news and notes from jess and dan

some days are like that

...even in Australia, right? 

Reese dawdled by the car when we returned home from our idyllic errand-running.  He swung around and around a little oak tree near the curb while I carried Xander into the house.  I heard a cry and turned to see him laying face-down on the pavement behind our car.  He tells me that he was spinning and that he fell off the curb. The result?  Twice-bitten and scraped lip, scraped upper lip and nose, bruised and scraped forehead.

The day kindof spiraled down the drain from there.  Once you clobber your face, your good will is used up, I suppose.  He had a runny nose that prevented the nose/lip scrapes from drying, and that bothered him all day.  He thought it was still bleeding and asked me to make his blood stop. :o(  Poor kid.  He also had a tough time getting out of his car seat later, fell twice, gave himself a black eye, refused to speak to me, and then fell asleep on a friend's couch. 

He looked MUCH better the next day, when I took these pics, and his mood is improving as well. 

  

oh noooooo

Reese looked a little bleary this morning.  I blamed it on too little sleep this weekend and thought perhaps the bruises on his face from falling down the front steps on Saturday were contributing to it.  It's not pinkeye.  It's not pinkeye.  It's not pinkeye.  It's not.  I dropped him off at school.

Picked him up three hours later.  He's blearier.  And gooky.  Crap.  I had no other explanation for it by this point but kept humming my mantra in my head...it's not pinkeye, it's not pinkeye, it's not pinkeye.  Ugh.  Pinkeye?

I had Adam, who is a pinkeye pro after watching it sweep his family last week, take a look at Reese's eye.  It's pinkeye.  Yeah, I knew.  I had just hoped not.  Crap.

So, we escaped it for almost six years of parenthood, but it finally caught up to us.  I'm crossing fingers that none of the rest of us catch it.  Yeah, I hear the Allen-Short family cackling uncontrollably after reading that.  I can dream, right? 

The good news is that nobody was symptomatic yesterday when I visited my newborn nephew, THANK GOODNESS.  I'm still not symptomatic and I'm the only one who entered the house with the baby, and only held him after thoroughly washing my hands. 

The bad news is that this probably means quarantine for 3 days (if only Reese gets it) to a week or more (if anybody else catches it).  I had planned a lovely morning of voting and hanging out around town with Griff tomorrow.  With Contagion Boy joining us, I'll have to rework my voting schedule and probably skip the free scoop of ice cream at Ben & Jerry's.  I was really looking forward to having a morning with Griff.  :(  Oh, and of course the facial injuries and infection happen less than a week before Sabot's school photos.  Think he can be all healed up by Friday?

now THAT was a nasty experience

In the interest of avoiding my second or third sinus infection of the year (or, more to the point, in the interest of avoiding being terribly sick for a month straight and then having to take gut-blasting antibiotics from which it would take me another full month to recover), I bought a neti pot today.  I've been meaning to do it for over a year, inspired by what seemed like good science (saline lavage of sinus cavity, gotcha) paired with the glowing testimonials of my mom and two of my dearest, smartest, crunchiest friends, Janna and Lynz.  Thing is, there is probably NEVER a time when pouring water up one nostril to let it flow around your septum and back out the other nostril will sound like an entertaining thing to do.  So after not finding one at Target, I didn't look terribly hard...and got really, really sick this past spring. 

So now, I'm sick again, and it's taking another turn for the worse (mmm, sinus pressure paired with spinny head, fatigue, body aches, and oversensitivity to light/sound, just what I wanted for my birthday, thanks!), and now we have a sparkly new granola-friendly Whole Foods around the corner from us.  Before getting sicker and needing the dreaded Augmentin, I caved and bought the neti pot, a bag of fine-ground neti salt, and a dropper bottle of essential oils to add to the solution. 

Then I leaned over my kitchen sink, hooked up the spout to my right nostril, and poured.  Then, because I'm such a stickler for following proper procedure no matter how uncomfortable the process, I did it again on the left. 

I love how the package advises using it daily to improve breathing.  'Cause, you know, I really like to start my day feeling like I'm drowning.  Good times.  Sign me up for that.

I followed up the water torture with inhalation of steam spiked with tea tree oil, lavender oil, and garlic.  Already took odorless garlic this morning and got back on the B6/B12 train this afternoon.  Hopefully I can nip this thing in the bud.  If not, at least I'll be doing a good impersonation of a drowning hippy. 

