I took Wren to Dr Levitt at 8.30 am this morning which is when the practice starts answering phones. Oops. Apparently the doctors only start at 9.30am on Thursday. Dad and I were preparing to wait till 9.30am with the car fully loaded with our gear for the two nights in Vancouver. Canada when I saw Dr L coming from her car.
She very kindly agreed to see Wren right away (even though clinic rooms were in darkness).
The results?
His crackling in the lungs is still there but not worse. His pulse-ox was 94 which is lower than his usual 99 but not enough to account for his lethargy. His worsening cough could be a sign that he is managing to cough it out, especially as he is now only 98.4 while he has been at 99.4 for days (not a fever but still not totally normal).
Dr Levitt felt it was fine to take Wren to Vancouver and we set off by 9.15am. We had not driven more than 5 minutes before Wren was asleep with his pediatrician-lollipop in his mouth. We pulled it out and he slept all the way to the border at Blaine which was about 1 hour and 45 minutes. We arrived at my father's father-in-laws 45 minutes later only a scant 2.5 hours from start to finish.
An hour and a half later after playing in the yard and having a light lunch Wren said he was ready for nap. He slept ANOTHER two hours for his usual nap period. He is now acting happy and more normal although he has suggested we go home to his own his with his own toys. He is watching Dora the Explorer on DVD instead.
We took an afternoon walk to the playground and he went down the slide, on the swings and hid in the hedge. The neighborhood is similar to ours in Seattle but its interesting how many children you see out in the streets, sitting on their stoops and generally running and shrieking. There are many kids where we live but they don't use the streets as much. Perhaps we shall see that more in summer. Perhaps our street is busier than this. Even now I can hear children yelling and shouting. Wren asks what they are saying.
I think Wren was very short of sleep yesterday, waking too early and then only taking a short nap on a bicycle ride. He went to bed late when we were at Tara's so he missed out both ends and probably needs more sleep rather than less with being ill. I shall put him to be early tonight and hope he continues to enjoy it!
Meanwhile, I am loving having Dad here but as always happens on family visits I am VERY behind on my own life. Bills are piling up, I haven't kept up with correspondence [Josh, could you check on the left front pile on my desk and see what date the new school staff wanted our letter about Frost to make class choices?]
I am planning to catch up on coffee with friends, cooking slow soups and swimming when school gets out next week. Dad leaves on Monday.
Next cardiology appointment for Wren is July 6th and Dr Levitt said she would recommend another chest X-ray that week to confirm the pneumonia is cleared. I think I will schedule one for his cardiology clinic to do it at the same time.
Friday, June 12, 2009
Thursday, June 11, 2009
Ups and Downs
Wren has been doing well considering his diagnosis on Monday. His fever abated completely that day and he has had energy and relatively good humor since. Yesterday we took him out on a bike ride and to watch sports day at Frost's school.
Now I am concerned we overdid it.
In the night he had a few bouts of coughing which I have not heard since the bug struck and this morning he is not himself. He did not want to get up and cried as if exhausted. When he woke again and said he wanted to get up he coughed and lot and then cried saying he didn't want his cough and didn't want me to pat his back (I do it to help the coughing).
The only thing I could suggest that would console him was lying on the couch and watching Dora which he is now doing.
We are supposed to be leaving for two days with my Dad's in-laws in Vancouver B.C. but I am going to swing by the doctor with Wren first thing to check the sounds of his chest have not worsened despite being on Day 3 of Augmentin.
Now I am concerned we overdid it.
In the night he had a few bouts of coughing which I have not heard since the bug struck and this morning he is not himself. He did not want to get up and cried as if exhausted. When he woke again and said he wanted to get up he coughed and lot and then cried saying he didn't want his cough and didn't want me to pat his back (I do it to help the coughing).
The only thing I could suggest that would console him was lying on the couch and watching Dora which he is now doing.
We are supposed to be leaving for two days with my Dad's in-laws in Vancouver B.C. but I am going to swing by the doctor with Wren first thing to check the sounds of his chest have not worsened despite being on Day 3 of Augmentin.
Tuesday, June 9, 2009
Pneumonia
Wren has pneumonia. The X-ray showed "lower right lobe infiltration indicating a pneumonia of viral or bacterial origin." It is unclear which - it is "patchy".
