Monday, June 27, 2011

Rough Week

We had a very scary thing happen last week.  Andrew woke up from his nap on Monday and his lips, fingernails and toenails were bright blue.  This was a pretty alarming sight, so I immediately called his pediatrician and they told me to head straight to the emergency room.  We jumped in the car and headed straight to Texas Children's Hospital - they just opened a new location in Katy.  Luckily, my sister was over at the time, so she was able to come with us to the ER.  By the time we got to there, Andrew was running a temperature of 101.  They ran some blood tests, did an EKG and a chest x-ray and everything came back normal.  His oxygen levels were also in the normal range, so there wasn't any clear reason for the blueness at that point.  The ER doc wanted us to go ahead and check into the hospital for overnight observation.  When a person turns blue, it is usually because of a lack of oxygen (which he wasn't experiencing) or a problem with the heart or lungs.

Brent was able to meet us in the ER and was there when we were moved to the hospital room.  They had to give Andrew an IV in the ER, which was pretty awful as you can imagine.  Once we were in our room, we pretty much just waited for any changes in his condition.  The doctor came and checked on Andrew and since everything was seemingly normal, they told me that he probably just had a virus and the blue was just a strange symptom of the virus.  This was not very reassuring for me, as I just wanted some answers for what was going on with my child and it didn't seem like "just a virus".  The blueness did go away after about 2 hours, but he continued to run a fever.  They kept him on an oxygen and a heart monitor and everything stayed in the normal range.  I slept with Andrew at the hospital and it was a rough night - neither one of us got much sleep.  Nurses kept coming in every 4 hours to check his vitals, and the IV was very bothersome for him.   At 4 am I asked the nurse if they could take out the IV, and the doctor approved.  After that, we were about to get a couple hours of sleep.

By the next day there hadn't been any indications that Andrew was in any danger, and we had gotten approval from the doctor that we could go home.  It takes a long time to get all the paperwork together for release, and during this time Andrew once again turned blue.  Andrew was immediately hooked up to the oxygen monitor again and another EKG was performed and everything was normal.  I had a long conversation with the doctor she told me that she had been in contact with the cardiologist and the pulmonologist (lung dr.) on staff.  The cardiologist had seen the results of all the tests they had run so far and checked Andrew herself, and was not concerned that there was anything wrong his heart.  This was good news, but still didn't give us a reason why he was turning blue.  We scheduled Andrew to have an echo cardiogram done on Thursday.  An echo cardiogram is like an ultrasound for his heart, but he would have to be sedated because he has to be still for 45 minutes.  They wanted to do this test while we were still in the hospital, but they only do it at the main campus TX Children's.  They also scheduled an appointment with the pulmonologist, but that appointment wasn't for another week.  They did want to run a blood test for the pulmonologist, but it required taking blood from an artery in Andrew's wrist.  As you can imagine, this is very painful, especially for a 2 year old.  After 2 failed attempts to get the blood, we decided to nix the test for now.  At that point there wasn't nothing left to do and no more test to run, so we were sent home with no answers.  We now had 3 doctors tell us it was probably just a virus, but none of them had an answer for why Andrew kept turning blue.

The next couple of days at home were pretty much the same.  Andrew continued to turn blue and run fevers.  The morning of the echo cardiogram Andrew woke up with his highest fever yet - around 105.  We quickly gave him some Motrin and gave him a cool bath and we were able to get the fever down to around 102 pretty quickly.  We called and spoke to a cardiologist at TX Children's and asked if we should go to the ER or go the the appointment for the echo cardiogram.  He said that we should go ahead and come in and get the echo done, so we drove over to the main campus TX Children's in the rain in morning traffic.  When we got there we told the nurses that Andrew had had a high fever that morning, and upon hearing that, they were hesitant about giving Andrew the sedation medication.  Brent and I were pretty annoyed and frustrated at that point and just didn't know what to do.  We were able to sit down and have a long conversation with the cardiologist and explain all the events of the past few days.  After speaking with him and doing a cursory exam on Andrew, he too did not think it sounded like it was a heart problem and also believed that it could just be a virus.  We got on a conference call with Andrew's pediatrician and decided that we would go back to the ER the next day (the 5th day of fever and blueness) and have some more tests run.  So again, we left the hospital with no new information.

Brent took off work on Friday and we all went back to the ER.  This time we went with our bags packed, expecting to probably have to check back into the hospital.  They did more blood work in the ER (including inserting another IV) and also did a urine test.  Again, everything came back normal.  His white blood cell count was a little below average (normal is 5-10 and Andrew's was 4), so this was another indication that he was probably fighting a virus.  There was no reason to check into the hospital, so we decided to just go home and see how the weekend would go.  Andrew continued to turn blue and run fever all weekend, but the good news was that it wasn't happening as often, and the fevers were not getting too high.

We scheduled another appointment with the pediatrician for this morning so they could run the same tests they did in the ER on Friday, and then we could compare the results and see if there had been any changes.  Andrew's last fever/blueness was early Sunday morning (around 5 am - 7th day of fever) and did not return for the rest of the day.  This was pretty promising, but I was very cautiously optimistic at this point.     

I felt very happy and relieved to go into Andrew's room this morning and see his rosy pink lips and feel his cool forehead.  This was the first time in 7 days he was not running a fever in the morning, and also meant he had gone 24 hours without a fever.  I felt pretty good driving over to the doctor's office, but still didn't know if we were out of the woods yet.  The first thing the doctor did was listen to Andrew's heart and when she lifted up his shirt she exclaimed, "Oh, he has roseola".  He had a rash on his tummy, which appears once the fevers break, and meant that he is on was way to recovery!  The rash starts on his tummy and can later spread to his limbs, neck and face. Roseola is a common virus in children Andrew's age.  The fevers usually don't last 7 days, but it is possible.  The blue lips and nails are not at all common (I don't think she had ever seen it in kids with roseola), but she said that it it is common for hands and feet to get extremely cold with fevers, so it could have something to do with that.  We are keeping the appointment with the pulmonologist for tomorrow and I rescheduled his echo cardiogram for Thursday.  I would feel a lot better just knowing that there truly is nothing wrong with his lungs or heart, and hopefully someone can give us an answer as to why Andrew kept turning blue.

Here is some basic info about roseola: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001963/

So needless to say, Brent and I are feeling so happy and relieved right now.  There are few things worse than worrying about a sick child and just feeling so hopeless and helpless and not getting answers from the numerous doctors you talk to.  We couldn't hope for a better news than we received today.

Andrew in the ER with an IV in his hand.  They wrapped it up so he wouldn't try to take it out.
 

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