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Old 12-19-2003, 10:55 AM
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Question Any Pediatricians here, serious question

So it goes like this, my 12 year old (92lbs) yesterday at 7:30am complains he is not feeling well, took his temperature (103.1) give him some tylenol to bring the fever down. Fever down to 100.5 by the time we go to see the doctor, doctor takes strep culture which comes back negative. Check temp again at 4pm 100.5 (still), again at 8pm (yup, 100.5). Tylenol given again just before bed time. Child wakes up at 6:15am fever back to 103, again, tylenol given and fever checked again at 11:30am (101.7), child now at 12:47pm has a fever spike back to 104.1. Some nausea (not to the point of throwing up), some diarrhea. healthy appetite (one banana, 4 pieces of toast, and lots of Gatorade). Congestion sounds like it has gotten worse, not better since yesterday. Doctor prescribed tylenol or equivalent


My concerns are his fever spikes, along with the fact that he is never sick (ok, chest colds, but that is not unusual in my family). His background history just is with his spinal surgery (he takes 1500 mg of amoxacillin before any dental work) two years ago this January. Should there be concerns that no blood work has been done??? Should blood work have been done yesterday to rule out anything else????? A nervous, concerned father wants to know......................................


Sincerely,

Bill S
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Old 12-19-2003, 11:51 AM
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First of all Bill, I'm not a doctor, but but Jersey is listed as having regional outbreaks of the flu. I'm in the process of raising my fifth child (ages 3 to 24) and I've been down this road all too many times. I'd just go ahead and call the pediatrician's office and tell them what's going on and go from there. I hope it passes quickly.
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Old 12-19-2003, 12:31 PM
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Bill:
You might shoot an email off to Hal Copple.
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Old 12-19-2003, 01:05 PM
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Sorry to hear about your boy, as a parent (fortunately all adults now) I now how it feels not to be able fix it. Good luck and hope he's feeling better soon.
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Old 12-19-2003, 01:15 PM
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Thanks guys, been down to the hospital for blood work and a chest Xray....Still waiting for a read on the Xray, 1-2 days for the different cultures to come back on the blood work.....................


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Bill S
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Old 12-19-2003, 02:18 PM
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Bill,
keep a watch on the fever. If it spikes again, even with the negative cultures, call your Pediatrician. The symptoms "sound" like the flu that's wiped out most of our area schools but since he's had spinal surgery, remain concerned. Atypically, Reye's Syndrome could be a concern but you're too vigilent. You know your child and if his behavior changes drastically or any convulsions, return to the ER ASAP!
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Old 12-19-2003, 02:30 PM
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Dan,

My first thought was of Reye's Syndrome, but again, none of the lethargic or the truly "A" typical symptoms. Done enough of my homework on this one. Did not spend all that time working in and around hospitals early in life without picking certain things up. Cultures will be in within a day or so, chest films came back clear according to the "board certified" radiologist I had read them..............So, we watch and wait now............Thanks for the heads up though...............


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Bill S.
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Old 12-19-2003, 02:44 PM
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My wife and I both volunteer at the local Boys & Girls Club as medical guidance counselors and 30% of the kids this week are out with the flu with symptoms similar to what you described. The main concern especially if bone grafting was performed during his spinal surgery is harboring a low grade infection, thus as you know prophylactic antibiotics should be prescribed for even minor issues and before all elective procedures. Keep the electrolytes up with the Gatoraide.
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Old 12-19-2003, 02:52 PM
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No bone grafts were needed, just lots of titanium hardware. have already spoken with his original spinal surgeon, and his primary pediatricians (she is good), all looks just fine for now. A combination of tylenol or bayer asprin for the fever, amoxacillin (500mgs) for the next couple of 8 hour shifts, watch and wait for the rest...Right now he is relaxing on the couch in the familyroom awaiting the first night of Hannuka to begin.......Fever is down to 99.6 for now, so this too we'll be watching throughout the night and into this weekend..................


Thanks again for the ideas and thoughts.


Sincerely,

Bill S and family
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Old 12-19-2003, 04:00 PM
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Bill, I am a doctor (general surgeon). Sounds like your kiddo has influenza. Tis the season. Keep a vigilant eye and this too will pass. Let us know how he fares.

