Wild Ride
There's no way I'm going to have the time today, or even in the next few days, to tell this whole story. So here are the highlights:
N spikes a fever of 103.5, axillary. He's grunting as he breathes. He looks awful. I call my doc, but she's not in clinic today. So I call Family Medicine over where I work, and they have me bring him in. They start talking about crackles in his left lung, and how horrible he looks, and how we can't drive him to a hospital ER because might 'crash' in the car, and how they're really worried about him, and how they can't find his left testicle (WTF?), and how they think that it's probably a really bad bacterial pneumonia and he's probably going to need to be in the hospital a while, and I should be prepared for that. After THREE HOURS they finally figure out what they want to do with him, which is transport him to Childrens Hospital. Except when they call Childrens they find out that they don't have any beds available if he needs to be admitted, which they are certain he does. So they insist that the thing we should do is call 911 and have an ambulance take him to County hopsital, two minutes away, but not where I wanted my chld to be taken. (This isn't about prejudice or socioeconomics or anything, it's about me knowing way too much about understaffing and lack of funding and the general craziness that goes on at County, being that I write about it all the time.)
Still, I let them. The ambulance guys come in, look at him, bundle him into the ambulance, blow oxygen past his face for a couple of minutes, then usher us into the ER at Women's and Children's at County, where we're seen immediately, a definite benefit of the whole ambulance ride. (One funny aside; as we're driving, the ambulance guy is giving his report to the hospital on what they're bringing in, and he tells them the patient is approximately 40 kilos. I didn't think it would be prudent to interrupt him, but I almost choked on my tongue. The kid's not even 40 pounds! He's not even 30 pounds! He's about 13 kilos. I hope that ambulance guy, nice as he was, doesn't have a side job as one of those weight-guessers at a carnival, is all I can say. The folks in the ER had a good laugh at that one, as they were expected a truly obese 88 pound 3-year-old to come in, and here comes eensy beensy little N. They thought they had the wrong patient!)
Anyway, at W&C they went to the other extreme, telling me essentially that he just has a bad cold. The resident kept telling me he didn't hear any crackling, and that his oxygen sats were fine (they were), and yeah, the coughing is bad, but he'll just give me some inhaled albuterol to take home and that would be that. Then the attending comes in and says, "I hear definite crackles in the left lung, and they sent him here by ambulance. You need to do an x-ray to be sure."
X-ray showed some diffuse haziness and one area that the resident said, "you could argue that it might be a little touch of pneumonia" but nothing particularly worrisome. The good news was that his heart, which had been enlarged last year and was supposed to be followed up this month, is back to normal size. So they got me a taxi back to my car, and sent us home...seven hours after we'd left.
Today? No fever. A bit of coughing, but that goes down after we give him some albuterol. More or less back to his old self--he was even out back insisting on hitting baseballs off of his tee this morning. So, yeah, I feel foolish. Except I know I did the right thing, taking him to be checked. It's just everyone else after that who was sorta losing it, and things got out of hand.
Never, ever dull 'round here.
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