The Little D is sick again, making it the second time in a month, but really, she's been sick most of the time throughout too. The first time was in India. Well, that's not even true either. The morning of our flight (literally on our way to the airport), we stopped by our pediatrician's office to be told that she had an ear infection. Which is exactly WHAT we wanted for her before a 24 hour flight. By the way, she handled it like a pro, and seemed mostly ok after we got there. We count dripping noses as "ok" around here.
But about a week into the trip, she developed a fever. It started off low grade. We noticed it when we went on a weekend trip with my family. She seemed tired and out of sorts, and not really sleeping well. But it was hard to say what that was related to really. We had just driven up to this resort town for the weekend. It was a good 4 hour drive, and the last bit was super windy. Being the brilliant travelers that we are, we pulled out a video for the kid just before we got to our destination. And realized that driving on a windy road and watching a video just don't go hand in hand. And by realized, I mean, G got vomited on. One second everything seemed ok and the next, meals from the last 3 days seemed to be erupting from our kid and onto G's lap. God, can you imagine what that would have been like if I'd been the one holding her?? We were less than five minutes from our destination and woefully underprepared for the vomit. So good times all around.
Anyway, we assumed she was carsick, and blamed ourselves for the video. And assumed that she didn't want to nap because she had slept in the car. Or because there were a million monkeys outside our hotel room and she was having way too fun pointing every single one of them out, with a "inkey -- oooh ooh oooh." It was only later that afternoon that we realized she felt a little warm. The next day, on our way back, she fell asleep on me for most of the trip and felt HOT. I was already to starting to freak out at this point. D hasn't gotten that many fevers in her life, and the only time she did, we discovered she had a kidney condition. So of course I started to worry about her having a break through infection despite her daily antibiotic dose. But it was a Sunday, and we didn't really know where to take her. She seemed to be hanging in there, and that evening, I had my mom call a doctor. Earlier in the week, we had taken D to a doctor because she kept poking at her ears and we wondered if she still had an ear infection. She didn't. My mom called him again that evening, and eventually, he picked up. At this point, we had already been dosing her, but we did again. Checked her temperature again a while later and it was 105!
So we freaked out and asked to take her to the hospital. The thing is, we've been lucky. We've never had to take D to the emergency room at home. She's supported by a pretty amazing medical staff. Man, that makes her sound like a cancer kid or something. But you know, we've called our doctor at home on a Sunday rather than going int the ER. We've never had to wait with a sick child in anything other than a doctor's office. So imagine having to do that for the first time in another country. Where the "waiting room" is the hallway and mosquitos are swarming left and right. Where there appears to be no line whatsoever and the nurses seem unclear as to whether there's even a pediatrician around who can see our kid.
They gave us some random medicine to give to her and told us to take her clothes off and wipe her down with water. When we were finally seen, it was whatever doctor was on call. I explained about her VUR and that I was worried this could somehow be related to that. It turned out that all he was prepared to do was send us home with meds. He didn't really know how to deal with the extra VUR component. So finally, they got us into see a pediatrician. Walking upstairs to see him, we wandered past the wards. And I'm telling you, it was like a scene from a war-torn country or something. It was a children's hospital, and basically there were rows and rows of beds with kids in them. The beds looked ratty. Families were sleeping in hallways and the foot of their kid's beds. I've dealt with the Indian health care system before, and have gotten pretty good care overall, but I gotta say that I'm lot more tolerant when it comes to myself than I am with our baby. And I'm betting G was freaking out as we were walking up.
So the ped didn't seem super convinced by my diagnosis. I was thinking after that he must see it all the time. Random pushy people trying to say they know what's wrong with their kid and berating him for not giving more meds. I don't know. Maybe. But at the time I was pissed, because of course I know that I'm not most people. I'm usually right for one thing. :) OK, so maybe that makes me sound like it a know-it-all. But I am fairly involved when it comes to this stuff and have a fair bit of insight into D's various medical conditions. And I know that while her fever could be viral, with her history, the possibility of a bacterial infection was too high to ignore. And I guess this doc didn't know that I wasn't just some pushy "American" parent, but that's exactly what he wanted to do, ignore the possibility altogether. Well, not entirely. He thought we should collect urine and get it tested. And he finally prescribed antibiotics but made it clear that he was doing it only to appease me. Didn't bother to mention that we should collect the urine before starting the antibiotics. And told us to head down to the labs downstairs to give the urine sample.
