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From Kelly 3:
Kelly was taken to OR where her arms and legs were set in plaster. Thomas had also been taken through the OR as he had a broken wrist. When Kelly woke from the anaesthetic, she was back in the children's orthopedic ward in the same bed as she'd been in such a short time before. She could feel the wet diapers around her bottom and realised where she was.
Now read on!
Kelly was still drowsy from the anesthetic, but gradually became more aware. She realised that the drips going into her were not in a vein in her arm this time. The drip tubes went into the top of her hospital gown and disappeared. When two nurses came to change her, she asked about this. One said to her, "Kelly, now you're more awake, I think it's time to explain some things to you. You know you've broken both legs and both arms after the automobile hit you. I'm afraid to say that you also have another problem. Last time, you had what are called 'closed fractures' - that means that the bone didn't break through the skin. This time, the automobile hit you so hard that the bones of your leg punctured the skin of your legs and stuck out." Kelly made an noise probably best translated as "Euwwgh!" The nurse smiled at her, "I can understand your reaction. No, it isn't a nice thought. But there is a problem. With 'open fractures', like your legs, there is a risk of infection so we've got you on antibiotics to try to fight that, but, if there is an infection in the ends of your bones, even though the doctors cleaned them carefully in the OR, you may be on antibiotics for a long time and the infection, if you get one, will stop your bones in your leg from healing properly. Now we hope that won't happen, but the doctors put a special line into your chest so we can give you antibiotics just in case you might have an infection and, because the line is a special one, we won't need to keep stabbing you to put new lines into your feet. Last time, because both arms and one leg were broken, we had to use your good foot for lines, but as both legs are broken, we didn't have any choice: we could either have put a line in your neck or the special line in your chest, so for several reasons, you have the chest line. It's called a Hickmann Line. We'll need to change the dressing every week, but won't need to flush it as the doctor has ordered saline and the antibiotics through one of the two ports and the other has pain relief drugs as your legs would really hurt you otherwise. You may be feeling rather drowsy still and that's probably due to the drugs for your pain. Is that all right, Kelly?"
"Thank you, nurse, I think I understand. What you're saying is I'm probably here for some time."
"I'm afraid so," came the nurse's sympathetic reply.
Kelly settled back to just wetting her diapers whenever she felt any pressure from her bladder as she'd done when in the ward the last time. She was surprised how easy it was to slip back into not bothering to hold back at all. Her head was really full of cotton wool and she found herself drifting off to sleep so easily. Her parents came to visit her the next day with Karen and Tom, who'd only been kept in overnight to his disgust. He'd liked being diapered by the nurses and was jealous of Kelly getting such lovely attention. Kelly found that she kept drifting off to sleep while they were there. The drugs she was given for the pain worked as she was aware of just a dull ache from her legs particularly and a milder sensation from her broken arms. Kelly's mom went to speak to one of the nurses who came back to take Kelly's temperature. Kelly's mom was worried because Kelly's face looked flushed and she felt hot to the touch. When Kelly saw the nurse coming with the 'in the ear' thermometer, she turned her head automatically to one side to allow the nurse to slip the probe into her ear canal to record her temperature. The nurse read the digital read-out and whispered to her parents, "You're right, her temperature is up. I'm going to call the doctor."
Suddenly, Kelly's body started shaking as if she were violently shivering from being cold. The nurse said, "Oh dear! That looks like rigor - I'll get the doctor now!" The on-call doctor came within minutes. She looked at Kelly, turned to the nurse and said, "I'll arrange for her transfer immediately to pediatric ICU. You're right, nurse, she's got septicemia." She went away to make the necessary calls as Kelly's parents sat there in horror. The doctor came back to speak to them, "What's happened is that Kelly has osteomyelitis - a bone infection - from the dirt which got into the open ends of the bone when she had her accident. This has spread to her blood stream and caused septicemia. I'll not pretend, this is very serious and Kelly could die from this. I need you to know that as you'll be allowed to stay with her while she's in intensive care. We'll give her more antibiotics and hope that we've got to the infection in time. I must warn you she won't be well at all but we'll do our best." Kelly's mom just burst into tears. Her dad felt like crying too as they loved all of their children dearly.
