Saturday, May 7, 2011

Murphy's Law Bites Me In The Behind

About 10 days ago, I took Jamie to the ENT for a consult on ear tubes.  The immediate verdict was "yes, he needs tubes."  We left the office with an appointment for surgery on Monday, May 9th.

That would this coming Monday, two days from now.

Now, Jamie was in the middle of a double ear infection when we saw the ENT and on a course of Omnicef for the infection.  Incidentally, Scot was infected with the same nasty strain of bacteria and had a sinus infection - one that was resistant to the class of antibiotics that both he and Jamie were on.  He ended up having to get another course of medication, this time a different class.

Given that I knew this bacteria was a tough nut to crack, I was naturally worried that Jamie would finish his course of medication and, in the week between finishing it up and his surgery date, promptly relapse, spike a fever, and screw the surgery date.  

With this weighing on my mind, I called our pediatrician's nurse line at the end of last week (over a week ago now) and tried to ask them how to handle this gap between medication completion and surgery.  I attempted to explain that I was worried that he wouldn't clear the infection and by not clearing it end up sicker and possibly interfere with our surgery date.

Short version:  it went poorly, they were exceedingly rude to me, and while promising me a call back after speaking with our pediatrician, never did so.

Because I was embarrassed by what happened and knowing that I had been labelled "that" parent that is problematic, I didn't push the issue further.  Jamie finished his Omnicef on Monday and seemed to do well the rest of the week.  His nose was a bit snotty off and on but nothing that was egregious.  I figured we'd make it to surgery day, get tubes, and be home free.

Wrong, wrong, wrong.

Last night was the first clue that something wasn't right.  He woke up around 11:15 or so and wouldn't be comforted.  He'd rock in the rocking chair with me and be fine.  I'd tuck him back into bed and 3 minutes later he was crying again.  I gave him some Tylenol, rocked him, put him back to bed.  Again, 3 minutes later he was crying.  In the end, I sat in his bed with him on my chest until nearly midnight and the Tylenol had finally kicked in.  I got him tucked in and fell into my own bed.

This morning he was cranky.  He wouldn't eat.  He didn't have a temp but I just knew something wasn't right.  I took him out with me to run an errand and while I was getting him in the car, I asked him if his ears hurt and he said yes.  (OK, he nodded, but close enough.)


I didn't bother calling the pediatrician for a number of reasons but mostly because I knew that they probably didn't have any appointments open by that time.  Since he didn't have a fever I decided to watch him a bit and see how he did.  If he didn't improve we could take him to Children's urgent care.

Then he fell asleep in the car on the way home and it was only 9:30 in the morning.  Something was definitely not right.  When we got home, I put him to bed and he slept for about an hour and fifteen minutes.  He still wouldn't eat.  He was still cranky.

Scot packed him up and took him off to urgent care.  Guess what?  DOUBLE EAR INFECTION.  What a shock.  Unfortunately, the doctor there didn't want to listen to Scot about the fact that this strain of bacteria was going to laugh at cephalosporins.  Their treatment plan was to give him an injection of Rocephin to get him through until his ear tube installation on Monday.  This was not a comfortable procedure - the Rocephin burns when it's injected.  So much so that they mixed it with lidocaine - which also burns when injected until the numbing takes effect.  Jamie was NOT PLEASED to be stabbed in each thigh at the same time with stuff that burned going in.

By the time they got home he was exhausted so I put him down for another nap.  He slept for 2 hours.

In the meantime, I called the ENT.  I was afraid that all of this was going to prove a problem on Monday - especially if the Rocephin wasn't capable of bashing the bacteria into submission.  I was scared that if he spikes a fever they'd refuse to put him under anesthesia.  Also, if he spikes a fever, I am only allowed to give him Tylenol because Motrin is not allowed as part of his pre-op instructions.  So, I won't be able to properly control any high fevers he gets.

The good news is that the ENT wasn't worried.  He said that as long as Jamie doesn't develop chest congestion, we can push ahead with surgery and that the Rocephin should get us that far.  The truth is, that the best thing we can do for Jamie is get the tubes in place.  We have antibiotic ear drops we can give him that will get exactly where they need to go once the tubes are in.  Right now, they're useless, but with tubes they're like a guided missile against the infection.

Jamie seemed to feel better once he was up from his nap and actually ate a decent dinner after refusing food all day.  So far his temp is only slightly elevated and easily controllable with the Tylenol.  Now it's just a matter of getting through the next 36 hours.

But, really, Murphy and his little law can just fuck right off.

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