I woke up today very happy to be working from my Troy office today. I was unimpressed with the 40-60 minute one-way commute to Farmington Hills earlier in the week. I got ready and was taking my vitamins when I heard a soft mewing noise. I assumed the cat was up to some shenanigans and swallowed another pill when the cat walked by me, croaked, and sat down to observe. The mewing noise continued but was obviously not being made by Soup. I followed it upstairs to find Lilah still asleep but whimpering in her crib. I ran my hand over her forehead and felt her burning up with fever. She sat up and reached for me, pitifully saying, "Oww Mama," when I took hold of her. I took her temperature - 101.2. I don't have a sickly or feverish child on a regular basis. In fact, her previous ear infection was the only time she has ever cleared a low grade 99 for teething. I wasn't alarmed as much as concerned.
I gave her Motrin and a vitamin C/zinc lozenge and snuggled her after getting her a some water. She refused any food. Dano was up by then and helped me get her settled with a movie as I tried (unsuccessfully) to sneak out the door without her noticing. It killed me to leave, even knowing she was in the best possible hands.
Her fever went down to 99 in an hour and she was playing. I was relieved and went about my work day while still communicating with Dano. I toyed with the idea of getting her a Saturday morning appointment so we didn't have any weirdness pop up over the weekend. I got her new patient forms all filled out and faxed a records request to her previous pediatricians. After only 4.5 hours, the Motrin wore off and Dano reported she was listless and feverish again, this time climbing to 102. I had no Tylenol to supplement with in the house, so I expressed my concern to Maryl, the head nurse who has been in charge of my training. Within minutes, Lilah Rose had herself an appointment with Dr. Kolin for 2 hours in the future.
I watched the computer system click away as the office staff threw a chart together in no time for my daughter, who hadn't been more than a name to them moments before. Unlike other offices, they wanted her to have more Motrin before coming in, choosing to believe the parents and examine a comfortable child rather than have to see the fever and misery for themselves. I got a call telling me that Dano and Lilah were in the elevator - the MAs had been watching out the window. I was unsure how to proceed from there. Maryl said, "Go be a Mom." I was so thankful.
I went to the waiting room to find it empty. They had been taken straight back to a room. The MA Crystal was in the middle of getting Lilah to stand on the scale - 26lbs! Even with a fever she was still laughing and playing around. Her temp was down to 99 after the Motrin again. We only waited about 10 minutes for Dr. Kolin. Lilah had already told me she wanted a girl doctor at the new peds office, so I figured we'd see how she took to Dr. Kolin. She came in and said, "Hi Lilah Rose! I'm Dr. Myra!" She gave Lilah a high five and said she felt so lucky to be the first one to get to know her, and that she was beautiful. She asked me if anything pertinent had been going on lately, anyone we knew with strep, any colds or teething. I mentioned her knee infection and the doctor took a look and said she wasn't at all worried but checked the knee and hip lymph nodes anyway. Her ears looked "beautiful" and no infection there. No cough or congestion. She took one look in Lilah's mouth (with Lilah saying, "Blah!") and spotted some ulcers. "Coxsackies! That's Hand-foot-and mouth disease." Just a virus to run its course. She'd have a high fever for a few days and all we needed to do was keep it down and keep her comfortable. They didn't even have to strep test her. I was amazingly thankful they didn't try to throw her on antibiotics for no reason.
When Dr. Kolin was finished, she offered to hand Lilah back to me. Lilah said, "No, don't want to go to Mama." Lilah was totally comfortable with her. She explained everything she was doing to Lilah before she did it, and was quick without being brusque. We were out in under 30 minutes. I was back at my desk plugging away at my stack of health forms and Lilah was happy as a clam with a fistful of stickers and an orange sucker. In 3-5 days, she'll be good as new. Currently, she is screaming as loud and as long as she can since the ulcers hurt. "Aaaaah! Honey, it hurts. Aaaaaah!" It might be a long weekend, but I haven't felt this comfortable with her care since Dr. Hatfield. She can stay at this practice until she's 18 as far as I'm concerned.
Friday, July 15, 2011
Sunday, July 3, 2011
The infection pt. 2
Before I could fall asleep, I had to check on Lilah to make sure she hadn't spiked a fever or perhaps died (these obviously being the only options). Other than sleeping on top of her blankets and it being chilly with the air conditioning on, she was fast asleep with cool, dry skin. Her bandage was still intact and looked exactly the same.
