The Bills Are In

I did this for Kole too, but we finally have all the bills in from the birth of Karissa. It's actually easier just to skip all of Kathy's prenatal care and OB check-ups. We'll just call that squaring-away our deductible.
The first bill in was for Karissa - this was essentially her hospital bill for being cared for and housed for four days. Technically it was Wednesday through Saturday, but from hour to hour it probably added up to just over 36 hours. This cost was $6,671.97 ... and that is the total, not the balance due after insurance.
The next bill was for Kathy - essentially her OB/hospital bill for the C-section and after care in the hospital. Total cost was $10,590.60.
So, the total tab for walking into Arlington Memorial Hospital, having a baby via C-section, then walking out three days later with no complications to speak of and both mother and child relatively healthy - $17,262.57.
I have what I consider to be top-notch health coverage from my employer, entertainment bulldog Fox. I have United Healthcare and I pay top dollar for the PPO program. I won't say what my out-of-pocket tab is from all that, but if I added up every house bill I have - mortgage, electricity, gas, cable/internet/phone, City/water, etc. - the balance from all this baby activity and my out-of-pocket expense easily tops the sum of all those bills, and then some.
Oh ... then came the bill from Cook Children's Hospital for that 3-day nailbiter: $11,948.47, again before out-of-pocket. That's 30-gees in the span of about two weeks. Ouch.
I'll just say this - thank God for health insurance, and for a career that allows me access to it. And I don't mean that facetiously.

Karissa's First Month

The load of two kids is not quite like it was with just one, and it's showing in my blog postings. It's harder and harder to find free time, especially when only Kole is sleeping more than 4 hours at a clip. Some here are considering four hours all told in a night a great night.

The big picture is - Karissa has grown a good bit in her first month, and is already in "1" diapers, out of Newborn. To recap, she was born weighing 6 lbs. 13 oz., but left the hospital at 6-3. A week later she was 6-11. When Kat took her into her routine doctor visit that became the Cook Children's hospital fiasco she was 7-6, then last Sunday when Kathy took her to the doctor last Sunday when we were concerned about her congestion she was 8-12. So, she's growing normally and mostly healthy - though we can't seem to get her breathing completely phlegm free. For the most part she sleeps well, but it's mostly during the day. She's got her day/night thing all screwed up and spends too much time awake at nights while snoozing through the daylight hours. She spends much more time with her eyes open and is noticably observant. When we hold her and just stare at her (and there is a lot of that), she will now dart her own eyes around, as if she's studying our faces and getting to know us. It's cool.

Kole now calls her "kwiss-ah" and is increasingly inquisitive. Still, he's a bit too rough and doesn't understand that he needs to be gentle. He pats her like a dog and sometimes will just squeeze her foot like she's a toy. When she cries Kole likes to mock the cry and scream at the top of his lungs then laugh at himself. That's getting old. For the most part, however, outside of some isolated incidents, he's being a good brother - though we're not real sure he's real aware of everything going on, and that she is permanent.

The next moment that all four of us in the house are completely healthy will be the first. I've had an annoying cough/congestion thing going on that I am sure I'm on the tail end of then crap keeps coming up. Kathy has had a bladder infection related to her C-section, then Kole came down with strep throat last week. Then there was the Karissa congestion thing after coming home from Cook Children's. So, we're adjusting to sharing each other's germs and breath.

Obviously, I've attached video of Karissa's first bath. She was much more agreeable than Kole - while Kole himself thought that it was time for everyone to have a bath, including him, so he was a bit of a turd while all the attention was heaped on his sister. Again, as we monitor his mood and behavior as it relates to Karissa, he hasn't really been overly jealous - openly competing for our attention while we're holding Karissa. He has, though, challenged his mother to what her capacities are at this point. In that respect, the "Terrible Twos" have come out full-force. One day he will defy every rule - mocking timeout punishments, and moments after being disciplined for throwing a toy, will wait for Kathy to relax and get back to feeding Karissa, then will take a toy, stare his mother in the eye, then chunk a toy across the room.

