Friday, April 06, 2012

103.8

*warning! The following post describes some yucky stuff. Skip it if you're easily grossed out.*

The trouble with being an Emergency Medicine doctor's wife is that you're an Emergency Medicine doctor's wife.

You've probably already gathered that being married to an ER doctor means:
A) you're home "alone" (with the kid(s)) a lot
B) when said kid gets sick, you have a doctor you can trust
C) see A
 My last post was supposed to be a bit about doing laundry with Ella because she is such a good helper. There are photos from Laundry Mountain and everything.

But I never got around to finishing it because I started it at almost 3 a.m. and the sheets in the dryer were finally ready to be put on the bed. Justin got off work at 3 a.m., so we ended up chatting, and days went by before I even looked at the post again.

The laundry photos will have to wait.

On Sunday morning I got a text from a friend in the neighborhood, inviting Ella and I to a play date in the park with her daughter that afternoon. Since Justin was working, this was a most welcome diversion on a classically beautiful Southern California Sunday. Of course the girls were cute swinging next to each other and giggling. Bonus, two of their friends were there with their parents, so we had one of those idyllic afternoons in the neighborhood park. Sure, Ella's godmother posted photos of her family skiing in Colorado during Spring Break, but this was fun, too!

My friend and I decided we needed BBQ chicken pizza from a local restaurant/bar, so she called in an order for us to pick up and bring back to our house to eat together.

When we got to Main Street, Ella looked exhausted. I teased her about getting worn out in the park, and remembered that I had woken her up from her nap so that we could leave the house. "Home," she said.

"We are going home. We're just going to get some food, first, and then we're going home. They're going to come with us, so we can have dinner together and you two can play!"

"Home." I took her out of the stroller.

Naturally, the food wasn't ready, so we waited outside, chatting with the man who owned the dog that was tied to the bench. Ella started crying and wanted me to hold her, instead of playing with her friend, sitting by herself on the bench like a big girl, or even petting the dog. She didn't even want milk. Or raisins. Not even raisins. Even bouncing on my knee only elicited a smile, not a giggle attack.

We went inside to check on our dinners; they were almost ready so we got the bill. Ella's friend was sitting on one of the bar stools, and I was carrying my girl, standing between the bar and the restaurant tables. We were surrounded by people.

Suddenly, my back felt warm.

I shifted Ella's weight to my other hip and looked over my shoulder.

"She just threw up all over me!" I held her, looking at her face.

"Do you want to take her straight back to the bathroom?" my friend asked.

Ella looked stunned. There wasn't even any crying. She threw up again, all down her chest and mine.

To the bathroom we went. She vomited again as I opened the restroom door. I put my (dripping) backpack on the table with the flowers on it. Thank God it was a relatively big bathroom, for a bar-restaurant. My poor girl was standing near the toilet and she was finally starting to cry. She puked again. Only partly into the toilet.

I honestly don't really know how it all worked. I tried to wipe her off with some toilet paper--at least her face. I peeled off her pink sweatshirt, trying not to wipe puke over her face or into her hair. It was even on the sleeves of her pretty gray shirt with the fairy whose wand has flowers magically floating out of it. She stood there looking shocked and pathetic next to the toilet, while I wiped the floor with paper towel, again thankful that we were in a remarkably clean public restroom. I caught a glimpse of myself in the mirror over the sink and switched to wiping at the white cotton shirt that was plastered to my chest. I cleaned off my neck and as far down my shirt as I could reach, but wiping at my sleeves and my shirt really wasn't helping.

I couldn't figure out how I was going to get us out of the bar, how I was going to get us home, with any semblance of dignity. Was Ella going to puke again? Was this what they mean by projectile vomiting? She was definitely getting some distance. I couldn't walk through the bar and the neighborhood in just my bra, which was puked on, too, so what good would that do? I was going to have to make everyone see us this way while they ate their dinners. Then, I remembered that I had a friend with me, but couldn't figure out how I was going to get her attention, figuring that now she was dealing with her own daughter, and whatever mess we had left in the bar, and her cell phone was probably out of her reach. Fortunately, she came to the door, "Olaina? Can I do anything to help you?"

