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June 16, 2009

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Thing 1. 103 and 104 is not moderate in my book, it is high.
Thing 2. My neice had hallucinations & high fever which turned out to be Hepatitis A. Dreadful illness against which they did not vaccinate babies in the 2003 era but they do now.
Thing 3. Sick kids...even decidedly cureable sick kids...are not fun at all.
Thing 4. We had an inexplicable recurrence of fever after apparently beating strep throat too. My unproven theory is that little bits of the bacteria lurk in the system and try to reassert themselves when antibiotic therapy ends. Both my kids experienced post-treatment fevers that resolved on their own. Weird.
Thing 5. ZOMG you are funny.

My Widget has just recently decided that it would be interesting to stick his hand down his diapers, pull out what's there, and then smear it all over himself in an effort to get it off his hands.

He did this twice. In two days' time.

I may choose to dress him exclusively in one-piece outfits for a while. It's that or potty train, and I'm not sure I'm ready for that.

As for the illness...whoo. It sounds scary, and I'm in awe of your sang froid, at least in writing. I have no internet-osis, I'm afraid, but you have my prayers! Du courage.

Didn't you say Patrick had a tick bite? Have they considered this might be tick-borne? There's a tick-borne infection called ehrlichiosis that causes fever, headache, and low platelet count. I've had it and its miserable. It's treated with doxycycline.

My fiance, obviously slightly older than Patrick, but still- is have those SAME symptoms! High fever (104), lots of puking, coughing and nonsensical stories, also a migraine-ish (light sensitive) headache that just will not go away no matter what. He was diagnosed with pnemonia (I know I spelled it wrong) and is now on his third day in the hospital, still with the horrible headache. I think they misdiagnosed him, personally.

My money's on Donna's diagnosis ... and DAMN that would be a trip if that (the ehrlichiosis) were really it, something so rare and obscure that it would have probably taken 10 doctors and 30 days to figure out! Who needs a medical degree when you have Julia's readers?

So sorry to hear about your trying few weeks. In such situations it's best to keep one's sense of humor, as you demonstrate on a regular basis :) I have no sage advice except to say that it sounds like Donna might be onto something, and that you needn't be timid when dealing with medical professionals. You know what they say, the only foolish question is the one left unasked.

Oh and Caroline is simply stunning in both of those pictures.

I am completely dazzled by your ability to remain calm in the face of a 103/4 fever and hallucinations, so I am going to click on your ads many times. Can they tell if it's one person clicking repeatedly? Doesn't matter, I will try anyway, because HOLY COW! The one time in his life that my son was that sick I was a nervous wreck. And there were no hallucinations involved.

delurking to mention that sedation is often a cultural/geographic mishmash. For example, in much of the US, a colonoscopy is a procedure done with general anesthetic. In English Canada, it's usually done with a "conscious sedation" and in French Canada, one generally grits one's teeth and then heads right back to the office afterward.

(For the record, I don't know any canadian children's hospitals who sedate kids for stiches either).

I want sedation. That's neither here nor there, but I thought that I might feel better if I said so.

I don't.

Didn't read the comments on the other post (for once, but time's been short!) But, our Children's Hospital doesn't sedate for stitches either. I think it's a desire to avoid sedation as much as possible. Theoretically, for instance, they should have an empty stomach and most young kids haven't been sedated yet and do you really want to find out of there's some issue with it over a couple of stitches that didn't require it in the first place?

My youngest had to have an MRI at about 11 months and then again 3-4 months later. The sedation they tried to use the first time had the reverse effect on him, though we didn't notice that until it was just about time to lie him down in the tube. That was kind of freaky -- he turned agitated and sweaty, etc.

So, in general, I think they feel that for kids that won't really remember the being held down, etc (or at least not enough that they can talk about it later!) -- it's easier.

Good luck with Patrick -- high fevers make me nervous!

I used to see colored lights when I had a really bad fever. Mine were just super realistic dreams of RED and ORANGE and HOT. It was kind of strange.

Hrrrm. Two and a half weeks ago my MN mother became very suddenly ill to the point where I, stuck in Colorado and helpless, was freaking out. She had a high temp 104+, confusion, near incoherency a splitting headache that lasted for days. She was admitted with a "weird" case of pneumonia (no real coughing and only some slight congestion in the upper right lung). The doctors tested her for everything, legionnella bacteria, meningitis, etc. She hospitalized and on IV antibiotics for about 4 days but fully recovered after only 10; which is odd, because you would think that a 70 year old woman would take longer than that to recover from pneumonia.