Dr Levitt suggested being conservative and using Augmentin to treat the pneumonia.
Wren is looking better in terms of this recent virus but still coughs deeply on occasion.
Dr Levitt suggested being conservative and using Augmentin to treat the pneumonia.
Wren is looking better in terms of this recent virus but still coughs deeply on occasion.
Hospital X-ray quarantine
I took Wren to the pediatrician this morning and she was not happy to hear even more 'crackling' in his lower right lung area. She did a rapid flu test at her office (it was negative) and sent us to Children's for a chest X-ray.
When we arrived at Children's we were screened at the door asking whether we had fever plus any of a list of symptoms. Of course, Wren DID. Then they became very excited and put us into quarantine with masked staff and no check in. Then a senior nurse came to screen us and asked for Wren's condition and symptoms. I explained what was going on and she left to discuss whether he could have swine flu or was OK, whether a mobile radiology unit could come into the isolation room or he could go to general radiology. I told them about the flu test but that didn't seem to reassure them. I googled it after returning and it seems that the tests are not foolproof:
"For detection of seasonal influenza virus infection, sensitivities of rapid diagnostic tests are approximately 50-70% when compared with viral culture or RT-PCR, and specificities of rapid diagnostic tests for influenza are approximately 90-95%. Sensitivity and specificity of these tests for detection of the novel H1N1 flu virus are unknown."
Novel H1N1 = swine flu.
So, eventually she returned to tell us that they thought Wren was not a flu risk because he wasn't actively coughing and while the fever indicated "something was going on" that the cough was from his last illness. We were left to wait in the radiology waiting room for 30 minutes.
We are waiting to hear what was seen on the X-ray. Wren still has a fever but far lower than the 104F (40 degrees) he had at 3.30am.
Heather, I am going to email you - I don't think we can leave Wren with you tomorrow. Sigh.
When we arrived at Children's we were screened at the door asking whether we had fever plus any of a list of symptoms. Of course, Wren DID. Then they became very excited and put us into quarantine with masked staff and no check in. Then a senior nurse came to screen us and asked for Wren's condition and symptoms. I explained what was going on and she left to discuss whether he could have swine flu or was OK, whether a mobile radiology unit could come into the isolation room or he could go to general radiology. I told them about the flu test but that didn't seem to reassure them. I googled it after returning and it seems that the tests are not foolproof:
"For detection of seasonal influenza virus infection, sensitivities of rapid diagnostic tests are approximately 50-70% when compared with viral culture or RT-PCR, and specificities of rapid diagnostic tests for influenza are approximately 90-95%. Sensitivity and specificity of these tests for detection of the novel H1N1 flu virus are unknown."
Novel H1N1 = swine flu.
So, eventually she returned to tell us that they thought Wren was not a flu risk because he wasn't actively coughing and while the fever indicated "something was going on" that the cough was from his last illness. We were left to wait in the radiology waiting room for 30 minutes.
We are waiting to hear what was seen on the X-ray. Wren still has a fever but far lower than the 104F (40 degrees) he had at 3.30am.
Heather, I am going to email you - I don't think we can leave Wren with you tomorrow. Sigh.
Monday, June 8, 2009
Now Wren has it
Wren is sick. He has had a fever since late last night. I noticed him grunting and moaning in his bed and checked his temperature. He was 102. This afternoon he was 103.4 F (39.67C). He has been on Motrin, thymactiv and grapes. He was very tired most of the day and watched Robots, Ice Age and Dora and slept a lot. He slept almost the whole drive back from Mt Rainier (we returned a day early).
He had a lot more energy this evening and ran around playing "handsack" [hands up] with a stick. When you put your hands up he shoots you dead. He also spied on the raccoon who was creeping across the lawn to steal our catfood. Apparently, based on the muddy water and opened catfood bin in the kitchen, the raccoon has figured out how to open our catdoor by pushing and tapping on one side of the door then slipping in your fingers to force it open without a magnet.
I took Wren's temperature at bedtime expecting it to be low and it was 102.4 (39.1C). Sigh.
I hope he recovers faster than Frost who had a fever for 4.5 days.
I will be taking Wren to the pediatrician tomorrow to listen to his chest. I am mainly concerned that he not develop pneumonia from his previous chest cough (which he had not completely overcome) mixed with this new one.
