Ben and Klara went in on Monday, Oct 7, to have their ears checked to make sure everything was ok after they had both had double ear infections. They were both pronounced over their ear infections. Ben still had a little fluid in his ears, but nothing that was looking infected. Just left over fluid from his ear infection. Klara was totally fine. I mentioned that that day he had been running a low grade fever of about 99.5 and had been acting kind of lethargic. Just generally laying around. His appetite had slightly lessened, but nothing terrible. The dr looked him over really well. His heart rate was a tad elevated, but nothing worrisome. She sent us home and told us we would have a very low threshold for coming back. Any higher fever, any vomiting, more lethargic or not eating or diarrhea and she wanted to see him again. She also suggested keeping him home the next day even if he was feeling ok, just to get him over the hump.
Well, the next morning, around 7 am, he spiked a fever. It was 101.5. I gave tylenol and watched him. He only ate 2 mini muffins for breakfast. I called all my clients that I had scheduled that day to cancel. I, obviously, was not bringing him to school, and was going to need to bring him to the dr. For lunch, all he ate was a small bowl of cereal. After his nap, at 1:30, his fever spiked to 102.5. I gave tylenol again. Our appt was at 4:10. We got there and his fever was still at about 100. The dr looked him over. He was really lethargic by then. She was checking him over and he was pretty much just sleeping in my arms, which she did not like. So, Dr. B called the cardiology fellow to let them know what was going on. She came back in and told me, "well, I called the cardiology fellow and I didn't like what he said, so I made them get Dr. G on the line. I asked what was said and apparently the fellow wanted us at Lurie for a 48 hour admit and Dr. B advocated for us and said "no way. That is unnecessary. This is looking very much like a viral process which can be handled with labs and chest x-rays and if necessary we can have them go to CDH." Dr. G agreed with her (we love our cardiologist!) and said we could take care of everything in the suburbs. Dr. B thought it would be a good compromise to go to CDH ER and get some rehydration as well as get the labs and x-ray done there.
So, off to the ER we went. But, first, I took all 3 kids home to get Ben's meds. I did not know if this would be an overnight admit and I wanted to be prepared. I like to make sure I have his meds with me just in case. Sometimes the ER doesn't have them right on time and I can just give them out of our stash and keep theirs when they eventually come up. We got to the ER and Ben was NOT happy. Once he realized what was going to happen, eh started screaming. But, once they let him eat, he did eat 8 chicken nuggets. So, at least that was progress. They had a child life specialist come in and she was GREAT with all 3 of the kids. She brought the huge bubble machine and an iPad and played Elmo for Ben. It helped a little, I think, when he had his IV put in. They got him rehydrated and got labs done. The labs showed he was definitely dehydrated and definitely has a viral process going on. Which one, could take 24 hours to determine. So, we were sent home (see! No need for 48 hour admit!) with orders to keep up with tylenol every 4 hours. And when they say every 4 hours, they mean it! I missed his 2:00 am dose by 30 minutes. All of a sudden he woke up and started throwing up and was burning up. Temp was 102.5 on the thermometer, under the arm. Gave the tylenol. By 3:30 it still was 102.5. I stripped off all his clothes, down to his diaper. By 6:30, it was finally down to 101. Gave his 6:30 dose of tylenol and Joe said after that it stayed pretty low.
During the day, he had been reasonably ok. But, not eating a ton of food. And, as soon as his dose of tylenol is due, his fever starts creeping up. He was looking pretty good around 6, and I thought, "hmm, maybe I can see if we can skip his 6:30 dose. He looks ok." Sure enough at 6:25, his fever crept up to 100. So, no skipping that dose. I gave that, along with his other 6:30 meds, which include cellcept and iron. (we are skipping aspirin until he is fever free-off of meds- for 48 hours). Then exactly 20 minutes later, he threw up. A lot! So, I called the on call cardiologist, who said to redose only the cellcept, and if needed the tylenol. So now, I wait. to see if the fever creeps up to where he needs more tylenol. I am hoping he absorbed enough that it won't go back up. And I am hoping some good sleep will help him geto ver this tonight.
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