't converse in Hebrew. Eli had to accompany me to my appointments while I, like an idiot, felt like the third party at my own appointment. This time around I decided to go private. I don't want to name names (but if you're pregnant or a woman looking for a Macabi doctor call me so we can talk more specifics), but the private guy just wasn't nice enough for what it costs to go private. Look, I get it, health care is free here, so the doctors aren't being paid well enough to treat their patients like customers. But somehow Canadians and British citizens had pleasant health care experiences, despite the public system. What is it with Israeli doctors?

Ok so I decided a few weeks ago that I need to just adjust to the culture here and it's silly to pay private when there's a free route. So I was off to a doctor in a different building that I hadn't heard of before. My appointment was at 2:30 today. I got to the office a half an hour early, hoping to get in early and be home in time to get Yehuda Or from the baby sitter. No luck. At 3:10 I decided to go get something to eat and come back. At 3:30 my turn came and I entered the room optimistic about a new doctor, despite the long wait.
"Shalom!" I said with a big smile. She glanced up at me. No smile.
"Yes." She said while she continued to type on the computer.
"I'm pregnant, and I was seeing a private doctor, but-"
"Go to the nurse."
"Now? Can I go after our appointment?"
"No. Do not come see me without first going to the nurse. Go and then come back."

After (the VERY sweet and friendly) nurse took my blood pressure and weight I returned to the waiting room for the doctor. A very tired older woman was waiting. I said to her in my broken Hebrew "I'm so sorry, but my appointment was at 2:30 and I had to go see the nurse. But now I have to go back to the doctor. Can I go before you?" She shrugged. I hoped that meant yes. When the door opened I glanced at the older woman with an apologetic look and went in.
"Hi again." I handed her the records from the nurse.
"Do you want to do the genetic testing?" She got right to the point.
"Umm, I don't think so. What do you think?"
"I don't know. You have to decide."
"Ok, no, thanks."
"Do you want to see the baby and hear the heart beat?"
"Yeah, that would be great."
"On the bed."
I made a split second decision to change the paper myself that covered the surface, I could see the dent of the last woman clearly.
Finally - a treat! I got to see the cutest little bean. It was wiggling and kicking and I couldn't help but smile.
"I'm trying to measure the femur but it won't stop moving." She sounded very annoyed, and not at all entertained. I laughed, I couldn't help it! She glared at me and pushed the device a bit harder onto my stomach.
"Is everything normal?"
"This isn't the in depth ultra-sound, I'm not looking for normal. It's appropriate for the age of the pregnancy."
Ok... sheesh....
After the ultrasound she did a basic exam. While doing the exam she stops and says to me "You have milk! Are you breastfeeding?"
"Yes." I said feeling ashamed (for no good reason).
"STILL?" She walked back to her desk and started writing. I found myself stammering about weaning and starting to nurse less. Then I realized, what the heck am I doing justifying myself to this woman? Why should I care what she thinks about me? After a few more pleasant and comforting interactions I left the office and felt like kicking something. How did she manage to make me feel so awful? An ultrasound is so exciting, it should have left me flying high, but the bad taste from the doctor is lingering. I think I just need to make peace with the role that doctors play here. At least for now. I really hope that bedside manner is something that slowly penetrates this culture and becomes a value. I am very grateful for being able to get competent and FULL medical care for free, but I do believe that it's possible for public health care to coincide with nice doctors. At least not bullies! For names and more details, feel free to email me, and if you know of a great OBGYN, please let me know!

Monday, January 3, 2011

A New Life

I apologize for the long gap of time between posts! I mean, there are hundreds of you checking here daily to see if I've written my next riveting post, I know... ;) But the reason is a good one! After lots of thinking and discussing, I've decided to actually post this wonderful news: I'm pregnant! (I hope it doesn't feel too impersonal and strange if this is how you're finding out, but the internet has made announcements so darn easy, it's hard to resist utilizing.)

It's funny how (at least for me) just when it feels safe and comfortable to start telling people, I'm finally not in dire need of help and sympathy... Thank G-d, the nausea has been much more manageable this time around (with Yehuda Or I was out of commission for 20 weeks), and I'm starting to feel like myself again. The intensity of pregnancy is like nothing else - my body is simply not my own. If I don't eat every two hours a wave of nausea washes over me and I suffer the consequences for hours. If I don't get enough sleep, I can count on a miserable day, as if I'm stuck under water while the world functions normally around me. But enough complaining! I'm pregnant! I have another special little neshama growing and developing inside of me! I'm so busy with Yehuda Or and being a wife/student/housekeeper that I almost keep forgetting. Then, something reminds me (maybe the bulging tummy that no longer fits into anything?) and I get this silly smile on my face and sigh - this is so cool. The first trimester, just like last time, is a tough time for me. I feel so physically awful, but on top of that, I just feel very low emotionally. I'm over-sensitive, and everything feels like an insult. I felt like I had to prioritize in a way that I wasn't satisfied with. Forget stepping into the kitchen and cooking (poor Eli's been eating tofu patties for the past 3 months), or keeping the house spotless... as my mother in law said, "as long as my husband had clean socks and underwear, the laundry was considered done." I just felt like I had energy for ONE thing, and I wanted that thing to be my focus for Yehuda Or. So the house got messy, and my social life went on hiatus.

Now that I'm slowly coming out of hibernation, I have a sudden passion for clean floors and an empty sink. I also really miss friends and having the energy to be out of the house for more than 20 minutes. The experience definitely reminded me that we don't have a community, and that it's something I really want. I didn't feel like I had support physically when I really needed it (but I do have to thank my wonderful sisters-in-law for stepping in!) and Jerusalem felt like a city of strangers when all I wanted was someone to call and say "I'm bringing over a pot of soup," or "I'm taking Yehuda Or to the park, you need a nap." I know that moving to a more community-oriented area won't magically mean life-long friends, but I think that in a place where I don't feel so anonymous, I'll feel more motivated to put myself out there and be more assertive socially. We've decided to move before the new baby, G-d willing, and now we're on a hunt for our next home. Hopefully one we can settle into for more than a year. I'm feeling a need to grow some roots and get attached.

And so, as if the past few years of my life haven't been full enough, the adventure continues, and our family of three will G-d willing be expanding into four. The baby is due on the Fourth of July... how patriotic of us. Of course, Eli being Canadian had no idea why I thought that date was so funny. I'm transitioning into maternity clothes, and my tummy is at the point where people look and say to themselves "I think she's pregnant, but maybe she just has a big stomach." Fun phase... but soon enough I know it will be clearly pregnant and I'm so excited to feel those first real kicks of reassurance. I wasn't going to blog throughout this process, as I feel it's a very delicate experience and one that deserves constant thanks to Hashem. But I think that it's a magical time - it feels good to share the emotions and realities while I go through it - and I think it's exciting to read about as a friend or a stranger. So thank you for being a part of it!
Stay tuned for more practical posts about being pregnant in Israel - doctors, maternity clothes, nursing equipment, doulas, birth classes, hospitals, etc...

And Happy New Years!