Many kids at Frost's school have had this virus (flu) over the last week - 7 out of 10 kids in his small class. Two of them had fevers as high as 104.7 which we are hoping not to emulate. All are recovered but it seems to be a 3-4 day fever and nasty barking cough with some sore tummy, headache and lots of exhaustion.
Everyone is wondering if this is the swine flu or just some other flu. Nobody knows but we are taking precautions by having Wren checked early. Depending on how he is doing tomorrow I may ask for rapid flu test to decide whether or not to give him Tamiflu. Right now, he seems to be doing as well as anyone with a moderate fever.
He had a lot more energy this evening and ran around playing "handsack" [hands up] with a stick. When you put your hands up he shoots you dead. He also spied on the raccoon who was creeping across the lawn to steal our catfood. Apparently, based on the muddy water and opened catfood bin in the kitchen, the raccoon has figured out how to open our catdoor by pushing and tapping on one side of the door then slipping in your fingers to force it open without a magnet.
I took Wren's temperature at bedtime expecting it to be low and it was 102.4 (39.1C). Sigh.
I hope he recovers faster than Frost who had a fever for 4.5 days.
I will be taking Wren to the pediatrician tomorrow to listen to his chest. I am mainly concerned that he not develop pneumonia from his previous chest cough (which he had not completely overcome) mixed with this new one.
Many kids at Frost's school have had this virus (flu) over the last week - 7 out of 10 kids in his small class. Two of them had fevers as high as 104.7 which we are hoping not to emulate. All are recovered but it seems to be a 3-4 day fever and nasty barking cough with some sore tummy, headache and lots of exhaustion.
Everyone is wondering if this is the swine flu or just some other flu. Nobody knows but we are taking precautions by having Wren checked early. Depending on how he is doing tomorrow I may ask for rapid flu test to decide whether or not to give him Tamiflu. Right now, he seems to be doing as well as anyone with a moderate fever.
Sunday, June 7, 2009
Smores
We had dinner by the fire outside this evening. Dinner was sushi and red wine followed by smores.Until a few days ago, Dad did not know what smores are (roasted marshmallow and a few squares of chocolate sandwiched between two Graham crackers). This evening Dad and Frost had some practice making smores and eating them.
Grandad discovered that the marshmallow in smores makes them very sticky. I discovered that I really cannot eat more than two half-smores (one cookie each) without feeling sick. While we ate and cooked the raccoon ate the deer food in the feeder nearby. Dad scared him away to let the deer, who were afraid of it, eat. But it returned shortly and the deer went away.
Wren wanted raw marshmallows and chocolate. He was very cranky after missing nap so he got what he wanted. Frost is right, it is unfair that Wren gets his way. I need to work out a better way of avoiding meltdowns and conflict. Wren can be very plaintive and explicit about his needs but utterly irrational at the same time.
Dad is reading the Roadside Geology book and keeps making interesting comments like the news that Washington was inundated 100 times by giant glacial lake collapses and that lahars from earlier erruptions have been gargantuan and reached as far as Tacoma and Renton.
Josh started the fire for me after my firelighter didn't light. His solution was a balled lump of paper towels. These were very successful. This is the only picture I have of someone with a marshmallow on a stick and Joshua does not even eat marshmallows or does so very rarely.
Grandad discovered that the marshmallow in smores makes them very sticky. I discovered that I really cannot eat more than two half-smores (one cookie each) without feeling sick. While we ate and cooked the raccoon ate the deer food in the feeder nearby. Dad scared him away to let the deer, who were afraid of it, eat. But it returned shortly and the deer went away.
Wren wanted raw marshmallows and chocolate. He was very cranky after missing nap so he got what he wanted. Frost is right, it is unfair that Wren gets his way. I need to work out a better way of avoiding meltdowns and conflict. Wren can be very plaintive and explicit about his needs but utterly irrational at the same time.
Dad is reading the Roadside Geology book and keeps making interesting comments like the news that Washington was inundated 100 times by giant glacial lake collapses and that lahars from earlier erruptions have been gargantuan and reached as far as Tacoma and Renton.
Josh started the fire for me after my firelighter didn't light. His solution was a balled lump of paper towels. These were very successful. This is the only picture I have of someone with a marshmallow on a stick and Joshua does not even eat marshmallows or does so very rarely.
