Digest this.

I am pouring the creamer in my coffee when out of the corner of my eye, I see Dylan not eating, which in and of itself catches my full attention.   I glance over at him to witness his hand slowing lowering into the remaining milk of his cereal bowl.  The Cheerios are nowhere to be found, presumably in his belly, but the milk has become a watercolor scene across my table.  Dylan deliberately sweeps his hand in the white liquid and gently carries it across the table.  Then he lifts his hand, now in the position of a downward claw, where five continuous drips of milk fall off, one stream from each fingertip.  He watches this messy phenomenon of gravity for a few moments and then, SPLAT!, slams his hand down into the lake of milk on my kitchen table.  Deep sigh.  "No!  Dylan, honey we don't do that.  That's naughty and you know it.  That's 1."  To keep my kids in check, we usually do a count for each offense, when they arrive at 3, that means a stay on the naughty step in our foyer.  He looks at me and grins with a white sparkle in his black eyes.  He responds, "That's 2!" and laughs.

The day then continues with Dylan finding more trouble, this time centered around the fifth member of our family.  Our chocolate lab is a lovable, anxious dog.  She is probably best summarized by saying she is completely insane.  She is has done everything from destroying a friend's checkbook to shredding two Bibles (she must not care for religious texts, since she did these offenses on different days too).

As if I don't have enough on my plate, this dog is also a load of work.  There's a shocker...  more things to handle every day.  As a puppy, within weeks of bringing her home, she started getting sick, which didn't bode so well for crate training.  I believe this is probably partly why she is the way she is...  NUTS.  The other part being her squirrely disposition and unbalanced psyche.

To add insult to injury, she has considerable digestive problems and requires prescription dog food that can only be purchased at our vet's office over 30 minutes away.  After years of dealing with this, and our boys joining our family, I will never forget the vet, who is also a friend, telling me that there is a good chance the dog would possibly need, get this... DIGESTIVE ENZYMES with her meals.  Seriously?!  You have GOT to be joking.  As time passed, she in fact didn't need them, but you get the point.

The boys shove the dog out of the way when she kisses them.  They try climbing on her to ride her.  And they frankly take her love for granted.  But there are the quiet moments when I have seen Michael not knowing anyone was watching, walk over and gently pat her head, "Why you sad?  Good girl, good girl, Haley."  Or Dylan stroke her back saying loudly, "Niiiiiice.  Niiiiice."

The one thing that I will give this dog mad props for is that she has always been loving and sweet to two little boys that have terrorized her from the start.  She stood firmly and patiently when as babies they would pull themselves up to standing onto her, their tiny fists full of her fur.  She didn't wince or growl.  Although, she did look at us with a stare that said it all, "Can you please pull him off of me?  It doesn't feel so great."  She sprints to greet them outside their bedroom doors after naps as they stroll out, dazed with rosy cheeks.

I am grateful on this morning that she is the sweet dog that she is.  Ting.  Ting-ting-ting.  Bap, Ting.  I am hearing noises as I stand in the laundry room that I immediately recognize.  Oh no...!  Dylan is in the dog bowl.  Each "ting" and "bap" are kibbles hitting our ceramic floor in the kitchen.  "Dylan!  Out of there!  No no no!  We don't do that."  I dodge around the counter to find him with handfuls of the dog food ready to throw.  "Dylan...!"  He instantly starts returning the food to the bowl.  "Ok.  Ok, Mommy."  Well, at least he listens.  He begins collecting the kibble around the kitchen with his tiny forefinger and thumb.  He knows that my frustration is boiling over.  "Ok."  Then he loudly starts singing the "clean up" song.  Cheerily, he has rectified the problem.  Mommy is happy now and he toddles off to find more trouble.

Dylan always seems to find trouble.  Quite the converse, though, trouble has really plagued Dylan the past few weeks.  My little guy has had some digestive highs and, well I guess to put it nicely, lows.  

