Friday, May 16, 2014

Adventures with the (not) measles

Well, once again, it's been awhile. I've been in a writing funk lately. I'm not sure why. I've gotten busier, for sure. Sylvia is moving more and napping less. And Peregrine has hit his 2's hard. Sometimes, when naptime rolls around, I just feel like zoning out completely. Doing something incredibly boring that requires no brain (hello Facebook!).

We've also been bogged down with sickness for the last month. I had a sore throat and on-and-off cough for weeks. I had a few miserable days, but mostly I just felt tired, down. I held off going to the doctor because I never go to the doctor, and it's not like I can take any medication while breastfeeding, but finally, I gave in. I called the doctor, and set up an appointment, and within hours, my sore throat went away. And didn't come back. Seriously. Apparently, all I had to do was call the doctor. Not even see her. Just threaten to see her.

File that one for future reference.

But, really, likely the reason I wasn't getting well was because I wasn't sleeping. Because my already-owly daughter decided to start cutting her teeth, while miserably ill with a mysterious disease that is now formally known around here as the Not-Measles.

Backpedaling a bit.

Sylvia has one of the best immune systems I have ever seen. The kid does not get sick. Her brother goes to school and picks up every germ out there, he strokes random cars lovingly, he chews on his shoes, and then he goes and shares water bottles with her, or sticks his finger in her mouth just for the fun of it. Sylvia has had some runny noses here and there, but other than that? Germs don't appear to affect her. Andrew and I call her Iron Woman.

Anyhow, she got sick. Bad. Poor baby was miserable. She was whiny and cry-y and wouldn't sleep at night and just wanted to cling to me in misery all day. One night she spiked a high, high fever very suddenly, her first fever ever. I had already given her Tylenol for teething, so we just waited it out. The Tylenol kept it manageable but she was a sad, sad baby. Two days later, I was changing her diaper and I noticed a rash on her belly.

I don't know what made me think of the measles. It's not like I'd ever seen a case before. But the rash was new and different, and I had been wondering why Peregrine was showing zero signs of even fighting sickness while Sylvia was so miserable. We had been in Bellingham the prior weekend, and I had heard of some measles cases there, so I guess that brought it to the forefront of my mind. So, I went and did what any self-respecting mother would do: I googled it. Dr. Google confirmed my diagnosis (though that isn't saying much, Dr. Google would confirm a diagnosis of cancer or necrotizing fasciitis if I wanted him to), so I decided to call my pediatrician and see what he said.

Unfortunately, the office had just closed, so I talked to his nurse-on-call. After grilling me for half an hour on symptoms and exposure, she decided measles was a possibility and that I should take Sylvia to the ER just in case. Only, I've never been to the ER. I dread going to the ER. I have heard too many horror stories of 4-hour wait times and terrible hospital bills and I didn't want to put my sick, tired baby through that only to learn that she was, I don't know, allergic to teething or something random and stupid like that. So I went to a minor emergency clinic instead.

The doctor there examined her, grilled me on symptoms and exposure again, and finally told me he was 99.9 percent sure she had the measles. He explained that there was nothing I could do but keep her fevers down, nurse her lots and give her Pedialyte for fluid replacement, and keep her from unvaccinated babies. He assured me that she is strong, that she had fought it admirably, and that, barring some unforeseen complication, she would recover just fine.

So I went about my merry way, wore my baby, nursed my baby, monitored her temperature, put cream on her rash, and introduced her to the joy of sugary fluid replacement drinks. She had a few more miserable days and started getting better.

Then Public Health called. Or rather, Peregrine's preschool director called, telling me Public Health had been calling her non-stop and asking for my information, and could she please have my permission to release it. Then Public Health called. And kept calling, and calling, and calling.

Apparently, they should have been involved from the get-go. I was surprised that they weren't, honestly. I was surprised that the doctor had just let me go without even signing anything. I assumed he would just write a report later, but apparently, he didn't. Word reached Public Health via a grapevine related to the preschool, whom I had notified shortly after the diagnosis, when I tried to notify everyone I might have inadvertently exposed.

