Appointments, Infection & Fevers

This has been one crazy week....

Monday
Drove 45 minutes to Brooke's 8:45am / 9:30am heart appointment. She had an echo and EKG done. At the last cardiologist appointment, the hope was that the hole in her heart was closing. Scott took Brooke to get a chest x-ray done at the beginning of the month for the file to be sent to the cardiologist in time for this appointment so he could get a closer look. Brooke cried when she was weighted and measured (24.5 lbs and 36"), but she was totally fine during the Echo, EKG and blood pressure - all of which she has cried in the past. Of course, she munched on snacks and water the whole time to keep her distracted.

The Dr. said that the hole is still there but smaller. Even though she and her heart are getting bigger, the hole is still getting smaller in proportion to the size of her heart. He heard a clicking sound (which apparently he heard at the last appointment) which is an indication that the heart is trying to close on its own. There was another doctor (in training?) there and she couldn't hear anything wrong with the heart - another good sign it is closing and small enough that only a seasoned cardiologist can hear it.

While we were at that appointment, Jack fell and tore off a top layer of skin on a bump on his knee. This red bump wasn't there on Saturday, but on Sunday, it appeared and was getting bigger, red and pussy. I actually took a picture of it Sunday night to compare it Monday to see if it was getting worse because the thought of it being infected had crossed my mind. When he fell, the two doctors took at look at it and said I had to take him to our PCP because it could be an abscess! (Jack was hospitalized for a week when he was 15.5 months old due to an abscess.)

So I drove back the 45 minutes to drop the kiddos off at day care (by our house). As I was starting my 50 minutes back to work, I called our PCP and they were able to see Jack that afternoon. So I turned around and worked from home for a few hours, picked the kiddos up from day care and took them over to the PCP appointment. (Jack is 32.5 lbs an almost 40".) She said it wasn't an abscess, per say, but it was infected. She prescribed a topical antibiotic (3x per day for 7 days) and an oral antibiotic (2x per day for 10 days).

Tuesday
Woke Brooke up to take her to speech therapy, only to find her with a fever of 101.2. Gave her Motrin to break the fever, took her to speech therapy at 8am, picked her up at 9am, took both kiddos to day care, then drove into work.

When I picked the kiddos up from day care, Mrs. Angela told me Brooke was still playful but slightly off and clingy. She had a fever in the 102 range around 3:30pm (when the Motrin wore off), so she got some Tylenol. But by 6pm, the fever was back up in the 102 range. Water and a bath got it down to 100 and another dose of Motrin at bedtime.

But at 2:30am, Brooke was crying out for me. Her fever was up to 104.1, so another dose of Tylenol, stripped her down to her diaper, ice cold water for her to drink, wet wash clothes with ice in them over her back, chest and forehead... and 45 minutes later it was down to 100.9.

Wednesday
Brooke woke up with a 103.9 fever. Gave her Motrin and although she was okay, she was just a bit clingy. By mid-afternoon the fever was up again in the 103 range but brought down with Tylenol. By bedtime, it was around 101 and she fortunately slept through the night.

Thursday
Brooke woke up with 105.1 fever!! Ironically enough, it was good that she still have the fever for her 9am infectious diseases appointment. She has had the above referenced fevers that arereoccurring every couple month that our PCP can't figure out why she is getting them. So we were referred to an infectious disease doctor to see if he could figure out what was going on. She was great; she took the time to get Brooke's history, exam her and laid out the possibilities. It could be viral, but she doesn't think so because no one else gets sick and it is reoccurring. She said there are many kids out there that have something similar. There are several possibilities of what it is. One is some Mediterranean fever, which she doesn't think it is. One is something genetic but she isn't ready to do genetic testing on her. Another is PFAPA. This also has other symptoms such as sore joints, sores in the mouth, fevers every 4 weeks, etc. - nothing that Brooke shows, but I get the impression this is what the Dr. thinks is going on with Brooke.

The good news is Brooke's is mild, in that it doesn't affect her. However, if it did or if it gets to that point, we could put her on the steroid prednisone at the first sign of a fever and it would clear it up that day - so no 3 to 5 days of fevers. But we agreed that since Brooke is functioning fine even when she has her fevers, that we didn't need put pump her up with steroids. Another more radical option would be to remove her tonsils - I think because if you remove those, less chance of getting sick but still not entirely clear on the connection but doesn't matter because that was dismissed pretty quickly.

The dr. did say to just treat the fevers with Motrin and Tylenol and so long as she is acting okay, no need for ER visits. She did say that even high fevers won't cause any brain damage; and she said it was good they didn't induce seizures. For now, we do another round of blood work. And a chest x-ray next month. And a follow up visit in October. And I need to do a fever diary, documenting when, how high, how long, any other symptoms.

After the appt. I took them to day care, came home to work and a few hours later, went back to pick them up to take Brooke to get 4 vials of blood drawn. Man does she NOT like that.

Friday

Drove 35 minutes to Jack's 8:45am ENT appointment and literally waited 2 hours in the waiting room before being brought back to the office - then another 15 minutes for the Dr. This was a follow up from his last ENT appointment due to a possible ear infection at the end of March. At the time, he said if Jack had another ear infection in then next 6 months, that Jack would need ear tubes again; and he wanted to check Jack every 3 months... hence this appointment.

Fortunately the ENT said Jack looks good. Ear drums are moving well and there is no fluid in the ears. The right tube is still in there, but blocked and not functioning (but that is okay). He wants another hearing test done on Jack, which we'll have to do toward the end of next month. And with any luck (meaning: no ear infections), we won't have to see the ENT for another 6 months.

Then I drove back the 35 minutes to our house where I was able to work from home for the afternoon (since my morning was shot in the waiting room), but had the kiddos with me as day care was closed.

Ms. Brooke woke up this morning with a fever of 105.3. Motrin right away and she sat all morning either in a car seat or stroller (during Jack's ENT appt.). She did fall asleep on the way home and went right down for her nap, so she must have been worn out.