Madison is sick!

The scourges of childhood....

Madison's fever started innocuously enough.. she was cheerful and bright on Thursday 29th October, laughing and reacting to everyone the entire day...

It started suddenly right after her bath.. Chris was on call that night, so Nancy was helping me with her bath while I got ready to feed her. When Nancy passed her to me, I suddenly realized her mouth and lips felt really warm to me and alarm bells went off. Her body still felt cool and a quick axillary temperature read 37.3C. I prayed that I was just being paranoid and put her to bed after her usual night feed.

The nightmare began soon after around midnight. She started crying and when I went to her she was burning up. Her temperature read 38.5C and she was irritable and fretful. I nursed her and then removed her warm clothing, then started to sponge her down with tepid water. After an hour, her temperature was still high, so I had to dose her with oral paracetamol, which she HATES.... she was gagging and crying but I managed to get most of it into her. She fell asleep soon after, but everytime I tried to put her back in her cot she would cry out again, so in the end I wore her in a sling and let her sleep till morning.

The entire Friday she was febrile and miserable. I was dosing her regularly with the oral paracetamol, but each dose was getting worse, with crying and gagging. She started to have several loose stools with the fever.

In the afternoon we brought her to see Dr Wong at the KKH private clinic. She told us to monitor her symptoms and to collect some urine to check. By nightfall, she was still febrile and tired. We put her to bed early but she was up again by midnight. This time her temperature soared to 39.5C and I panicked. Chris was post call, but I got him up to help sponge bath her and give her more paracetamol. Her lips were like fire when she nursed, and she refused more than a little feed, before falling asleep. Again I carried her in a sling to let her sleep better, with a wet towel around her neck to cool her off. The night seemed like a dream, spent on the couch with my poor sick darling.

Saturday morning was terrible. She woke crying and refused the breast. Nothing would change her mind. Rocking, walking around and waiting 20 minutes were all in vain. Panic started to creep up to me and on the brink of tears, I called Pa and Ma to ask them what to do. They told us to come over so they could give us some respite and to decide whether or not to take her to the emergency department. We drove over at 0645h and tried once more to feed her. Thankfully she took some milk and then Pa and Ma took over her care while we got some rest.

During the day we managed to get some urine while putting her in a potty and did a urine dipstick which came back negative. She took a small amount of plain porridge in the morning and seemed to improve slightly. The rest of the day she was still feverish and tired, so we kept her indoors and tried to encourage her to drink as much as she could tolerate. By the evening, however, her temperature started to rise slightly and she was cranky and tired. We decided to spend the night at the Novena house so that we could get help quickly if we needed it.

Saturday evening I decided that Chris and I should go out for dinner, to get a breath of fresh air as well as to celebrate his long awaited news of registrarhood. This weekend was supposed to have been a happy celebratory one, but ended up an entire living nightmare. We went to the Marriot cafe for dinner. This was the first time I had been out for dinner in 2 months! Nancy and Maria helped watch Madison via the baby monitor after we put her to bed. She settled to sleep without much fuss, which was unusual for her as well. We had a great dinner, and thank goodness, as we were relaxed and feeling better by the time we returned.

However, the night was not to end happily. By midnight Madison's fever soared again. Despite sponging and paracetamol, she remained above 39C so we called it quits and decided to go the emergency department. Thankfully Pa and Ma were back from their dinner outing so they took us to KKH.

We were lucky. Our initial assessment queue number was next in line, and when they took her temperature it was 39.5C so she basically was seen almost immediately, via the ' RED DOOR' . A kindly MO, Dr Ng Chee Kong attended to us, 4 paranoid doctors and 1 baby. We were 'hovering' while he checked Madison, and I was asking him ( rather, practically telling him !) to do these blood tests! Madison already had EMLA cream on both the dorsum of her hands in preparation for these blood tests. He suggested doing the urine specimen so we stuck the bag on her again. After consultation with the registrar on call that night, we settled on a full blood count and collecting some plain tubes for dengue serology to be processed on Monday via the outpatient clinic. I must say Dr Ng would have done them that night but the registrar on call didn't agree, so the poor guy felt a little stuck between us all!