The remedy is the experience, right?

aw, crap

So, I spoke too soon.  About an hour after I sang the praises of Bactrim, I noticed that Xander's neck looked rashy.  Took off his onesie, and the blotchy rash was across his collarbone and around the periphery of his armpits.  And starting to form around the insides of his elbows and knees.  Pinprick rash on his abdomen.  Soon it was across his back and on his arms and legs. 

Awwww, man.  I was lovin' the Bactrim.  Don't be sulfa-allergic, kiddo! 

After a rather fruitless exchange with the dial-a-nurse at the pediatrician's office ("we can't really know for sure what it is...") and a more productive call with our nurse practitioner ("classic sulfa rash"), I'm off the Bactrim and switching to Augmentin.  Which doesn't thrill me.  But whattaya gonna do, such is the life of the breastfeeding mom.  The pediatric nurse didn't seem to think it's necessary to put "sulfa allergic" in Xander's chart, but when we go for next month's appointment, I'm going to insist that Dr. Smith make a note about it.  My intuition was right about Griff's reaction to amoxicillin a couple of years ago and I'm sticking to my guns this time, too. 

On the up side, my sinuses are still improving and I think Augmentin is a shorter course than the Bactrim?  Dan's picking it up, I'll see.  I can yawn without intense pain, so that's nice.  Go, 20th century drugs!

antibiotics rock

To the good people who developed Trimethoprim-Sulfamethoxazole, my undying gratitude goes out to you.  I don't care whether it's bacteriostatic or bacteriocidal, the fact is that it's resulting in a lovely and rapid turnaround of the post-viral party that was going on in my sinuses.  I've been sick for a MONTH with first a mild virus, then something that was probably the flu, and then endless symptoms that I blamed on getting over the last illness and the advent of High Pollen Season...but this week when the lingering ick turned to intense pain and swelling of the palate, combined with exhaustion and body aches, it was time to give my poor overworked immune system a little help.  Took my first dose last night and another this morning (and a big GO ME for swallowing those horse pills, I have a gag reflex from hell), and this afternoon I'm happy to report that my palate is on its way to feeling semi-normal and my energy is much better.  When you've felt like garbage for a month, semi-normal is amazing.  Let's hope it's fully-normal in a few days.  I'll be zapping the buggers for a full two weeks, though.  Leave no survivors!

colorblindness

As mentioned below, I'm wondering if Reese is colorblind.  Griff could recognize and name lots of colors around age 2-2.5, but Reese is still not there.  He can label blue, black, and pink pretty easily.  Often green.  Yellow, rather spotty success.  He calls things "orange" a lot.  Red?  Almost never.  And it's the red that makes me wonder.  What is he seeing?  Is color recognition just not what his brain wants to work on right now, or is he actually colorblind?

My dad is red-green colorblind.  I believe his decreased color sensitivity would be described as protanomaly (red-weakness), judging from what I know of the things that challenge him - things like differentiating a red flower in a green bush, or being able to accurately label the colors of electrical wires.  I *think* red appears green to him.  Red-green deficiencies are sex-linked - carried on the X chromosome.  This makes my sister and myself carriers of a color-defective X chromosome, which means all of our sons have a roughly 50/50 chance of being colorblind. 

I've never had any doubt that Griff got my "good" X, but it's looking like Reese may have been given the other one.  I'm going to show him some images from a pediatric colorblindness test in the next few days and see if he points out the shapes or not. 

I wouldn't say this is a huge concern or that there's anything we would (or could) *do* once we find out, but it would be helpful for us to know this about Reese, and for his teachers know in the future.  We'll need to help him to find strategies to deal with some situations, like memorizing the positions of red and green traffic lights instead of relying on color.  (Hmmm, and that's another thing, by this age Griff was able to tell me to stop or go by observing a traffic light - again, different kid/interests, or difference in vision?)  I wonder if colorblindness is reason for an IEP these days? 

lions aren't scared of shots...

...but Griff sure is.

