its been a long 4 days

{Warning: Get comfortable... your eyeballs may hurt after reading this post}

On Friday, B started running fever. We were out visiting family all day and when we got home that evening, I took his temperature. It was 102F. I gave him some Motrin and figured that by the morning he would be fine. I took his temp Saturday morning... still running a fever. We rotated Motrin and Tylenol all day long. The lowest that we could get his temp was 101F and the highest (that we are aware of) was 103.7F. We tried every fever breaking trick in the book - letting him just wear a diaper, keeping the house a little cooler (but not too cool as we did not want to induce more chills for him), tepid baths, etc. I began to get worried by early evening (6pm or so) because he had not wet a diaper or taken in any fluids for 4+ hours at that point (very unlike B). Around 7pm, his temp was 102.1F so I made the decision that it was time to head to the ER.

We arrived at the ER and thankfully we didn't wait long. We were taken immediately to triage. His weight was taken (21lbs 13oz - fully clothed/diapered) and we were brought into a room. The nurse took his vitals - O2 97%, HR 150bpm - both great for his age. They took his temp and it was 102.6F. Another nurse came in and administered some Tylenol. They asked us to have a seat in the waiting area. After waiting for about 10 minutes, we were called to registration. We verified our information and went back into the waiting room. About 15 minutes later, we were brought into our room. The doctor came in and asked for a quick run down and decided it would be best to do a rapid strep swab (oral), an influenza type A and B swab (nasal) and a chest x-ray. He said it was pointless at that moment to do bloodwork because we would obviously see that Brice's white blood cell count was elevated but it would not tell us why.

Two nurses came in for the swabs and a radiology tech came for the x-ray. My mom was in the room with us at that point because Daddy had stepped out to make a phone call. My mom asked if she should come back and the tech said no. So we walked to the x-ray area and I went into the room and she was telling me how to hold his hands up by his head and I replied that I couldn't be in the room because I was 18 weeks pregnant - I guess she didn't realize! They had another tech hold his arms up. All the while, I waited in the hall outside the door, holding his pacifier and blanket and fighting off tears knowing he was okay but he looked like he was in a torture contraption...

{this is not B... just some random kid off the internet... plus B was screaming the whole time!}

The doctor came into the room later in the evening to let us know that his diagnosis was bilateral bronchial pneumonia. I was shocked. I honestly figured, at worst, he had the flu. He said he wanted to give B a shot of Rocephin and put him on a 10 day course of Augmentin. We had to hang out for an additional 45 minutes after the injection because they wanted to make sure that B did not have a reaction to the shot. Around 10:50pm, we were discharged (still with a fever of 102) but with a plan of action. Little did I know that I had a looong night ahead of me.

I didn't crawl into bed until 12:30am. I was in the nursery from 3:15am on. When I went in to check on him, he was screaming and so hot to touch. I took his temp and it was 103.3F. I stripped him down, gave him Motrin and he was wide awake until 5:00am. He finally fell asleep on my chest until 7:30am. We called several local pharmacies looking for one that was open so we could fill his prescription. We ventured out, dropped the script off and I ran into the grocery while we waited for it to be filled. We went home and gave B his medicine (side note: B does not like medicine. at. all.) and put him down for a nap. He napped for 2 hour spurts at a time - either in his crib or on my chest while I sat in the chair in his room - all day long. Around 4pm, we finally saw a break from the fever. His temp was 98.7F and he was such a happy little boy. It was nice being able to play with him and to see him smile and laugh. And we could tell when the fever was kicking back in because he started to get cranky. We gave him a bath early, fed him dinner and he was sleeping by 7pm.

Monday started very early but thankfully, fever free!! We had to be out of the house for 6:30am to make it into New Orleans for an 8am doctor appointment. We arrived with plenty of time to spare. The nurse weighed B (21lbs 12oz - fully clothed/diapered), took his temp and brought us into a room. B's pediatrician came in and I handed him a sheet of paper that I typed up documenting when I took B's temp, what it was, when I administered Tylenol and Motrin, and our eventful ER trip. I answered his questions and he looked at me and said, I can tell you right now that B does not have pneumonia. He asked me to get a copy of the x-ray film and the radiology report because he was curious to see what they both showed. He said that ER doctors are not typically equipped to handle infants and young children (I totally agree) and that they are rather quick to hand out broad spectrum antibiotics. He wanted to discontinue B on the Augmentin but stated that he would only do so after viewing the films and the report, just in case the ER doctor was correct. He went on to state that B may have roseola - a condition where a child runs high fevers for 3 days and then breaks out into a rash. I was frustrated and decided that I would drive the 45 minutes back to the ER to pick up the films and radiology report and that I would drive another 45 minutes back so that I could be with the pediatrician when he read them. So off we went...

