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Jun 27, 2010

Mystery diagnosis

I spent Friday afternoon helping my friend, Melanie, unpack moving boxes at her house. My mom helped us for a while, then graciously watched Gavin and Lexi so I could finish up. Melanie bought me dinner then dropped me off around 6:00.

Gavin and Lexi were clearly ready for bed. Gavin ran his own bath. As the kids were playing in the tub, I noticed that Gavin had a rash on his lower torso, bottom, and legs. It was light purple, and the spots were about pencil-eraser sized. I wondered if it was a heat rash. (Mesa is very HOT right now!) I also noticed that Lexi's diaper rash, which had appeared that morning, was much worse. I decided to call the after-hours service my Colorado pediatrician offers, but not until the kids were in bed.

The nurse I talked to thought Lexi's rash sounded like a yeast rash. She called a prescription into our neighborhood Walgreens in Colorado. I could pick it up in Mesa the next day. Excellent. But what she said about Gavin stunned me: "Hang up the phone and go to the nearest Emergency Room immediately. He needs to be seen within the hour."

What?

Her response really scared me. What could be so serious that he couldn't wait for urgent care the next day? Couldn't I watch and wait? She was adamant....and yet quite vague about her concerns. She refused to tell me what illness she suspected. So we got ready for the ER. I gathered some snacks and water and a pitiful collection of entertainment options for Gavin. I had no idea what to expect.

My parents were out, but my 16-year-old sister was asleep on the couch. I put the baby monitor next to her ear and roused her enough that she promised to listen for Lexi. My parents would be home in a little while and take over from there.

En route to the ER, I called Garry and Melanie to let them know what was happening. Garry felt helpless. Melanie offered to meet me there. I'm so glad she did.

We settled into the waiting room with 30 other people at 8:15 p.m. The receptionist hinted at a long wait. In triage, the nurses said the ER had no beds.

Gavin thought the whole thing was a grand adventure. As the hours ticked by (we spent four just in the waiting room), Gavin acted like he was on speed. He was happy and energetic and talking loudly and running around the room. Melanie and I took turns trying to entertain him, although Melanie did the lion's share of the work. I was physically and emotionally exhausted when we arrived in Mesa last week, and my reserves were depleted. A few days hadn't replenished them sufficiently for a night such as this.







One of Gavin's favorite games was playing catch with his stuffed animals. He would hand Russell or Charlie (of course they came with us) to one of us and say, "Catch him to me!" That meant he was ready to catch. I laughed every time. At other times, when we would encourage him to take a drink or read a book or sit down, he would say, "I ready all did." He meant to say, "I already did." This is a favorite phrase these days.

Just after midnight we were transferred to an ER exam room. (I expected the waiting room crowd to erupt in a chorus of cheers, but they didn't.) This change of pace was nice, but we found ourselves in a small, more dangerous room with a door, and Gavin didn't appreciate being contained and having safety restrictions. He was totally buzzed.

Finally, a nurse came in to take vital signs. When she finished measuring his respirations, Gavin exclaimed, "She feeled me up!" We had a good laugh over that. A Physician's Assistant eventually arrived to examine Gavin's rash. Gavin laid on the exam table and was amazingly calm, quiet, and cooperative for the exam. The PA was surprised that we had been referred to the ER, and she didn't offer a diagnosis at all. Gavin didn't have any other symptoms (besides his crummy appetite, which persists) and was clearly feeling fine. I felt pretty foolish, very frustrated, and extremely tired. The PA ordered a rapid strep test because of the rash, but none of us were surprised when it came back negative.



The events in the ER exam room took two hours to unfold. The waiting was almost unbearable. After getting strep results, we waited almost an hour to be discharged. By 2:00 a.m., Gavin was exhausted and ornery. He was screaming. I was on the verge of a nervous breakdown. At least Melanie was a calming influence!

We got home around 2:30 a.m. Lexi had been awake (and screaming, mostly) since 10:30 p.m. Poor baby...poor Granny! I put her to bed. I put Gavin to bed. I put myself to bed. Lexi got up at 4:00, and then we all slept until 8:30. Then we all enjoyed a three-hour nap in the afternoon. Gavin seemed just fine, although the rash didn't fade.

It wasn't until bedtime Saturday that I noticed Gavin's fever. I administered Motrin and checked on him frequently. At midnight he was burning up. I slept next to him and listened to him grind his teeth all night. This morning his fever remains (though lower than at midnight), he has red spots on his cheeks, and says he "feels gross." He's sure acting like he feels gross.



What is in store for my sweet, sick boy? I hope this mystery illness resolves without another trip to the ER.
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