To add to the oddness, she had spent quite a bit of time at my sister's place prior to becoming ill and they live in Shafer/Lindstrom/Osceola area.

Hrm...

They usually sedate kids for stitchs by numbing and a shot to sedate them just before stitch time, no veins involved. I've always insisted on it, I remember being tied up in one of those papposes.

As for Patrick, I'm with Donna. Wont it be strange and oh, so cool if it's the folks in the computer that figure it out?

Hang in there, it's awful to have a really sick child.

Throat swabs for strep? Is that what he had and tested negative? Yeah, they're not always right. My son's false negative for strep led it to be untreated, thereby becoming scarlet fever. Very high fever, vomiting, and sick as I've ever seen a child outside of a hospital. So, not out of the realm of possibility that strep never left and he had a false negative.

In any event you're doing all you can but jeeze! I'm so sorry, if I lived nearby I'd make you tea. I remember weeks like that.

And in the middle of it all, you write beautifully and make me laugh. Your attitude is great, and the kids are adorable, as always.

I hear you questioning (between the lines)...take P back to the docs and demand they treat him until they figure out the cause......you won;t rest until you do :)

I'm so sorry about the stitches and sickness, but... good lord, your babies are gorgeous!

Versed is not a full sedation - it is a general woosy/drunkenness that makes them calmer and wipes the horrible memory. It leaves the system quickly. And it can be taken orally.

So sorry about all the sickness. I hope that fever comes down quickly.

Whenever I was running a high fever as a child I used to have what I called my "fever dream". Always just pulsating kind of colors. Hard to describe. Can still visualize it though. Didn't really feel threatening, but also not comforting.

I agree with some previous posters ... 103/104 for several days is high ... I would also go back to the doctors. In the meantime, cold damp washcloth wraps around the calves help lower the temperature.

I hope everyone's happy and healthy again very soon!

Delurking just to note that you didn't mention Patrick taking any Tylenol or Motrin. His temperature should not be getting to 103/104. When he's getting to 101, he should be getting a dose of one of those two meds. NO ASPIRIN THOUGH!

We had three diaper dismantles in one week. Seemed like a mistake the first time but v.2 and v.3 were definitely premeditated. Walls, crib, carpet, hair - it was everywhere. I think I still have PTSD from it. So glad that was only a phase!

didn't have time to read all the posts so maybe this was covered- but does he have any tick bites recently? low platelets, fever and elevated liver enzymes are all hallmarks- and he needs doxycyline if that is the case.

friendly er doc advice, worth what you paid for it.

1 - depends on your pediatrician as to when tylenol/motrin are recommended. Mine says fever is there to do a job, so only give meds if the child is miserable, not to bring the fever down. As long as the fever doesn't stay at 104 or go above, it's viral and with rest and fluids, their body will kick it on its own in good time. I'm talking fever in general - not Patrick's. With the other symptoms at the same time, I would definitely stay on it and consult with pediatrician about meds or no meds.

2 - good friend's son had a fever that went above 104 and they went to the emergency room because above 104 usually means it's bacterial, not viral, and is getting out of hand, so antibiotics are needed. Where Patrick's already on antibiotics, if it goes above 104, I definitely would not wait for pediatrician or mess around with urgent care.

First of all, this is my first comment, but Julia, I love your blog...you write beautifully and your kids are adorable.

Second of all, as a mom and a pediatric ER nurse, I offer that Patrick's fever is not unusually high for a child. Hallucinations or vivid dreams with fever are also not uncommon. My own 3 year old still talks about the dinosaurs he saw in his room the last time he had a high fever. All of this being said, I'm glad you're seeing your pediatrician tomorrow. Make sure you mention the tick bite. He/she will help you think through what's next.

Lastly, I've sedated kids and not sedated kids for painful procedures. In my experience, for a short procedure like stitches, the screaming and fighting is not from pain (the area is always well-numbed) but from fear. The sedative invariably kicks in AFTER the procedure is over, and then you have a very zonked-out kid to watch very closely. Those sedatives pack a wallop and every kid reacts to them differently...and they are risky, especially for the very little ones.

