Once You Get On, You Can’t Get Off

Ilias developed a fever in the small hours of Tuesday morning. It was oscillating between 37.5 – 38.75°C, so we called the doctor’s post (our own doctor is on holiday) and agreed to bring Ilias in for a check-up. You can’t be too careful with such a young baby.

The doctor examined him, then told us he saw nothing untoward. We should keep an eye on him and make sure that he stayed hydrated. We agreed to call the next day with a status update.

Wednesday morning, Ilias’ fever was subsiding. It was below 38°C and steadily dropping by the hour. Good news, we thought; he was on the mend.

We called the doctor, as arranged, and gave him our update. He asked us to bring in a sample of pee, so that he could test it. Ilias wasn’t required to attend.

I biked the bottle of pee over to his surgery at 11:30 and noted that it was cloudy. The doctor made the same observation, then ran a test on it and informed me that there was a possibility that Ilias had somehow sustained a urinary tract infection. He made an appointment for Ilias with a paediatrician at the VU Medisch Centrum for the same afternoon.

The doctor’s manner as he wrote out the referral for Ilias was laconic, so I thought we were going to the hospital for what amounted to a second opinion. I expected the paediatrician there to look at the temperature chart we’d been keeping, see that things were quickly returning to normal, and send us home with the advice to keep an eye on things for a couple of days.

That’s what we expected. Here’s what actually happened.

After arriving at the hospital and registering Ilias as a first-time patient, we reported to the Paediatrics department, where we had the appointment. We were soon ushered into a room, where a female doctor joined us shortly afterwards.

This doctor informed us that she wanted to insert a catheter into Ilias’ tiny penis in order to extract some pee for a urine test. This was an unwelcome opening salvo and quite unnecessary as far as we were concerned. Fuck that!

We told her that Ilias can pee on command, which is true. We hiss in his ear and he starts to pee. You can scoff, but it has to be seen to be believed. He does this reliably.

Unfortunately, the doctor then partially undressed him to examine him with a stethoscope, causing him to pee a large amount into his nappy. This left him with nothing left to pee for the sample.

We continued to protest against the idea of a catheter and managed to buy ourselves some time with the jar of pee we had brought with us. The doctor was first afraid that the jar wouldn’t have been sterile when we used it, but we explained that it had been cleaned with boiling water and this was then deemed acceptable.

We were soon joined by a nurse, another doctor and a woman whose job it was to draw blood. Each began to chip in with observations and advice. The pressure on us was quickly ratcheted up and an obvious, concerted effort was being made to make us succumb to the will of the white coats.

The precise chronology of events becomes a blur at this point, because things suddenly started to move very quickly.

In my recollection, a couple of very awkward, painful and extremely stressful attempts at drawing blood came next. Ilias screamed and squealed like a piglet as the needle was pushed into his tiny vein.

After what seemed like an eternity, blood was extracted, the ordeal finally ended and we were sent to another building, accompanied by the nurse, to await an ultrasound scan of Ilias’ nether regions.

That was a relatively relaxed affair, by comparison, but turned up a slight thickening somewhere near the renal pelvis.

Back on the other side of the hospital, we were confronted with the blood and urine test results, which, together with the ultrasound, all confirmed the diagnosis of a suspected urinary tract infection. We were informed that the hospital wished to admit Ilias and immediately begin administering a course of antibiotics.

At that point, things started to take on a surreal element, as we found ourselves participating in what felt like a theatrical production with us cast involuntarily in the leading roles.

A heated discussion ensued. We stressed that Ilias’ fever was dissipating and explained our stance on antibiotics, namely that they wreak havoc on intestinal flora, particularly in such a young child, and are an absolute last resort, as far as we’re concerned.

After being given some time alone to consider our options, we were interrupted and politely but firmly informed that we actually had no options, so we may as well acquiesce and expedite the proceedings. We sought clarification, just to be sure there was no misunderstanding, but we had correctly understood their meaning. If we refused treatment for Ilias, steps would be taken to have our parental authority revoked, so that he could be treated regardless. Visions of being restrained by security guards or police officers began to flash in front of my eyes. I suddenly felt as if I was playing the role of a Jehovah’s Witness in some bad movie.

At this point, it dawned on me that they thought Ilias might actually be going to die. When I said as much, the language the doctors’ used became steadily less flowery until they admitted in no uncertain terms that, yes, he might die if we didn’t act soon.