Yeah. It's on. Hardcore.

Then ... two days later, Kole will not let Kathy take a step without him lovingly shadow each step, hugging a leg or looking to be held and cuddled. Kole has become a loving hugger, even patting his Mama or Daddy on the back or shoulder while being hugged. He has his moments, and sadly for Kathy, I get much more of them because I'm out of the house more because of work or travel. Kole now knows the sound of the garage door opening, and will open the house door to the garage singing and dancing the praises of his Daddy. It's an awesome sight and feeling, I can't lie ... until I find out what a shit he's been to Kathy most of the day. So, onward we go with the Terrible Twos, and all its ups and downs.

Karissa continues to be awesome. We just need her to spend more of her cranky awake time while the sun is up, then do more of her 4-hour sessions of sawing logs when mom and dad choose to do so also. All told, when the report card is analyzed and broken apart, we got it pretty good around here and we're thanking the appropriate Authority for the blessings every day.

Back Home ... Again

With the approval of Froggie and Elmo, Karissa was back at home Sunday afternoon - napping after giving up hope on the Rangers and Cowboys.

The final analysis of her illness is this: urinary tract infection, as evident by the sight of Enterococcus Faecalis in her urine - a bacteria/germ that gets into the urinary tract via feces. Much like E. coli, but not E. coli. In the end, we could have had sensors in her diapers telling us exactly the moment she poops, we could change it within seconds, and she could still get it. Poop is going to be near the nether bits in the little greenhouse confines of a diaper one way or another.

One weird twist is that the doctor said there were such low traces of this bacteria, it was as low as many other germs often found and classified as "contaminants", introduced by the catheter. So, in reality, possibly, the germ they found could have come from the catheter - and her fever was just caused by some other virus that Kathy, Kole or I gave her.

That's all water under the bridge. Eventually they did find something and kept her to treat it. She was discharged today (at 10:00am on 10-10-10, oddly enough) and came home and that's that. She will have to go back in and have a test where she will again be catheterized, they will inject a dye into her bladder, then the process is essentially a flouroscopy of the dye - watching the muscles pee the fluid out, making sure that no fluids are going in reverse - back into the bladder. That would help explain some of why bacteria was allowed to get up her uretor - if that's what happened. Again, the germ they found very well could have been a contaminant of the instrument used to catheterize her the first time. Whatever. Prescribe my girl some drugs, tasty little fluids that get injected into her mouth, let her heal at home and leave her alone.

Now - Kole is as sick as a dog. He's been hacking like he just smoked a pack of Benson & Hedges Menthol 100s. He has a snotty nose and is too young and too much of a boy to care so he takes his hands, wrists and elbows and rubs the snot around his face from ear to ear. It's cute but ... he's sick and it shows. His eyes are tired and red and he'll likely see a doctor tomorrow if nothing improves from the over-the-counter medicine we're dousing him with.

It's been an interesting past few days, but again we find ourselves thankful for Joan putting everything she has on hold to help out and stay with Kole, as well as all the friends and family who kept Karissa and our little clan in their prayers. But, nothing can make me as thankful for the scene right now - all four of us under the roof we call home, snotty faces and all. We're a nuclear family once again, a little wobbled and dazed, but I got to have my moment in our comfiest chair with my wife and son on my lap with my baby snoozing inches away. All is right with the world again.

Update - Saturday night

Not that it's horribly bad news or that Karissa's condition has taken a turn for the worse, but Karissa will stay at Cook Children's Hospital yet another night.

The diagnosis is still UTI - urinary tract infection; however, it was not E. coli they found in her urine yesterday but Enterococcus Faecalis, which is just another germ/bacteria that can get into the body through the ureter and cause an infection.