Julia, be assured that you did your very best for your sweet baby. She may remember the scary experience, but she will also remember that her mama was right there with her the whole time to comfort and protect her. Thank God for good parents like you. I've certainly seen enough of the other kind.

Also a mom and also a nurse! Echoing what Beth wrote: fevers of 104 are not unheard of in kids. Nor are the delirium dreams that Patrick had unusual. However, the low platelet count concerns me a bit. Just be sure to have the CBC rechecked.

I vividly remember having stitches as a kid. I got only local and mom's hand to comfort me. Mom's hand was ten times better than any sedative or pain-killer. (The ice cream afterwards was a nice balm for my wounds too.)

Hope the sickness/injury season is over for you soon.

I am in awe that you are still standing. Caroline and Edward are absolutely beautiful. Hope Patrick feels better soon.

Gosh the comments are like an episode of House. It makes me want to write symptoms on a white board and shout "Sarcoidosis!"

Hallucinations as companions to fever are not uncommon and curvy lights and walls that sway and blankets that do whacked shit sounds like fairly standard hallucination-fare.

I hope they are recover soon. Poor sick kids and poor you on-call mothering.

P.S. My son sleeps in two piece PJs but I put on a onesie underneath which has guarded against Diaper Incidents.

Gosh, I've got my son sleeping in 2-piecers, but haven't yet experienced what you describe (however, mine is currently unenthusiastic about going diaperless, to my dismay as I've started to suggest he needs to be considering trying a potty, so maybe I'm safe -- at least from what you experienced with Caroline in the crib).

I'm relieved to see the several nurses & doctors commenting that Patrick's fever isn't wildly high for a child his age, because it sounds high to (ignorant) me. But that said -- and I do hope his doctors work out the cause soon, and that he recovers, those two things not listed in order of priority -- I'm impressed that you can tell when Patrick is hallucinating. Remember "What is that word I am looking for? Translucent? Imaginative? Carbon? No! I know!" How different, really, is that from funny lights? Different enough, apparently, but only to you ... not to (at least this one of) your faithful readers.

I live in the same metro area as you and have also had sick kids this week. I would totally assume that the 8-year-old had swine flu (101 degree fever, upper respiratory symptoms, sick since last Wednesday) except that her 5-year-old sister got sick the same day with similar symptoms and was chipper and healthy by Saturday.

I think there must be something nasty going around in addition to the H1N1. Either that or my 5-year-old had the briefest, mildest case of flu in history.

My curiosity could have been satisfied when we took the big kid in to urgent care, but they're no longer testing for flu unless there's a compelling reason. (They didn't do a blood test, either, so if she's got something weird with her platelets we wouldn't know.)

The sedation or lack there of is because of the risks in small children.

High fevers...btdt...ours were strep induced and with motrin on board I got it down to 104 (yes, we had hit the over 105 range). Scarred the living shit out of me but we didn't have any hallucinations with it. And, btw, we got a negative rapid strep test but the longer one showed a raging positive.

You definitely have my sympathy.

My daughter would unzip her one piece fleece footie pajamas. We would find surprises every morning. A friend told me to cut off the feet of the pajamas and put her in the pajamas backwards with the zipper on her back. Worked beautifully!

Well, if Patrick was a dog, I'd be going with the ehrlichiosis. Also, if Patrick was a dog, he would have been on the doxy as soon as the platelet count came back. But veterinarians are crazy like that.

Feel better soon, all of you.

Wow, I'd start looking for internet cures for the Evil Eye. :) What a week. Many sympathies. And hopefully a glass of wine to calm the nerves.

We have been experimenting with 2 piece pajamas on my 9 month old. I may have to reconsider that. And I have been thinking about your hook on to the table high chairs too, since she started kicking the table at a restaurant and I realized that that would start at home soon enough.

Hope things get better. And well.

Sorry for all the trials and tribulations but on the upside you can write all the mileage off on your taxes (joke people)

What I really want to know is how you can resist Caroline's eyes? They grab me by the heart everytime you post a picture.

Perhaps Edward just like the quiet time to pursue his favorite pleasures in peace, no sister bonking him on the head, no big brother hovering saying let me show you how this really works, etc.