As with everything else in his life, Dylan does nothing in moderation.  He is a garbage disposal when it comes to food.  He eats when he is hungry and he eats when he is not.  The child shovels sausage links in his little mouth with his cheeks bulging.  He can down 5 of them in a sitting with other breakfast foods.  He also loves cheese and I have witnessed him eating 4 slices of gourmet deli sliced cheddar as if it was the last food on earth.  But the one in the record books was when he was shortly after he turned 18 months, he ate 9 and a half McDonald's chicken McNuggets and a half of an order of large french fries.  It makes my own stomach hurts just thinking of it.

A ha!  You say.  This is clearly good for kiddos that need more calories.  And right you are.  However, with every good thing, there is always another question to be answered that leaves me scratching my head.

Imagine that your physician tasked you with starting a high-calorie diet.  You begin cramming food in.  To put it politely, at some point, the food must exit.  And my guess is that your metabolism hasn't suddenly sky-rocketed since you have started eating more food and your pace of digestion hasn't increased, if anything is excruciatingly slow.  At a point, you're full.  Packed full of food to the top, until things, uh, get moving.

Now imagine that you are doing all of this with a system with less than ideal plumbing in your body.  You must rely on medications to help manage the entire digestive process, but are still tasked to sustain high caloric intake and good nutrition.  In the end, you wait...  you wait for nature to happen.  But it just isn't happening.  You continue eating and continue waiting.  Your belly hardens and the meds work furiously.  While a normal part of human nature, what seems so simple, in CF terms is actually highly complex.  All meds must be working on optimal performance to continue aiding and promoting regular digestion...  for the boys this includes digestive enzymes every time they eat, laxative therapy, antacids, digestive aids to help open the stomach to help food pass through and appetite stimulants.  Complex to say the least.

To put it nicely, after the massive necessary binging, what goes in, must come out.  And most importantly, as parents, we must be vigilant and observant...  is everything, well, working?

Lately for Dylan, it has not.  He has been struggling with "backing up" issues lately, where he is not going potty regularly, but not entirely "backing up" where a kiddo ends up throwing up, which is often the case.  This can happen because digestion is so slow that the kid is packed with food that has no where left to go.  I am simplifying it.  There are even more significant fall out from all of this like menacing bowel obstructions and lower GI complications.  Surgery is not uncommon.  We even know families where their child was born with a bowel obstruction and immediate surgery was required.

In the recent two weeks, Dylan keeps downing food, but his belly is managing the process ineffectively.  We keep adjusting his meds and then Saturday comes the blow out.  Phew!  His little belly finally relaxes.  It is softer, almost fleshy if you rub it.  The way a chubby kid's belly should be.  But it is the next morning that sends a flash of worry through me and my husband.  By afternoon our fears are not alleviated.  Because of the intestinal distress and other apparent symptoms, we are afraid that he has had a hernia.  And his symptoms are not subsiding as the day continues.

By late afternoon, we confer with the on-call CF doctor and share the ongoing situation and our concerns.  Panic sets in and my mommy instinct tells me that we need a physician's eyes on the matter and fast!  The talk with the doctor confirms my worries.  He immediately suggests we head down to the ER.  It is late Sunday afternoon when we drop Michael off at Papa and Nonna's house and start our trek downtown Chicago.  It is a cold, rainy evening and the monotone sweep of the windshield wipers are nothing short of annoying.  Dylan drifts off to sleep in the warmth of his carseat.  My husband and I are frustrated that our little guys have to endure such trips.  We just want everything to be okay.

Because of concerns of the boys being exposed to germs and viruses, the doctor has called ahead and we are whisked quickly to one of the ER rooms upon talking to one of nurses in triage.  Little Dylan is now awake and angry that his face mask that keeps getting in the way of his pacifier.  He is also upset that he can't swill his sweet, cherry Gatorade, since the nurse has advised us that he needs fast until we know next steps.  Disgruntled, exhausted, and uncomfortable...  a perfect mix for a toddler nearing bedtime and out of sorts.