Chris was brave, he pricked Madison and got blood at first draw. Dr Ng was keen on attempting the blood taking, but I think we didn't have much confidence at his ability to take her blood. Poor Madison, she screamed blue murder while we extracted the blood enough for 3 tubes. Ma then took the blood down to the laboratory herself to get it processed. In the meantime I nursed her and put her back to sleep. The blood results came back in 45 minutes and showed a normal white cell and platelet count. Her Hb was slightly lowish at 11.4 g/dl. Slightly reassured we all went home and basically crashed. Madison slept on our bed the entire night quite well. All I remember was waking periodically to either feed her, check on her temperature and to pump once because she wasn't taking that much breastmilk.

Sunday morning Madison woke at quarter to six, she was still feverish and her appetite was appalling. Madison would take no solids, and breastfed only enough to keep herself hydrated. We were sponging her regularly during the day and putting the paracetamol suppositories in every 5 to 6 hours. She would sleep most of the day and wake slightly better, but deteroriate after an hour and become cranky and tired. In the evening Chris and I were exhausted but we decided to go out for a breather. We ended up at Wheelock place for drinks and a muffin at Starbucks.

Sunday night we went back to the Papillon home to sleep, as Chris had to work the next day. Madison went to bed fairly easily, but the night started again at midnight when she woke with a spike of temperature at 39.5C. Again we sponged her, put in another paracetamol suppository and hoped for the best. Again I carried her in the sling and brought her to bed for the rest of the night. That took close to an hour and she was miserable by the time we put her back to sleep.

By Monday morning, her fever was starting to subside, but she still ran a low grade temperature of around 37.7C. Madison was still cranky and irritable, and was still not feeding well. I decided to collect some urine for FEME and culture, just to ensure that we were not missing a urinary tract infection. Nancy was fantastic, managing to collect a small specimen for me which I rushed down to KKH for laboratory testing at around 11 AM. The specimen looked a little suspiciously contaminated, but it being so difficult to collect urine from her, I decided to just go ahead and get the specimen processed.

Madison was terribly lethargic and sleepy, which made me really worried. By lunchtime she was sleeping for over an hour, which she never does, and then Ma called me up saying the urine specimen showed some white blood cells and insisted that we treated her for a urinary tract infection. However I was not convinced and thought the specimen might have been contaminated as she had a bout of loose stools just prior. At lunch, Dr Wong called up and told us to bring Madison in for a review, which was fortunate. We rushed over immediately to the Private Children's clinic ( which shocked Dr Wong : " That was fast! Where do you live??!!" ), all in a flurry and major state of panic and doom.

Well..Madison of course, woke just as we arrived at the clinic, looking all bright and cheery... the best she had been all week! Just in time to see the doctor ...! We had also attached a urine collection bag on her to collect some more urine and she peed just then, clear as crystal! We sent the specimen off immediately too. Dr Wong examined Madison again, and reassured us with the results of the CRP and dengue serology which had been done with the blood taken at the emergency department, and they were all negative. Feeling heaps better, we left KKH feeling slightly foolish and paranoid.. but how can you take chances with your own kid! The second urine specimen was also clear of infection. It was the first time we all breathed a huge sigh of relief.

Monday night came not a minute too soon, and Madison seemed to border between a normal and slightly high temperature. Being cautious, we dressed her in short sleeves and covered her with only a light blanket, and turned the AC down slightly. Of course, she turned out to be afebrile the rest of the night, and instead became too cold! Her appetite returned slightly and she needed 3 feeds over the course of the night, instead of her usual one.

Tuesday she finally remained at normal temperature, but was in exchange extremely tired and cranky.... a little like chronic fatigue syndrome. She spent the day between whining and sleeping and I let her sleep as much as she needed at each time. Madison even fell asleep on my bed without much effort ! Her appetite was still appalling but we took it slowly and gave her a little banana, some grape, and chicken soup over the course of the day...

Thankfully there was a happy ending to the whole episode.. Madison did finally improve and get her appetite back, as well as her smiley cheerful self. Her energy level picked up gradually over several naps and by Thursday this week she was pretty much more like normal.

The only significant gain in the week was LANGUAGE! Madison is finally into babbling, non specific "dada" "baba" "nana" ..the only time she uses "mama" is in the middle of the night/ tired during the day/due for nap time or plain COMPLAINING!