Pint Size Emergency Care When Away from Home
Each time our family travels, I pack a small bag with every medication we might need in the event someone gets sick – and someone always gets sick.
Children’s Tylenol. Children’s Motrin. My older son’s inhaler to control his reactive airway disease. A thermometer. A variety of ointments for every itch or scratch that may occur. Band-Aids. Benadryl for the hives that pop up for unknown reasons. Plus my husband’s Epi-Pen after his unexplained reaction to something yet to be identified. The bag is hard to close, but I know the item I do not pack will be the medicine I will need.
This past Christmas, my 23-month-old son, Ike, began having a typical toddler drippy nose during our trip up north to see family. By the next day, his symptoms had progressed to a cough and a fever of 103. Having rushed to the doctor with my older son too many times for a simple cold, I gave Ike some Tylenol and Motrin, and tried to make him comfortable while controlling his symptoms.
That evening, when Ike seemed to be getting worse, I called our doctor’s advice nurse in North Carolina to consult with her about our situation.
Was Ike lethargic- Was he eating- Was he drinking- How was his fever reacting to the medications- What are our medical options-
Having visited the emergency room with my older son once before while we were visiting my parents, I had no desire to repeat the process. Hours of waiting had brought us an improbable diagnosis of strep throat which, a few days later, was determined to be roseola.
The advice nurse had us check back in with her every couple of hours before giving us her final opinion: we needed to see a doctor if Ike didn’t get better by morning.
Morning came and Ike’s fever was 104. He was coughing so hard it scared me. I dug out our insurance card and called the toll free number on the back to find out if our insurance covered a visit to the Urgent Care clinic that was less than one mile away from my parents’ house.
“It’s easier for you to call the clinic to find out,” the customer service representative told me.
I called the clinic.
“No, we don’t take that insurance.”
I looked through the phone book for more urgent care options before a half hour of digging through numbers and making phone calls put me back at square one.
On this trip, all roads seemed to lead the ER.
“The ER has a special time that they use for non-emergency patients who need care. You might want to call them. It’s like urgent care at the hospital,” offered the woman from the last urgent care clinic.
A call to the hospital revealed that we would have to wait five more hours for those “special hours” and we could not wait. Twenty minutes later, we were in the one place I did not want to be: an emergency room during the holidays six hundred miles from home with a very sick toddler.
The nurse practitioner listened to Ike’s symptoms and before it seemed we were even done telling him the situation, he did a quick check-up and was writing on his prescription pad.
Most likely some sort of virus, but it would be something we would want to keep an eye on, he told us.
All I could think was “I am keeping an eye on it. I’ve come to you to tell me how bad ‘it’ is.”
He suggested the all too familiar albuterol inhaler. A contraption we had come to know with our older son who had developed respiratory syncytial virus (RSV) when he was eight weeks old and had used his inhaler in his battle against reactive airway disease ever since.
“And if he doesn’t seem to be getting better, you may want to try this,” said the nurse practitioner. He handed me a prescription for Azithromycin, just in case “it” was bacterial. For good measure, he threw in some Prednisolone. We left the emergency room with a handful of prescriptions but no clear diagnosis.
Overnight, Ike got worse. His fever stayed up. The Tylenol and Motrin made only little dips in his temperature. His cough was even more persistent. All Ike wanted was for me to hold him and his body burned in my arms.
That morning, both my husband and I knew we had to get him back to a doctor. We arrived bright and early to the same emergency room we were at the day before; the arrival nurses looked nervous when they took Ike’s vitals.
With my lack of sleep and frazzled nerves over my son’s condition, I was in no mood for the jokester attitude of our newest doctor that arrived to look at my son. When I ran through the situation, he didn’t seem to want to listen, but, instead, listed a series of things he was going to do while berating me for not seeing how the Prednisolone worked out. In conclusion, he told us that Ike would probably be admitted to the hospital based on his oxygen levels.
I felt like the worst mom on earth.
They handed me an adult size hospital gown and told me to dress my twenty-five pound child in the mass of cloth.
Over the course of the next few hours, I watched a team of nurses put an IV into my toddler’s arm and take blood out of his other little arm. A chest x-ray had been ordered. So I held onto Ike while he wore a lead apron. He was too exhausted to struggle with me. Here I was, a mother that had braved natural childbirth because of her aversion to invasive medicine, watching my child being put through the wringer while my fear over his condition overrode my intuition that the doctor was headed down the wrong path.
A few hours turned into six hours. The doctor was notably absent from the entire process and the nurses were sympathetic but unable to give us an update.
And the results-
Nothing. Nada. Not a thing.
Ike was in his Elmo pajamas, brought from home to replace the monstrous gown, on a huge hospital bed. He looked pitiful with his arm taped up against the board that was put on him to hold the IV in place and, it seemed, we were no closer to an answer on what was wrong.
Finally, in walked the doctor. But with him was another doctor, one we had not met in our whole experience at the emergency room. He looked a bit disheveled, but he immediately put on a warm smile and shook both of our hands.
“Tell me what’s going on with this young man,” he said, after introducing himself and telling us he was a pediatrician.
I listed everything we had experienced over the past several days. He listened to all of the details and handled Ike with care. And, in a matter of minutes, he gave us his diagnosis.
The same thing my oldest had when he was eight weeks old; however, in my 23-month-old, I had been unable to see the parallel to what I had gone through with my infant.
The pediatrician ordered a swab sample of Ike’s nose discharge that would determine if it was RSV. He told us to continue the inhaler and assured me that the additional medications would not have improved the situation. According to this doctor, we were at the peak of the problem and Ike should begin to improve in the next few days. He assessed Ike’s oxygen level after having him use the inhaler and found it to be satisfactory enough that he would not have to be admitted.
The results of the test were back in an hour and they confirmed the diagnosis. Ike did have RSV, but would not have to be admitted. The pediatrician ran through a course of treatment that included the albuterol and told us that rest and time would help. The pediatrician gave us his phone number and an open invitation to call if it seemed Ike was not getting better.
His last bit of advice, “Wait to drive any long distance. You don’t want to have to stop in another emergency room on your way back home.”
Each time we travel, I know that germs lay in wait along the way to our destination. They lurk on the countertops and door knobs of the places we stop. And the overcrowded conditions of the holiday season are an invitation for viruses to hop a ride on one of my kids’ hands to take part in our festivities.
Hand sanitizer is my front line defense. After this past trip, I may even consider surgical masks. Okay, not really, but you get the point. In the mean time, I will lead with my intuition and ask for the on-call pediatrician if we ever end up in the emergency room again. That is until someone invents a travel size pediatrician I can tuck in my medicine bag.