Tuesday, January 29, 2013

*copied*

I would love to go into the full story but I am wiped. Instead, I am going to just copy my update from facebook here in order to not have to run around in circles.

poor little guy :(

Ok.... Long story short, we are home. I won't go into all the details because this would be too long. But the short of it, we left the house for PorkChop's appt and he was at 104.7 in the ear. Got to the doc's office and they weighed him (down a lb since his last check three weeks ago) and checked his temperature.... 105.5 under the arm.  Nurse left to find the doc (not let him know that we were ready but to find him). Dr came in, rechecked his temperature (still 105.5) and told us to just head straight to the ER, that there was nothing that he felt he could do with a presenting fever that high.


Got to the ER and they sent him through admitting pretty quickly. They had me strip him immediately down to just his shirt and diaper, refused to let his "soft" drape over him and then did his temperature under his arm.... back to over 104 but under 105. She took his weight, and then checked heart rate/bp/breathing. Breathing was still within normal at 35 rpm but his heart  rate was 175. The nurse forced motrin into him (literally.... was a really fun experience) and sent us out to the waiting room for a ward room to open.


ER doc was sure that he had the flu between his cough and fever so she did a flu swab, RSV swab, checked his ears and throat and said that once those came back, we would probably be out. About an hour later, she came back in to tell me that we needed a urine sample and a chest x-ray. So they cath'ed him and couldn't pull enough to do a "proper" test (duh.... dehydrated..... just wasn't presenting with any symptom of dehydration) but enough that they thought that they could check for infection. Which, they were now leaning toward a UTI/bladder infection. Xray came down, got their pictures and we were sent back to the room.


Fever was finally coming down at this point to just over 100, so barely a fever, so they brought in a dose of tylenol to piggy back the motrin. At this time, ER doc comes back in and said that she had good news... Flu and RSV swabs came back negative. They were still sending away for the 48hr cultures but she didn't see anything coming from that. But... his urine showed an elevated white blood count (20,800+)  blood (which she wasn't positive couldn't have come from the shitty cath that they did) and bilirubin of 2+. She also said that it looked like the sample had been "contaminated" so they wanted to do a catch bag on him for another sample.


She also decided that they would need to run some blood work because everything was saying that he had an infection but they couldn't find it. And given his history of these mystery fevers, she didn't want to overlook something. Especially since she said that there were markers of things showing up but nothing was connecting for her.


So then they drew blood, hooked PorkChop up to an iv for fluids and did the catch bag. An hour and a half on the iv (and nursing) and he barely had enough for a sample again but enough to re-run the initial tests quickly. No UTI or bladder.


At this point, ER doc came back and let me know that they would be admitting him for further testing. She threw out some possibilities of what this could be (honestly, only one sticking in my head is septic arthritis) and then started asking me what tests they have already run on him (which was none). Told me that they could possibly do a cat scan, MRI, spinal tap, etc..... At that point, I called hubby to come back up there to bring me what I needed for at least a night and to let him know because I did not want to be consenting to anything without someone there to discuss things with.


Blood work came back with the urinalysis and still no obvious cause. ER doc spoke to the on-call pediatrician and they decided NOT to admit PorkChop for the further testing only because its the flu season and they didn't want to expose him to anything else. Instead, she came in and talked to hubby and I about making an appt with pediatric infectious disease. Said that this could all be nothing, he could just be really prone to viruses. Or it could be autoimmune. Or it could be something that she, as an ER doc and not a pediatrician, is just missing.


So that's where we are today. For the first time ever, he has a recurrent fever this morning (before, once the fever has broke with medication, it has stayed broken, this time, it broke and came back during the night). I don't have any answers, I don't know what they are going to put him through. I can't even guarantee that they won't send him back to the hospital. I am very glad that someone is FINALLY going to get to the bottom of these fevers since our only link was at 6 months, his WBC was elevated with one of these fevers too. No other time has much anything been done other than guessing that it must be an ear infection because "no other signs of infection but the fever says something is wrong".

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