Mount Rainier
A few short days and a few 100 miles and we are now fever free at Mount Rainier with Dad, who is visiting from South Africa. The heat of the past week has subsided and we have low cloud obscuring the summit and enveloping the forest near Paradise with thick fog.
Yesterday, we drove to the Paradise Visitors Center but today we did some walks.
Before Joshua and Frost woke up, Dad Wren and I did a three-quarter of a mile circuit around the meadow at Longmire. It was close to 7am when we started and the swifts and swallows dipped in the mist over the bright reeds. Its a remarkable place: a big clearing in conifer forest where water bubbles with gases from a volcanic vent. The vent deposits mineral rich water at the surface - iron red mud, slimy yellow clays and strange basins of water in which strands of frothy green algea float. In the morning quiet you could hear the slow, fat bubbling at edges of the lake reminding me of Halloween sound effects. Wren enjoyed poking the venting areas with a stick to churn the red slime and bubbles.
After breakfast we took a longer hike to Carter Falls. The trail started about 2 miles beyond the Longmire camp and is usually 3 miles to the falls and back. It was quite steep at times and Wren liked to be carried most of the way. For the last third of the trail we found drifts of snow which increasingly covered the trail and made us miss Madcap falls on the way up. The snow covered a small watercourse to the side of the trail which had melted a tunnel under the snowcap. At places the crust was thin enough to fall through which made walking the path hazardous. Both Frost and Wren found this a bit stressful. Wren said he wanted to go home and after initial enjoyment Frost started a tirade about how unfair it was to drag him so far when he was so tired and it was dangerous and he was tired and hungry. We had snack but he really wanted to go down. The hike took 2 and a half hours of almost solid walking so we were all tired.
Here are Frost and Grandad posing in the bed of the Nisqually River which we had to ford on a narrow log bridge over a torrent flooded with glacial snowmelt. The riverbed is quite fantastic due to the debris left from the huge 2006 flooding which changed its channel and destroyed many roads into the park.
Here, Frost and I cross the bridge. If you are attentive you will see we are wearing different clothes because this picture of the bridge was taken on Friday when we stopped off on the way up to Paradise. Frost was very nervous about crossing the bridge, saying "it was dangerous, creeping and unsatisfying in the making. Those engineers should be sued!"
We tried to explain that when you are in natural places its good to see what your body can do and not have everything controlled and made safe for you but he was not convinced hence the rather fierce pout on his face.
This next picture shows Wren (2.5 years old now) looking down at the "water fountain" or waterfall in our language. He loves to look down waterfalls and still wants to return to the big "water fountain" higher up the mountain.
I took this picture of the walking party to try and capture the bones of the riverbed - the scale of the floor is awe inspiring years after the event. By the way, this flood occured about a month before Wren was born.
Frost crouches down in a hole where his foot fell through the snow. He enlarged it and climbed in. This was during the cheerful stage before he had become anxious after overhearing me suggest that we couldn't see the trail anymore due to snowcover and could become lost. Frost becomes very very opinionated and argumentative when he feels we are taking undue risk. I can't remember behaving like this with my parents. Me? No, never! Not when Dad drove us at an enraged rhino. Not when he dragged us into the mist on the Drakensberg. Not when we had to walk on a slippery cliff about the surging ocean 100s of yards below. No, not me. I was EASY.
This next picture is just of some debris in the rubble. I bought a book titled Roadside Geology of Mount Rainier (which Dad is now reading with half-closed eyes) and we are learning a lot about the reason for the various rock types and the formations we are seeing on our walks and drives.
Health
Wren's cough is still chesty and crackly and I would not be surprised if he has to see the doctor again on Monday. I have been giving him honey (on her recommendation) and he had a long steamy bath this afternoon. Frost is also coughing and Josh has also contracted the barking cough and general malaise but has no fever. Dad has it too - he is hoarse and has a bit of a cough but is denying it as usual. I have been taking reishi tincture and sharing it around to help boost our immunity.
New Bird List Today
Barred owl (near cabin)
Western tanager (Longmire)
Rufous hummingbird (Ashford)
Cedar waxwing (Ashford)
White crowned sparrow
Red-winged blackbird (Longmire meadow)
Winter Wren (carter falls)
Band-tailed pigeon (Ashford)
Chestnut backed chickadee (Longmire)
Animals
Red squirrel
Raccoons (eating the deer food and climbing on the deck)
Deer (at our feeder as well)
Yesterday, we drove to the Paradise Visitors Center but today we did some walks.