Kelly was taken to pediatric intensive care where she was sedated and an endo-tracheal tube was passed down her throat so that the nurses could control her respiration. her diapers were removed and a urinary catheter inserted connected to a monitored drainage bag so that the nurses could check her hourly urine output in case of renal failure. Her plaster cast on one arm was cut away so that an arterial line could be inserted into her radial vein at her wrist to monitor her blood pressure. Electrodes were placed on her chest to monitor heart function. Kelly's dad was in tears by now as his beloved daughter was hooked up to all the equipment. Being sedated, she was lying there on the special air mattress so still with the respirator rising and falling as it breathed for her.
One of the intensive care doctors came to see them.
"I'm not going to pretend otherwise, but Kelly is very seriously ill. She faces all sorts of risks over the next few hours and days, but we are fighting for her. We're giving her a range of antibiotics until the blood cultures we've taken come back, but she started off a strong, healthy young lady which is very much in her favor. I can promise you, we'll do our very best for her. You can visit at any time and stay as long as you like. However, there may be times when hospital staff need to care for her and we may ask you to wait in the relatives' room for a while, but otherwise, you can be here 24/7 if you want." Kelly's mom looked up at him with tears streaming down her face, "Thank you, doctor, we know you'll look after her well."
Fortunately for Kelly, she wasn't aware of the five weeks she spent in intensive care and the tears which were shed for her. By the time she was taken off sedation and the breathing tube removed, she was very much thinner from both muscle loss and the tube feeding she'd had. She awoke to see her mom sitting beside her and tried to speak to her, but found that the tube down her throat and lack of use of her speech muscles had left her unable to do little more than croak, even though she didn't realise why she was having problems speaking: her sedation had been deep enough that she had no memory of the past weeks. Her mom reached over and hugged her, crying all the time.
"Oh Kelly, it's so good to have you back with us. You've been so poorly!" Kelly looked puzzled. She croaked her questions, "What do you mean, mom? Why am I here and not in the children's ward? Why is my voice like this?"
"Kelly, I don't know quite how to tell you, but you've been seriously ill and in pediatric intensive care for some time. You had a blood infection which made you very poorly but you're much better now." Kelly took a moment for her brain to get around this. Suddenly she croaked what she thought was the most important question in the world for her, "How long have I been here, mom?"
"Some time, I'm afraid," was her mother's answer. Kelly restated her question, louder this time, even though the effort hurt her throat, "How long, mom?" Her mother blushed and decided that Kelly was getting upset by her prevarication over telling her how long she'd been there, "It's been five week's Kelly. You've been sedated on a ventilator which is why your throat is so sore and you've been given loads of antibiotics. Fortunately, they worked and the infection is gone. You're going to be transferred back to the pediatric orthopedic ward in a few minutes, but the staff wanted to give us time to be with you now you're awake."
"Five weeks?" Kelly asked, "Five whole weeks?"
"I'm afraid so, love," her Dad said. One of us has been sitting with you day and night, hoping and praying you'd make it. Kelly burst into tears, "Thank you, both of you. I'm so sorry I've put you all through this." Kelly's mom and dad kissed her forehead and her dad said, "It wasn't your fault, Kelly, you didn't want to be ill like this. We're just so pleased you're back with us again."
Two porters and a nurse came to move Kelly through to the pediatric orthopedic ward. She was slid across from her intensive care bed onto the bed in the ward with the help of all the nurses as she was unable to move her arms and legs because of the plasters and would have been too weak anyway. As soon as she was in bed, she was covered over and the curtains drawn back to allow the bed to be taken back to pediatric ITU. The curtains were then pulled again around a trolley as two nurses came to deal with her. Her arterial line had already been removed, but she was still receiving iv. fluids through her Hickman Line.