The subject heading is the name of a book that I had purchased in the hopes that it would help us out a bit with the vaccination fear.  Griff was never afraid of shots until his flu shot a year ago, which gave him just a mild and understandable fear of getting stuck with needles, but then when he had pneumonia last spring one awful nurse who was assigned to give him a Cephtriaxone (antibiotic) shot came in and without warning, pinned him down, pulled down his pants, and shot him in the butt.  Talk about a violation and sense of betrayal.  What's more, that shot HURT LIKE HELL; it had lidocaine in it, which burns.  Poor kid.  So from then until now he's been deathly afraid of shots and asks if he'll get one every time we have to go to see Dr. Smith or Dr. Conrad. 

Anyway, we went today for Griff's 5 year old checkup, which did indeed include some vaccinations.  I'm hoping that the next time we have to go through this, he'll be more able to screw up his courage.  For now, he's five, and unable to cope with terror, which meant I had to drag a slavering, cowering, shrieking child out from under an exam table and hold him in a bear hug while the nurse gave him his shots.  Reese and Xander were taken out of the room for this olympic event.  We opted out of having the PPD placed for now.  Enough trauma for one day.

Happier, more exciting checkup news:
1st vision check: he got the hang of it quickly and has either 20/25 or 20/20 vision.
Weight: 38.5 lbs
Height: 41 inches
Hearing check: postponed due to fluid in his ears - we're all getting over a cold
He brought his new bike helmet along to show Dr. Smith, and she was happy not to have to give him the helmet lecture. ;)

Following the shots, we visited Maggie Moo's for ice cream.  Both boys chose hideous blue cotton candy stuff, with multicolored sprinkles.  I've decided to keep MM's in my back pocket as the prize to follow shots in the future.

it's strep

 

Griff started complaining about a sore throat a couple of days ago.  It wasn't going away and was looking grody so I took him in and had them swab Reese, too, since he seemed like he was coming down with something.  Griff's strep test was positive.  Yay.  Reese's was negative but got sent for a culture, just in case. 

They had fun playing with the newish castle in the waiting room, at least.  There were no little people so Griff picked up some blocks and had them walk around and talk to each other.  It was one of the most successful and peaceful doctor's office visits we've ever had, and my first outing with all three kids!  I pushed my luck by taking all three to the grocery store to pick up the prescription.  Did fairly well EXCEPT that I decided to do some shopping since I was there AND I let them eat Bunny Grahams on top of the mini lollipops they had gotten at the doc's office.  So...sugared up kids and errand that took longer than 5 minutes.  Not smart.  But we survived. 

And, cool thing: babies are unlikely to get strep.  WHEW.  Apparently something about the pharyngeal mucosa before 15 mos of age makes it difficult for the throat to get colonized by streptococci.  Science is cool, especially when it swings in your favor.  No strep for Xander, most likely.  HOORAY!

get out and stay out

Dan's car's A/C is on the fritz.  We dropped the car off at the shop this morning and then drove him in to work.  Since it was his half day, the boys and I decided to just keep on movin' until it was time to pick him up. 

8:00 AM: drop Dan off at NAI

8:15ish AM: Einstein Brothers Bagels.  Too cold inside for Griff's comfort so we changed it up and had bagels al fresco.

9:00ish AM: Barnes and Noble.  Reese asks to visit every day.  Thought I'd make his day today.  Along with tall decaf one pump white chocolate mocha for me.

10:00 AM: arrive at Three Lakes Park for playdate with my friends Tricia and Melissa and their kids.  We're the first to arrive and feed the ducks, geese, fish, and turtles a pile of stale bread while we wait.  Friends arrive, we head to the walking paths where we discover a frog with an injured hind leg and about 20 different species of mushrooms.

Nature walks are always slow things.  There are rocks to be thrown into creeks, butterflies to pursue, mysterious holes to inspect.  We paused for quite a while at this bridge to drop gravel and look for spiders.  Tricia is on the left with Benny and Berge (June is out of the frame) and Melissa is on the right with Kelli.  Griff and Reese are the kids crouching in the center.

11:00ish AM: we finish our lake circuit and head to the playground for snacks and running around. Griff kidnaps my camera and later I find this interesting shot of my feet.

12:00 ish PM: can't leave Three Lakes Park until we visit the nature center.  Lots of tanks of fish and reptiles to see, bird call buttons to push, huge fake bugs and dead real ones to ogle, and ramps to run on. 

