Another "done good" story

[Sapphire Silk]

I've been asked for another "done good story" in my Anorexic Bulemic in Jail thread.

So happens, I have one

This story happened about a year after my jail story. I left my job at the county jail when I was in my ADN (Associate Degree Nursing) program to get my RN (my last story, I was still an LPN or Licensed Practical Nurse). I'd gone back to working for a home health agency doing pediatric home health, which really worked out for me because I was working 11p-7a on the weekends.

I was working with a 4 year old who'd been born with esophageal tracheal fistula. In English, that means there was a connection between the esophagus and the trachea. Every time she ate, food would go down the windpipe and she'd choke.

As a baby, she'd had surgery to correct the defect. She had a tracheostomy and a MIC tube (a special kind of feeding tube). She was an otherwise healthy child.

My job was pretty easy. Her parents were her primary caregivers; very nice people who owned a farm. I was their respite care: I would give her meds at night, hook her up to her tube feeding, and hook her up to an apnea monitor (she had sleep apnea). I'd deal with any problems through the night so the parents could rest.

Basically, I got paid to watch the kid sleep all night Which was good for studying.

One issue I had early on was getting kid into the apnea monitor. She hated it, would fight getting into it, and pull it off in her sleep. However, I noticed she really didn't have sleep apnea. It's a common issue in babies, and most kids grow out of it pretty quick.

So, one morning over coffee (Mom never rushed me out of the house, we'd often chat over coffee first thing) I suggested she didn't need the apnea monitor anymore. Mom was interested; she wanted to get rid of it but didn't know how.

Me: It's easy. Just ask the doctor to discontinue it. But he'll want some proof that she doesn't actually need it. So I'll document her breathing in the chart, and when you go see him next, bring it up. He'll probably d/c it.

He did.

Kid wanted to learn how to swim that summer something fierce. It was all she talked about.

Problem was, she still had the trach stoma. She didn't need it and didn't breathe through it anymore, but they couldn't close it until they knew she was eating normally in case they needed to control her airway again.

She got all her nutrition through the tube, even though she could eat normally. However, she wasn't eating much. She'd eat chips (loved Cheetos) and the skin off KFC, but not much else. Mom was very frustrated getting her to eat.

So she asked me for my thoughts one day.

Me: My guess? She's not hungry. She gets all her food at night while she's sleeping so she's not as hungry much during the day. Her body is used to that. So my thought would be, stop the tube feeding.

Mom: But if she's not eating, she'll lose weight.

Me: If she's like most other kids, she'll eat as soon as she gets hungry. If she wants to eat, she'll eat what you put in front of her. But we'll need a doctor's order to stop the tube feeding.

The doctor was willing to try it, so he wrote the order.

Within days, kid was eating a normal diet just fine.

And I'd talked myself out of a job Without the tube feeding, she didn't need skilled nursing care at night anymore.

But kid got to learn to swim that summer

[teh_blumchenkinder]

I've been asked for another "done good story" in my Anorexic Bulemic in Jail thread.
So happens, I have one

Yay!

I was working with a 4 year old who'd been born with esophageal tracheal fistula. In English, that means there was a connection between the esophagus and the trachea. Every time she ate, food would go down the windpipe and she'd choke.

I understood esophageal, and tracheal-- and that the two probably aren't supposed to meet... Sounds scary. .____.

And I'd talked myself out of a job Without the tube feeding, she didn't need skilled nursing care at night anymore.

Isn't that what nurses are supposed to do? Make everything better?

But kid got to learn to swim that summer

Huzzah! Summer safety!
Not to mention you saved them money, and the continued stress of Daughter's special diet and headgear... and my understanding is that the apnea thingy is annoying as all get out! Adults don't even want to wear it.
Thanks Panacea!

[Sunshine]

aw, thats an awesome way to lose a job!

[teh_blumchenkinder]

Possibly the best way? :3

[Victory Sabre]

Good for you.

This story hits home for me. I was born with this condition. Back in 1973 it was usually a death sentence. I had the surgery to correct it, and have been fine ever since (though sometimes food gets stuck in my throat on the way down because it's smaller than average). I never needed the stuff that little kid needed, or the doctors thought she needed.

I'm glad she's living a normal life now.

[Sapphire Silk]

aw, thats an awesome way to lose a job!

Possibly the best way? :3

Good thing about my profession: people are always getting sick. I've never been TOO worried about being unemployed (well, except when I lived in North Dakota).

Good for you.

This story hits home for me. I was born with this condition. Back in 1973 it was usually a death sentence. I had the surgery to correct it, and have been fine ever since (though sometimes food gets stuck in my throat on the way down because it's smaller than average). I never needed the stuff that little kid needed, or the doctors thought she needed.

I'm glad she's living a normal life now.

Problems like that are why the docs wanted to be sure she could eat OK before they reversed the trach. Glad to hear you had a successful surgery! It's pretty easy to correct now since the surgeons have so much experience with it.

[NateTheChops]

It's too bad you weren't one of the nurses working with my mother when my sister was having her early complications.

Whole other story for another thread.