Wednesday, October 7, 2009

Not so squeaky wheels

I have two kids who will scream blue murder about the tiniest little thing... aches, pains, upset tummies... you name it, it's worth getting some attention over. And then there's my youngest boy. He rarely complains. And if he does cry, you KNOW he's hurt bad.

He's the tough one I guess. I guarantee he has a higher pain threshold than I do...

Only sometimes that old saying about the squeaky wheel getting the grease is all too true... and being tough isn't a good thing.

I have one very sick little boy on my hands.

And I feel terrible because it took me so long to even realize it. I know that if it were either of my other two, I would have known and taken them in at least 24 hours sooner....

Guilt sucks. Parental guilt sucks even worse.

When I picked him up from school on Monday, he was complaining about an itchy leg... "an itchy wet leg". The "wet" thing made me stop right there and pull up his shorts leg to look... and what I saw was a small wound (like a scab that had been scratched off, or maybe a bug bite?) that had obviously been scratched at for a while. He'd made it bleed. It was gross but I'd seen much worse... no biggie.

So when we got home I took a minute to clean it up with disinfectant, put some polysporin on it and cover it with a bandaid. I even rubbed some after-bite on the area around the bandaid to calm down the itching so he wouldn't get after it any more. Then we moved on to the chaos of our evening and I never gave it another thought.

That evening, at hockey, he told his Dad that his leg was hurting. I only got this message yesterday when we were putting it all together....

Then the next morning (Tuesday, yesterday) he told me he wasn't feeling good - his stomach hurt. He seemed fine otherwise: no fever, good appetite, no other complaints... and normally I wouldn't instantly keep a kid home just because of some indefinable "sore tummy" on a school day (you know, one of those), but this is my boy who NEVER complains about anything. So I took him at his word and kept him home.

He laid on the couch watching movies, seemingly perfectly fine (no more complaints) for the rest of the morning. I decided, since he didn't really seem sick at all, I wouldn't waste the day and he could tag along with me while I ran some errands. But when he got up to get his shoes and jacket, he was limping. I asked him why and he said "I don't know, my leg is funny".

That didn't make much sense - but I just thought maybe it had fallen asleep or something from laying around for a few hours or whatever... and off we went.

I really should know better. This is my boy on the autism spectrum... he says the most bizarre things sometimes and his descriptive word choices can be totally off the wall. Like saying he has a "nervous throat" to describe that tightening you get when you're upset, etc.

I should have looked at "funny".

Instead, I drug this poor child along with me while I traipsed through the mall stopping at three stores I needed to hit... limping the whole time. But not complaining! He was just thrilled when we stopped for a few minutes at the pet store to check out the animals... and the popcorn I bought him from Kernals more than made up for the boredom of his having to wait while I shopped a bit.

It wasn't until we were back home, at 3:00 in the afternoon, that I noticed how gingerly he was sliding out of the van. It was a full 24 hours since his "itching" complaint before I asked him how bad his leg hurt and even thought to take a look at it again.

I didn't even connect the two issues: small scratched open scab + sore leg... until I looked at the red, swollen, baseball-sized area around my bandaid patch job. We left for Children's right then.

And when we got there it was relatively quiet... I told them I thought some kind of allergic reaction or infection was spreading on my son's leg. They took a look and got us into a room about 20 minutes later. And when the nurse removed my bandaid to reveal not one small wound, but a now large HOLE and a second opening both oozing puss, I think we effectively settled on infection pretty quick.

They took a sample to culture and decided, based on the extent and it's quick progression, to start him on IV antibiotics. Even though we don't really know which bacteria is involved, they've started him on something to kill both strep & staph (the most likely culprits). He has a pill he needs to take a 1/2 hour before the course of antibiotics (supposed to boost their effectiveness?)... so he got that then we had to wait. Then the actual IV takes half an hour. Then the flushing of the IV & wrapping....

They drew a line around the large red area surrounding the wounds with a pen. I remember my mother (or maybe my grandmother?) telling me never to write on myself within ink when I was a kid (after I colored myself some pall-point tattoos?) because I could get blood poisoning or something... I'm not quite sure - I just know that I've always thought it was a really bad thing to do. However, I'm going to assume that it was just another one of those old wives tales because really, these are medical doctors - so I'm not going to question them on their choice in instruments when coloring on my child. They should know, right?

The line was to mark the area so that we could see, at the time of his next IV course, how the borders of the infection area had changed. Then they dressed the wound, disconnected and carefully wrapped the IV port on his hand, and sent us on our way. We were there for about 4 hours, all told.

