25. My Blood

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Maggie fell asleep the moment she returned from her test. Josh and Debby were concerned. She hadn't napped since she was five and had just come to live with Josh. When she was still so undernourished and building energy. But by the time she turned six, she wasn't napping anymore, and was as active as any regular six-year-old.

Over the past couple of days, she just had no energy. It wasn't surprising. She wasn't eating. No food, no energy. Debby and Josh had discussed with the doctor about somehow force feeding her. There had to be a way.

They'd tried smoothies, they'd tried meal replacement drinks like Boost, they'd tried soups. Even clear ones. Maggie wouldn't take anything by mouth. Occasionally she might take a small sip of water, but a whole cup could last the whole day with plenty left over.

Something was happening to Maggie that just seemed completely inexplicable. The CT scan came back clear. Completely. There was basically nothing in Maggie's stomach or intestines.

"I'd like to do an endoscopy and colonoscopy," the doctor said. "I'd like to see if we're missing something we can see visually. Normally I'd have to have you give her a prep, but there's nothing in there to clear out."

Josh and Debby agreed. Of course they agreed. Anything to try to explain what was happening to Maggie.

Meanwhile, Maggie lay on her bed, her eyes half open, sunken into her thin face. She was pale, almost grey. Josh and Debby would lie with her and talk with her. She barely had the energy to talk. Even breathing was tiring her out. A heart monitor and an oxygen saturation monitor had been added to the equipment around Maggie. She had nasal cannula in her nose.

None of the tests showed anything abnormal. The doctor decided to place a nasogastric tube to get a nutritional formula into Maggie. She barely whimpered as they fed the tube into her stomach.  The first bag of formula was hooked up and set. The weak fight she'd put up against the tube had exhausted what little energy Maggie had and she had fallen asleep.

While Maggie slept, Josh and Debby silently cried, both still on the bed, flanking their daughter. She took up so little of the bed. The equipment monitoring her took up more room than she did. And still left room to spare.

"We love you so much, Bug," Debby said. "We love you so, so much. You need to know how much we love you."

Tears rolled down both their faces. Josh kissed Maggie's head. The parents' intertwined arms were Maggie's pillow.

"Maggie May," Josh sobbed. "Mama and I love you so so much. We want you to keep fighting, but, Baby, if it's too hard, it's okay. You can rest my beautiful girl. My little Peanut. My Maggie May. My Bug.  My Magnolia."

Both Debby and Josh cried. Both fell asleep from pure exhaustion.

They were awakened by Maggie writhing and moaning. Sure she was having a nightmare, Debby gently shook Maggie.

"Wake up, Bug. It's okay, you're okay. You're safe sweet girl," Debby said, reciting her usual mantra when Maggie had a nightmare.

Maggie's face contorted into a mask of pain

"MAMA!" Maggie screamed. "It hurts, Mama! It hurts!"

Josh hopped off the bed and ran out of the room to get a nurse.

"What hurts, Bug?" Debby asked, crying. "Maggie, Bug, what hurts?"

"My tummy!  My tummy hurts! MAMA!" Maggie screamed and sobbed.

The nurse came running in.

"I've called the doctor and the on call doctor is coming," she said before turning her attention to Maggie. "Maggie, sweetie, what's the matter! Where does your tummy hurt?"

"All over!" Maggie wailed.

"Can you lie on your back? So I can feel your tummy?"

"No!" Maggie screamed. "No! My tummy will hurt more!"

The nurse looked at Josh and Debby, who had no idea what to do.

They tried to coax Maggie onto her back and were somewhat successful. The nurse pulled up Maggie's shirt a little and they saw Maggie's stomach was protruding.  It didn't look right.

"That..." the nurse said. "The formula should be absorbed into her intestines almost immediately."

The nurse immediately turned off the pump feeding Maggie and unhooked it from the tube hanging from her nose. Maggie was still crying and screaming in pain.

The on-call doctor rushed into the room and asked the nurse to fill him in, and while she did that, he looked over at Maggie and smiled. Maggie tried to smile back while her breath was hitching from crying.

"I know the nurse just poked at your tummy," the doctor said to Maggie, after introducing himself as Dr. Berger. 'Like a hamburger, but spelled a bit different' he joked. "But I need to take a quick look, too, okay?"

Maggie renewed her screaming and crying.

"No!  It hurts!" She wailed.

"I know sweet girl," the doctor said. "I'm going to try not to touch too much, okay? I mostly want to look. But I might have to poke a little. I'll be as gentle as I can be. I promise. And if I'm not, you can kick me in the shins, okay?"

Maggie giggled just the slightest. With some help, she lay on her back some, and let the doctor examine her.

"Maggie, does it hurt more if I gently poke here," he poked her right side. "Or here?"

Maggie cried out when he poked the left side. The doctor frowned.

"Well, it's not her appendix on top of ... this," he said. Just then, Maggie sat up suddenly, hitched a breath and then threw up. The nurse rushed for the basin in the bathroom as Maggie continued throwing up. She was crying while she threw up. When she seemed to be finished, Maggie fell back on her pillow and fell asleep. Her stomach was back to a more normal size. The nurse estimated Maggie had thrown up the entirety of the feed she'd had thus far.

The on-call doctor signed off on stopping the feed. He thought Maggie might need a feeding tube inserted directly into her small intestine in order to feed nutrients and fats more directly into her bloodstream. He would consult Maggie's doctor when he came in and while the two of them would probably agree, Maggie wasn't Dr. Berger's patient and the surgery wasn't something that couldn't wait a few hours.

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