Public Health was actually quite pleasant to work with, if extremely aggressive about making sure I answered their calls. They didn't even seem surprised that the doctor had been so lacking in knowledge about formal protocol. (Apparently, one should never ever make a measles diagnosis clinically, and, as measles is freaking airborne, one should never just release a measles patient into the wild. Who knew? But, I'll tell you who knows now: I do. And so does that doctor, who, Public Health kindly informed me, was "educated" about his error. Anyhow.) They suggested (and even kind of begged) that I have Sylvia formally tested, both blood and urine, for antibodies to the measles virus to make sure that was what she had had.

And I worked my butt off for the next several days doing just that. They had me keep a log of everywhere she had been, and everyone she had potentially exposed, during all her theoretical infectious period. Fortunately, I have an excellent memory and a pretty stellar ability to keep track of every detail of something, but it was a daunting task. And a sobering prospect when that list included, you know, a good portion of the cities of Bellingham and Burien. But that was the easy part. I also had to get her urine and her blood tested.

Let me say this for the record: it is incredibly difficult to get a urine specimen, amounting to 50 milliliters of fluid, from a baby girl. First of all, it's difficult to get that much fluid into a baby, let alone out of her. I milked her love of the novelty of Pedialyte bottles for all it was worth. Poor child was force-fed more sugar water in those three days than I hope she consumes over the next month, at least. I had to put these bags inside her diaper, in the hopes of catching a full ounce-and-a-half of baby pee. Let me just say it was never proven impossible. I suppose those bags might work for a very still, calm baby boy, but Sylvia is a wiggle monster, and baby girl pee goes everywhere. We had eight failed attempts. Eight. She pooped in two or three of them, and as for the others, either she didn't pee a full 50 mils, or she did, and that much liquid dissolved the adhesive on the bags, rendering them entirely useless. We never did make it work. Her blood test results came in right after I finally made an appointment to catheterize her. I'm really, really glad that didn't have to happen.

The blood test, actually, wasn't all that bad. It was no pediatric finger prick, but a full-on blood draw, with arm veins and tourniquets and those little tubes of blood. But Sylvia did fine. I think she was more annoyed at the tourniquet than anything. She was having a great time flirting with the nurses, so she would fuss for awhile, then cry, then look up at them and laugh, and then fuss again, like she was trying so hard to be their friend, but the rubber cutting off her circulation (not to mention the twisted arm with the needle in it) was kind of throwing her off a bit. I think it was worse for Peregrine, who was anticipating the whole thing, and who has inherited his mother's great dislike for needles of any kind. Poor kid. He felt so bad for her. He kept saying, hesitantly, "I think Sylvia not want her blood draw."

Anyhow. In the end, the results came back: Sylvia did not have the measles. No one knows what she had. My second guess was roseola, but the nurse I talked to said it didn't sound like that. Who knows. She has cut another tooth since, so I think we can rule out allergic to teething. If that's even a thing.

It was actually kind of a bizarre experience, since, by law, I'm not required to cooperate with Public Health at all. I could have just said no, hung up, and been fully within my rights. So, while they were rather aggressive in pursuing me, they took great pains to make it as easy as possible for me. They paid for the whole thing. Practically every nurse or doctor I spoke to knew my name, and Sylvia's, and greeted us accordingly (and if they didn't know us, they apologized profusely for it). They helped me out with parking at the hospital, and didn't get annoyed when I got lost multiple times. Tests were expedited and results were communicated immediately. I was put at the front of every line, and allowed to come in during lunch breaks and off hours. It was weird. I've never felt like such a VIP in my life. Especially with strange doctors, where I'm used to being very much just a number.

But it's over now, and I'm so glad it's over. I have so much more respect for parents of chronically ill kids. I can't imagine the kind of stamina it takes to do that for more than three days. It was a whirlwind of stress and learning and so much relief when I learned I would not have to attempt another urine bag for a nice long time.

But, in retrospect, I should have just gone to the ER. Probably, I should have called Public Health first with my concern, then showed up at the door and told the receptionist, worriedly, that my baby had spiked a high fever and shortly after broken out with a pinprick rash, and I was concerned about possible measles exposure. Then I wouldn't have had to worry about any wait time or money at all.

Oh well. Next time.

1 comment:

  1. I'm so glad you wrote this. If only for Brian's and my singular enjoyment. Your positive perspective on experiences brings out the humor and joy. We love laughing along with you.