Landon's Story

The Beginning

The first question out of everyone's mouth is always, "Why?" The easy answer is we don't know. We may never know. In any event here's how it began.

Landon was born at a healthy 38 weeks gestation during a mostly uncomplicated pregnancy and birth. He came a bit unexpected, as I had been at the doctor that morning at 10AM showing no signs of labor and the doctor said it'd be at least another week. He then set out to surprise the doctor, something he has continued to do to many doctors since that point, and came into this world just 9 hours later.

As I said the labor was most insignificant. It was FAST, much faster than the nurses and doctor thought it was going to be as they were still rushing in with warmers and the proper equipment as he was being born. The doctor actually delivered him with no shoes on, just booties, because she did not have the time to change out of her clinic clothes and dress shoes into her scrubs, gown, and other delivery attire. The only thing significant about his delivery was that he choose to present both hand and head first, something mommy paid for but he did not suffer in the least.

None-the-less at 7:45pm myself and his dad became first time parents to a perfect baby boy. 7lbs, 12oz, 20" long. Born two days before Mommy's birthday, he will always be her best birthday present.

The hospital stay was normal. All of his newborn screenings came back normal. His first vaccinations and circumcision didn't bother him in the least. We stayed the normal 2 night hospital stay and then brought our little boy home. He was the perfect baby.
Nursed well, slept a consistent 2 hours, woke up to eat, then went right back to sleep. He only cried if he was hungry, and that was easily fixed. He seemed to eat A LOT at feedings. Much more than the nurses told me he would, but he seemed happy so we went with it.

After two weeks we had fallen into a routine. I was home on maternity leave, his dad was still working. I was also taking full-time online classes through the local college. We spent our days while daddy was at work alternating feedings and homework. Since he slept for 2 hours after eating I always had 2 hours for homework time, and I maybe took a nap or two.

At about a week and a half old he started spitting up a lot of milk. I called the nurses at labor and delivery and they insisted there was nothing wrong with him. That there was no way he could be spitting up 4 ounces or so of milk, because he shouldn't even be able to eat that much. We had already tried bottle feeding once, pumped breastmilk, and we knew he could definitely eat 4 ounces already. The other odd thing, my actual milk had not completely come in yet. It was still very yellow, meaning it was still high in colostrum. Being a new mom, I didn't think much about this either.

On October 29th, just a little over 2 weeks old we had an odd day and night. Instead of being content in his baby bouncer between feedings he refused to be put down. He would sleep but wouldn't be put down, I had a lot of homework, as always so I figured out a way to have him on my legs while I did homework. He was content like this. Again, I didn't think much of it. "Baby's get cranky...." is what I kept thinking.

The next day, after a rough night for all of us, he was still very cranky. I checked his temperature and it was 100.6 F. I then looked at our take home sheets for the hospital. They stated anything over 100.4 he needed to be seen. I called the clinic and could not get him into our chosen pediatrician (whom had only done his circumcision so far), but we got him in with another provider. I gave him the indicated dosage of Tylenol, and we pretty much left right away. What happened next in the clinic I will never forget.

His dad did not have to work that day, so we could both be there, something I'm thankful for to this day. We took him back and the nurse checked his temperature. I think it was 99.8 F. In any event she said he did not have a fever. This wasn't surprising to me as I had said I gave him Tylenol. The doctor came in and checked him out. Listened to his lungs and tummy, checked his diaper area, and asked us if anything else had been going on. I told him about the excessive spitting up and the crankiness that didn't seem like his normal demeanor. He shoved it off basically. He talked down to us, trying to tell us that maybe we didn't know how to properly take a rectal temperature. He said, "Babies don't get fevers." And sent in his nurse to teach us how to "properly" take a rectal temperature.

I was relieved he was ok, frustrated that the doctor didn't think we knew what we were doing, but still glad my new little man wasn't sick. The nurse came in and showed us how to take his temperature properly. 101.2 F. I shutter at the thought of what would've happened had that doctor not thought we were idiots. What if he hadn't sent his nurse back in to teach us how to take a temperature, which both of us already knew we were doing correctly. Thank goodness he was ignorant enough to think we were dumb. The nurse left the room, acting as though nothing was wrong and she didn't have to go tell the doctor that he'd screwed up, but had a clear paleness to her that said she wasn't looking forward to the conversation she was about to have.
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It's amazing how quickly things turned around after that. The doctor came rushing back in. Told us we were to go to the ER immediately, he would be calling them, and our son needed more testing. Some blood work and a potential spinal tap, he told us. Still at this point I didn't know what we were dealing with. I had come into the clinic that day thinking that all kids get fevers, they get colds, they get sick, and then they get over it. I was concerned, but also not completely informed about what we were up against at that moment. His dad also didn't seem to know.

We rushed him to the hospital. We learned from the ER doctors that meningitis was a potential culprit, and I think hearing that was when it got more real. My son would need blood work and a spinal tap. I choked over the thought of spinal tap. He was 8lbs, still probably less than 2 feet long, how on earth could they do a spinal tap on somebody SO little. We were in the ER a VERY long time. He continued on his 2 hours eating/sleeping schedule. They came in and tried to get blood several times, but even though they could successfully find veins he'd bleed 1/2 down the butterfly tube and it would stop. The poked a lot of times, and I think the 10th time finally had success in getting a very small amount of blood into the test tube. The lab tech said she could make that work and off she went.

Next was his spinal tap. His dad and I did not stay in the room for that procedure. It broke me to leave. I was still experiencing STRONG mommy hormones and he was SO little. The nurses and doctors insisted that this procedure was not something we should watch though, that he'd be ok, and they'd come right out to get us. I gave in, but I will never miss a procedure again. He was fine, the spinal tap was clean, he didn't act like he was in any pain, and it went well. I was a mess though. I held it together for us to upstairs. It was now at least 5PM, and his clinic appointment had been at 8:30 that morning.

