The Time Before and After

This winter has been so long, and rough.  We haven’t had everyone in school for a full week since before Christmas.  Between illnesses, snow days, or planned days of no school for an in-service or parent teacher conferences, every week feels like we are cobbling the days together and lacking the fluidity of our normal routine.  On Sunday evening I said to Ger “This is it – this is going to be our first week of ‘normal.”

On Monday afternoon, the kids got off the bus at 4:00 and Theo told me that he needed to use the bathroom.  At 9 years old, this doesn’t usually require an announcement, but I thought nothing of it and sat down at my desk to finish working.  A few minutes later he appeared at my side and told me “My pee is red.”

I looked at him sharply, and asked if anything else was wrong.  He told me that he had a pain on one side of his body.  “When did the pain start and how bad is it?” I wanted to know.  He told me that the pain started as he was coming home on the bus.  He grimaced as he told me that it was pretty bad, and I could tell that he was holding back how much it hurt.  He also told me that the red in his urine had started that morning.

A quick Google search told me that his pain was on the wrong side to be appendicitis.  I called his pediatrician’s office to ask if he needed to be seen immediately.  The nurse confirmed that yes, blood in urine should be seen.  The pediatrician’s office had no remaining appointments in the few hours left of the day, so I took him to walk-in care.

By the time we arrived, his face was pale and his eyes were wide.  I could tell that he was scared.  Even with no concept of what blood in his urine meant, he knew that it wasn’t normal.  I could only imagine his agony throughout his school day after seeing it that morning: hoping that it was just a one-time incident and that it would go away.  Terrified that the next time he went to the bathroom that he would see it again.

As we waited to be seen, I looked around the office.  I had plans to meet with friends later that evening for dinner, but I sent a message to both of them about what was going on and that I would let them know if I could still make it.

I knew that blood in urine could be serious.  I looked at the receptionist sitting behind the desk, greeting people as they came in, her hair knotted on her head, and a swelled midsection telling me that she was pregnant.  I thought ahead into the evening, that maybe I would still be seeing my friends for dinner, but that I wouldn’t yet have an answer on what was wrong with Theo, only a promise of “more tests.”

I could already picture the stark Before and After that I now could recognize in a preliminary fashion.  These moments were “Before.”  Sitting in the waiting room, minutes creeping by slowly.  Theo curled up in a chair with a book, his foot jiggling nervously in his black Chucks, uncomplaining about his pain.  If we had no answer, the dinner would still be “Before” – were I could run through the different possibilities with my friends, and ponder over how “we don’t know.”  A diagnosis of some kind would be “After.”  After that moment, nothing is the same.

I thought about my other Befores and Afters.  Before Nelle Died, and After Nelle Died.  Before Iris Died and After Iris Died.  Before that ultrasound and before I had any concept that a baby could die well into the second trimester.  Before pregnancy carried with it fear and anxiety.  Before I was aware of so many struggles and outcomes of pregnancy loss.

We were called back and a urine sample was taken.  Always wanting to please, Theo was detailed that his pain was coming and going (not constant).  I had asked him in the car how he would rate his pain, knowing the doctor’s office would ask and he told me “8 out of 10.”  When I responded “REALLY?” he quickly changed his tune and settled on a “6 or 7” when the nurse asked.  It made me wonder how much pain he was actually in, and whether he had overestimated, or if he was now downplaying.  He also told the nurse that he had avoided going to the bathroom all day at school after seeing the red in the morning.  That day must have been so hard for him.

The doctor came in and told us that his urine culture was clear – no blood, and no bacteria of any kind.  He told me that I would need to follow-up with his pediatrician to try to find a cause for the blood, but that would be for another day.  My heart sank as I thought that we were going to leave that evening without an answer.  I could picture the days ahead of going back into doctor’s offices, hours spent, time continuing to move slowly.  My head could not process what else it could be because – much like before entering the world of pregnancy loss – I simply was not aware.

The doctor suggested a strep culture after noticing that Theo’s tonsils were swollen.  He returned a few minutes later with a smile on his face and said “He has strep throat!”  I breathed a sigh of relief.  The doctor went on to say that this odd presentation of strep is something he had heard of, read about in medical journals, but never seen in real life.  Somehow the strep gets into the body in such a way that causes the pain and blood.  A course of antibiotics and assuming that his other symptoms did not recur, he would be fine.

And that was it.  We headed to Walgreens to get the prescription.  It wasn’t ready, so I took Theo home and headed to meet my friends for dinner.  The pharmacy was closing at 9:00 pm and I knew that picking it up would mean cutting my evening short.  I called and tried to transfer the prescription to a 24-hour Walgreens, but after 11 minutes on hold, I gave up.  I hesitated.  I felt like I needed the time with my friends.  Would it really make that much of a difference if he started the antibiotics in the morning, instead of that night?  He was already out for school the next day anyway.  He also told me that his pain had subsided when we had reached home.

Close to 8:30, guilt (reason?) got the better of me.  I paid my check and left in a flurry to drive back over to Walgreens, arriving 6 minutes before it closed.  There was another car in the drive thru ahead of me, and I finally pulled up to the window at 8:58.  The pharmacist disappeared to look for the prescription after I gave her Theo’s name.  9:00.  The lights all turned off in the drive thru and I was sitting in darkness.  Inside, I could see the pharmacy tech closing the counter window.  I wondered if the pharmacist had abandoned me – thinking “Done for the day!”  But several minutes later, she reappeared, telling me that the prescription had still not been ready and she had needed to prepare it.

And so, it was not a day of Before and After.  Just ordinary strep throat with a odd symptoms.  But, as so often for parents, and especially those who have been through that Before and After in a doctor’s office before, those moments are gripping and helpless.  I’ll never again be that parent who can calmly sit in a waiting room, annoyed by how long it is taking to be seen.  I will always be that person whose mind races ahead to worst case scenario.

Annnndddd… we spent yet another week without everyone in school for the entire five days.