Last night Namine had an incredible fever of 103.2. That was under the armpit, too, and we thought that was much too high for what the doctor had called just that afternoon “the tail end of a virus.” To us, it seemed like she was coming down with something else entirely. So we bundled up Namine and headed to the ER – me, Jessica, Namine, and my Aunt CR, who was visiting for the evening. I doubt it was as relaxing as she’d hoped the evening would be.
Namine had already shown that she didn’t have much of an appetite. My aunt had brought over some potato soup and breadsticks that she made – her food is amazing – but Namine wanted nothing to do with it. She took a bite out of a breadstick, but then she just sat there holding it, eyes glassy from feeling ill. She wouldn’t even try the soup.
So I got her out of her high chair, and I sat with her on the couch. It wasn’t long before she lay herself down on my lap and fell asleep. Jessica and my aunt ran out to the store to get some infant Advil (even though she’s almost three, Namine is too small for anything else) and some other stuff. I had planned on just putting her to bed when they got back. But upon taking her temperature, we discovered that was extremely high. At that point, I called the special needs line at CHW and let them know we were bringing Namine to the ER.
Once at the ER, we didn’t have to wait long to be taken back into a room. The doctors came in and told us what they wanted to do, but it did take a while for them to get going. They wanted to do an IV, a urinalysis, and a chest x-ray. I can think of three things Namine hates.
The IV wasn’t actually as bad as it could have been; certainly, other nurses have attempted IVs and gotten nothing. She didn’t blow the IV, either. But on the initial try, they didn’t get enough blood for all that they needed it for – cultures and whatnot. So they had to order for a second draw; someone came up shortly after the IV was done to draw blood from the other arm. That went smoothly and quickly. (When I recount it here it sounds all quick and easy. But there’s nothing quick or easy about holding down a crying child, who screams “No, no” the entire time.)
The urinalysis was worse, as far as Namine’s reaction goes, just because of the nature of what they had to do. But they got what they needed, and left Namine to relax. For a little while.
After a while, the doctor came back. He told us that the results from the blood tests and urinalysis should come back soon. Shortly after, a couple people from imaging came by to take Namine for her x-ray. She didn’t like that either, at least initially. They usually lay her down to take the pictures, but this time they had her sit in this chair. Namine seemed to think that was cool (or at least different), so she did well, and did it smiling.
Eventually, the test results all came back. The urinalysis turned up fine. Because they couldn’t explain the fever, they had thought that perhaps Namine had a urinary tract infection. (She doesn’t have a history of that, but it’s best to be sure.) The blood test came back fine*, and her chest x-rays looked good. In short, they had no explanation for the high fever, save for “it must be a virus.” So they told us we could go home, instructing us to just give her ibuprofen every six hours, just to keep the fever down and keep her comfortable. As comfortable as you can be with a fever, anyway.
* The doctor thought the blood test was fine. We disagreed, because Namine’s hematocrit level came back as 45. (Your hematocrit is the proportion of red blood cells in your blood.) Let me back up a bit. When Namine was just a tiny baby recovering from surgery, no one knew why she couldn’t keep her stats up. Her oxygen kept dropping, and no one knew why. Then one of the critical care doctors, Dr. Ghanayem, figured it out: Namine’s hematocrit needed to be higher than “normal.” When it gets low, she needs blood. (Aw. My little vampire.)
Anyway, this remains true now. Last time we were in the ER for the croup, a few weeks ago, Namine’s hematocrit was at 48. So we were concerned last night that, at 45, it was too low. The ER doctor disagreed with us. We did eventually get Namine’s special needs doctor on the phone, and he agreed that 45 was low for Namine, but it was still within acceptable range. This was good to hear, for two reasons.
First, a doctor recognized that Namine’s hematocrit needed to be higher than normal. Second, even thought it was low, it was still acceptable and that meant that Namine did not need a transfusion of blood (the only thing that has ever raised the number, because of course it adds red blood cells). Ultimately, Namine could still go home. But we didn’t want to go home unless we were absolutely sure it was the right thing to do. We weren’t so eager to go home that we would be willing to put Namine at risk.