2-3 years ago, they started doing IV antibiotics on an out-patient basis in the ERs. I think it's a great idea. I mean, what's the point in corralling an otherwise-well child in a hospital room for days just because they need a half hour of medical care every 12 hours? My boy would have been completely stir crazy (like every other kid out there, I'm sure) within hours. But this way, he could be in the comfort of his own home until it was time to come back for another course of the IV antibiotics. And they told me that when they could see that it was working (ie: the affected area was getting smaller) they would switch him to oral antibiotics instead.

I'm still waiting for that.

My boy was so sick on the way home from the hospital after that first treatment last night. We live 20 minutes from Children's hospital - and I had to stop 3 times because he was going to be sick. He didn't actually puke until we made it to our own front yard... but it was awful seeing him feeling so bad. At our second stop he walked out from the van onto the grass area I'd stopped beside and just fell to his hands and knees.... then he put his forehead on the ground, and then lay right down on the cold damp grass. My poor baby. I picked him up and helped him back to the vehicle - I just wanted to get him home! I was so worried. I've never seen him this sick. He looked like the walking wounded... what with the limp and the hunch and now the pale "I'm-going-to-heave-any-second" look on his face.

He slept good though. And this morning when I woke him bright and early to go get dose #2, he was walking better. We had to leave at 6:30 to get there ahead of our 7:00 designated time. Every 12 hours... I guess I should just be thankful right now that he didn't get his first course at 3 in the afternoon or something awful like that! Can you imagine?? 7:00 (am/pm) I can do....

This morning we were in and out in a hour. There wasn't a single person in the waiting room (first time I've ever seen that!). It was too soon for any results from his culture... and I was sad to see that the area hadn't shrunk at all - in fact it was spread a tiny bit past the ball point border from the night before. But we were really early in the course of treatment and he was feeling so much better that everything seemed really positive. He's walking better and says it doesn't hurt much anymore... and he's his usual happy self...

We spent a pretty quiet day at home. He didn't get sick after the second treatment (thank GOD)... but he was a little more tired than usual. To be expected I guess.

We were back there tonight for course #3. And we walked in to a line-up... and a very busy waiting room. I was prepared to wait. They'd warned me that they would try to get us in as soon as possible... but emergencies, understandably, have to come first... and if there just aren't any treatment rooms open... well, you might wait. Evenings are always their busiest times... and It's OK... my kid isn't suffering (now) and I would rather see a baby in respiratory distress or a toddler bleeding profusely from a head wound go first (I've been THAT Mom before too!). But there must not have been any real emergencies... because we were in and out in about an hour & 20 minutes this time. With a Popsicle to boot.

Only tonight, when they removed the wrapping, the angry red borders of the wound have almost doubled in size. Again. In 24 hours, again. And I'm thinking they should already be shrinking if the antibiotics are working? I really thought that tonight would be our last trip... that he would be switching to oral meds because he's feeling better and everything's looking good. But that's not what's happening. I'm trying not to panic as news stories of flesh eating disease flash through my head... and I'm trying to believe the Dr's reassurances that it's expected that it will "spread a little". But double in size?? Really?

So I'm clinging to the fact that my boy tells me he's feeling better... and it's obvious that the pain is down. Neither of those would be happening if something wasn't working, right?

So tomorrow morning, bright and early once again, I will take my son to Children's for course #4 of these antibiotics. And there's a hope that the culture might be showing something... and I'm just praying that the infection is finally getting smaller. They drew a new border tonight... it takes up the entire inside and some of the back of his thigh now...

I'm ready for this to be over already. It's so ugly and awful... I took a picture of it yesterday to show my husband - and made the mistake of letting my son see what the abscesses on his leg looked like. He freaked (my bad)... and I'm thinking it's a really good thing it's in a place that he really can't see well himself... if yesterday upset him, the way it looks today would really send him over the edge.

My poor child. What a lesson this is. I have to watch, and really pay attention, to this little man so much more than his "squeaky-wheel" siblings. I have no doubts that I'll always know when something's bothering them before it's too late... but this one? This is an awful way to learn the lesson of how something so small, when overlooked for just a short time, can so quickly blow up.


Anonymous said...

Oh my goodness the poor thing ... don't let the mommy guilt get to you too much ... just know you got a little trooper on your hands there ... here's hoping the culture shows something tomorrow and his leg is looking better!!!

Robin said...

Oh shannon, I hope he is feeling better. Don't beat yourself up about DO have a little trooper on your hands, and he is lucky to have you!!!!