"Kelly," one of the nurses said, "we're going to take your urinary catheter out now and put you back in diapers. All right?" Kelly was happy to be back there and in diapers and plastic pants, so mumbled her assent. The nurses pulled a disposable incontinence pad under her hips and slid the cloth diapers and drop front plastic pants under her hips ready to pull them snugly around her when the catheter was out. One nurse put on sterile gloves and took a syringe. Inserting it in the catheter balloon port, she sucked out all the water from the balloon in the Foley catheter and told Kelly to cough. As Kelly coughed, she pulled out the catheter, as Kelly gave a little gasp at the end of her cough as the catheter pulled out of her bladder and through her urethra. The nurse took away the catheter and drainage bag while the other nurse skillfully diapered her. The nurses went away to clear up and one of them came back with a bottle of water and a bib. She said to Kelly, "I suspect your mouth is really dry and you could do with a drink!"
"Yes please!" Kelly croaked back to her. The nurse tied the bib around her neck and sat on the edge of the bed to give Kelly her bottle. She sucked hungrily at the teat as the cold water was so soothing to her sore throat. The nurse had sensibly chosen a small holed teat so that, thirsty as she was, Kelly couldn't drink from the bottle too quickly.
"That's enough for now, Kelly, as you haven't been drinking and we don't want to make you sick, so I'll bring you another bottle later."
Kelly laid in bed with the soft warmth of the diapers around her hips and bottom, still with the bib round her neck. She guessed that she'd be being babied from some time and was looking forward to that! With that thought, exhausted by her transfer and all that had been done to her, she fell asleep.
She woke later to find that she was wet since she was still receiving plenty of iv. fluids to keep her hydrated and her kidneys flushed through. As she woke, she was aware of the warm trickle of urine running from her down between her legs to be soaked up by the already wet diaper. She thought to herself that it wasn't very much and a short while later, the same happened. The nurse came back with another bottle, of orange juice this time, when she saw Kelly was awake. Kelly thanked her as she was so glad of that cold liquid running down and soothing her throat.
At her next diaper change, the two nurses unpopped the plastic pants and pulled the front down between Kelly's legs. Her wet diapers were removed and she washed, dried and creamed with one nurse standing beside the bed and pulling Kelly towards her at hip and shoulders while the other creamed underneath her bottom at the areas normally in contact with the special pressure relieving air mattress. Kelly was then rolled flat onto her clean diapers. One nurse changed her gloved and lubricated a finger with KY jelly, "Kelly, I need to do an internal examination. When you were in intensive care, no one was worried about your bowels as you were too poorly to do anything about it anyway. Now we need to check before you start eating again. Is that all right?" Kelly smiled at her, "You do what you need to do. It's all right with me." The nurse gently inserted her finger into Kelly's back passage as Kelly suddenly felt a warm trickle of urine releasing and flowing over the nurse's gloved hand to run onto Kelly's buttocks.
"Sorry, nurse, I didn't do that on purpose, Kelly said, worried that she'd be told off.
"Kelly, there's something you need to know. You didn't have a very big bladder in the first place and, when you were here for so long, using your diapers as we expected you to, your bladder shrunk a bit. In intensive care, constantly drained by the catheter, it shrunk more so you really can't hold very much at all, which is why you're releasing a little and often. We did expect this, but didn't want you to worry about it until you were much better. Please, don't fret. I know you didn't do that on purpose."
"Does that mean I'll always be in diapers?"
"We don't know yet, Kelly. But if I'm being perfectly honest, the answer is 'possibly'. I'll get the doctor to come to talk to you about this as I can see you're worried by all this."
Later, one of the doctors came to talk to Kelly. She pulled the curtains around her bed and sat on the edge of the bed , smiling kindly at Kelly to reassure her. The doctor actually felt sorry for Kelly as she'd suffered so much so far and wasn't out of the woods yet.