You are holding up beautifully in the face of so much illness. Darn, but high fevers scare the ever-lovin' crap out of me. In part because my daughter is prone to febrile seizures. And in another part because she had one that zoomed past 106 in the context of a bizarre mystery illness that landed her in the PICU for almost a week after she crashed in the ER. They had put in a central line and ended up passing chilled saline through her body when the fever wouldn't abate. Man, I wish that experience would fade from my memory.

I hope everyone is feeling their best soon!

so sorry for what the kids and you are going through. with high fevers like patrick had, you may want to give him a room-temp or cool bath to bring his fever down quickly. i can ask my pediatrician friend what could keep his wbc low, but i think by that time you may already know from your own pediatrician.
also, per my afore mentioned friend, it's better to numb the area than shock the little bodies with a sedative.
you are truly unique! how do you remain so calm and collected and FUNNY!

Check out tick bite for Patrick, they can get on the scalp where you'd never find them.
Edward looks like a junior edition of Patrick!

The fever / hallucinations - totally 'normal' for some kids. My son gets a high fever for a couple days for no apparent reason, sees things that an aged rocker on LSD would be proud of, then snaps back as if nothing has happened. We have had a few phonecalls to the GP in the middle of the night, but now just ride it out. The hallucinations can be pretty wild but we have learnt to enjoy them. Bad news about the platelets though - hope he picks up soon.

Incidentally, 'Pineapple Head' by Crowded House was written about Neil Finn's son Liam having a fever and hallucinating at around Patrick's age. So there you go.

@nina took the word right outa my mouth! This is totally like an episode of House ... but only better because we get your writing AND pictures of your adorable babies!

Best wishes for a speedy recovery to Patrick. He is my favorite among all the boys I don't really know. Also among most of those I do.

Do ask the pediatrician about tick-borne diseases. I don't know about the one Donna mentioned, though it sounds possible. I do fear Lyme, which you must not ignore. Even if he seems to get over it, Lyme can linger in the body and cause chronic symptoms that are practically incurable. Early treatment is essential! Do check this with your doctor. Please...

Catherine is gorgeous and funny. the diaper thing: not a pleasant experience, but amusing. As is the request for a "buh". She is adorable.

You are one of a kind: writing such a (seemingly) lighthearted post under such circumstances.

Oooops...
I meant Caroline. (At least I got the first letter right.)

You're holding up fabulously through the crazy week; I hope you have plans for a glass of wine and a good book or a foot massage or something as your reward for not losing your mind. :)

I'm guessing the hospital did the minimum numbing they had to in order to get the job done. They don't like to just throw around anesthesia left-and-right, as there are some serious side effects possible with it. It sounds like they did the right thing there.

High fevers have a different fear in our family, as two of our kids have febrile seizures. (If Patrick had that, though, he wouldn't have remembered it.) I'm guessing you're already doing this, but we do tylenol every 4 hours and motrin every 6 around the clock with a high-fever-illness. They've ran fevers that high with something as simple as ear infection, but hopefully whatever he DOES have, the antibiotic can eliminate this time.

and oh, the diaper removing...it just sucks, doesn't it? When that happens in our house, I just remember the story from my Chicago friend, whose daughter decided to show her objection to naptime by taking off her diaper and finger-painting the walls with its contents. It could always be worse. :)

Another vote for our children's hospital not sedating for stitches. Went through same thing a year ago for my then-nearly two year old and they papoosed him. The only difference was they gave him a couple of injections of novocaine at the site rather than the numbing patch. But ultimately same process. And I would run a whole bunch of tests re: the tick bite as someone else mentioned. Lyme and Rocky Mountain Spotted Fever are two other distinct possibilities. Hang in there.

Oh my hell, we just had a hazmat cleaning like you describe. Twice in 24 hours. Actually, three times.

Our two year old was "down for his nap" (she said sarcastically) and pooped, and managed to smear poop on the back of his shirt, his shorts, on top of his comforter, on his walls, carpet...you get the idea. I handled baby clean up, husband handled room cleanup. I did note that there was poop on my baby's fingers and nails, which was duly scrubbed off, but thought nothing of it.

That night around 1 am he threw up, massively, over all his clean linens and new pajamas. We cleaned him up, cleaned up the room, found alternate pillow and linens, and put him back down.

Ten minutes later, he threw up again, and as I was cleaning him up I smelled...poop. The exact poopy smell that had lingered in his room from naptime, but it was coming from his puke.

I asked him, "Sweetie..you know at naptime, when you got dirty? Did you put your fingers in your mouth?"