12:45 PM: head out to pick up Daddy.  Arrive at 1:00 PM.  We're tired and hungry but end up playing with Daddy's model brain and making balloon animals with Lucien for an hour anyway. 

Griff was so taken with the little balloon pump that Lucien loaned it to him overnight, along with a supply of balloons and a book with instructions for making animals. 



Here's Griff and Dan with attempts #1 (green) and #4 (black, successful!) at making a dog.

Epilogue: the car's A/C is still not fixed.  The compressor is shot and the whole thing needs to be replaced, which will cost about 3 times the current value of the actual car.  With fall coming, we're going to sweat it out for a little while and then revisit the problem next spring when it gets warm again.  The car is a 1995 Dodge Neon - which is really a disposable car that has already lasted 12 years (9 of them with us).  We were hoping for about 2 more years before buying a newer car for Dan.  Argh. 

sick

The scene on Friday, April 27:

That's a nebulizer he's got there.  The mask was a prop, an attempt on my part to make it more like a fun scuba experience than a medical chore. 

This adventure began with a head cold and mild spring allergies, compounded by the fact that our A/C coil was broken and we had to have the windows open the week that the trees out front bloomed.  Great timing.  Apparently Griff's lungs were irritated by this one-two punch and that made a perfect situation for a bacterial infection to take hold.  He's amoxicillin-allergic, so Zithromax was the first antibiotic to try.  No dice, he got much worse very quickly.  The photos above were taken the day we went back to the pediatrician - he was prescribed Omnicef, the nebulizer (albuterol) several times a day, claritin, and a steroid.  Add multivitamins, Tylenol for fever, and a probiotic, and the kid was a walking pharmacy.

No improvement that weekend, so Monday saw us stopping Omnicef and poor kid had to get a shot in the leg of a more powerful antibiotic.  He also was subjected to a swab for a bacterial culture, and then we were off to the hospital for chest x-rays.  Good news: not pneumonia.  Bad news: still don't know what it is!  Another shot in the bum the next day (poor kid is permanently traumatized, I think).  By Wednesday we had a name for the bug: haemophilus influenzae (untypeable), and a new antibiotic.  Fun fun fun.  It should have responded to the second one, but didn't, gotta love drug resistance. 

All told:
4 antibiotics
2 other prescriptions
9 days missed from school

He's ok now, but goodness, enough sickness!  All done!

Oh, and the steroids made him eat like a horse and retain water.  Which, in a four-year-old, is almost funny...if it's not your kid.    Plus, you know what happens when a child stops retaining water?  Bedwetting.  Oh, yeah. 

crummies in our tummies

Here's the scene after round 2 on Friday night.  Poor Griff woke up sick and needed most of his bedding replaced.  He was really upset.  We finally got the bed remade, Reese tucked back in, Griff comforted and back to bed...in time to start round 2.  The washer hadn't even hit the rinse cycle for the first half of the round 1 laundry.  Griff was less upset by the encore than by the first onslaught; he just came to find me and said "aw, man, it happened AGAIN!"  It's funny how kids take this stuff in stride. 

After round 2 we had to find MORE sheets and yet another stuffed animal for him to sleep with.  Caillou had gotten hit in round 1 and the duck and giraffe (his babyhood snuggly toys) fell to round 2.  Desperate for bedding, Dan and I actually ended up taking the mattress off the office bed, complete with sheets, and swapping it with his mattress.  Fortunately for us, round 3 took no prisoners.  Whew.  He was tired but fine this morning.

We're crossing fingers that nobody else gets hit.  Family stomach bugs are the worst!

follow-up on the follow-up

So...it turns out that the ped I talked to on Friday (Conrad) was confused and read REESE'S chart to me.  We already knew that his culture came back normal.  Our ped (Smith) called today and told Dan that GRIFFIN'S culture came back positive for streptococcal pneumonia.  Granted, that culture is now a week old, his x-ray that day showed viral pneumonia, he's been off antibiotics for nearly a week, and all of his symptoms have improved tremendously.  She agreed that going back on the abx would not be necessary.

Thus endeth (we hope) the pneumonia.

