Doctor #3 Says...

Well, Drew's Mom came the closest with Nolan's funny rash and fever! She was closer than doctor #1 (who thought it was teething, possibly) and WAYYY closer than doctor #2 who thought it was bug bites and that 100 degrees wasn't a fever. It isn't Roseola, though- the fever was never high enough for that to be in the running. Doctor #3 believes that he has some virus (not sure which) and the rash is definitely viral. She couldn't believe that doctor #2 thought that this type of rash could possibly be due to insect bites (no inflammation, and only on the torso- apparently bug bites are more common on the extremities).

This makes me feel a WHOLE lot better, because a viral rash and fever makes sense. Random bug bites (about 50 in total) and an unrelated fever that won't go away do NOT make sense!

We are holding off on his vaccinations, though, until the fever resolves (we're on day 8) and until some additional lab work comes back clean. Somehow, my history of vesicoureteral reflux (VUR) didn't make it on to Nolan's medical history. Matt had a kidney ultrasound when he was born to screen for it, but Nolan has never had a kidney ultrasound.

Add in that he's below the 3% for weight (now a whopping 20 pounds, 13 ounces- the size of your average 9 month old) and has the hearing loss to boot... there are a few things that ring the "worry meter."

She drew another CBC today and the results indicate that there is something viral going on (normal WBC but elevated lymphocytes). In addition to that, she drew a chem panel to check his electrolytes, BUN, and creatinine levels. We expect these to be normal, but it doesn't hurt to be sure.

We're also doing some urine collection for a urinalysis. If it comes back clean, then that means no urinary tract infection. If it comes back positive, then we have to do a straight cath to be 100% sure of the source of infection. We should have the results by Friday (I'm taking the sample in tomorrow).

She also ordered a renal ultrasound, of the same type Matt received when he was a newborn. This should have been done on Nolan as well, but was missed from his work-up. Kidney ultrasounds are not that specific for VUR, however, so she wants to do a voiding cystourethrogram (VCUG).

I wouldn't want to go that far ordinarily (it's not a fun test), but it turns out that VUR is thought to be a dominant trait. Which means my kids have about a 50% chance of inheriting it. It has variable penetrance, though, so some kids show more symptoms than others. If Nolan's VCOG comes back positive for reflux, then Matt will have to have one, too. Hopefully it will be negative.

Other than his low weight, unrelentant fever, hearing loss, and funny rash, though- he looks great! He's in the 25% for height (31.5 inches) and is doing everything else he is supposed to be doing. When they asked if he had 4-12 words, I said, "Pshaw! Try around 50! And some 3 word sentences!"

He might be a little thing, but he's got a lot to say!

Fever: Day 8

He's running 100.1 this morning. Not high enough to be considered a real "fever," but nonetheless not normal. The good news: the rash on his belly is starting to disappear and hasn't spread. Doctor #2 might have been right about one thing- the rash and the fever may not have been related. If not, then what is causing the fever? For EIGHT days?

I'm probably a tad more stressed than I ought to be, but something similar happened to me when I was a kid. My mom was sent away from the pediatrician's office many times for an unspecified fever. She was finally taken seriously when I was in kindergarten and fell asleep. And wouldn't wake up. I was born with severe vesicoureteral reflux in both kidneys, which was surgically corrected when it was finally found. I'm not saying that I think Nolan has this (though it can be hereditary), but fevers with no known cause CAN be indicative of something more serious.

It's probably just a virus. But I'm taking a stand today. No well-baby shots until the fever/non-fever goes away or we find the cause. Wish me luck with doctor #3. Sigh...

So Totally Beyond Frustrated

I managed to get into the pediatrician's office today. To see doctor #2 regarding Nolan's unending fever, and the new funny rash.

We got to wait in the parking lot for our turn, because they wanted to keep us quarantined in case it was Chicken Pox. We were called in through a back entrance and put into an exam room. The nurse took a quick look and said it didn't look like Chicken Pox. She took his temp and his low-grade fever is still there. We're on Day Six of a 99-100 degree fever.

Then the doctor came in. He took a look and informed me that the rash was not due to a virus. He thinks it might be flea bites. Except they don't look like flea bites. But he's pretty sure they're not viral. Or bug bites. He just doesn't know.

I told him that sounded like a strange diagnosis, because they've been cropping up on Nolan's belly over the weekend and spreading beyond his torso. Oh, yeah- and he has a fever. THAT WON'T GO AWAY.

The doctor then informed me that 99-100 degrees is NOT a fever.

Really? Because doctor number one thought it was enough of a fever to do a WBC on the kid. I'm pretty sure there's a reason a LOW GRADE FEVER is called a fever.

I am so frustrated, and worried for my little guy. There are just so many unknowns that keep me awake at night lately.

Failure to grow, for no known reason

Hearing loss, for no known reason

And then you add in:

Fever, for no known reason

Rash, for no known reason

Yeah, I'm a little stressed out!

I just don't know what to do. Nolan is due for his immunizations on Wednesday, and if he still has this non-fever I don't want him to get the shots.

Could It Be?

Well, this might explain our unknown origin of the fever... (you might need to enlarge the photo go get a gander at the spots).

I'm not sure what kind of rash this is, but could it be Chicken Pox? Nolan was vaccinated against that disease at 12 months of age.

Now I just need an infectious disease expert to add to our portfolio. Sigh...

FUO

Well, the good news is that Nolan's ears are perfectly fine. And so are his throat, lungs, and nose. There is absolutely nothing wrong with him, except for a fever that will not go away. The official diagnosis? FUO- Fever of unknown origin. It sounds more like an alien disk descending from space than a medical issue, but there you go. So now we watch and wait, and hopefully the fever will disappear eventually. They did do a finger stick to see if his white blood cell count was up, and it's not. He's due for shots next Wednesday (well baby appointment) so hopefully the fever will be gone by then.

He's also up to 20 pounds, 10oz! We're almost at the 21 pound mark, so at least he's still gaining weight. This child seems to subsist on a diet of milk and three cheerios per day, but at least he's still gaining some weight.

Fever, Day Three

Nolan has had a low-grade fever since Tuesday evening. I managed to get into the pediatrician today- I hope it isn't another ear infection!

He has no other symptoms (other than not eating, but that's nothing new).

I want spring to hurry and get here so that we can get past the nasty season of infectious diseases!