His face crumpled and he wailed "Ye-eeeees!"

Uck. Pew. Luckily he had, I suppose, gotten it all out and was fine after that.

Caroline is adorable, by the way. She is a feminine version of my own youngest, with big Precious Moments doll eyes and all.

Oh, and I remember having plastic surgery on my face (bicycle-accident-related scar on my forehead) without sedation, when I was 11. I don't know why they needed me awake; perhaps they thought it was like brain surgery and they needed to keep me alert in case they cut something vital. I remember being strapped down and huge needles being forced into my forehead; when I screamed they told me to shut up because i'd scare the babies in the hospital.

Um. Then when I asked, after what seemed an eternity, how much longer it would be, one of the interns (yep, interns operating on my face) cracked wise, "Why, you got a hot date to go to?"

My mom was LIVID. She'd had no idea that i wouldn't be sedated, or that I would report that the surgeon in charge of the interns had a very colorful vocabulary.

Just an FYI - when the children get bigger (particularly bigger than you) they WONT sedate them for a quick stitch but will do the numb & sew...so, if this stitch thing is suddenly all new & the child is much bigger than you the holding them down part is REALLY hard. (I should know)(we had to call in the Mr. from work to help) (and an extra nurse)
So, personally, I would advise letting them get some stitch experience while they're young & sorta manageable - that way when they're big you won't have to call in the reserves (hopefully).

Obviously I don't recommend giving them a good whack with something so they NEED stitches to get the experience...I'm thinking if the opportunity presents itself it could be a good learning experience.
Jeepers I'm snarky this AM - must need more coffee.

My youngest (when she was two and a half) had hallucinations with a fever. She woke up screaming in the night, "THERE'S A POLICE OFFICER IN MY ROOM!" I was pretty sure that there was not a police officer in there, and when I checked on her, there wasn't, but she was hotter than the sun and turnrd ot to be about 105. lots of motrin and a tepid bath did the trick, but it took about two hours. She doesn't remember it now, but I sure do.

Whatever Patrick has sounds like what my son (and several of his school mates) had recently. He had a high fever and terrible headache, spent 2 days hoem from school, went back to school on the 3rd day, got sick on teh bus and stayed home the following day. His little friends had similar symptoms. My son was not diagnosed with anything at his doctor visit, but some children in his class were diagnosed with either strep or walking pnuemonia.... all of us moms just call it the "plague". The school had to send home a letter stating that any child with any fever or flu-like symptms could not return to school for 7 days! My son started his illness last Sunday and although he is back at school, he is still run down a bit- sleeping in later, falling asleep right after dinner. It took alot out of him.

As for stitches, my older son was 3 when her nealy cut his finger off... and they did not sedate him to stitch him up. (He sliced through his tendon!) He passed out though.... so I guess he did not feel it. Two months later when he split his chin open and required sticthes they once again did not sedate him, and he once again passed out!!

No needles, fentanyl comes in lollipops and versed comes in yummy syrup and they are not so much oblivious as wonderfully loopy and compliant. Before the surgery to repair the defect on his hands, he went from two year old HOW COULD YOU rage to (I quote word and goofy grin) "I love you Mom" in the space of a few minutes.

High fevers and hallucinations not so rare... The platelets worry me more. what were his rcbs/wbcs? Is his fever going down yet? How long has he had it? Have they tested him for H1N1? If his symptoms are even suggestive they are required to test and report. Likely though, a case at his school would have been reported...

Looking forward to hearing all are hale and hearty again on your side of the world, and the evil curse has vanished...

Dayum typing on an iPhone is freaking hard...

Sounds from the comments like there's another exciting disease going around, and that moms know about it before docs or the media. So it goes. Definitely pursue tick-borne diseases. FWIW, my daughter had high recurring fevers a year or two ago... checked for ehrlichiosis, Lyme, etc., but no cause ever found. It resolved on its own but later she was found to have antibodies to cytomegalovirus, which may or may not have been the cause.

Reading all these comments just dislodged my own memory of a recurring dream I had with fevers as a child. All my friends and family were conspiring to build a doomsday machine and I was powerless to stop them. (Damn cold war...)

As far as sedation for stitches goes, I think I'd be more comfortable just numbing them and holding them down. Stitches only take a short while, but sedation takes forever to wear off. Just my $.02.

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