The 4th of July weekend was a busy one for us. I worked Saturday and Monday, days I could have had off, to help get a friend’s house ready for him to move in. Sunday was a whirlwind of fun, fellowship, and business. I spent a lot of the day playing volleyball. Nathan bounced between aunts, uncles, grandparents, his mother, and good friends. Understandably by the end of the day he was exhausted and emotional. We chalked it up to the busyness, the potluck food, and the liberal amounts of root beer lovingly administered by uncles and friends. He slept the whole way home, and all the way to his bed, for which we were grateful.

Around 3:30 Monday he came into our room crying (our rooms adjoin). Before we could get to him he was on his hands and knees vomiting and filling his diaper with diarrhea. By later in the morning he had blood in his diarrhea. He felt well enough to play some, however.

Tuesday he was very listless and vomiting more, but the diarrhea appeared to have stopped. Tuesday afternoon it returned, and so we took Nathan to the closest ER, which was a small hospital in Bolivar. They gave him an IV, took his blood, and then admitted us, because the staff pediatrician was not on call until 7:30 the next morning. When she came in she did more blood tests (more blood tests quickly became a trend), because she didn’t like what she saw. She told us she was afraid Nathan had Hemolytic Uremic Syndrome (HUS). The tests showed the levels of certain chemicals controlled by the kidneys, so if there was a trend of those chemicals not going the right direction, he probably had it.

[HUS is a clinically diagnosed disorder, meaning that they look at over-all symptoms and circumstances for diagnoses. The two big chemicals they monitor are Creatinine and BUN. The kidneys manage the levels of them, and when they get too high they do a lot of damage to the kidneys. The basic explanation of HUS is that a bacteria attacks the body, and the process of fighting the bacteria puts too much stress on the kidneys and they begin to shut down. A majority of HUS cases are caused by E Coli. Nathan's was not. We may never know what initially caused this for him. The treatment is essentially to help the kidneys do their job so the body can spend it's energy fixing the kidneys. If small measures don't work, Dialysis usually does. If it is caught early enough, usually there is no lasting damage to the kidneys.]

Since Bolivar was not equipped to do anything further in our care, we were sent via ambulance to St. John’s, where we had excellent care and were given lots of information on HUS. Dr. Downs, who was in charge of Nathan’s care at St. John’s, continued to monitor his blood levels, and warned us of the possibility of transferring for dialysis, since St. John’s is not equipped to do pediatric dialysis. Thursday night we were transferred to Columbia in case Nathan ended up needing dialysis. His levels had made two jumps in the wrong direction, so we anticipated that it would be likely.

Nathan and Natalie arrived at Columbia around 1AM, and Miriam and I arrived shortly after. We had a fairly uneventful but mostly sleepless (for adults) night. Thursday Nathan’s levels were closely monitored, and a catheter was inserted. Although his levels of Creatinine and BUN did get higher they did not take a big leap. His potassium was still too high, and he was given a medication to help him eliminate that. The decision was made that we would plan on putting in a peritoneal dialysis catheter in Friday morning, and put in a central line as well (which will be used for blood draws, etc, and prevent him from getting even more needle pokes).

The surgery went well, and pretty soon they hooked up to dialysis. Peritoneal dialysis pumps a liquid into his belly, which absorbs toxins via some sort of osmosis, and then pumps it back out. Then it does it again, and keeps pumping and absorbing, and draining, until they decide he’s better.

Nathan was understandably tired Saturday, but he really enjoyed seeing a bunch of his aunts and uncles and both grandpas who all drove up to see him. Jedediah got his first giggle out him since the whole things started. Sunday showed huge improvements in energy, alertness, and attitude. He smiled, giggled, and ate more than he had all week.

Whenever he’s been awake he seems to try to hold onto anything that’s familiar. When his uncles were here he couldn’t stop repeating their names and telling them hi. He is constantly greeting us and Miriam by name, even when we have just been sitting here not moving.

His blood tests have begun coming back with minor improvements. This is of course a huge improvement to us, because they aren’t drastic declines anymore. We don’t know how long it will take for him to get better enough for them to send us home. Some patients make fairly quick recoveries, and some take a while. But overall the prognosis is hopeful. Once his incisions from the surgery heal some more, and if he continues to improve, they will move us out of the ICU in a day or two. The main advantage to that will be comfort, because the ICU has very small rooms.

Through all of this our faith has been challenged, stretched, and grown. But God has been faithful and carried us through. Things we feared have been helps. Our families, church, and friends have come through in unbelievable ways. But mostly, God has given us peace and hope. This hasn’t been easy, but God is good and is carrying us through.