Roland
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Old 12-19-2003, 04:26 PM
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aspirin is a no no for kids;tylenol ,motrin a better and safer choice.Keep in mind that a fever helps mount a better immune response and 104 is not particularly worrisome in a kid.Way too much press on the flu issue this year;not that it cannot be very dangerous in susceptable individuals ,and common sense precautions are warranted.(easy to say as a doctor,harder to think about as a dad)Fluid,fluids,fluids chuck
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Old 12-20-2003, 04:31 AM
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Fluids are in, fever is down to 100.3 this am, we'll see where the days leads. At least he is hungry this morning, always a good sign..........


Bill S.
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Old 12-20-2003, 06:54 AM
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Bill,
When they say "fluids", they mean water, and other things that will be healty for him...don't let him dip into that Manishevitz (sp?) wine on Hannukah, got it?

I am not a doctor, and I don't play one on TV. Though I do have a college degree in human biology. Sounds like the flu to me too. Tell him the wife and I wish him well. Is this what I have to look forward to in just a few months?

Steve
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Old 12-20-2003, 07:01 AM
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Bill,
Like the rest of the Docs, sounds like the flu. Your most important test was a thoughtful exam by a competent Dr. Fluids are critical--small amounts frequently. Tylenol and ibuprofen (Advil, Motrin) are good for treatment of fever and aching. I think we have a little better success with the ibuprofen drugs than Tylenol and they are maybe a little safer. You can give Tylenol and Motrin at the same time if you need to. Email any of us if you have questions about dosing.

I understand your fears. Our 14 yr old boy has Ulcerative Colitis. He has been in Riley's children hosptial several times. My wife is an RN and I am an ER Dr. but we still often feel helpless and afraid for him. Thankfully, he has done very well. It is just part of the "daddy job" to want to do every thing possible.

In another day or two your son will be enjoying the holidays more than you.

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Old 12-20-2003, 08:28 AM
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Bill,

So sorry to hear about your son. I had the very same symptoms a couple of months ago. That is why I wasn't able to go to Willow. All my kids had the same thing--real bummer.

This flu bug is a bad one as it hangs on and on and on and on. I made one of my guys here at work sick for 10 days.

Make sure he drinks like a Russian celebrating (insert anything here)...ugghhh, just make sure it isn't VODKA! Personally, I'm a fan of watered down orange juice.

David
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Old 12-20-2003, 09:00 AM
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Gatorade was designed to replenish lost electrolytes. It's easier on the stomach, readily available and recycles well.
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Old 12-20-2003, 11:12 AM
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bill, i can't reply to any CC posts at my office, where read about your child's illness yest, and got home just in time to be drug off to a reception, then my printer ran out of ink, giving me this big fat "out of ink" warning in front of me.

Anyway, i am always leery of any over the phone medical opinions, and try to not do much of it myself. Even in a flu season, where everybody seems to be sick with pretty much the same symptoms, your child's doctor will remain wary that the illness just might be masquerading as something else. So if things do not go "according to plan", it is always good to check in with his physician, to see if any additional evaluation is warranted. But it sounds like your child's car is in good hands, and remember, always best for a parent to do the "parent stuff", ie, fluids, symptomatic car, and let the physician do the "medical stuff."

But pediatricans always want to hear if a parent continues to have an uneasy feeling about their child's illness.

Hope things are better now.

your old friend,

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Old 12-20-2003, 12:12 PM
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Hey Bill,

I hope your son is feeling better by now. My 14 year old just went through a bout of the flu. It was really hard on him. Stayed with him about 4 days total. Missed a couple of days of school. But, when it was over, it was over and we all knew it!

Take care of him.

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Old 12-20-2003, 04:58 PM
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How's the little guy doing? Did he turn the corner?

Roland
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Old 12-20-2003, 05:33 PM
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Temp is down to 99.8 for most of the day...One spike back to 101.8 in the early afternoon.....His need for food intake has increased which is always a good sign.......Still has a nasty chest related congestive cough which is more of what we are worried about, but we'll await the blood workup from Friday before we go into anything further....Better to be safe than sorry............


Bill S.

PS: Thanks for asking (both on and off the forum)
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