I took Aaron to the pediatrician this morning -- a follow up to the follow up to his annual appointment back in early December. At that time I had brought up my (slight) concern that he sounds stuffy all the time ("Mommy" sounds more like "Bobby") and frequently snores. It probably doesn't help that he keeps that damned blankie shoved in his mouth at night, but that doesn't explain why he doesn't seem to hear the subtle differences between "m" and "n". So I brought it up. I also brought up his "itchies".

He was diagnosed at his very first well-baby checkup with a mild case of eczema and at the time, that pediatrician explained to us the close connection between allergies, asthma, and eczema. With that diagnosis, our sensitivity trifecta was complete. If you've spent more than 5 minutes around me and we've come within 200 feet of a flower, you know which one I have. I remember 60% of summertime as a child through a Benadryl induced fog. The other 40% I don't remember at all because that sh*t knocks me out cold. Josh has asthma.

We were actually pleased, all things considered, that Aaron's predisposition leaned toward something we could deal with topically*. And his case was so very mild that we were pretty lax (read: I think we bought the lotion) about the whole treatment thing. He did get a bath every night for the first two years of his life (suggested so that we would remember to apply the lotion every day. As I said, he got a bath every night...) and we were always careful about lotioning up when his skin seemed dry and we remembered where we had put the lotion. So, yeah. Definitely easier to manage than inhalers/pills/shots.

Anyways. Back to December. As the doctor got out her little flicky light to look in his various orifices (orifi?), I mentioned the itchy/snory/nasaly talking stuff. So she took a look. Might be allergies, she thought, but didn't feel confident with making that the official diagnosis since she couldn't see past the earwax in his right ear. Do you know how bad of a mother you have to be to allow your child's earwax to build up to the point that the pediatrician is visibly disgusted? But, damn it, q-tips are evil! She sent us home with instructions to use drops to clear the ear (the only one ear thing still puzzles me, but I can't argue -- I saw the crap that drained out of my poor baby's ear after using those drops for a week) and the recommendation to start him on a half teaspoon of cetirizine hydrochloride (Zyrtec, OTC) once a day, then come back in a month to see how things were going.

Fast forward to a week and a half shy of a month later. Aaron's getting dressed one morning (taking longer than usual, if that is even possible) and he keeps stopping and holding his head in a funny position. "Shhh, Mommy. I'm trying to hear but there's a bubble in my ear." To my credit, I immediately though "ear infection". I was plagued with them as a child (or at least that's how I remember my childhood winters. Is it any wonder that fall is my favorite season?), so I asked what I thought were the sensible questions (Does it hurt? no Is it a ringy sound? no Does your throat hurt? no) and took his temperature. No fever. As we were tying up his shoes, he exclaimed "There! It popped! Now I can hear EVERYTHING!" Ah. Problem solved. Probably just a drop of water. Why it didn't occur to me that water from his bath the night before shouldn't still be in his ear, well, see above where I discuss being this close to having my mommy card confiscated re: earwax buildup. Instead, I just smiled at not having to deal with something else on a morning that we were already late for school and hurried him downstairs for a healthy breakfast (Carnation instant + a banana, no doubt).

A week and a half later, the Dr. pulls out her little flicky light to check his various face holes. Throat and nose peeks still lean her in the direction of allergies, but let's check the ears and hey! Looks like this child is just getting over an ear infection! In both ears! Has he complained of any pain? no No fever? no Wellllll, looks like his body was strong enough to fight the infection off without antibiotics which is what we'd prefer to see, but there is still fluid in there so we can't really get a good picture from which to assess whether or not the allergy meds are making any sort of a difference. But we're still leaning that direction, so come back in two weeks. In the meanwhile, let's add in a dose of fluticasone propionate (Flonase) to see if we can give his system a boost with whatever else it is trying to clear.

Fast forward to last Thursday (8 days before today's follow-up). Guess who wakes up with sniffly and congested? Who comes home from school all pissy and complainy (well, okay that's fair. Who besides me?) and has started intermittently hacking into his elbow? Who's cough has become so bad by the weekend that he's waking himself up in the middle of the night? And who's mommy decides to "give it a day or so to work itself out"? (In all fairness, by Sunday night the cough is much better and he is back to sleeping through the night, lumberjack-snores notwithstanding.) On Tuesday I'm in "he's already got an appointment on Friday, so no need to panic, his snot isn't that green" mode. On Thursday afternoon it (finally) occurred to me that this "cold" might interfere, yet again, with our as yet unassessed allergy trial. Too late to call in and move the appointment, of course.