"We expected this and will try a hydrostatic distention under general anesthetic - that means you'd be put to sleep and a catheter put into your bladder. Fluid would be run into the catheter to try to stretch your bladder to help it to hold more, and there's an operation called clam cystoplasty where some of your intestine is used to make your bladder bigger. Or there's a new method where you have a special catheter put in which has a valve which holds back your urine until a certain pressure is reached. It then releases and allows your bladder to empty. This is changed for a higher pressure one every couple of weeks to try to stretch your bladder slowly if the hydrostatic distention doesn't work. This is supposed to stretch your bladder slowly. You can use this with a leg bag to collect the urine or, for someone your age, you might prefer to stay in diapers. If we do that, you'd need to do Kegel exercises to try to get back control of your bladder muscles, but you needn't worry about that now. Just continue using your diapers as you did last time for the moment. That's what they're there for, after all!" the doctor laughed. Kelly smiled back, reassured as, at the moment, she'd rather be in diapers and being babied by the nurses.
"I'm afraid you've got hardened stool in your back passage and we need to clear that out before you start eating again, but you're used to that. You had that last time you were here, didn't you?" Kelly smiled and agreed with her.
The next day, when Kelly was feeling much more her usual self, apart from her arms and legs still in plaster, one of the nurses came to her to say that she was going to get ready for Kelly's enema. The nurse came back with another nurse and the usual trolley with diapers, plastic pants and their equipment. there was a jug on the trolley with a syringe in water on the trolley which Kelly could see.
"Any ideas what you're getting, Kelly?" one of the them asked her.
"I'd guess it'll be another oil enema to soften everything up, followed by a soap and water one to help me to get rid of it all?" was Kelly's response. The second nurse laughed, "Got it in one, Kelly. How did you guess?"
"The oil filled syringe was a big clue!" Kelly laughed.
"You're right and we'll give that time to soften your hardened stool and then a '3H' - high, hot and a hell of a lot to get rid of the oil and the stool, we hope." Kelly's plastic pants were undone and the front pulled down so that the nurses could remove the wet diapers and then wash and cream her. Fresh clean diapers were positioned under her and a lubricated gloved finger from one of the nurses dilated and lubricated her back passage. This was followed by the nozzle of the enema bottle of warmed oil . Once the nozzle was inserted as far as it would go, the nurse slowly squeezed the oil into Kelly's rectum. As soon as she'd done this and removed the nozzle, the other nurse followed up with a large butt plug with the retaining flange to sit against the outside of her anal sphincter. Kelly gasped as the large part of the plug was passed though her anus so that the slightly narrower part of the plug would be gripped by her muscles there. Her diapers were pulled up tightly between her thighs to help to hold the plug in place while the oil did its work. Her plastic pants were pulled up between her legs, over her abdomen and poppered shut. Finally, the nurse checked that all of the diapers were inside the plastic pants.
"Kelly, would you like a drink?"
"Yes, please! Could I have some cranberry juice, please?"
"Of course you can, Kelly. It's good for you anyway as it helps to prevent urinary infections."
The nurse came back with the red bottle of cranberry juice and put the bib around Kelly's neck, then gave her the bottle, talking to her as Kelly sucked thirstily at the teat. While the nurse was doing this, the doctor came to see Kelly.
"Don't stop, nurse, Kelly obviously is thirsty and it would help if you heard what I'm saying so that you can remind Kelly if she needs it. Kelly, you remember last time that you were here for some time while your bones set. I'm afraid that the infection has stopped your leg bones form healing as there was infection with both of them where the bones had burst out through the skin when the automobile hit you so hard. We've decided to leave it a while longer as the last X-ray while you were in pediatric ITU show that the bones are just beginning to set and we'd rather not have to pin or plate your legs, but you'll be here for some months yet, I think. Also, as your arms had recently been broken, we're going to leave the plaster on them for longer until we're absolutely sure that they are thoroughly healed. All right?" Kelly agreed that she understood. The nurse asked Kelly about what the doctor had said to her to check that Kelly had understood. Kelly replied, "I'm going to be lying here for a long time with these plaster casts itching like fury sometimes until I'm fully healed. You'll have to be doing everything for me for quite some time yet."
"Do you mind us washing and creaming you, changing your diapers and gibing you these enemas and laxatives which you had last time? Be honest. It helps if you can talk about it."
