Friday, July 15, 2011

A rough week

We got back home Sunday night from a great trip to Arkansas for my cousin Emily's wedding. Monday was nice. Robby and I unpacked everything, got the laundry done, baked some cookies for Tim's pharmacy, and enjoyed just being home. Tuesday started out odd. Robby woke up crying at about 7:00. I ran in to get him and tried to console him. We just snuggled in bed, then he rolled a little. By 9:30 he was conked out on my shoulder. I put him in his crib and caught up on some things. At 11:30 he woke up crying again. When I went in to get him, he was burning up. When I changed his diaper, I took his temperature and it was 103.5. I took it again thinking it might be a fluke, but sure enough it was the same.

I called Tim to see if he could get an appointment for him at the clinic. They fit us in at 1 so I hurried and got us ready and met Tim at the clinic on base. Since he had absolutely no other symptoms but the fever, all the NP told us to do was give him Tylenol. But she mentioned if the fever didn't go away by Friday or if it got any higher, we needed to come back and they would have to get a urine sample and do bloodwork to see if they could figure out what it was. Well, by 4:30, it was at 104.5.

At that point it was too late to go to the clinic and based upon advice from our private, on call nurse, Mandy, at around 6 we loaded him up in just a diaper, covered in a cold wash cloth and headed to the BAMC ER.

I should have known our visit to the ER was going to be frustrating when Tim dropped me off at the door and I had to go through a 5 minute maze to even get to the ER (they are doing some construction and you literally have to walk through every department of the hospital just to get to the ER). When we talked to the check-in triage nurse, I explained his high fever, and she took his temperature using one of those forehead scanners (remember, he had a cold washcloth on his head for the past 30 minutes) and it was only 101.

Once we saw another triage nurse, she took it rectally and it was higher. After we were in the waiting room for about 2.5 hours, a nurse approached is and said she wanted to take his temperature again to see if he needed some Motrin. It was 102.8, so they gave him the max dosage of Motrin. By the time we finally got back to area to see the dr, he was feeling better and his fever had significantly reduced, but Tim and I decided it would be better for them to run tests to try to pinpoint why he had the fever since it had been so high. We waited a bit and finally a dr who resembled my high school chemistry teacher with his long stringy hair in his face finally came in to see us. He came in, introduced himself and said, "ok so he's had a fever since July 3". Tim and I looked at each other confused and said that was incorrect. He said it was in Robby's chart that a call was made to the nurse's line on July 3rd. Then we remembered we were concerned because Robby had been pulling his ear, but it ended up being nothing. So we explained it was unrelated, and tried to explain the day's events and what the nurse practitioner said would need to be done if the temperature increased. Again, the dr said "So this has been going on since July 3". We said no, it started this morning, but he laughed and said that it said in his chart it started on the 3rd. At this point I was frustrated because he wasn't listening to anything we were saying, he was just caught up on thinking Robby had this fever for over a week and we just now decided to bring him into the ER. He tried to look in Robby's ears, then wanted to look in his throat. He asked how they had looked in his throat in the past. I told him I held his forehead then they used a tongue depressed and looked at it. When he started looking at it, Robby fussed and the dr said "We won't worry about it, he clearly doesn't like it". Ya know, because that's how we had hoped a dr would try to diagnose our child, using only techniques that make him happy. After reminding him that the NP said they would need a urine sample to rule out a UTI, he said the would do that then. And since Robby coughed once before the dr left, he wanted a chest X-ray done. Let me just say, when he left the room, Tim was laughing and I was fuming. The dr acted like he didn't know what was going on, and honestly seemed a bit inebriated.

He sent two nurses in with a bag to collect urine, but it was a bag with adhesive to attach to Robby and just wait for urine to collect that way. Based on Tim's peds rotations, he knew it wouldn't be a clean sample that way so he told the nurses he would prefer they catheterize him (which is what the NP said needed to be done) after about 30 minutes, the dr came back by and said he wanted them to use the bag and laughed at what Tim said about it not being a clean sample because "urine is urine" and "I wouldn't want something stuck up me, so I don't want to do that to baby and make him uncomfortable". Again, because I definitely don't want my child to get a proper diagnosis if it's going to make him uncomfortable for a few minutes. He sent us to get the chest X-ray. It was so sad because we had to have him sit on this little bicycle seat type thing, put his legs through two holes, hold his arms up and close him in this clear thing while they took a few X-rays. He screamed the whole time and Tim and I did what we could to comfort him. When we went back to the "room", the nurses eventually came back to attached the bag for the urine sample. Of course as soon as we took his diaper off he peed all over the place. They tried to get a cup quickly to collect it but couldn't. So they adhered the bag to him and told me I could put his diaper back on over it. At this point we had been there for about 4 hours, both of our phones were dying, and Robby didn't have any clothes. We also hadn't eaten. So, Tim decided to run home and grab a few things then come back. After about 30 minutes, I checked the bag and it had come loose. I got a nurse and he said they would probably need to cath him to get the sample. I expected that so I just sat and waited 45 more minutes passed and the dr popped in to say he wasn't concerned with the urine because he looked at the X-ray and it appeared to be viral bronchialitis. But he had to wait until the radiologist looked at it and decide. The radiologist is supposed to read it within an hour of it being done and we were pushing an hour and 45 minutes. Tim finally got back and I told him what the dr said. He told me that even if it was, there wasn't any way to treat it since it was viral so we might as well leave. He got the dr and the dr then told him it looked like lower left lobe pneumonia to him but the radiology resident didn't see anything and they were still waiting on the radiologist to read it and sign off on it. Tim decided that if there was no treatment other than what we were doing and they weren't going to admit him, we were going to leave because it was doing Robby no good to be out at 11:30 at night. So he talked to a nurse, the nurse turned to the dr who was walking by and told him we needed to talk to him. He said "ok" and proceeded to walk in to be with a new patient. At that point, Tim and I were so mad we just walked away, signed a form saying we were leaving against medical advice and left. We had been there for almost 5.5 hours at that point and had no answers. We got home put our poor boy to bed and collapsed into our bed.

