(no subject)

[rivka]

Alex got a nasty cold over Thanksgiving. She had a persistent, dry, hacking cough afterward, which, as often happens following a cold, lasted for weeks. A couple of days ago, the cough started to get ugly, and ramped up with tremendous ferocity. This morning she coughed so hard that she vomited.

So this afternoon we saw one of our pediatrician's partners. She diagnosed Alex with a sinus infection that has been, in the doctor's very words, "seething" since Thanksgiving. It is now causing the dreadful cough, and has also backed up her Eustachian tubes and started an ear infection. Although the AAP now recommends that most ear infections not be treated with antibiotics, it seems not to apply in our case. Alex now has a big bottle of bright pink, bubblegum-scented, sludgy, but apparently tasty Amoxicillin. We also bought her a bottle of combination antihistamine and cough syrup to help her sleep. (The sinus infection drains when she lies down, so she feels much worse at night. Plus, as a special bonus, antihistamine = sedation.)

The doctor's visit went surprisingly well. Alex's 15- and 18-month checkups were utter nightmares. She started crying and clinging the moment we stepped into the exam room, and graduated to hysterical sobbing when the nurse tried to measure her or the doctor tried to examine her. Developmentally normal, our ped was quick to assure us, but still a wrenching battle that left all three of us unhappy and drained.

A couple of weeks ago, coming home from our last trip to Elmira, Alex suddenly initiated a game of "doctor." She had her nail clippers, which have a magnifying glass at the business end, and announced that she was going to use them to peek in her doggy's ears. We spent about 45 minutes on that car trip examining each other and her doggy. Several times since then she has initiated doctor play, as well - always a monotonous (to me; it's endlessly fascinating to her) rehearsal of a well-child visit. One of the children's librarians found us two picture books about going to the doctor, and she's been demanding them up to five times a day.

We started to prepare her yesterday for the likelihood of a doctor's visit today. She was excited to leave for the appointment: "Go to doctor! Go to doctor!" While we were in the car, we talked about things the doctor might do. (Peek in ears, peek in mouth, listen to chest and back.) We also brought her favorite of the two doctor books with her, and re-read it in the waiting room. When they brought us back to the exam room, although she didn't cry, she clung to Michael pretty tightly and rested her head on his chest. We walked around and around the room looking for things that were the same as in her book, talking about what Thomas (the main character) did with the scale, the blood pressure cuff, the tongue depressor, and so on. It seemed to help so much. Alex was calm when the doctor came in. She let her listen to her chest and back without protest, and accepted the ear exam. She only cried when the doctor wanted to look in her throat. Throughout the exam, we kept talking about what Thomas did in the book, and how Alex was being just like Thomas.

The doctor responded very well to what we were trying to do. She let me hold the tongue depressor, for example, instead of insisting on putting it Alex's mouth herself. She even engaged Alex with the book - she flipped through to find out what happens at the end (Thomas gets stickers from his doctor), and told Alex that she could have stickers at the end too. But really, I think most of the work was done by Alex, through play and through hearing and talking about the stories.

You know, they say that "children work out their issues through play," and it always seemed a reasonable enough idea. But it's something else to see how amazingly well it can work in practice.

Oh, and additional good news: we weighed her, and she's gained almost two pounds since the first week of November. That takes her up to the 25th percentile for weight. Yay!

Comments

[treadpath.livejournal.com]

Tamsin also seems to have gotten the Ear Infection of Doom... something we were unaware of--sometimes kids with ear infections start grinding their teeth in their sleep. It is the most disturbing sound, like nails on a chalkboard or... well, tiny teeth grinding. Just to warn you so you don't freak out, as I did, and wake your partner up at 4:30 AM to resuscitate the internet so you can look up "tetanus"...

Hope Alex feels better soon!!!

[rivka.livejournal.com]

And Tamsin likewise! Poor little thing.

[kalmn.livejournal.com]

tell alex she has something in common with one of your friends in minnesota. i'm calling for an appointment in the morning because my ear pops every time i burp. mildly unpleasant.

uh, on to more dignified topics. the thomas book wouldn't happen to be by gunilla wolde, would it? i have nearly the full set of her english language books with a little girl protagonist, starting out with "this is betsy" and going on from there. ;)

[rivka.livejournal.com]

the thomas book wouldn't happen to be by gunilla wolde, would it?

No, Susan Kuklin (http://www.cricketmag.com/activity_display.asp?id=1731). It's illustrated with photos, which is particularly nice because it's easier to connect with real life.

(I Googled for Wolde, and wow. Very cute books. Did you also, as a child, read the B is for Betsy series? And Understood Betsy? I know I had to read Rebecca of Sunnybrook Farm in self-defense, because so many grownups wanted to talk to me about it.)