So, I just got to the hospital, sent Kathy for a night of sleep in her own bed for the first time in three nights, and I'll do the nighttime shift here. Earlier today I worked the Texas Tech-Baylor game on our air. The game was at the Cotton Bowl and kicked off at 11 am. So, I was there this morning, got out around 4:00, got home and only got to spend no more than 15 minutes with Kole - who had been watched by Joan again for the day. Kole was sitting at the dinner table having a snack as Joan prepared his dinner and I leaned down to tell him goodbye. I knealt to his side and said cheerfully, "Okay boy - be good for Grandma!" And in an instant he had figured out that I was leaving again, began crying loudly and clutched onto my neck like he never wanted to let go. It absolutely tore my heart out. I gave him a second look to tell him he'll be fine and tears were streaming down his face. Not only has he been battling a cold and feeling like crap, but I really do feel sorry for him and wanted to just gobble him up and kiss his head for the next 10 minutes. This really has been a huge transition for him, and within the past four weeks he has begun school, then came the birth of Karissa and the revolving door of family watching him and keeping him for the night. All trusting family who loves him more than he knows, but especially over the past three weeks there have just been large chunks of time spent without Kathy and I together with him and I think he's finally figured out that he doesn't care for it too much. Then comes the guilt on our part that when we do spend time together with him, there is the fact that a) he's a 2-year-old, b) there's a whole new set of rules when Karissa is around, c) Mom and Dad are spending a little more time than normal getting on to him and disciplining him. At the same time, he's probably just starved for the attention that he is now noticing is whittling away a little bit at a time from one or the other of us.

Poor guy. He'll be okay, and get through this just fine. Unfortunately, it's Karissa who we're most concerned about now since she's in a hospital instead of being at home. One more good night of antibiotics and we should be able to get her out of here tomorrow.

Until then - I have the Rangers playoff game on, flipping over to the Colorado-Missouri football game, and obviously my laptop so I can keep in touch with everything else. Might be a little boring, but Kathy has done this the last two nights and it's time for me to get my turn.

Update - Friday Night

Results from Karissa's urine sample came in today and there was evidence of a urinary tract infection. There were signs of E. coli in her urine, which is the easiest sign of it.
If all other tests (the bacterial tests from the spinal tap, etc.) are negative in the morning, then she'll be released and be back home by mid-afternoon. We're told that this is very common - especially for girls - and indeed there was another little girl two doors down with a UTI. That girl was just 11 days old, where Karissa is 16 days.

She's been so good through all this. It's still painful to see her in her little arm cast which keeps her IV in place, but she's been alert much of the day and she is increasingly keeping her head up for several seconds, swivelling from side to side and examining her surroundings.
I arrived at the hospital this morning after dropping Kole off with my dad and Kay, then came up to relieve Kathy before 10:30 am. She was able to come home, shower and rest and gather some things, then was back up by 5:30 to take another night shift. I offered, but she said that if she were at home she probably wouldn't sleep anyways, wondering how things were going back at the hospital. So, I picked Kole back up and got home - he was wiped out! I barely got through the door and he was taking off his shoes and running to his bedroom door saying "Nap! Nap!" Holy Jeebus - he's never requested sleep! So, I had him in bed, re-told the harrowing story of the Little Pigs again ...

Quick Aside: Why do classic children's tales have to be re-written? In this book Kole has, and there's no telling who gave it to us, or which garage sale we bought it from, there's no more wolf-to-pig banter of "Little pigs little pigs - let me come in! ... (pig) Not by the hair of my chinny-chin-chin ... (wolf) then I'll huff, and I'll puff, and I'll blow your house in!" Was that deemed racist or sexist or insensitive to Muslims or Eskimos or transvestites? It's a classic passage that kids like me save to memory.The story now - or at least in the book Kole has - the wolf walks up and says "Let me in or I'll blow your house to smithereens!" The pig has no quick-witted retort, and in the next paragraph the wolf blows the first two houses to smithereens. I can't for the life of me think of why those passages needed changing - and for some other reason, it's obviously still bothering me!