We headed downstairs. It was almost 10 by this point, and the lab was about to close. They gave us a little cup to collect her urine in and told us to drop it off within the next half hour. Um, yes, that's exactly how I would collect urine from an infant. Just hold the cup under her and tell her to go. We pointed this out to the nurse there and she finally said that if we wanted, we could go buy some bags at the pharmacy downstairs and stick one in her diaper. So I don't know if you guys remember my last attempt at urine collecting with a bag. Well, these were the exact same ones. So I headed back upstairs to find the doc again, and explained that the chances of D urinating in that thing was next to nothing, so what about if we used a catheter instead?
As luck would have it, as I was explaining, the other doc, the one that we had seen previously, actually showed up! I guess that's why he had asked my mom to call him later. He usually did rounds at this hospital anyway, and figured we could see him then if needed. I'd actually liked him when we'd seen him the week before, so when he jumped into take a quick look, I was relieved. Rather than a sign of appeasement, he agreed that we should start antibiotics, and reminded us to wait until we'd collected the urine before giving them. We knew this from our scare last year -- by the time we were able to collect any urine, we'd already started antibiotics, so the urine test didn't pick up any bacteria. It was #1 reason they hadn't been able to diagnosis her VUR right away. So yah, we know better but I had been pissed at the first doc for not mentioning it. But this doc still didn't buy that a catheter was necessary. It's invasive and painful, he said, why make her go through it? And how can I argue with that?
So anyway, off we went back home. By this point, D's fever had dropped a little. We stuck the bag in her diaper and waited for her to pee. She fell asleep but we kept waking her every hour or so to check her diaper. Actually, we noticed though that she cried every time she peed and that was a signal to wake her up. That didn't bode well for the UTI. But like before, she managed to pee everywhere but the bag. Sometime around 1 or 2, she cried again, and I grabbed her to soothe her back to sleep. And realized she was shivering. She shook and shook uncontrollably. After about 10 minutes of it, we were officially freaked out. We woke the whole household and ran her back to the hospital. She shook the whole way there, and vomited while we were waiting to see the doc. Soon after the shivers stopped, her fever started to climb, and she must have gone from no temperature to 104 in under half hour. At this point, they decided to admit us. When we went upstairs, the staff pediatrician was still there, and agreed that admitting was the best course. I guess the shaking and crying during peeing were the new symptoms that convinced him that a bacterial infection was likely. They started antibiotics and I didn't care that we didn't have any pee collected by this point.
So there's more to the hospital stay, of course, and I'll continue the story next time. But yesterday, she got sick again, and I was struck by how differently everything went this time around. We happened to have an appointment with a urologist already scheduled yesterday. And the day before, when it seemed like D was feverish again, I'd called and scheduled an appointment with our pediatrician also. At the urology appointment, she got her usual 6 month ultrasound and then we saw our doc. We'd already mentioned her fever to the nurse. The doc came in and immediately said that he wanted to cath her and collect urine. The catheter is a terrible procedure to watch and clearly painful, but it was nice to have it done by some one who was super competent at doing them. He looked at the urine and said that it didn't look too cloudy, so he felt comfortable not amping up her antibiotics right away. If there had been more particles floating around, he'd have suggested otherwise. But at any right, we'll know by tomorrow if this is a UTI. We then went to our ped's office, who collected blood, and had immediate results showing that this is unlikely to be a bacterial infection. So all signs point to good news so far. Our ped suggested that we have the urology clinic cc her on the urine culture results because they're not open on the weekend. But she would call us as soon as she got them. By 10:30 yesterday morning, I was heading home feeling loads lighter than I had been when we woke up. Our experience last year was very different, of course, so it's hard for me to blame the Indian hospital/doctors. But it just feels so nice to now be part of such a well-oiled machine.
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