I woke up at 5 and contemplated checking on her again but decided to stay sane and go back to sleep. At 8 I woke with a start at the cat nudging me awake to alert me that she had thrown up under the dining room table. I heard Lilah whining in her crib so I went to get her. Her skin was ice cold because she had thrown all the blankets out of the crib and sat in the air conditioning. Her bandage looked wet and had an odd color to it. I changed her diaper. The whole time she was chanting, "Take it off, Mama? Yeah? Gonna take it off now?" while tugging at her bandage. I took off the tape and unwound it. The swelling was reduced. The redness had calmed down to a gentle pink and was receding from the sharpie lines. The blistered area in the middle was more open and the surrounding skin was peeling a bit but I saw nothing but bright red tissue underneath. No pus, not a bit of drainage. Just healing skin.
The bandage, however, was not so lucky. It was soaking wet (possibly from the aloe goo) and covered in a rainbow of infection colors - greens, milky whites, and yellows. No smell but the aloe, thank goodness. But I looked at it in horror and couldn't believe that had all been in my child's body. Her body, yes, but thank God not her blood. Not yet.
Maybe I've been too nonchalant about her cuts and scrapes in the past. In an effort to make a tough little warrior who doesn't come crying to her mother with every stubbed toe, I might have glossed over the fact that she is still young with a developing immune system and we live in a world full of nasty invisible things. I will still let her stand up and brush off a hurt when she falls, but next time she bleeds I will make her pause from her playing to clean and cover the area. Soap, water, and Calendula if nothing else.
I truly believe my aloe plant did most of the good work in drawing out the infection and healing the underlying tissue. Other than the hydrogen peroxide and bactroban (even though hydrogen peroxide is a naturally occurring compound in the body), everything I used on her was natural. I'm not a super hippie type mother and I am a medical professional, but I think so many of the over the counter products we use in our day to day life could be equally substituted for things that were created and placed in the environment for our use. Animals know what plants to eat to cure different ailments, but humans are really bad at trusting nature after having been indoctrinated to run to the drugstore. Maybe more on this to come. For now I'm just beyond thankful that Lilah is fine. She never even knew anything could be wrong and that's the way it should be.
I woke up at 5 and contemplated checking on her again but decided to stay sane and go back to sleep. At 8 I woke with a start at the cat nudging me awake to alert me that she had thrown up under the dining room table. I heard Lilah whining in her crib so I went to get her. Her skin was ice cold because she had thrown all the blankets out of the crib and sat in the air conditioning. Her bandage looked wet and had an odd color to it. I changed her diaper. The whole time she was chanting, "Take it off, Mama? Yeah? Gonna take it off now?" while tugging at her bandage. I took off the tape and unwound it. The swelling was reduced. The redness had calmed down to a gentle pink and was receding from the sharpie lines. The blistered area in the middle was more open and the surrounding skin was peeling a bit but I saw nothing but bright red tissue underneath. No pus, not a bit of drainage. Just healing skin.
The bandage, however, was not so lucky. It was soaking wet (possibly from the aloe goo) and covered in a rainbow of infection colors - greens, milky whites, and yellows. No smell but the aloe, thank goodness. But I looked at it in horror and couldn't believe that had all been in my child's body. Her body, yes, but thank God not her blood. Not yet.
Maybe I've been too nonchalant about her cuts and scrapes in the past. In an effort to make a tough little warrior who doesn't come crying to her mother with every stubbed toe, I might have glossed over the fact that she is still young with a developing immune system and we live in a world full of nasty invisible things. I will still let her stand up and brush off a hurt when she falls, but next time she bleeds I will make her pause from her playing to clean and cover the area. Soap, water, and Calendula if nothing else.
I truly believe my aloe plant did most of the good work in drawing out the infection and healing the underlying tissue. Other than the hydrogen peroxide and bactroban (even though hydrogen peroxide is a naturally occurring compound in the body), everything I used on her was natural. I'm not a super hippie type mother and I am a medical professional, but I think so many of the over the counter products we use in our day to day life could be equally substituted for things that were created and placed in the environment for our use. Animals know what plants to eat to cure different ailments, but humans are really bad at trusting nature after having been indoctrinated to run to the drugstore. Maybe more on this to come. For now I'm just beyond thankful that Lilah is fine. She never even knew anything could be wrong and that's the way it should be.
Saturday, July 2, 2011
The infection
Ages since I last blogged, yeah yeah, don't judge me.
Lilah has been harder to keep up with every day. As per her normal 2 year old development, she has mood swings to rival a prepubescent girl. One moment my adorable daughter can be playing with me or reading a book. The next, she's grabbing my glasses off my face and smacking me with them, angry at a situation I'm not even aware of yet. We try our best to handle these things calmly as they arise, but some times are more difficult than others.
