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Views: 1121 Created: 2020.04.30 Updated: 2020.04.30

Ages and Stages - A Continuation

Ages and Stages - Part 23

Ages and Stages - Part 23

POSTED 04-30-2020

As Karen approached the MRI waiting room, she was met by Doctor Fayette Baron. "Mrs. Matthews, I need to speak to you for a moment," she said, in a tone instilling urgency, yet not particularly alarming.

"Yes," Karen answered, "what do you need?"

"I am Dr. Baron," the rather petite woman introduced herself. "I have been made aware that when the MRI was ordered, the nurse seemed to skip over the authorization for contrast media. I really need to get a better look at exactly what is going on in your little boy, and using contrast would be quite beneficial. Please look this over and if you have any questions, please ask."

Karen took the sheet form Dr. Baron's hand, and glancing it over, asked, "Are any of the side-effects dangerous?"

"All drugs hold a potential for side-effects; from the very mild, nearly undetectable ones, to the rarely occurring life-threatening side-effects. This contrast has been tested, and used for years, with very little reaction. I would have no reservation in using them on my own child, but the decision is yours."

Glancing over the sheet one last time, Karen accepted the pen Dr. Baron held out to her, and signed the order. Dr. Baron practically grabbed the paper form Karen's hand and rushed back into the MRI room.

Time passes slowly when waiting for word on one you love. It seemed to drag on forever as Karen tried to busy herself by thumbing through a few parenting magazines from the end table. Karen found a an interesting article about diapering and potty training the older child, followed with an article in the next issue dealing with extended nursing. She was intrigued by the mention of children being nursed up to elementary school and some comments from one woman in England who is still nursing her daughter at age ten, and plans to continue until puberty. There was a brief mention of a mother in the Netherlands who nursed her son up to the age of thirteen. One of the doctors in the article dismissed this practice as too extreme, yet his colleague wrote that this was perfectly fine as long as both mother and child found the arrangement agreeable.

Nearly two hours after meeting Dr. Baron, she returned to the waiting room. "Mrs. Matthews, I'm sorry for the delay. You may go in to see Johnny for a few minutes. I think he could use your assistance. Then Dr. Jaromir Krijnen would like to consult with you for a few minutes."

Karen entered the MRI area, and as she approached John, she was met by a somewhat foul, yet strangely sweet smell. John had filled his diaper with his inveterately large morning bowel movement. One of the nurses directed her over to a padded side table, where she could change his dirty diaper. As she laid John on the table, she noticed his somewhat listless state. She surmised that this was probably due to the mixture of Benadryl, Versed, and the contrast. As she pulled the tapes and pulled open the diaper, she was greeted with a much stronger odor, and an ungodly mess. The poop covered his entire backside, and had worked its way between his legs, and now totally encased his scrotum and penis in what appeared to be a thick brown paste resembling fudge frosting, without its tasty appeal!

John weakly whined, "I'm thirsty." Karen reached into her diaper bag and pulled out a baby bottle of the Miralax and formula mixture. As John nursed at the nipple, Karen happily went about the task. She used several baby wipes to clean the boy's bottom and especially his scrotum and penis. She pulled out a fresh Pampers 7 and placed it under him. After a light coating of Desitin and baby powder, she taped up his diaper. She heard footsteps approaching and looked up in their direction.

Karen saw Dr. Baron with a tall man in a lab coat. "This is Dr. Krijnen," Dr. Baron said.

"Hello, Mrs. Matthews," he said with a very heavy Dutch accent. "I would like to speak with you, privately, for a moment. Dr. Baron, could you ask one of the nurses to watch Johnny for a minute while we speak?"

"Certainly, Dr. Krijnen," she answered, as the male doctor lead Karen into a side conference room.

"Mrs. Matthews, I am not one for small talk or painting rosie the news," he said in his broken english. "What we have have is a rare situation. I would like your permission to do a biopsy of your son's left testicle. We have seen nodules, many. Nodules... like seeds... on his testicles. Particularly on the left one. We need to test this for cancer."

Karen's mouth dropped open. She had heard of testicular cancer, but that was a disease for old men. "I thought only old men got that!"

"It is not the same testicular cancer found in the mature or elderly. It is something different. It certainly is not a death sentence! It may be nothing. However, I cannot risk that. I need to do the biopsy, NOW!" he insisted, as he shoved papers toward her.

Karen was a zombie. It was like a dream, a very bad dream. He handed her the papers and she signed. "Is this where you stick in a needle and remove the mass?" Karen asked.

"No... It's a little more complex," He answered. "We need to remove a few nodules surgically. Each one is approximately the size of a large grain of rice. We don't want to risk breaking one open, just in case they contain some nasty carcinogens." More papers and she signed again. "We will open the scrotum on the left side. The incision will be very small and barely noticeable after it heals. We will expose the testicle and very delicately remove a few of the nodules. These will be sent to the lab upstairs, and we will have to wait for their appraisal before we proceed."

"What do you mean by proceed?" she asked.

"If the report comes back negative, which means its a good thing, we will close the surgical wound, and he will heal up in a few days. It's a very small incision," Dr. Krijnen explained.

"And what if it's not-so-good?" Karen asked, choking back tears.

"Worst case scenario would be if we may have to remove the whole left testicle. IT would depend on the make-up of the nodules and the infiltration. "Even with our modern technology, an MRI is not flawless," he explained. "The display would indicate that the testicle is nearly fully engulfed in these nodules... but it could be shadows or artifacts in the MRI." Karen just sat there and nodded her approval to the procedure.

"When can you..." Karen asked.

"Right after lunch. I attempted to call together a surgical team. We are fortunate, by God's grace; the team is doing a testicular removal right now in the OR in the next building. As soon as they finish that procedure, and get something to eat, we will start John's procedure. Probably about 1330 local time... sorry, I mean 1:30 PM."

Karen returned to the boy, who was now sleeping on the table. "Mommy is right here, baby," she whispered to him. The orderlies came in a few minutes later and transferred John to a gurney, and with Karen in tow, they whisked him down the corridor and through the bridge to the next building. As they prepped John for surgery, one of the older nurses led Karen to the cafeteria.

"You get something to eat," she nearly ordered Karen.

"I'm really not hungry. I just want to be with my baby." Karen insisted.

"Nothing is going to happen for a while, the surgical team is all at lunch right now. They need nourishment to take proper care of your baby, and so do you!"

Ages and Stages - Part 23

POSTED 04-30-2020

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