I opened the door, "Look at me!" I took another desperate swipe at my shirt. "There's a sweater in the stroller, under the seat. Could you bring it here?"

Thank God.

"Oh no! Did you step in it?" I looked in dismay at the smeared puddle on the floor near the door. She was wearing sandals.

"Yeah, but don't worry about it."

I got more paper towel and started cleaning the floor. "Is it awful out there?"

"They cleaned it up."

I managed to get my shirt off and wrap our clothes up in some paper towel to carry it through the bar. I dried off my purse and picked it and Ella up, opening the door to let in the poor woman who had been knocking on it for her turn.

"Sorry!" I squeezed by.

My friend helped me put my credit card back into my wallet while I signed the bill and we left.

"So embarrassing!"

"Don't be embarrassed! There's nothing you could do to control it."

"That's true. Is it awful that I'm glad it happened in there instead of on my carpet at home?"

"No, I'd be glad, too."

I wanted to call Justin, but he was at work. I knew there was nothing he could do. She threw up. Kids do that. You don't interrupt the ER because someone throws up.

Maybe I could text him. Just ask him how he was feeling, in case it was something she ate.

No. That would make him worry. Best not to bother him.

I called my mom. I just had to tell someone what was happening because it was gross. And scary. And embarrassing.

Of course she wanted to come over to help me, but I didn't really see the point (Again, what can anyone do? Kids puke). Besides, my parents own one car between the two of them, and my dad was painting at an art studio. She did, however, convince me to text Justin.

Text: Ella just threw up all over me. Seriously soaked. Lots of puke. Any suggestions? Am going to take her temp.

Ella's fever was 101.1 at 6:20 p.m.

Within an hour it got up to 103.8.

Justin called me right after he got the text; fortunately it was not a busy day at the ER and he was working an afternoon shift, so he would be off at 11 p.m. He counseled me through medication dosages and suggested Pedialyte, but there was no way I was putting her into the car or the stroller to get to CVS. I took her shirt off to help her cool down and decided we could wait to put her in a bath because puke in the bathtub would freak both of us out. Also, she wasn't exactly sitting up with any kind of strength, so I was afraid to put her in water. We had diaper-wipe baths. If her fever didn't go down in 15 minutes I was to bring her to his ER, rather than risk a febrile seizure and an ambulance trip to the ER closer to our house. (Not that there's anything wrong with that ER, but wouldn't you rather have your baby seen by doctors and nurses you know?) She lay limp in my arms, resting her head on my chest.

Ibuprofen and acetaminophen got her fever back down to 101.8, and then into the 99s at 8:30 p.m. We kept her up late (and by "we" I mean me and my mom, who came over after stopping at CVS for Pedialyte as soon as my dad got home), so that we could monitor her temperature and hopefully have her sitting up if she threw up again. In that time, I remembered that Sesame Street has a website with videos, so Ella was introduced to Elmo, Grover, Bert and some friends. We also saw our first Disney movie--Cinderella. Apparently, Mom bought it for Ella sometime before 2005 (that's when the previews are advertising new releases). She was born in 2010. Anyway...

For me, the best part of having my mom visit was that I got to have a shower. Ella wasn't letting me put her down without crying, so I couldn't have done it without her here. Also, I ate a slice of that pizza we bought. It didn't feel right eating in front of Ella when I wasn't going to let her eat, and while I usually expect her to play in the bathroom while I shower, the combined possibility that she would puke or cry the entire time made that an untenable choice.  Ella loves my mom--usually when she comes over, Ella literally squeals and runs in circles in delight. This time, she wouldn't even let my mom hold her for very long, preferring to be in my lap. I told my mom to just bring her into the bathroom if she started freaking out.

Ella, who couldn't even muster a smile for Grandma's visit, became so restless with exhaustion that we only watched a little of Cinderella before letting her go to sleep in her crib at 8:45 p.m.

