Tuesday, August 21, 2007

A double whammy

We've had some drama around here lately.

Saturday evening, we noticed a spot on William's leg, one that sort of resembled a bug bite. By Sunday lunchtime, it was a big red angry blotch, weeping a yellowish fluid onto his calf. David freaked out, immediately speculating on all the terrible, horrible, no good, very bad things the lesion could be.

At the same time, William seemed to be coming down with a cold. He started coughing on Saturday night, too, and he even...and you know how strange this is for my child...woke up in the middle of the night and had to be comforted. There are a couple of key ways I can tell when William is not feeling well: when he doesn't sleep well and when he turns down food. So we knew something was afoot. I took him to his Mama Dee's house on Sunday morning so I could go to Sunday School, and he seemed to be feeling okay. But the cough got a little worse, and so did the congestion.

Naturally, William chose to get sick the very first weekend that David was on call for his new job. And so let's just say that David was already stressed out by the endless barrage of Mommy pager calls, some silly and some serious but all requiring his time and attention. William's health issues sent David's stress levels skyrocketing.

Luckily for us, David's new boss/partner and William's new pediatrician, Dr. Keown, lives in our neighborhood. David called her up, and she came by on Sunday evening. After making the appropriate fuss over how adorable William is (she speaks my language!), she examined his leg (and the diaper rash that seems to be hanging on, regardless of what we slather over it). She agreed with David: looked like a classic case of MRSA.

MRSA, for you laypeople out there, is the abbreviation for Methicillin Resistant Staphylococcus aureus. It tends to more common among people who live or work in healthcare settings, particularly those with compromised immune systems. But not always anymore. And it's also possible for people to be carriers of the bacteria but not actually get sick from it, and guess who works in a healthcare setting and then has to come home each night? But we have no way of knowing for sure how William contracted it. In fact, David and I are speculating that William may have had it before, back when we were visiting Natchez and he developed a big lesion on his leg that I assumed was a spider bite. That lesion eventually healed up on its own, with a little assistance from our trusty friend Neosporin.

So now we're just treating William. According to our old pal Dr. Google, community-associated MRSA is not yet as resistant to as many antibiotics as hospital-associated MRSA, which has been around a lot longer. So that's good. But it is evolving. And the Mayo Clinic reports, "CA-MRSA can be particularly dangerous in children. Often entering the body through a cut or scrape, MRSA can quickly cause a wide spread infection. Children may be susceptible because their immune systems aren't fully developed or they don't yet have antibodies to common germs." So even though we don't know for sure how William came down with it, the important thing is that we're getting him treated for it quickly. And everyone thinks he will be fine. He definitely seems fine. He's taking a super-antibiotic that I've dubbed Sectumsempra, in homage to the Harry Potter spell, and I'm putting special cream on the lesion. Dr. Keown saw William down at the office yesterday afternoon, and she thought it already seemed to be improving. The diaper rash seems to be slowly improving, too.

As for the cold, well...we're getting a little more serious and a lot more consistent about the treatment. We've been using albuterol, a bronchodilator, in an air chamber whenever William develops wheezing associated with a cold. We first started doing that last winter when he had RSV. Now we're going to up the ante by giving him an anti-inflammatory med, a corticosteroid called Flo-vent via his little inhaler/air chamber twice a day, along with regular hits of a combination of albuterol and something else that goes by the name Combi-vent. Dr. Keown said she wants him to stay on this regiment for the time being, perhaps until it gets cold, to see how well it controls things. Apparently, symptoms and presentation can change in small children, so we're just going to go forward with this plan and monitor things.

Since he really doesn't wheeze unless an illness has triggered it, I'm not sure exactly why he would need the meds all the time. But again, maybe it will help. I'm just relieved that William is pretty agreeable about submitting to the air chamber now. He doesn't fight it anymore, except in rare instances. We hit on a wonderful solution last time around. In desperation, we held the inhaler up to one of his teddy bears. "Look, William, look at how Mimi Bear is taking her albuterol! Oh, it helps her breathe and she feels so much better," we'd say enthusiastically while pantomiming the whole procedure with the purple bear.

Eventually, William caught on, agreeing to sit still and breathe through the mask. Now he smiles and claps for himself every time he finishes a puff. I can't emphasize enough how much better that has made it for all of us. Used to be, he'd buck and twist and scream with rage, while I frantically tried to keep the air mask clamped over his nose and mouth. Now we don't have to work so hard, and I guess it's not scary anymore.

The doctors at David's new office were very impressed with how calmly William took his albuterol yesterday. They tried to administer some meds via the old electric nebulizer machine, and let's just say that did not go over well. William reacted the way he used to with the air chamber. The physician's assistant put the mask over his nose and mouth, while I tried to hold him still. At first, he was suspicious but not angry. But then the PA turned the machine on, and it began whooshing and clicking noisily. William freaked out, twisting on my lap while I whispered desperately, "It's okay, baby, it's okay. We're almost done. It's okay, it's okay, sweetie. Look, it's your Curious George book." But William was both frightened and nobody's fool. Curious George was not going to make him settled down and submit to the big scary noisy machine. As he wheezed through the mask and glared up at me through a river of tears with a betrayed look, he seemed to be telegraphing to me, "Et tu, Mommy?." Oh, that look!

God, I hate times like that. William trusts me to take care of him, to make things all better, and that trust is a beautiful, gorgeous, shimmering strong thread that connects us. He didn't know that hooking him up to that machine was part of my promise to take care of him and help him feel better; he just understood that it was scary and that I was allowing it to happen. I was just as relieved as he was when he wrenched that mask off, and the PA turned the machine off. Whew.

Now he's more or less back to his old self: toddling around the house and making a mess and laughing and eating as much cheese as I'll let him. We played a wonderful game of Chase this afternoon, in fact: William "chased" me around the island in the kitchen until we were both laughing so hard that he fell down and flopped on his belly and I collapsed next to him. Honestly, those are the times when I think, "It really doesn't get any better than this."

I just stopped writing for a few minutes because William was crying. That's the second time in four nights that he's woken up, crying. David thinks he's gassy because the antibiotics are kicking in, and that may be making him uncomfortable. I lifted him out of his crib and settled into the glider in the corner of the darkened bedroom. Two seconds in, William snuggled his head beneath my chin, collapsed against my body and sighed, and began to breathe evenly. I rocked for a few minutes, just enjoying the baby scent of his soft hair and enjoying the (even and wheeze-free!) breath against my neck. Now that he's a toddler, William rarely wants to sit still long enough to cuddle with his mama. So I have to savor the few minutes that I get. And they are precious.


Anonymous said...

Get well soon, William!!!!


Anonymous said...

Sorry to hear that William has not been feeling well :( HUGS!