It was a lot to take on board. After all, just a couple of hours previous, we had been of the opinion that our son was shaking off the remnants of a two day fever and was almost back to normal. His behaviour was that of a healthy baby. It was rather hard to accept from the assembled group of people that he was actually so direly in need of treatment that a court order might be necessary in order to guarantee that he receive it.

Fast-forwarding somewhat, we consented to the treatment, which was to have been my decision anyway, irrespective of the duress. Sarah strongly felt that she had been pressurised into the decision, which she had, but I was too alarmed and afraid by then to feel much indignation. I just wanted my son to remain alive.

Multiple failed and very painful attempts were made at putting in an infusion needle, but they just couldn’t tap into one of Ilias’ minuscule veins. He screamed and writhed in pain at each intrusion of the needle into his tender young flesh. It was absolutely fucking heartbreaking to listen to his helpless, tortured squeals. Every nerve in my body was telling me, as his parent, to get up, kick the shit out of these fuckers and end his torment there and then.

Cutting a long story short — I need to sleep — Ilias has been admitted to hospital and now has an infusion needle in his scalp, after the previous line in his foot also failed following a single infusion. He is being given an infusion of wide-spectrum antibiotics three times a day.

Sarah is with him 24 hours a day and he — and thus she, too — is expected to remain in hospital for at least a week.

Today (Thursday), Ilias no longer has a fever and appears to be a perfectly fit, healthy baby. From the doctors’ point of view, though, they got to him early and he is responding to the treatment.

It will be a few days before the blood culture reveals which bacteria are present in his blood. At that point, they’ll know whether he has been on the most effective course of antibiotics, or whether they’ll need to start him on a new course of more directed medicine. Some antibiotics can be administered orally, others have to be given intravenously; so, depending on how well chosen the current drugs are, and whether or not any new antibiotics to be taken a few days from now can be given orally or not, the duration of Ilias’ stay in the hospital will be determined in due course.

That still leaves the question of how he developed this infection in the first place. No anatomical abnormalities were found during the ultrasound, but a close inspection of his valves has not yet been conducted. It could be that one of these valves is leaking fluid in the wrong direction. Equally, it could simply be a case of extraordinarily bad luck, with a fleck of faeces having found its way into Ilias’s urethra, possibly via a particularly full nappy.

There are tests that can be done to determine the presence of faulty valves, but these haven’t yet really been discussed. It’s still early days.

Eloïse and Lucas have spent their first night without their mother, which, all things considering, went very well. The whole family, including Sarah’s mum and dad, visited Ilias and Sarah in hospital today. Naturally, that’s a trip we’ll be making every day until we can bring them home.

I’ve left out a lot of detail from this story, but with a wife and mother in hospital and two children to care for at home, there aren’t enough hours in the day at the moment.

I’m keeping an album with photos of Ilias’s stay in the hospital. The photos don’t make for very pleasant viewing.

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Which would you rather have? A root canal that lasts for three hours or your in-laws coming to stay with you for three weeks?

I’m lucky enough that I get to have both: the root canal yesterday, the in-laws’ arrival tomorrow.

On a more positive note, I don’t have cancer (as far as I know).

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Road Test

Ilias had his first bath on Thursday. Newborns have a uniquely lovely smell, a scent that supposedly aids bonding, so we like to let it sit for a week or so after birth. He was looking a bit flaky, though, so we decided it was time for a bath to spruce him up a bit.

He wasn’t terribly impressed with the baby bath, but a couple of days later, Sarah put him in the shower sling and took him under the shower with her. He seemed to really like that and didn’t mind the water spraying all over him.

Today, we took the children in the car and went to the Amsterdamse Bos, more specifically the goat farm there. This was an important confirmation of the new car’s ability to seat the three children in a row with with plenty of room to spare. Lucas and Ilias were in ISOFIX child seats, with Eloïse seated on one of the collapsible booster seats that we had built into the outer seats of the second row.

The real test, however, was for Ilias. How would he cope with being driven in the car? Neither Eloïse or Lucas had enjoyed their first journey, that’s for sure. Even now, it’s always touch and go whether Lucas will manage to keep the contents of his stomach on the inside.

Well, I’m pleased to say that Ilias currently leads the board in the easy car baby stakes. He didn’t wince, either on the way there or on the way back. Perhaps he was too distracted by his big brother and sister staring at him (at this young age, he faces backwards in his car seat).

Before we went out, I managed to catch some nice shots of Ilias sleeping.

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Einde Kraamtijd

If I were writing this blog solely for other people, now would be a good, if somewhat belated moment to discontinue it. I don’t think anyone reads it any more.