Mom left after I put the pukey clothes into the washing machine.

When Justin got home after 11 p.m. I started to cry.

He peaked at her (I had left her door more than just ajar, for just this purpose) and he said she looked fine. She was breathing regularly and at a good rate. He had medicine to help her stop throwing up if that part got too bad.

She slept through the night.

The next day he didn't work until the evening, so he was able to watch over us. Ella was still listless and feverish, but the acetaminophen and ibuprofen combo kept it under control.

Then, she got a rash. I don't even remember if it was Monday or Tuesday, but I was changing her diaper (obviously, potty training went on hold for a few days), and I noticed red splotches on her ankle and foot. I called Justin into the room, and we noticed it was on both feet. It wasn't raised, just a little, red, kinda spidery rash. It was hardly anything, so I didn't worry. Too much. Justin thought it might be just a little something from her fever.

It got worse.

It spread over her foot and up her leg. On both sides.

"It looks like roseola." That's a rash that kids sometimes get after having a high fever.

"But don't rashes start on their bellies?"

"Not always," said the doctor.

"OK. What can you do for it?"

Nothing.

As the day wore on, the rash got worse. It started to appear on her hands, too. Not much, but it was there. 

There was also a spot on her thigh, but it was totally different. At first it was just a red bump. Then it looked like a zit with a whitehead. Then it was just red again.

Later that day,  the bumps were all over her butt, too.

Those, he was worried about. "We'll watch them and make sure they don't get infected."

This is where having a husband who is an ER doctor starts getting complicated. I know that he knows medicine. I know that he is a doctor. I was THERE for part of the double major that had something to do with biology AND chemistry. I SAW the cadavers during medical school. I had a baby during his residency program.

Yeah. That's where I get stuck. I can't think of any distinguishing factor of his three years of residency other than that we brought Ella into this world. I know it was grueling, I know there were long hours, and there was little sleep and almost no money. But I HAD A BABY.

So I wanted to Google the rashes so that I could figure out what was wrong with my baby girl and whether I should take her to see the doctor.

Tuesday, I did not Google.

Her fever was down, her spirits were up. I did not Google. I was not feeling well, so I took a nap when she did and Justin volunteered to watch her when she woke up so that I could sleep more. He made me dinner (saffron risotto chicken and stir-fried vegetables! Delish! Seriously, this man is amazing).

 She slept until almost 9 a.m. Wednesday.

The only perk of your kid being sick is that you might get more sleep, if you don't stay up worrying (and Googling) about it.

We woke up before her and resumed worrying (and woke her up by checking on her).

The rashes looked angry. Later in the day, one of the rashes was worse, one was better.

"Maybe I should call the doctor," I said.

"Maybe you should."

Of course, it was lunchtime and the office was closed, so I had to call back and by that time Justin had to leave for work. To pass the time, we Googled. Roseola? Could be. Hand, Foot and Mouth? Could be, but not likely since her mouth looked fine and the pictures online were so gruesome while her rash was so relatively dainty. Foliculitis? Could be.

The appointment desk woman asked me Ella's symptoms (throw up, 103.8 fever, rash) and said, "I know Roseola can come after a high fever. Let me put you through to our nurse."

I had to leave a message. Seriously? I called the appointment desk back and they said the nurse listens to her messages quickly, but she might have been giving someone shots, so I should wait for her to call back. The woman was really nice about it, but I wanted to drive right over there and get Ella seen immediately.

So I waited. (And surfed WebMD.)

Sure enough, the nurse called back and we discussed the rashes. She seemed impressed with my descriptions (ie. bumps smaller than the size of a pencil's eraser), but conceded that it is very difficult to describe a rash over the phone, so she made us an appointment for 3:45 p.m.

I could let Ella sleep until 3 AND have a shower!

I love our doctor. She knows Justin is an ER doc and sees a lot of children, so she always takes that into account, both in talking about diagnoses and medicine (with him--I'm still a layperson) and in considering that he might bring something unusual home from the hospital.