... so anyway, the boy was down and asleep after a good day with Paw Paw and Gram. I called Kathy and Karissa had been asleep basically since I left. Things are looking up, and as long as the tests are negative in the morning we'll have our little girl back home where she belongs.

You Just Never Know What May Come Next

Today Karissa went in for what was to be a regularly-scheduled doctor's visit with Dr. Hampton - her pediatrician. Kathy's mom joined her on the way up there and I went to work. It was all supposed to be fairly routine for an exam and a vaccine shot or two. She weighed in a 7 lbs, 6 oz.
Then Kathy called me at 10:37am to tell me that they checked Karissa's temperature (at Kathy's request) and discovered that she had a fever of 101.2, at which point the staff informed her that when a newborn that young (4 weeks or younger) has a temperature over 100.4, it crosses some magical threshold to where the baby needs to be brought to a children's hospital for further tests and observation. It was not a suggestion. Kathy knows Ft. Worth better than Dallas, so she picked Cook Children's Hospital in Cowtown. Boom. It happened that fast. It's a call I wasn't counting on taking - Kathy in a faint and quivery voice telling me that Karissa has been ordered to go to a hospital.

When a newborn is that young, the internal system isn't advanced enough and there is a potential for something bacterial in the bloodstream to reach the brain. So, this was merely to see if Karissa had anything bacterial or if it was just a simple virus that caused her fever to rise. I know I've been hacking and sneezing around the house lately from allergies; Kathy has had her own illnesses here and there related to the pregnancy and breastfeeding; and Kole after he wakes up in the morning or from a nap frequently coughs like a 2-pack-a-day smoker, and of course he will sometimes cough 10 inches from where Karissa is laying without covering his mouth. So, we're all suspect for giving her something.

Our little princess was given a spinal tap, had an IV in one arm and had blood taken from the other. She was a little trooper, calming soon after the pierce of the needle. Being a children's hospital they know a fair amount of tricks - and for a baby Karissa's age and size the trick is to dip a pacifier into a sugary liquid, then as the needles make their entrance the baby is feverishly sucking away. Karissa was doing so and survived the poking well enough. They immediately gave her Tylenol and an antibiotic and her temperature was back normal in no time. Basically, from the spinal and blood work, they'll be tested for bacteria. I don't know the exact chemistry of it all, but I guess from what they tell us samples need to sit in a petri dish for 24-48 hours to culture and see what bacteria, if any, is evident.

Kole and I went up this afternoon, and as much as I want to play down the urgency of Karissa being hospitalized - and how indeed it is precautionary - nothing could have prepared me for the site of my little 2-week old angel with a bandaged right arm where her IV was placed, plus with other wires coming from her - though those were simply adhered to her skin to keep her heart rate. All this not even 12 hours after I sat on the sofa feeding her a bottle at 7:15 this morning.

I held her and tried to keep myself together since Joan was in the room, but did find myself ducking behind the bassinet as a shield to have a quick moment with my girl and a quick and stern chat with God and to let my eyes drain a bit. After about 10 minutes everything didn't seem so bad, especially after getting the update from the nurse that Karissa was doing as well as she could and was essentially healthy - but was just spending the night while waiting for tests.

Kathy gets Mom of the Week honors for basically catching this on her own. She was at Dr. Hampton's for the regularly scheduled appointment and had to suggest to the nurse that they take Karissa's temperature. She told them that she felt hot - maybe just from being over-clothed, or something, but she definitely felt hot to her. The nurse didn't say "No", but said something that tried to explain away why she may have felt hot. Kathy wasn't fist-pounding persistent but did follow by saying something else before the nurse finally appeased Kathy by taking the baby's temperature. When they discovered Karissa's fever, surprising even themselves, they credited Kathy's "mother's intuition".