Thursday, December 10, 2009

Physio

Just to let everyone know, the boys are doing much better. They are coughing, but with asthmatics, seems no matter what illness they get, a cough is guaranteed. Ryan has almost lost his voice but doesn't stop him from his constant chatter.

Both boys went back to school yesterday afternoon. They were running around here in the morning, playing tag, throwing balls, being crazy. If they are well enough to do that, they are well enough for school. Besides, if I waited until they had no cough, they would never go to school.

Yesterday was physio with Steve as well. I gave Matthew the choice of going to physio or heading home afterschool. I was shocked. He chose to go to physio. That speaks volumes to the relationship that Steve has made with Matthew.

This is no longer a client-professional relationship. It has stepped over into something else. Something more wonderful. Something more therapeutic. A big brother of sorts. One who has gone through so much of the same. One who can give advice in a way I can't. He's walked the road (shoes and bar included) and come out the other end with some invaluable information. And he wants to pass it on to Matthew. And Matthew listens to what ever he says. After all, Steve is much cooler then mommy. Steve has a faux hawk.

Tuesday, December 8, 2009

A Tale Of Two Fevers, Chapter 2

Here's hoping this is the last chapter of this tale.

Last night, 30 min before bed, Ryan started barking like a seal. Those of you who know what that means know my heart sank thinking I was headed back to the ER for a second night. For those of you who don't know, the barking is from croup, or in this house, a really bad cold settling into an asthmatic's chest.

Luckily, this is not our first seal and we have meds to work with this. I gave Ryan his ventolin and flovent. Nothing. Then, I gave him one more dose of ventolin. I know, I know. Not good to give extra ventolin without being able to check heart rate, but I was desperately trying to stay away from the hospital for a second night in a row. And, my gambled paid off. Within minutes, the barking ceased and breathing rate went back to normal.

Until this morning. The bark is back.

In the past, I have been able to convince a doctor at the walk in clinic to give me a prescription for dex (dexamethasone). Usually one shot of dex is all he needs.

I'm going to give it a few hours, see how he is doing before I head to a walk in. After all, I still have Matthew home, sick. His headache woke him at 6 am, luckily, a dose of motrin helped him back to sleep and is still sleeping at 8:15 am. Unheard of around here. Hoping that is a good sign.

Tis the season for seals and runny noses.

Monday, December 7, 2009

A Tale Of Two Fevers, And A Lumbar Puncture

First, I have to say that Matthew's physio appointment on Friday went well. His old p/t was pleased with how loose his foot was. Yay! That means that Steve is achieving what we had hoped. We may be able to make the complete switch soon.

Also, his p/t told me that she really pushes him. More then she has ever pushed a 7 year old before. In fact, she pushes him almost as much as she would push an adult. Her words were "He is one tough 7 year old." Those words became very important to me a few days later.

Ryan's fever started Thursday afternoon. It seemed to bounce from about 38.5 C (101 F) to 39.8 C (104 F). He was lethargic, tired, cold and had an upset tummy. But he was doing fairly well with piggy backing Tylenol and Advil.

Matthew's fever started at noon on Saturday. Same symptoms except he also had a headache. Fever was about the same and was responding fairly well to Tylenol and Advil.

Sunday. Ryan seemed to be over the worst. Matthew, got worse. His headache was really bad and not responding well to anything. Neither was his fever. I was only able to get it down to 39.4 C (103 F) He had a few naps, and each time he got up, his headache was worse.

7 pm. He woke again. This time his fever was 39.7 C (103.5 F) and his headache was intense. And his neck was hurting in the back. Really badly. And he wasn't able to have any medication for another 2 hours. He was sobbing uncontrollably.

I decided to take him to a walk in to see what could be done. He must have looked and sounded bad. We got in before all the people waiting.

The doctor was worried about the headache and neck pain. I was too. I remembered what his p/t had said two days before. This is a kid who doesn't complain about pain very often. And he was debilitated by it. She quickly mentioned Meningitis and a lumbar puncture and sent us to the children's hospital with a letter hoping to rush us in.

We didn't have to wait long, but in the meantime, after crying steadily for almost three hours, he fell asleep. Made it easier to talk with the doctor when he came in.

The doctor was great. He discussed the possibility, the outcomes, the research, the side effects, the options, everything. Then he examined Matthew and we discussed what to do again.

In the end, the doctor was pretty sure a puncture would come back negative but was very concerned over the level of pain in the head and neck with no other cause. He said he would agree if I decided to take him home and wait it out. But he would also feel better having checked the fluid.

I decided to go ahead with it. I had not seen Matthew in that kind of pain since his calcanial osteotomy. And we were all ready at the hospital. And we were already out of the waiting room. And it was really really cold outside. And I was worried if I took him home, I would end up back a few hours later waiting to be seen again.

We went ahead and did the lumbar puncture.

And all tests came back negative/normal.

The best diagnosis is he has a really bad viral infection causing a terrible headache. Keep up with the Tylenol and Advil and they gave me some codeine to help manage the headache pain. And to come back if things don't get better in a day or two.

Today, Matthew is doing better. Fever is down to more reasonable numbers, headache has been manageable with medications, and he had a 2 1/2 hour sleep this afternoon.

And the boys actually had a squabble. Always a sign they are feeling better.

Thursday, December 3, 2009

A Day Off School...

Tomorrow the boys are off school for parent teacher interviews. But instead of having a pj playing games watching tv day, we are heading off to Matthew's old p/t across town. We only get this opportunity every month or so and we take it when we can.

Not sure what to think heading into this appointment. Last night, while I was stretching his foot, it seemed, good. And, I really really like the relationship that is developing with Matthew's new p/t, Steve.

But am I fooling myself? Am I falling for the magic that this new relationship brings? Matthew actually looks forward to p/t now where he used to hate it. The drive is 5 minutes rather then 45+ minutes. It is all around easier and more fun.

But is that what is important?

Or is it what is important? Maybe I have been stressing too much on keeping his foot stretched perfectly, getting every last degree of dorsiflexion as possible. Stressing over even the tiniest loss. Worried we are headed for more casting, long terms stays in St Louis, even surgery.

Maybe Steve's laid back nature is more in tune with Dr Dobb's. Less stress over it. Cast here and there when needed. Fix the problem slowly, rather then all at once.

After all, it was after seeing his old p/t all summer that his foot had tightened enough to need recasting in October.

Will update after his appointment tomorrow.

Wednesday, December 2, 2009

A New Mom To Report Cards Wonders What To Do

The boys brought their report cards home last week. I am proud to say that they both achieved excellence in almost every single area. Ryan got a B on patterns (gosh, the kid is in kindergarten...we are not concerned) and Matthew got a B in phys. ed.

Now, getting all A's and a B in phys ed is an outstanding report card. We are not concerned at all about Matthew's grades. But I am curious. At the beginning of the year, I let his teacher know about his foot. I never thought about him having a different teacher for phys ed. So, currently, the phys ed teacher does not know about Matthew's foot.

That means, the grade he received is comparable to every other child that teacher works with. That B is rather great in that perspective.

So, that begs the question. Do I tell the phys ed teacher about Matthew's foot? Not so that he grades him accordingly, but so that he knows that if he sees limitations, it is not for lack of trying but for physical reasons.

Or do I just let it be and have him continue to work with and grade him as a student without physical problems?

I'm torn. What would you do?