So. I took Aaron to the pediatrician this morning. Little flicky light confirms that the nose and throat are dealing with something non-allergy related and possibly some underlying allergy related stuff. Ear still has fluid. This time she described it as "thick orangey fluid". Is it wrong that my mind immediately went to "Orange Julius"? And then she asked him to take a few deep breaths while she listened to his lungs. And then she asked him to pretend to cough. Which he did, except he didn't pretend. And then she asked him to stand on the ground while she listened to his lungs because "it helps them take deeper breaths because it opens up the lungs". And then she asked him to sit back down on the table and wait for Joanne to bring in the nebulizer machine. And then he had to hold that tubey thingy up to his mouth and breathe in all that fine misty medicine for 6 minutes which at first he thought was "cool because it's just like the medicine that W has to do at school and Miss K won't let me watch because that might make W embarrassed to have me watching him take his medicine" but after about 2 minutes it was more like "how much longer do I have to hold this thing and keep breathing and why is 4 more minutes such a LOOOOOOOOONG time". And then she still couldn't hear what she was listening for or maybe she heard exactly what she was listening for but was going to give us a chance to get clear out of his lungs before she sent us home with $100 worth of prescriptions for inhalers with scary sounding names like ALBUTEROL and FLOVENT and also for a spacer chamber and a mask to make sure that he is breathing in every chemical particulate because MY GOD WOMAN, YOUR CHILD IS WHEEZING. Also, a prescription for a 10-day course of penicillin which, by the way, he could likely have an adverse reaction to because his mother is extremely allergic to penicillin but because he's never been prescribed antibiotics before and therefore hasn't had an allergic reaction to any antibiotics, this is where we will start him but please keep a careful watch and call us immediately if you notice a rash or any other reactionary indications such as difficulty breathing but we hardly expect you to notice that one given the state that you let your child get to this time. Also, please bring him back on Monday for a follow-up visit.

It's early to draw the conclusion that he has asthma. Not that my mind hasn't already jumped there and set up camp. There's the possibility that it's "asthma-like symptoms" brought on by seasonal allergies/respiratory stress and we'll only have to deal with it on a once-or-twice a year basis. God knows, asthma has done little to slow his father down. So it's not a life sentence even if it turns out that he has to start "managing" his respiratory health before he starts kindergarten. But it sucks and I hate it and all the guilt-driven "what could/should I have done differently" paths that my mind insists on exploring. I keep flashing to images of my little baby lying there in the NICU, so strong, so big, so healthy, so mysteriously unable catch a full enough breath minutes after he was born to clear him to go home with us that very first night. All these other little babies around him so much worse off that I couldn't very well ask "why me". Couldn't very well whine to the mother who had spent the last 3 months driving back and forth every single day to spend time with her new baby girl during "visiting hours". Couldn't very well cry on the shoulder of the parents of the little one so fragile that you had to use those special gloves built into the sides of her "crib" to touch her. Everywhere I look, someone's got it worse. And yet there it is -- the anger and frustration of not being able to shield him from pain and discomfort crushing my own chest, constricting my own breathing.

I'm going to be a basket case when he goes to pick out his first pair of glasses. He is totally f*cked when it comes to the vision genes.

*Yes, yes, I know that eczema can be as frustrating to deal with/treat as either of the other two, but in his case we were looking at having to buy and remember to slather on unscented lotion after each bath. Totally doable.



Lora said...

good lord that's a lot.

Jake has gross skin. I do nothing about it. I rarely bathe the child. Once a week, maybe. Twice. It helps. Petroleum sends him into a tailspin, and anything the derm suggested is full of it.
I just let him run dirty and rub him down with olive oil and keep my fingers crossed he out grows it.

good luck with the asthma.

and I'm dreading the vision genes too.

our poor boys

Curiosity said...

Hi! I know I've been incommunicato for a while (lets pretend that I'm a secret agent rather than someone sensitive to poor drug reactions, okay?), but thought that I would stop by to say hello. Best wishes with the health issues, and as much as I know that it likely won't make much difference, it is not in any way your fault.

Any future offspring I have are doomed to all sorts of mysterious illnesses. ...Unless they get my husband's genes, in which case they will live happily to 100 with no issues at all. But damned if those kids won't have trouble finding their socks.