Jan 15, 2011

Jacob's ER trip

You know how the story goes.  Luke (7)  goes to school and gets a germ.  Germ invades body and he gets very ill.  105 plus fever with very stiff neck (couldn't put chin to chest).  Doctor got alarmed and sent us to the ER.  Tests say it's the Flu basically.  A bad one, but not meningitis (which is what they were concerned about).  Medicines.  Better.

Repeat with Kaley (11).  Repeat with Dan (hubby).  Beth says the mantra over and over that she is not allowed to get sick so she ignores the symptoms and keeps going.

Meanwhile, we sent Jacob (12) over to my Mom's house.  Partly because it's not fun in a sick house.  But also so that we could possibly avoid him getting it.  It would be bad on his kidneys.  And he's on a new immunosuppressant med right now so it makes him more vulnerable.

Friday at 8pm, I was thrilled.  Everyone was sleeping.  The baby.  The hubby.  The kids.  I was just about to settle in with a book or bed.  Call from Mom.  Jacob hit 105.2 and it was climbing.  All the things they were doing weren't helping it come down.  She only has aspirin in the house and can't give him that due to Reye's Syndrome possibility.

I called the pediatrician to see if we could avoid the ER but she thought due to the kidney issue, he must go.

The ER was very full.  Triage got him back within about 15 minutes though just due to his very high fever.  Once back there, they took his blood pressure and it was 99/37.  The triage nurse let out a gasp, asked if he was dizzy (Jacob said yes).  He called to the back for the need for a bed NOW.  Got a wheelchair for him and wheeled him back.  We bypassed all the other waiting people.

They took a history, etc.  I gave him Tylenol when I got him there and it took his fever to 103.1 but since he cannot have ibuprofen ... that's all they could do for him medicine wise.  I'd read that with FSGS (kidney condition) that he is not allowed to have it.  Nephrologist emphasized it with me too.

They hung a bag of fluids 1 liter (1000 cc's/ml).  Took many blood tests, etc.  All it showed was Flu A and slight dehydration.  But after the whole liter, there was no improvement in his fever or his condition. Blood pressure was still very low, chills, pain, dizzy, he was basically "out of it".  Their hands were tied.

At one point we were even discussing him being admitted.  At that point he started crying.  They left and I asked what was going on and he said he wanted to get out of there.  He hated the hospital and wanted to go back to my mom's house and sleep.  So I told him the only way we could get out of there is if his fever goes down, he starts to feel better and his blood pressure goes up.  We prayed.  I told him to visualize those things happening.

Within a few minutes, he perked up.  I know, sounds too good to be true.  But it's absolutely the way this happened.  He was still very sick but he took control over his fears and his brain told his body how to act.   His blood pressure was 99/60.  They decided to give him one more liter and let him go home.

So at 12:30 his fluid were gone.  He was able to get his next dose of Tylenol.  (4 hours had passed).  They did one final temp and a final blood pressure just for the record.  But this time it wasn't our regular nurse who'd been great all night.  It was a new person.  Clearly her job was to clear the room.  Period.   Fine with me, we wanted to go home.

Problem?  His blood pressure (laying down still, after 20 ounces to drink by mouth and 2 liters by vein) was 101/33.  No, that's not a type-o.  Right before this measurement, he said he was feeling dizzy again. He started looking really sick again.  The nurse didn't even notice the number.  We pointed it out.  Let's just say she wasn't a nice lady about any of it.

And I was torn.  I want to go home.  She's wanting to send us home.  But is it safe to send him home with that kind of number??  I looked the hallway for our nurse but he was involved in a trauma in the other hallway so not available.

My gut was saying something wasn't right.  This nurse was a ... uh, er ... well, let's just say I cannot use the word that comes to mind.  So in pure disgust, she starts telling me off.  She yells at us how he's fine.  It's just instrumentation (mind you it's the same blood pressure machine all night.)  "And besides, he's been discharged!'  (Translation:  I don't have time for you.)  We insisted on one more blood pressure measurement and she (not happy about it) did it.  But first, she jerked him to a seated position ... 101/41. Works for me.  Close enough.  Let's go home.

He went home to my Mom's house (she can baby him better since he's the only sickie there).  And all he wants to do is sleep anyway.  She also has a blood pressure cuff so we can monitor him there.

I did some quick research and have no clue still why his blood pressure was still so low after all those fluids.  Sure it can drop if you're dehydrated but after all those fluids, it shouldn't still be low.  Guess I'll be calling my pediatrician on Monday to see what she thinks.

His kidney condition is usually associated with High blood pressure.  So very strange.

Today, his blood pressure is actually elevated quite a bit.  So go figure.  But afterall, they forced 2 liters of sodium water down his veins very quickly.  The balancing act is that we're always trying to monitor his sodium levels and his fluid intake as to not stress the kidneys.  We knew we'd have to watch for edema.  Even the ER doc said that this was a delicate balancing act .. to give fluids but not too much.

I took him Tylenol and Tamiflu.  He's still almost 104.1 temp.

Remember the old commercial "Calgon ...take me away!"?  Let's just say I understand.

Oh, and lest you forget, we still have 2 more kids who haven't had this.  aaaaaaaaaaugh!


  1. Beth, my cousin has a daughter with very severe kidney issues (actually, now she has no kidneys) and recently had a bout with very low BP. If you'd like I put you in touch - if for no other reason than having a BTDT Mom to talk to.