If you think I should abandon this blog, just let me know. Or rather, don’t, because you’re not reading it, anyway. Just fail to comment and I’ll figure out on my own that I should be spending my time more usefully.

Anyway, to the business at hand…

Ilias is now just over a week old. He’s made his inaugural trip to Bagels & Beans, twice in fact, but slept through the experience both times. For Sarah, too, it was the first time outside the door in a week. I’m sure that felt good.

Ilias lost his umbilical cord after just three or four days. It dried up and dropped off as expected. I’m always glad to see that shrivelled black thing snap off.

Sarah’s mum is struggling somewhat with Ilias’s name(s). It’s a grandparent’s prerogative, I suppose. Apparently, Sarah’s brother is planning to call his next child Hawk, Hawkin or something like that. I think that’s the greater challenge, personally. Ours names are much better, but then I would say that, wouldn’t I?

Laura, our midwife, came here yesterday for a final visit. She brought with her a dried placental membrane, which she has framed for us with a handwritten account of the birth. It’s an instant heirloom and something already very special to me.

It was also Grietje’s last day today. Woe is us, now our maternity nurse has gone. It has been a pleasure to have Grietje around and the children were, by now, very accustomed to her presence. She will be missed. It’s all down to us now, as our routine reverts to something resembling the pre-Ilias era.

Ilias underwent his hearing test yesterday, which he passed without difficulty. He also had blood extracted from his heel to be tested for various diseases.

His weight has almost returned to that of his birth. Some loss in the first week is completely normal and he should grow beyond his birth weight in the next couple of days.

Ilias now has his own vanity domain, iliasm.net, to match Eloïse’s, eloisem.net and Lucas’s, lucasm.net. Overkill, perhaps, but they may prove useful one day. In fact, I’m certain they will.

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Ilias Eoin Linus Xavier Macdonald

Our difficulties with choosing names for our children are well documented. If reading that gives you a sense of déjà vu, that’s hardly surprising, because they’re actually really well documented.

This was almost the hardest decision we’ve ever had to make, to my mind surpassed only by the deliberations that surrounded deciding whether or not to buy our current home a few years ago.

We’ve had a good idea what the baby’s first name would be for several months, regardless of a male or female outcome, but the cerebration regarding the other names continued through the weekend, the result of which was that one final change was instituted late yesterday afternoon. For us, girls are easier to name than boys. We don’t really understand why that is so, but it’s definitely true for both Sarah and myself. As such, we had quite a firm idea of the additional names we would bestow on a girl, whereas our options for a boy were much more provisional.

When Sarah and I awoke this morning, we had no further doubts and thus knew that we had finally arrived at our new son’s name.

The Dutch sun must have been waiting for August, because the transition from July has seen the weather here dramatically improve. Today is a beautiful, sunny day.

Once I’d seen to the morning’s immediate chores, I biked over to the stadsdeelkantoor on the President Kennedylaan and registered the birth of our latest offspring. Today is the our final day to do so without risking the wrath of the Dutch bureaucratic hydra, so I wanted to be there well before closing time. It was very busy, probably because a lot of their staff are now away on their holidays.

Whereas Lucas was given a hooded bath towel for the achievement of being born, Ilias’s gift was a cuddly toy in the same I Amsterdam theme. The gift was accompanied by a card emblazoned with the message Welkom nieuwe Amsterdammer! (Welcome, new Amsterdammer!). The text on the other side, loosely translated, reads:

Dear parent,

The city has gained a new Amsterdammer! Congratulations on the birth of your child. And with this birth gift, I would like to welcome your child to our city.

Amsterdam is a vivacious, idiosyncratic and colourful city. We feel it’s important that your child grows up healthy and makes use of the facilities that the city has to offer, playing with friends, actively participating at school, taking part in sports, dancing or making music. Together with you, we’ll work to make this happen.

I wish you and your child a bright future,

The mayor of Amsterdam
Eberhard van de Laan

It’s the little things in life that count, don’t you think? I think it’s a nice touch that new babies (and their parents) are welcomed to the city in this way. It promotes a sense of belonging.

The outside of the house is decorated with blue streamers and a couple of large plastic storks, so no-one in the neighbourhood can be in any doubt that our family has gained a new member. Most people are probably on holiday, anyway.

I took care of Ilias’s health insurance this afternoon, adding him to our family’s policy. Hopefully he won’t be causing me to make any claims on it for the foreseeable future, but it’s good to take care of such details as soon as possible.

Time, now, to turn my attention to more photos. Yesterday’s photos are already on-line.

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