In other news, I got to be a "Star Parent" at Sabot for the first time today.  Turns out that Star Parenting is mostly being a hall monitor and chatting with the other Star Parent.  Griff was very happy to have me there and kept coming for visits in the hallway.  He would stay long enough to realize that Starring isn't all it's cracked up to be, then return to his classroom just long enough to get really lonely for mommy, then start it all over again. 

patient follow-up

First, the boring update.  Then cute kiddo pics.  Then the geeky x-ray stuff.

Update:

Griffin: off antibiotics, seems almost totally fine to me, some cough but it's better.  Nasal culture came back today - nothing but normal flora there. 

Reese: culture came back yesterday: also only normal flora.  No sick crankiness - he's totally teething cranky + entering-terrible-twos cranky.  It's nice to have only two out of the three.

I'm pretty sure that the "pus" the doc saw in their ears was uninfected fluid.  Swelling leads to negative pressure.  Negative pressure leads to fluid.  Fluid leads to the Dark Side.  Seriously - it provides a breeding place for bacteria.  The problem is that people think fluid = infection.  Not so.  Fluid might lead to infection but its mere presence doesn't mean infection is there.  The boys are nonfebrile and acting normal.  Nobody is complaining of ear pain.

Except for me.  Well, actually, the ear pain and whooshwhooshwhoosh are better, but my sinuses are clogged.  Today my jaw is hurting.  I'm still hoping I can chase it away but tomorrow may see me breaking into my secret stash of amoxicillin. 

Dan's still feeling cruddy but is on the upswing.

Pics:

Do these children look sick to you? Reese spent yesterday dismantling the dishwasher and unloading the dryer.  If I play my cards right, I may never have to do housework or pay for home maintenance again. Griff is back to doing headstands on the furniture.  Remind me why I kept him out of school all week?

X-ray:

Griff waiting to have his picture taken.  He looks so small!

 

 

Dan had a copy of his x-rays and the report burned to disk today.  Griff enjoyed seeing his bones and organs, as did Dan and I.  We found his slump and weight-shifted stance (see the spinal curvature?) somewhat amusing. 

If you click on the image, you'll see a bigger copy of it.  The perivascular cuffing is the junk in the middle of his ribcage.  No, not that junk, that's his heart.  The stuff around the periphery of the superior portion of the heart.  Yeah, that.  If you look hard you can see how it surrounds the bronchi.  The important thing here is that he does *not* have the wedge-shaped shadows characteristic of bacterial pneumonia.

There's something really gorgeous and delicate and vulnerable about these images.  If given my druthers, though, I'd prefer never to be in a situation where I get to see this kind of gorgeous picture ever again.  I'll settle for just seeing the outside of healthy kids instead.

3 years, 11 months, 2 days

...that's how long we managed to go without ever having to take a sick child to the hospital.

So, Griff's not all better, despite 5 days on Zithromax.  A re-check at the pediatrician's on Monday indicated that his ears are both infected and his lungs still sound lousy.  His cough sounds better, he hasn't had a fever in a few days, and he's acting much healthier, but he's still sick.

The ped ran a new CBC, which came back normal.  Poor Griff knew what was coming this time and didn't want the finger stick but was really, really brave.  The fact that mommy caved for the second time in a row and let them give him a lollipop probably helped to bolster his bravado.  He also took the nasal swab like a champ, although Reese (who also has infected ears and is on day 4 of Zithromax today) was not as thrilled with it.  We'll find out on Thursday or Friday what lovely critters the kids are growing in there.  Dan and I will probably re-medicate ourselves accordingly - whatever this bug is, it laughs at azithromycin. 

Dr. Smith prescribed Cefzil (cefprozil), which made me worry, because Griff is allergic to the penicillins and that gives him a 1 in 10 chance of reacting to cephalosporin drugs.  The problem is that the penicillins and related cephalosporins are more effective against crud like this.  So we've got the Cefzil and I dosed him with crossed fingers and Benadryl at the ready.  So far, so good.

Then, because 1.5 hours in the ped's office and fetching a prescription from the pharmacy wasn't enough to keep two sick kids and their sick mama busy for an evening, we went for a chest x-ray.  You know, just for kicks and to keep our insurance company on their toes.  No, really, it was to see if the pneumonia is bacterial or viral.  Apparently bacterial pneumonia looks wedge-shaped on x-ray images, while viral pneumonia is more diffuse and hazy.  Now that you know that, you can hire yourself out as a radiologist and collect the big bucks. 

