Sunday, August 22, 2010

A Painful Weekend

Last week ended with the promise of of a great weekend ahead. Brad and I had an overnight getaway in Austin planned on Friday, with the kids playing at a neighbors and their grandparents coming in later that evening to care for them. Saturday, Brad's brother and fiancee were coming to join in on the weekend of family fun. But, as usual, life didn't work out as planned.

Thursday, Aiden complained of a headache and spiked a low-grade fever. He had no other symptoms and had been playing outside with other kids for quite a while, so I figured he may just be overheated or a little dehydrated, gave him some Tylenol, a bunch of watered down juice, and sent him to lay down and rest. His headache went away, and within an hour he was back to his normal, rambunctious self. He was fine the rest of the evening, but once again woke me up in the middle of the night with a headache. A dose of motrin, some cuddling, he was back to sleep. I was relieved--every time Brad and I plan a date, it seems our kids get sick.

The next day, Aiden was fine throughout the day, but in the afternoon, began complaining of a headache again. He had been playing outside and came home complaining that he "felt like his brain was banging the inside of his head." I gave him fluids and another dose of motrin and sent him upstairs to lay down, and after about an hour, he was fine. Brad and I decided to go on our overnight as planned, figuring that the grandparents could handle the headache issue for a night, and since we were only an hour away, we felt fine to leave.

That night, though, things got worse. At bedtime Aiden complained of a headache, but the sitter didn't give him any medicine for it. When his grandparents arrived to take over, Aiden's head was hurting worse, and within a couple hours, Aiden was vomiting from the headache pain. After he threw up, he fell asleep and was fine until morning.

Brad and I came home Saturday morning and heard of the previous nights events and began to suspect that these weren't run-of-the-mill headaches. Throughout the day Saturday, Aiden would complain of a headache, we'd medicate him, the headache would go away for a couple of hours, but before he could even get another dose of medicine, his headache would be back. He complained of nausea and couldn't even walk across the room without crying. I decided to call the Nurse Advice Line at the hospital here on post, and the nurse felt we should have Aiden seen by a doc within the next 24 hours, and that we shouldn't wait until Monday. Aiden was in a period of feeling fine by then, though, so we planned to wait, see if the headache returned, and if so, then take him to the ER to be seen. 

Aiden was fine all afternoon and evening, but by bedtime, his headache was back, so we put him in his jammies, packed a bag of blankets and loveys and activities, and headed to the ER for what we figured would be a long wait (Saturday night AND a full moon, we were doomed!). After waiting a good while, we were finally seen by a PA. From the moment she walked in, I was not impressed. She walked, went straight to Aiden (without washing her hands, by the way) and started tapping on his forehead and face--Does this hurt? Aiden told her no, and she finally introduced herself and began to half-assed examine Aiden. She would ask questions, but didn't listen to our answers and would interrupt me when trying to explain his symptoms. At one point, I had just said, "He has thrown up once during the headache and has felt nauseated several other times," when she then asked "Any nausea or vomiting?" in the next breath. It took all my patience to not scream at her, "YES YOU IDIOT! IF YOU WERE LISTENING TO A THING I JUST SAID, YOU'D KNOW THAT!" But I kindly answered the question without any yelling or snarky comments. She looked in his ears and his mouth and then declared, "Yup, he's got a little fluid in his ears and a little mucous in the back of his throat, so it's a sinus infection." She scribbled down a prescription for antibiotics and shooed us out the door. When I tried to question her, "He hasn't had any cold symptoms or allergy problems, no runny nose, no stuffiness, nothing..." she cut me off. "But he isn't hurting in the face or the usual sinus places..." but once again, she cut me off. I gave up and decided we would just gut it through the weekend and then see his normal doctor on Monday morning. It wasn't until after we left that I realized that in her incompetence, she hadn't even done a basic neurological exam to rule out any sort of neuro event! I knew in my gut she was making the wrong call, a sinus infection just didn't make sense with his pattern of symptoms, but I was too tired and frustrated to fight her about it and felt like our best bet was to wait until Monday morning to see his doctor or another pediatrician in the clinic.

Aiden and I headed to the van while Brad headed down to the hospital pharmacy to pick up Aiden's meds. While Brad was waiting, Aiden's headache went from painful to excruciating, and by the time Brad got to the car, Aiden was sobbing in pain and begging me for medicine. I quickly gave him a dose of Motrin and we began to drive home, but the entire ride home, he begged me to take him back to the hospital so they could "make him better." Aiden HATES the hospital, it took bribery and tons of reassurance just to get him in the door of the ER just a few short hours earlier, and now he was begging me to take him back. I was fighting tears the entire drive, feeling utterly helpless and ready to drive back and strangle the PA. He cried the entire ride home and ended up throwing up just as we pulled in the driveway. We carried him inside, coaxed a few crackers into him and re-dosed him with Motrin, since he'd just vomited all of the dose we gave him, and tucked him into bed.

The next morning, he woke up early with his headache back, and began vomiting. He was sobbing in pain again and begging for us to make it better. We couldn't get him to keep anything down all morning, not a single cracker or dose of medicine, so we decided to take him to the Acute Care Clinic that has hours on Sunday mornings.

Of course, by the time we get to the clinic, Aiden is feeling better and asking for food. He's running around like his normal rambunctious self--in the span of fifteen minutes after his last vomiting episode! He'd thrown up three times in 2 hours, but now that we decide to take him in to the clinic, he's acting fine.  Brad and I proceed to take him in, knowing that if we were to go home now, he'd be back to vomiting and feeling awful again in a matter of hours, but were just waiting for one of the doctors or nurses to tell us we're attention-craving crazy people who are making it all up.

Luckily, we got assigned to a pediatrician, and he was wonderful. He did a complete neuro work up, he talked to Aiden and listened to him describe his pain and symptoms. He listened to our account of his morning and asked questions. He declared that this was a typical case of childhood-onset migraines and sent us home with a list of dietary triggers to avoid and anti-nausea medicine to help Aiden keep the pain-relievers down when things got bad. He told us the best way to manage the headaches--medicine within the first 10 minutes of onset or even before, if Aiden began having auras to indications a headache might be coming, followed by laying down in a darkened room for 15-30 minutes with cool compresses to the head. He even took the time to explain to Aiden the importance of coming home for medicine at the first sign of a headache, even when he was playing, so we could help him. He filled out all of the forms we would need for Aiden to get medicine and time to lay down at school. And he scoffed but, in his professionalism, refrained from bashing the PA who had made a bad call, simply stating "There are absolutely no signs of an infection, his ears and sinuses are normal--just throw out the antibiotics."

I was so relieved to have a doctor actually listen to us all and complete a thorough exam before diagnosing Aiden. And when we followed the strategy he'd outlined for us the rest of Sunday, we found that Aiden would usually doze off for a few minutes and wake up with the headache completely gone--we were able to knock it out at the "slightly painful" stage instead of trying to fight it at the "miserably excruciating" stage. Now I'm just hoping that we'll have the same luck at school--I've spoken to his teacher (who is also a migraine sufferer and is sympathetic and understanding) and to the school nurse, who is on-board with letting Aiden lay down in the clinic in the dark for a while if he needs it. Now I'm just hoping this won't be too disruptive to his learning and that we'll be out of this headache pattern soon. If it continues, we may have to be more aggressive with medications, but I'd rather not have Aiden on anything unless we have to.

1 comment:

Becky said...

I am so glad you had a good doctor finally listen to you guys.

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