We picked up the radiology report and while waiting on the films, I decided to read the report. It stated: "FINDINGS: The heart is within normal limits in size. There is no evidence of a pleural effusion. There is increase in the perihilar lung markings compatible with perihilar pneumonitis. IMPRESSION: Perihilar Pneumonitis." Now I am not a doctor, so I had no clue what portion of the lungs were the perihilar areas but I did know that the prefix pneumo- means lung and the suffix -itis means inflammation (so lung inflammation). I also read the ER doctor's report and it stated: "... Chest x-ray, rapid strep and influenza A and B obtained. Rapid strep and influenza are negative. Chest x-ray reveals bilateral perihilar infiltrates. Rocephin administered. IMPRESSION: Pneumonia. PLAN: Augmentin, follow-up with pediatrician Monday." We received the two x-rays and headed back to New Orleans.

We waited to see the pediatrician again. The nurse attached the radiology report to the door so that he would know we were in the room waiting. He came in and said that he read the report and the radiologist noted perihilar pneumonitis. He said that was basically puffy/inflammed areas of the lungs. He took the x-rays out of the room to look at them. When he came back he stated that he believed that the films looked normal and to discontinue the Augmentin. I walked out the office feeling even more confused and frustrated than ever before. I was curious as to why the ER physician and the radiologist (who for petes sake went to school, has an MD and specialized in reading x-rays) concurred and our pediatrician disagreed. All I knew was that I did not feel okay with what was going on. For me, my son's health is not a game of Russian roulette. I don't believe in pushing antibiotics if a child (or adult for that matter) is not in need of them. And it could have been purely coincidental that B started to show drastic improvement once we started the Augmentin or the Augmentin was actually working. I didn't want to risk pulling him off the antibiotics because I didn't want the infection to have the opportunity to come back worse than before (especially with it potentially being in his lungs). I decided it was time for a second opinion because all I knew was that over the weekend my husband and I had a very sick baby on our hands.

I met my mom at Home Depot and she read the reports and we talked about who I should contact regarding a second opinion. I thought about the pediatrician that B's cousin sees but I was uncertain as to whether or not I could get a same day appointment. I wanted answers and I was not willing to wait. My mom said "what happened to the Marty Kleins of the world" - he was our pediatrician and a good family friend (and one of the most amazing doctors ever). Dr. Klein retired several years ago and Dr. Lawrence took over his practice (I saw her a few times as an older teenager before Dr. Klein retired). My mom and I almost said it simultaneously... what about Dr. Lawrence. I waited until they were back from lunch and decided to just "pop in to say hi." She and one of my favorite nurses from the practice were chatting with Brice and I. They asked how he was doing and I said "Well..." Dr. Lawrence looked at the films and immediately agreed with the perihilar pneumonitis diagnosis. She held up one the films and pointed to a section of Brice's lungs and said "Do you see all of this white junk... that does not belong in his lungs." I instantly felt relieved... like I was making progress in being an advocate for B's health. She also stated that she would not go as far as saying pneumonia but more like acute bronchitis - it most likely started out viral and the reason he was responding to the antibiotics was because it was a secondary bacterial infection. Apparently at this age, they are more prone to the viral gunk picking up a host of bacteria. I told her that 1 week ago we were in Urgent Care because B was running fever and it had lasted for 4 days and we were told that he had a virus. She said she could almost guarantee that virus was the primary infection and it turned into a bacterial one several days later. She advised to continue the antibiotics. FINALLY, a freaking answer as to what was going on with my sweet baby boy.

At times being a parent is made much more difficult than necessary. I know that I don't have MD behind my name but I do know when my mommy instinct is screaming saying "something isn't right... red flag alert." I definitely look forward to the day when B can say "Mommy this hurts, etc." - it's tough trying to search for clues as to what could potentially be wrong.

But I am very happy to report that as of this morning, my sweet little monkey is almost back to working at 100%. He is playing hard and giggling, smiling and crawling all over the place. The only thing that we need to work on is his appetite - he still is not showing much interest in food - but that will come in due time.

Now I am off to catch up on everything else I let slip by this weekend. Have a great day!