I was worried that Griff would be really fearful about going to the hospital and having his x-ray taken so I talked it up.  He's been to the hospital before with Dan (and we picked the same hospital, the one with the famed "underground parking garage") but not as a patient, and he really isn't big on visiting the doctor in general.  I told him we'd stop at home, take some medicine and get some dinner and clean diapers for Reese, and then go to the hospital to have x-rays.  Do you know what x-rays are, Griff?  It's when they use a big camera to take a picture of your insides!  Wow!  My camera can only take pictures of your skin and clothes outside your body but this camera can take pictures of your bones and your lungs and your intestines.  Cool! 

Mom's marketing plus the parking garage excitement made for a smooth trip.  Miraculously, the outpatient registration lobby was nearly empty and the woman behind the desk was happy to meet me, having checked in lots of my husband's patients.  On our way to the radiology department, I remembered Curious George's hospital adventure and reminded Griff of it, and...duh...that George gets an x-ray to find the puzzle piece he ate.  It's not every day that a 3 year old gets to live a Curious George story.  Radiology was deserted except for my two guys who were thrilled to explore the waiting room.  The radiology tech was wonderful with Griff, and Griff happily went down the hall with him, quietly cooperated with all the instructions, and stood patiently while his pictures were taken.  Then we talked about the computers in the room, what the lead aprons are for (he got to wear a little lead loincloth), how the cameras send pictures to the computers, the way you can take an x-ray of any part of the body, etc etc.

Getting back into the car a few minutes after bedtime, Griff exclaimed, "THAT was FUN!!"

Yeah, but let's not have any repeats any time soon, ok?

Dan was on call last night.  I had had the forethough to have Griff's results sent to him as well as to the pediatrician, so when he got called in to HDH last night and logged in to check his patient's info, he was surprised to find Griff's x-rays waiting there for him.  He called up the radiologist and reviewed them right then.  Nice to have some perks to late nights at the hospital!  He said the films were really cute, this tiny little boy body.  He apparently got all mushy about his little guy and the radiologist didn't quite get it.   I thought it was sweet, though.

So...the results:  no bacterial pneumonia.  Hooray!  There is "perivascular cuffing" which is apparently consistent with viral pneumonia, but no bacterial bugs in there so far, so that's good.  The gunk in his ears (and mine, and Reese's) is probably a bacterial secondary infection.  Once we find out what kind of bacteria it is, we can go from there. 

Dan will be able to get a copy of the digital images for me and plans to get it after the report is dictated so we can have a copy of that, too.  I'm psyched to share the pictures with Griff, who will be THRILLED to see his own bones. 

Chatted with Gayle Smith today, she's also encouraged by the results (I didn't mention that I had them before she did).  We're going to keep Griff on the Cefzil in the hopes that the bacterial yuck in his ears doesn't migrate south, and possibly change antibiotics on Thurs/Fri when the cultures come back.

I finished my Z-pack yesterday and my ear is throbbing today.  Sudafed is helping but I wonder if I should start some Amoxicillin or Augmentin.  Oy.  Wonder what superbugs we're breeding?

Griff's out of school until further notice, in order to prevent him from contracting anything else.  His classroom is a mess, lots of flu and strep and various coughing illnesses.  Dr. Smith doesn't want his immune system to take another hit right now.  I'm inclined to agree.  That and I don't want to share what we've got. 

Ok, so that was long and rambly, sorry, but it's what's going on.  Exciting, although perhaps not the kind of excitement we'd prefer.  The original plan for last night was to take the boys to see the lights at the botanical gardens.  Cross your fingers for us that we're all healthy soon and can get back to having fun!

house of contagion

# of children with walking pneumonia: 1
# of adults catching walking pneumonia: 1.5
# of family members on heavy-duty antibiotics: 2
# who will probably start them tomorrow: 1
# of guests who might take home unexpected souvenir: 2

Yes, it's as much fun as it sounds.
Yes, we're enjoying saying Mycoplasma pneumoniae. 
No, daddy's stethoscope is not a toy.
No, we do not have enough Kleenex.

And in case the above is too vague:
Griff has it
Jess is catching it
Reese is on his way to being medicated
Dan thinks he's safe for now