I woke Ella up from her nap and told her we were going to see our friend Dr. Awesome. "She has special books and toys you can play with. And she has a special chair you can sit on. She's really nice. We like her a lot."

"Fun!" It worked!

I had forgotten about the waiting-room fish tank with Nemo and friends in it, so when we got there it was even more exciting than we expected.

When it was our turn, I reminded Ella of her toy that helps her see into her dolly's ears, and of the stethoscope that she uses to listen to her belly (yes, she listens to her own belly, and yes, it is a toy stethoscope. We don't let her touch Justin's [gross] medical equipment.). I opened my mouth wide to demonstrate, telling her it was like when she lets me see her teeth while we're brushing. We all made the "ahhhhh!" sound, repeatedly. She did the best she could, and I tried not to seem panicked when I could hear her gagging on the tongue depressor.

Ella was "a model patient. You're daddy would be proud!" Dr. Awesome said.

To enhance our doctor-patient relationship I mentioned that Dr. Awesome's son actually attends the same daycare/preschool as a little girl friend we saw last week.

Hand, Foot and Mouth has been going around his school. Different strains. Her son just went back today after a nasty bout of the stuff--the strain he had was far worse than Ella's--he had a "scary rash." She even sent him to the dermatologist.

You know it's bad when the ER doctor sends his kid to the pediatrician and the pediatrician sends her kid to the dermatologist.

Ella did have a couple of spots in her mouth, at the back. She said Ella isn't contagious since it's been 48 hours since her fever was above 100 degrees, but I wasn't actually sure that was true since it all blurs together after a while. Heck, I couldn't even remember if I had had a shower since that one on Sunday night and it was Wednesday. Probably, but maybe not. She said if I wanted to keep her home another day that would be fine, but I didn't have to. Ella would definitely be fine for Easter.

She figured that the one-time-only vomit was because Ella felt so bad from the sudden fever.

I asked her to look at the other rash, too, and she said it looked like it was healing nicely. She said warm baths would help it, but would make the Hand, Foot and Mouth rash worse, so warm compresses would be OK if it seemed like it was bothering her, but that there was really nothing we could do but keep her skin clean.

Which is easy to do with a non-potty-trained toddler. Right?

Ella didn't want to leave the office. She was happy that I finally had given her a fruit-yogurt smoothie pouch to drink. I had to coax her out the door. She pointed at Dr. Awesome and said, "doctor" and "bye-bye" which was fun for us to hear.

When Justin called me after I texted him the diagnosis he said, "Are you glad you got a second opinion?" (Earlier, when I texted him that we got onto the doctor's schedule that afternoon, he had replied, "I'm glad." He really doesn't begrudge me taking Ella to the doctor; he knows I'm a mama bear and it's what I have to do, and a second opinion never hurts.) And I am glad. No matter which of the diagnoses he had suggested, there was nothing we could do besides give her Tylenol to keep her fever down, but there's something comforting about having a nurse take her temperature, and reciting her symptoms to the nurse and the doctor, and having it all written down on her medical file.

Justin is the guy we would have seen if we went to the ER with these symptoms. He would have looked in her mouth and seen the spots and the tiny blisters on her fingers and toes and told me there was nothing I could do but control her fever to make her more comfortable.

She's really been fine today (it's Thursday now) and yesterday--she's been dancing around and playing with her toys. When we got home from the doctor's office while she was still in her car seat she asked for "music" and did her little John Travolta fingers, so I promised her we'd turn some on when we got inside. She has one heck of a shimmy. Today her rash is so much calmer and has faded and smoothened considerably.

Did I mention that the doctor said she is not contagious? But I'm still worried that she'll give it to other kids, and the last thing we need is the kids in our circle of friends passing this virus around. Besides that it will never go away, I don't want to be the source of the neighborhood's misery just because I thought it would be fun to take pictures of our kids hunting for Easter eggs on the green belt.

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