On Father's Day, Lilah was enjoying herself and running through the sprinkler with her cousins in the Ball's front yard. Kim, Dennis, and I were supervising the kids. I turned my head to answer Dennis and I saw his eyes get wide and he yelled, "Baby girl, you get back here!" At the same time, I heard Adam and Mike yell, "Lilah! Get out of the road!" I whipped my head around to see Lilah merrily frolicking in the middle of the street. I took off to get her, yelling at her to come back. She laughed at me and ran away. I was faster and caught up with her. I grabbed her by the arm, snatched her up, and shook her.
"You don't ever run away from your mama and you don't ever go in the road." By the time, she was crying hysterically and trying to wriggle away from me. I plopped her down on the steps for a time out. I was shaking. I told Kim and Dennis, "If I hadn't been so intent on getting her back here, I'd have spanked her butt." They both agreed they'd have spanked their kid.
The rest of the day went off without incident. She fell and scraped her knee at one point. There was a bit of blood and dirt, which I washed away. But Lilah is continually falling and scraping something so to be honest, I wasn't too concerned.
A week later, the scabbed knee was still scabbed and there was a tiny red area around the spot. I thought that curious, and made a mental note to keep checking on it.
Three days ago, the scab seemed to be more raised and a bit swollen. The reddish-pink area around it had gone from minimal and light to fire-engine red and larger. While (again) playing in the sprinkler, the scab softened and I brushed it away to see if there was any noticeable infection underneath. There wasn't (even after a bit of prodding until Lilah pushed me away). I told myself I would check on it in the morning.
By morning, it was a good inch larger on all sides, bright red, warm, and swollen. I kicked myself for bothering it in case I spread something. Still not a peep of complaint from Lilah and no fever (both pain and fever would have hinted at something systemic, not localized to the knee anymore). We went to the zoo and I worried about it on and off all day, reminding myself I would do some research when I got home.
When we got home and she was down for her nap, I did some digging. Apparently it was pretty common to get a staph infection in a wound like a scraped knee, staph being an opportunistic bastard. I had to wade through yahoo answer sites (where panicked mothers literally told the public and instructed their own children to open and dig out ANY wound and dump peroxide in it or you would get MRSA, have to go on IV antibiotics, and die anyway no matter what) to get to actual medical journals with helpful photos and treatment. I nearly had an anxiety attack while waiting to get a reasonable plan of care together for her. I snapped at Dano, cried, held the baby as if for the last time, and finally organized my thoughts. Lilah was unimpressed, but I held a warm compress to the area to bring the infection to the surface. I put hydrogen peroxide on it and let it bubble and boil. She squirmed and told me to stop it. I was relieved to have found some all natural remedies as well as the old medical stand-bys. I applied some bactroban ointment and Calendula salve. Calendula is a flower that is approved to treat wounds and inflammation in Germany. In America of course, if it doesn't come out of a lab it isn't worth the time it takes to grow the plant. I happen to have Calendula on backup supply at all times because it works beautifully and I don't have to worry about her eating it or something. The Calendula salve was applied liberally.
I then took a sharpie and traced the edges of the redness exactly. This way, I could track if the redness was spreading, reducing, or staying the same without the need to just "eyeball it". I had also nearly smacked myself in the head when I remembered the healing properties of aloe vera. It has been proven to heal hurts (even surgical wounds!) nearly twice as fast as those without aloe due to its vitamin E, C, and zinc. Also, it increases blood flow to the area to promote healing. Aloe alone has strong antibiotic properties. It reduces inflammation and speeds up the healing process. I have an aloe plant in the house, so I cut off a big fat leaf and slit it longways all the way to the top. Using a spoon, I scraped the gel (i.e. sticky, gooey slime) from the middle of the leaf and piled all that loveliness onto a 4x4. I bound that 4x4 loosely to her wound, taping it lightly in place with paper tape so she couldn't tug it loose. Lastly, she was allowed to suck on a vitamin c and zinc lozenge to boost her immune system and I gave her ibuprofen to reduce the swelling and any discomfort she wasn't vocalizing. She snuggled with us and watched Doctor Who with Tu (her new giant plush giraffe she named herself) and read stories until it was time for bed. My strong hope is that she wakes up in the morning happy, healthy, and with the redness decreasing from the sharpie border lines. I am trying hard not to be scared or worried. I am hoping she will heal herself with a little help and not need any more meds. I am hoping.