"No, I don't mind. You're all so kind and gentle about it. It's kind of nice not having to worry about anything and knowing I'm well cared for. I'm really grateful for all of you caring for me." The nurse laughed, "That's what we're paid for, after all."
"No, but the kindness is real. You're all so lovely to me." Thank you for that, Kelly. We all like looking after you. You don't make a fuss and you never complain. We're not supposed to have favorites, but you've become a favorite of all of us! You're always so polite to us. You should hear some of the children!"
"I do," Kelly replied.
"I think its awful the way some of the others speak to you. You're trying to help them, after all. Could you put my earphones on and turn my iPod on for me?"
"Of course! Can I do anything else for you?"
"Not at the moment, thank you. I'll just have to lie here while the enema does its work." Kelly laid there with the butt plug forcing her anal muscles apart as it held the oil in place. She was fed lunch, then the nurses came to give her the 3H enema while the curtains were drawn at the windows and the lights turned off so that the other children could have an afternoon nap.
A waterproof sheet was eased under her and covered with disposable incontinence pads. Her diapers were removed and she was washed clean and then creamed thoroughly both front and back, with two nurses rolling her on her side while the other nurse applied and rubbed in the cream. Kelly had really begun to enjoy all the care and attention she received in the hospital. Finally, well waterproofed and protected by the diaper rash cream, she was rolled back onto a thick pile of diapers. Plastic cuffs were tucked around her plaster casts in case of leaks to keep the plasters clean and dry. The nurses prepared their equipment and one of them explained what they planned to do.
"Kelly, we're going to use a colon tube to get you cleaned out as much as possible. We're going to use a Higginson syringe to pump the soapy water into you which will start to fill you up so I can work the tube further around your colon. When I've got far enough, we'll pull your diapers up and put your plastic popper pants on, then continue to pump you full of the soapy water. When we're done, I can pull the tube out and you can hold it as long as possible, although I guess that won't be for long! OK?" Kelly agreed that it was all right with her. Her legs in their plaster casts were pulled over to the edges of the bed, leaving her wide open to the nurses' attentions. When she was in the right position, the third nurse left the other two to their task and went to keep an eye on the children supposedly taking their naps.
The nurse who'd spoken to Kelly lubricated her rubber glove and gently dilated her anus, working lubricant around, although the oil still inside her helped. The enema can was on the trolley holding all the equipment and the nurse lifted the lubricated end of the colon tube, glistening with lubrication and held the end over her diaper. Another nurse lifted the Higginson syringe over her diapers and squeezed the bulb of the syringe until the colon tube was full and soapy water came out of the eyes at the end.
"They'll be a lot more soapy water here in a while," the nurse holding the colon tube said to Kelly, with a smile. She then held the rounded tip of the tube against Kelly's anal sphincter and pushed gently. As soon as Kelly felt the tube against her, she relaxed and the tube slide forward inside her anus and into her rectum.
"Squeeze now, please Kelly, as we're about to start the soapy water in you. As my colleague pumps, I'll work the tube up into you as far as possible." The nurse holding the Higginson syringe squeezed the bulb gently as the hot soapy water was pumped into Kelly. As she did that each time, the nurse holding the colon tube advanced it further into Kelly, twisting and turning the tube to help it round the bends and flexures of Kelly's colon. Kelly was aware that she'd peed on the nurse's hand as she was advancing the colon tune. Kelly apologized, but the nurse shushed her, telling her not to worry as she couldn't help that. Eventually the nurse advancing the tube pronounced herself satisfied. The nurse holding the syringe laid the syringe on her chest between her forming breasts and Kelly could feel the warmth of the syringe, full as it was with the hot soapy water. This nurse pulled Kelly's thick and hopefully thirsty diapers around her and pinned them tight, then pulled the plastic pants up over the diapers and poppered them closed, leaving the colon tube emerging from the top of the plastic pants and up to join the syringe lying on her chest. The nurse who'd advanced the colon tube removed her gloves and dropped them in the bin attached to the trolley holding the diaper change Kelly had just had, along with the enema equipment, smiled at Kelly and went out of the curtains to wash her hands. The nurse, who had been squeezing the bulb, smiled at Kelly, then said to her, "Ready?"