Robby whimpered and cried in his sleep all night so I didn't get much sleep. When I got up to feed him at 5, he was burning up. I didn't want to take his temp and wake him completely up, so I just gave him some Tylenol and fed him then put him back to sleep. At 7 he woke up, since Tim needed to get up anyways he went and got him. He took Robby's temp and it was up to 104.1.
I took Robby and Tim called the clinic to make an appointment.  They could get us in at 8, so Tim arranged to just take us to the appointment and stay there with us.
We were going to see Robby's actual pediatrician, whom we haven't seen before.  Since Robby didn't have any other symptoms other than the fever, she was concluding it was viral, but wanted to do some tests to make sure.  They had to cath him and draw blood to do the tests.

Then she said she wanted to give him a shot of Rocephin just in case it is an infection since we wouldn't get the results of the tests until the next day.  That way he at least had a day of treatment if it did end up being something.  We were there for about 2 hours.  I can't tell you how sad it was to hold him down when they were inserting the catheter.  When they were drawing the blood and giving him the shots, I told Tim he would have to hold him because I just couldn't do it.  It broke my heart that he was screaming so much.  When they were done, we had to wait 30 minutes in case he had a reaction and they wanted us to come back on Thursday for a followup.  After we waited, Tim took us back home and Robby and I laid on the couch.

We slept for about 3 hours.  We both needed it.  Once he was awake, he screamed every time I moved him or set him down.  He wanted to be held but I could tell it hurt when I touched him.

The lowest his temp got that day was 101, but it creeped back up to 103.5 towards the end of the day.  We gave him a cool bath, which he hated, of course.  And kept a cool washcloth on him.

Again, he whimpered and cried all through the night.  He woke up to eat at almost 6 but screamed when I picked him up.  It was so sad to know that he wanted to be held but also know that it hurt him when I touched him.  The only thing I could do to comfort my son while he was sick was to hold him and that is what hurt him.  I fed him and took his temp.  It was down to 101.8!  While still a fever, he was much lower than the past two mornings.  We went to his appointment.  Everything was about the same and nothing had grown on the cultures, but they like to give them 48 hours just in case.  So they gave him another shot of Rocephin just in case something showed up later.  We got home after the appointment and laid down on the couch again.  Again, we slept for about 3 hours.  But every time I moved him, he screamed.  By around 3, his fever got down to 99!  I was so relieved!  He started rolling around a little and was interested in one of his toys.  Tim gave him a bath and he seemed to enjoy it, but soon after, he started whimpering and crying.  He did that all night again, and I was just praying he would wake up happy in the morning.

Morning came and the screaming came, too.  Thankfully, he had no fever, but it still hurt him to be touched.  I gave him some Motrin, hoping that would help with his body aches.  We just hung out in our bed.  He fell asleep on me, then would wake up and I would sit him up on the pillows.

He would scream for a bit, but then would calm down.  He has taken about three 2 hour naps today, but finally at this point, he is playing in his exersaucer and is interested in his toys.

He also got to the point where he would sit in my lap so we could sing and dance without him screaming.

I'm praying that this is almost over and he will wake up happy tomorrow morning.  It was so scary when his fever shot up so high.  We were worried about lasting damage from the high fever, but thankfully it looks like he is ok.  I hope my sweet guy doesn't get sick again for a very long time.  We are all very exhausted from this experience.


Mandy said...

Oh my goodness, I hate seeing pictures of him so miserable! Poor boy! Glad he is feeling better though. My on-call pay can be made in Magnum bars! Hehe

Jamie said...

So sorry for sweety Robby and you guys! And you describing the care you received in the ER made me furious..what an idiot of a doctor. Thank goodness your husband knows about the medical field and what is appropriate to do for a sick child! Hope Robby gets back to 100% very soon!