Before Joshua and Frost woke up, Dad Wren and I did a three-quarter of a mile circuit around the meadow at Longmire. It was close to 7am when we started and the swifts and swallows dipped in the mist over the bright reeds. Its a remarkable place: a big clearing in conifer forest where water bubbles with gases from a volcanic vent. The vent deposits mineral rich water at the surface - iron red mud, slimy yellow clays and strange basins of water in which strands of frothy green algea float. In the morning quiet you could hear the slow, fat bubbling at edges of the lake reminding me of Halloween sound effects. Wren enjoyed poking the venting areas with a stick to churn the red slime and bubbles.
After breakfast we took a longer hike to Carter Falls. The trail started about 2 miles beyond the Longmire camp and is usually 3 miles to the falls and back. It was quite steep at times and Wren liked to be carried most of the way. For the last third of the trail we found drifts of snow which increasingly covered the trail and made us miss Madcap falls on the way up. The snow covered a small watercourse to the side of the trail which had melted a tunnel under the snowcap. At places the crust was thin enough to fall through which made walking the path hazardous. Both Frost and Wren found this a bit stressful. Wren said he wanted to go home and after initial enjoyment Frost started a tirade about how unfair it was to drag him so far when he was so tired and it was dangerous and he was tired and hungry. We had snack but he really wanted to go down. The hike took 2 and a half hours of almost solid walking so we were all tired.
Here are Frost and Grandad posing in the bed of the Nisqually River which we had to ford on a narrow log bridge over a torrent flooded with glacial snowmelt. The riverbed is quite fantastic due to the debris left from the huge 2006 flooding which changed its channel and destroyed many roads into the park.
Here, Frost and I cross the bridge. If you are attentive you will see we are wearing different clothes because this picture of the bridge was taken on Friday when we stopped off on the way up to Paradise. Frost was very nervous about crossing the bridge, saying "it was dangerous, creeping and unsatisfying in the making. Those engineers should be sued!"
We tried to explain that when you are in natural places its good to see what your body can do and not have everything controlled and made safe for you but he was not convinced hence the rather fierce pout on his face.
This next picture shows Wren (2.5 years old now) looking down at the "water fountain" or waterfall in our language. He loves to look down waterfalls and still wants to return to the big "water fountain" higher up the mountain.
I took this picture of the walking party to try and capture the bones of the riverbed - the scale of the floor is awe inspiring years after the event. By the way, this flood occured about a month before Wren was born.
Frost crouches down in a hole where his foot fell through the snow. He enlarged it and climbed in. This was during the cheerful stage before he had become anxious after overhearing me suggest that we couldn't see the trail anymore due to snowcover and could become lost. Frost becomes very very opinionated and argumentative when he feels we are taking undue risk. I can't remember behaving like this with my parents. Me? No, never! Not when Dad drove us at an enraged rhino. Not when he dragged us into the mist on the Drakensberg. Not when we had to walk on a slippery cliff about the surging ocean 100s of yards below. No, not me. I was EASY.
This next picture is just of some debris in the rubble. I bought a book titled Roadside Geology of Mount Rainier (which Dad is now reading with half-closed eyes) and we are learning a lot about the reason for the various rock types and the formations we are seeing on our walks and drives.
Health
Wren's cough is still chesty and crackly and I would not be surprised if he has to see the doctor again on Monday. I have been giving him honey (on her recommendation) and he had a long steamy bath this afternoon. Frost is also coughing and Josh has also contracted the barking cough and general malaise but has no fever. Dad has it too - he is hoarse and has a bit of a cough but is denying it as usual. I have been taking reishi tincture and sharing it around to help boost our immunity.
New Bird List Today
Barred owl (near cabin)
Western tanager (Longmire)
Rufous hummingbird (Ashford)
Cedar waxwing (Ashford)
White crowned sparrow
Red-winged blackbird (Longmire meadow)
Winter Wren (carter falls)
Band-tailed pigeon (Ashford)
Chestnut backed chickadee (Longmire)
Animals
Red squirrel
Raccoons (eating the deer food and climbing on the deck)
Deer (at our feeder as well)
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