[minnehaha.livejournal.com]

I read and liked Understood Betsy, although it's hard to remember the details after all these years. It was the maple sugaring that has stuck with me the longest, and the obviously gay aunt... um... Ann? The book was my mother's; I wonder what happened to it.

K.

[tammylc.livejournal.com]

We are very familiar with the cold turns into sinus infection routine around here, so you have my sympathies.

Liam likes his Amoxicillan too - he calls it the "tasty medicine."

[rivka.livejournal.com]

We gave her water in the medicine spoon after all the medicine was gone, because she was crying for more. But part of that might have been the novelty of a medicine spoon - previously, she's always used a dropper.

How long does it usually take Liam to start feeling better?

[tammylc.livejournal.com]

In my original email, I'd started writing "the nice thing about antibiotics is how fast they work" but then deleted it for some reason. In our experience, we start seeing some improvement the very next day, and LOTS of improvement by day two.

[rivka.livejournal.com]

Oh, good! We're flying to Memphis on Friday, so I'd like her to be her normal cheerful self by then.

The doctor said that sometimes the first day or two is even worse, because the sinuses are draining. There's something I didn't want to hear! The antihistamine/decongestant seems to be helping a lot with the symptoms, at least.

Do you find that sleep gets a lot worse when he's spoiling for a sinus infection? We've had the most godawful couple of weeks with sleep - the post-lights-out cuddling and rocking has stretched longer and longer until, the last several days, it's taken an hour and a half every night. And naps are awful too. I'm really hoping that all of that is just symptomatic of how awful she feels when she lies down.

[tammylc.livejournal.com]

You should be great by Friday.

Sleep and personality both suffer. Even with Liam being sick with stomach flu yesterday, his personality was more "him" than when he was suffering from the ear infections. As soon as we got him started on the antibiotics all of that got MUCH easier for us, I'm pleased to say. I hope you find that too!

[spiritdancer]

Our pediatrician's rule is ear infections under two get treated - period (and they define "ear infection" as "we can see purulent fluid (pus) behind the ear drum). We seem to have managed to avoid the most recent accumulation of fluid in the ears going to infection - David's now had 3 infections since October (two rounds of amoxicillin, one round of omnicef, and he LOVED the flavor of the meds, thank goodness!).

I'm hoping we're done with ear infections for a while, because the local rule is tubes after 4 infections in less than 6 months or 6 infections in a year ::sigh::

[rivka.livejournal.com]

Our pediatrician's rule is ear infections under two get treated - period (and they define "ear infection" as "we can see purulent fluid (pus) behind the ear drum).

That's kind of an odd rule. The AAP recommendation is based on the fact that most ear infections are viral - which means that antibiotics don't help, even if you're under two. But it shouldn't surprise me that pediatricians aren't a monolithic body, I guess.

Poor David. I hope he is finished for a while.

[spiritdancer]

That's kind of an odd rule.

*nods* "Tis why I mentioned their specific definintion - red, painful, bulging eardrums don't get antibiotics - only if the appearance shows pus. Believe me, we've had two episodes of fluid buildup likely due to a virus that didn't progress to a full-blown infection requiring antibiotics. And all three docs in the group know I have an otoscope, and that Mama knows what infection vs fluid buildup looks like. As a result, they get me in pretty darn quick if I call ::chuckle::

I've been threatening to breastfeed the next one to age 20 if it'll prevent the dang ear infections (David didn't have one until after he self-weaned at about 9 months or so).

[malibrarian.livejournal.com]

Sarah just had her second ear infection this year, she woke up one Saturday last month and started telling me that her ear really hurt her, took her in to see the nurse practitioner who said she had wax in her ear and cleaned it out. And then she saw the raging ear infection. And you know, our pharmacy has amoxicillin for free this month.

Sarah watched Alex singing Jingle Bells yesterday and wanted to know where her friend baby Alex had gone. She's amazed that she's so big. And gaining weight like she's doing, she's going to be big girl Alex any day now.

[rivka.livejournal.com]

To hear her tell it, she's a big girl already - but I'm sure Sarah would be quick to correct her! Although I will say that when we get well past bedtime, she's not averse to pleading, "Mama cuddle baby?"

[kip-w.livejournal.com]

Yay for Alex!

[wcg.livejournal.com]

Yay for Amoxacillin, and for weight gain! And it's just so good that she was able to teach herself about visiting the doctor.

[selki.livejournal.com]

You know, they say that "children work out their issues through play," and it always seemed a reasonable enough idea. But it's something else to see how amazingly well it can work in practice.

Similarly, one of my nieces did lots and lots of firefighter playing/reading after she was scared by a fire in the apartment building where they used to live.