"I guess so!" came Kelly's reply. The nurse started squeezing the bulb and, when it had refilled, squeezing again. Kelly could feel the hot soapy water being squirted high up inside her and her abdomen start to fill. She found it a pleasant felling as the warmth spread inside her colon as it filled with the soapy water which was soon to be discharged into her waiting diaper.
One of the other nurses gave a whispered verbal, "Knock, knock. Can I come in?" at the curtains so Kelly quietly agreed, both of them keeping their voices low so as not to wake the other children in the ward taking their afternoon nap. She came in holding a jug full to the brim with more really hot soapy water and used it to refill the enema can, leaving the remainder of the jug on the trolley. Turning to the nurse who was still pumping Kelly full of the enema solution, she whispered to her, "Let me know if you need more."
"I'm sure this will be enough," said the nurse, still pumping, "but I'll call you if I do need more. Thanks." Kelly loved the fact that the tube, so high up inside her colon, didn't cause painful cramps as she filled with the soapy water. The nurse tipped the remaining contents of the jug into the enema can and kept pumping. Suddenly Kelly felt rather full to bursting and said so.
"Actually, Kelly, you've done very well! I was just about to stop as the can in virtually empty and I think that should be enough for today! Clench your muscle tight down there as I'm going to pull out the tube now." She grasped the front of Kelly's plastic pants with a handful of the diaper as well around the colon tube to wipe it as it emerged from Kelly's back passage. She pulled and pulled and Kelly remarked in surprise as the end came clear, "Gosh! I didn't have all that inside me, did I?" The nurse smiled, "That you did! The colon isn't as short as the school textbooks show, going straight up across and down. It folds around several times so is longer than you'd think. I would guess that this has been nearly at your cecum where your appendix joins. You know where I mean?" Kelly agreed that she did and looking down at her very and obviously swollen abdomen, said, "Gosh! Isn't my tummy big! I wonder if this is what it feels like to be pregnant." The nurse laughed quietly, replying, "I don't actually know as I've never been pregnant, nor had an enema like yours, but your tummy is bulging enough to be pregnant! We've filled you very full to try to ensure that you really are cleared out this time so we won't have to do this again for a while at least. I'll leave you now. Try to hold it as long as possible. I'll keep popping back to check on you and, when you think you've expelled it all, let me know and we'll change you and make you comfy. We'll probably leave you with the curtains around you as you will probably want a sleep yourself after all of this. Enemas can be tiring for the patient." With that, she left through the curtains.
Kelly laid there, trying to hold back on the huge amount of soapy enema solution inside her. Her bowels were churning as the irritant soap did its work. A large spasm wracked her and she felt some release into her waiting diapers. Another spasm convulsed her and she gladly decided this time tom relax and let go. The release of so much hot soapy fluid along with the now softened stool which had been filling her was genuinely orgasmic as Kelly gasped from the waves of emotion flowing through her and emanating from between her legs. She thought she must have emptied herself when another wave of contractions hit her colon as she expelled again. She shuddered as a further orgasm wracked her. Just then, the nurse gave the verbal knock and came in when Kelly had said it was all right.
"How are you doing?"
"All right, so far!" was Kelly's reply. The nurse gave her a reassuring smile and left again. Kelly could feel the warmth of all that soap and stool spreading between her legs and up the front of her diaper. Again and again she released more soapy water until she really did feel exhausted. The nurse, true to her word, kept checking on her until Kelly said that she had finished, she though as she hadn't passed anything more for about twenty minutes.
The nurse disappeared and came back with two others and the diaper trolley to remove the now very soiled and wet diapers to clean her up. That was a major task as so much stool had been blocking her colon as well as all that hot soapy water which had soaked her diapers.
What happens next? The next installment of Kelly is being written now!
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