Upstairs they put an IV in, something that also wasn't an easy procedure. They started him on a broad spectrum antibiotic and some saline. At this point we were just waiting for answers. His blood work had shown all indications of some sort of infection, but the blood cultures needed time to grow so we waited. We continued to give him anti-fever medication and we got through the night. He was a ball of radiant heat the entire night, despite all the anti-fever meds, his little body was on fire. When the doctor talk about a fever that won't break, he was the perfect example of this. He refused to be set down for the most part, but would sleep in someone's arms so we rotated who held him. Since I was nursing, I still was up feeding him all night. Through all of this he really never stopped eating, which was nothing short of amazing.

Blood cultures take 48 hours to come back. His pediatrician, the one he had actually chosen came in that morning and said he had gone down to the lab himself. He asked the lab techs if anything had started yet, and they told him it looked like staphylococcus. For those not familiar staphylococcus is a very common bacteria found many places. Chances are it is on your skin right now. It is mostly harmless especially if it remains outside of the body. MRSA (pronounced mer-sa) is Methicillin Resistant Staphylococcus Aureus. It is known as a hospital-aquired infection because it is very common in hospitals. It is resistant to the most common types of antibiotics and is considered a "super-bug". It is the result of years and years of improper antibiotic uses, and over use of antimicrobial measures. My little man got this in his blood. We will never know how.

The pediatrician, Dr. C, changed his antibiotic to one known to treat MRSA, vancomysin. This is a very strong antibiotic, even for adults, but it was his only chance. The doctor changed this med before the staph was even confirmed, before the cultures were done, because continuing without proper treatment would surely lead to septic shock and death.

The most curious part of his diagnosis is that we don't know where it came from. Given the incubation period (the amount of time it takes to show symptoms after being infected by an organism) it is likely he acquired it at birth or sometime during the post-labor hospital stay. Most people infected with MRSA get a skin rash around the area where they got infected. He never got any such rash. It is something many of the doctors and nurses who saw him, and who still see him, continue to ask about and be absolutely amazed at.

After changing the medication, and getting the positive culture back it again turned into a waiting game. MRSA treatment requires 14 days of IV antibiotic treatment past the point of a negative blood culture. This meant that there was no way for us to know when we would for sure be going home. Since the blood cultures had to grow for a full 48 hours, we wouldn't even know until 2 days after the start of the 14 days that we had started. The hospital Landon first got admitted to was in our home town. His dad could still go to work and we could see each other in between work. I could go home quick to get needed items as well. One of the first needed items was his Halloween costume. His first Halloween was spent in the hospital. He was at least feeling significantly better at this point.

The next drop on our roller coaster ride would come when he kept losing IV's. This was an almost daily experience. He was also very hard to get blood drawn from, a problem when we knew he'd need so many blood cultures. It was becoming apparent that this little hospital was not well equipped for the journey he still had to go through. The discussion started about what to do next with him. He needed a PICC line, which is a more permanent form of an IV. The hospital we were in did not carry PICC line's small enough. So even though his doctor thought originally it was something we could get done close to home, he needed to be transferred to a larger children's hospital 3 hours away. Since daddy had to work, it was just my little bug and me.

Once we got there, via ambulance ride, the journey started to go a little faster. We fell into our hospital routine. Something I had no idea would stick with us and be used periodically in the future. Over the next few days he had many procedures, and twice as many doctors. Due to the odd circumstances surrounding his illness the new doctors didn't want to miss anything. He received a full body bone scan, a full heart and organ ultrasound, a lot more labs, and finally his PICC line placement which had to be done surgically. Ironically PICC lines are notorious for being a route for MRSA infection. We were assured they would take all the precautions.

Which brings me to his precautions in general. Everybody who entered his room had to gown and mask up. Booties, gloves, gown, mask, eye gear and hats. His room had its own entry way just for dressing and undressing. Visitors and ourselves did not have to gown up, but everyone else did. The hospital stay was eye opening for many of these things that are actually quite common, maybe even more common now.

Our hospital routine lived on a four hour schedule. I blame this on the vital schedule, because every four hours they'd come. Typically he'd be sleeping. He'd always wake up for the blood  pressure, and they'd always get ridiculous readings. I to this day do not know why they even tried. He then would get changed and eat. He started to stay awake after eating and we would play for awhile. When he fell asleep for another nap I would instantly move onto my online homework, which was always at risk of falling of the charts and being past due. I left the room 3 times a day to eat breakfast, lunch, and supper. There was a long tunnel to the cafeteria, and that was my exercise for the day. Mostly though the hospital routine consists of just doing whatever needs to be done next and maintaining meal times as well as possible.

While we were there daddy visited when he could. We didn't have a lot of resources, and he needed to work though so unfortunately he missed a lot of his first son's first month of life. Landon rocked his treatment. He experienced no severe side-effects from the medication, and every day he just kept getting better. He started to connect and react to others. He always smiled at all of the nurses. He had a favorite nurse who swaddled him just right and he'd sleep longer. She nicknamed him "burrito".

Almost a month later he finally got to go home. We had many questions, would it affect him long term, did he need more treatment and followup, would he be more likely to get this infection again in the future? I still to this day wonder if my milk didn't come in because my body knew he needed the extra antibodies. The doctors did not know everything, but assured us he'd be ok. It was a wonderful day when he finally got to leave the hospital. His favorite nurse was there to say goodbye. He got to go for his first walk outside. He also soon after had his first bath.

I to this day think Dr. C saved his life taking action and putting him on the right antibiotic right away. The large children's hospital was wonderful, and would come through for us again in the future. Unfortunately this was just the first of his roller coaster rides, but we survived. His story will continue....



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