We arrive in our tiny hospital exam room and we dress Dylan in the kiddy gown they nurse gives to us.  We all try to relax.  Quickly the attending ER physician and a fellow doctor come into our room and quickly begin with a barrage of focused questions.  Their tone is warm and there is a reflection of kindess in their eyes as they assess Dylan's situation.  They decide that an ultrasound is definitely in order and based on my context about the recent digestive issues they also order an x-ray of his belly to ensure there is nothing impacted in his intestine (i.e. an obstruction).  Now we wait.

Tick tock.

Tick tock.

We play with bubbles. These bubbles are fantastic!  They don't break when they land on things.  Dylan still frustrated that he can't have his "Gay-or-ay" (translation: Gatorade) is distracted for the time being.  He giggles and claps his hands.  He inspects them as they land on objects in the room, and SMACK!, he pops them with his tiny hands.  He loves these bubbles and they are completely a Godsend.

Tick tock.

We also play with Pla-Doh.  He loves making little balls and pretending to tee them off with a straw in his best golf swing.  Periodically, someone knocks on our door and my husband takes Dylan to have a test done.  Minutes later they arrive back at home base in our little dimly lit room.

Tick tock.

Exhaustion and hunger are wearing on us.  I look at my watch.  It's nine o'clock.  I am hoping that Dylan will take a nap or at lay down and least rest since it is getting way past his bedtime.  We flip through the only 5 channels, all with kids programming, on the TV and distract Dylan with a movie, Shrek.

No Academy Awards for us adults.  My one indulgence of the Oscars is the red carpet.  I enjoy watching the gorgeous celebrities strutting around in glitter and glitz and my questions always percolate...  what designer dreamt up that gown?...  What jeweler sculpted those stunning earrings?...  And, oh God!, what were she and her stylist thinking?!...  Instead of the flash of paparazzi and pirouetting socialites on the screen, we are subjected to watching a green ogre in ghastly hospital lighting as we wait.

My husband kneels next to the hospital bed where Dylan is laying.  Sweetly, Dylan takes his hand and starts rubbing my husband's head as if comforting him.

I swoon.  What a gentle, adorable little boy.  He is soothing my husband even though he is the one laying on the white hospital linens.  He carefully runs his hand from my husband's head, down his shoulder, down his arm, and rubs his forearm.

I am in awe.  How selfless.  How brave.  No one teaches these things to children this young, at least explicitly.  Dylan then quietly slumps back against the bed and refocuses on the TV.  Warm tears well up in my eyes.  My husband turns around, looks at me and grins, "Did you just see that?"  We both know how incredibly special our little boys are.

After a few more minutes, I make my way out into the shocking, bright lights in the hallway of the ER.  My eyes are screaming as I gently blink to ease in the blur of doctors on phones, doctors on computers, and doctors talking with more doctors.  The head doctor recognizes me and says she will check on the results of the tests that have been run.  Within minutes she pops her head in and says things are expected to look fine and we will likely be heading home.  She just needs to wrap up the final notations on the ultrasound.  Phew.  Crisis averted.  Within the next 20 minutes we do our routine check-out paperwork, prescriptions, and repack our bag to leave.  We are heading home.

The saga still continues throughout the week with Dylan's belly.  I spend repeated time on the phone with the CF Care team and dietitian trying to sort through his current state of digestion and next steps.  We adjust medications and continue to sleuth through the problem together.

While I still have no answers and certainly no consistency with how he is doing, I am strangely thankful this morning when I end up cleaning one of the biggest messes of my life.  After some trusty bleach and a load of laundry, things are back on course for the day.  All mothers have been there...  waiting for a kid to "go".  Or changing that diaper that is completely incomprehensible.  But even in these most stressful situations, I inevitably thank the Poop Gods and give a sigh of relief that everything has returned to normal...  at least for now.

As I finish the clean up, I contemplate the next time I can pick up a gossip magazine to thumb through all those Oscar red carpet moments.  It's better this way, anyways, I decide.  Maybe next time I can bring the magazine with me.