Lilah has been harder to keep up with every day. As per her normal 2 year old development, she has mood swings to rival a prepubescent girl. One moment my adorable daughter can be playing with me or reading a book. The next, she's grabbing my glasses off my face and smacking me with them, angry at a situation I'm not even aware of yet. We try our best to handle these things calmly as they arise, but some times are more difficult than others.
On Father's Day, Lilah was enjoying herself and running through the sprinkler with her cousins in the Ball's front yard. Kim, Dennis, and I were supervising the kids. I turned my head to answer Dennis and I saw his eyes get wide and he yelled, "Baby girl, you get back here!" At the same time, I heard Adam and Mike yell, "Lilah! Get out of the road!" I whipped my head around to see Lilah merrily frolicking in the middle of the street. I took off to get her, yelling at her to come back. She laughed at me and ran away. I was faster and caught up with her. I grabbed her by the arm, snatched her up, and shook her.
"You don't ever run away from your mama and you don't ever go in the road." By the time, she was crying hysterically and trying to wriggle away from me. I plopped her down on the steps for a time out. I was shaking. I told Kim and Dennis, "If I hadn't been so intent on getting her back here, I'd have spanked her butt." They both agreed they'd have spanked their kid.
The rest of the day went off without incident. She fell and scraped her knee at one point. There was a bit of blood and dirt, which I washed away. But Lilah is continually falling and scraping something so to be honest, I wasn't too concerned.
A week later, the scabbed knee was still scabbed and there was a tiny red area around the spot. I thought that curious, and made a mental note to keep checking on it.
Three days ago, the scab seemed to be more raised and a bit swollen. The reddish-pink area around it had gone from minimal and light to fire-engine red and larger. While (again) playing in the sprinkler, the scab softened and I brushed it away to see if there was any noticeable infection underneath. There wasn't (even after a bit of prodding until Lilah pushed me away). I told myself I would check on it in the morning.
By morning, it was a good inch larger on all sides, bright red, warm, and swollen. I kicked myself for bothering it in case I spread something. Still not a peep of complaint from Lilah and no fever (both pain and fever would have hinted at something systemic, not localized to the knee anymore). We went to the zoo and I worried about it on and off all day, reminding myself I would do some research when I got home.
When we got home and she was down for her nap, I did some digging. Apparently it was pretty common to get a staph infection in a wound like a scraped knee, staph being an opportunistic bastard. I had to wade through yahoo answer sites (where panicked mothers literally told the public and instructed their own children to open and dig out ANY wound and dump peroxide in it or you would get MRSA, have to go on IV antibiotics, and die anyway no matter what) to get to actual medical journals with helpful photos and treatment. I nearly had an anxiety attack while waiting to get a reasonable plan of care together for her. I snapped at Dano, cried, held the baby as if for the last time, and finally organized my thoughts. Lilah was unimpressed, but I held a warm compress to the area to bring the infection to the surface. I put hydrogen peroxide on it and let it bubble and boil. She squirmed and told me to stop it. I was relieved to have found some all natural remedies as well as the old medical stand-bys. I applied some bactroban ointment and Calendula salve. Calendula is a flower that is approved to treat wounds and inflammation in Germany. In America of course, if it doesn't come out of a lab it isn't worth the time it takes to grow the plant. I happen to have Calendula on backup supply at all times because it works beautifully and I don't have to worry about her eating it or something. The Calendula salve was applied liberally.
I then took a sharpie and traced the edges of the redness exactly. This way, I could track if the redness was spreading, reducing, or staying the same without the need to just "eyeball it". I had also nearly smacked myself in the head when I remembered the healing properties of aloe vera. It has been proven to heal hurts (even surgical wounds!) nearly twice as fast as those without aloe due to its vitamin E, C, and zinc. Also, it increases blood flow to the area to promote healing. Aloe alone has strong antibiotic properties. It reduces inflammation and speeds up the healing process. I have an aloe plant in the house, so I cut off a big fat leaf and slit it longways all the way to the top. Using a spoon, I scraped the gel (i.e. sticky, gooey slime) from the middle of the leaf and piled all that loveliness onto a 4x4. I bound that 4x4 loosely to her wound, taping it lightly in place with paper tape so she couldn't tug it loose. Lastly, she was allowed to suck on a vitamin c and zinc lozenge to boost her immune system and I gave her ibuprofen to reduce the swelling and any discomfort she wasn't vocalizing. She snuggled with us and watched Doctor Who with Tu (her new giant plush giraffe she named herself) and read stories until it was time for bed. My strong hope is that she wakes up in the morning happy, healthy, and with the redness decreasing from the sharpie border lines. I am trying hard not to be scared or worried. I am hoping she will heal herself with a little help and not need any more meds. I am hoping.
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