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Thursday, September 14, 2006

Backstory - August 13-August 25

On August 13th, Chris and I were feeling the normal strain of a 4 week old newborn and a 2 year old...Chris and Dante went to the Crescent Lake Park playground to get out of the house and get some fresh, if humid, air. Chris went to lift Dante up to the monkey bars and he slipped out of Chris's hands and landed flat on the platform. He was upset, but calmed down and played a little more. When they were leaving, Dante was fussing about not wanting to walk, but this is his normal hot day-close to nap-by the way I'm 2, behavior. So, they're driving home and Dante is alternately crying and laughing. Chris just thinks he's tired and drives around a little more hoping maybe he'll slip into a nap. Then Dante really started to protest and was pointing at his pants, so Chris came home immediately and went to change his diaper...

Upon laying Dante on the changing table and removing the diaper, Chris immediately saw that the area of Dante's right groin looked as if his hipbone was broken and protruding out; but he's still moving his legs..... So, we try to avoid panicking, thinking one false move and the fracture will slip and Dante will be paralyzed, and we called in to the Dr.s office. It's Sunday so we have to wait for the referral service to call the nurse and the nurse to call us...... After talking with the nurse and eliminating a break or fracture, she asked "By the way, has he had any fevers or vomiting? No? Hmmmm. okay." At which point she advised us to head on down to the ACH ER. There the nurse immediately says "Oh, Yeah. That's a hernia."

Thus begins the confused, baffled, and generally perplexed body count of medical profesionals that would review his injury. Before the diagnosis finally came almost 2 weeks later, that count would stand at 8 misdiagnoses. Disconcerting at best.

Back in the ER, the resident took a look at Dante and asked a bunch of questions. Poking, proding, leaving and returning several times. When Chris mentioned the nurse's "diagnosis" he nodded as if in agreement and started to listen to the enlarged area with his stethascope. Frowning and nodding he started pressing Dante's lymph nodes up under his arms and neck, at which he asked The Question: "Has he had any fevers or vomiting? No? Hmmm..."

Enter the Attending Physician; "Yeah, it's probably a hernia. They can do that sometimes when the [insert medical speak here]..." The Resident, not quite convinced said - "I don't think so..."

SO, after an x-ray, blood work, ultrasound, and a consult with the Infectious Disease Specialist ("Maybe it's the Hanta Virus!") they determine it's the lymph node and perhaps he has Bartonella (aka: cat scratch disease). "That's my best guess at this point." says the Resident. God love him, he was really wanting to nail it down , but it was just beyond their scope down there in the ER. They sent us home with some antibiotics and saying we needed to wait on test results.

On August 15th, we went to Dr. Patranella (our pediatrician). She said to go ahead with antibiotics just in case it is an infection. It appeared from the ultrasound that he smashed a lymphnode, but that she didn't like the looks of the x-ray, could we get another one?

On August 17th, we were changing Dante's diaper and remarking about how awful the bruise looked on his lymph node, when we noticed that the perineum was hard and swollen. We called the doctor and got an appointment for the next day.

On August 18th, Dr. Patranella said it could just be drainage or another lymph node, but that the chest x-ray showed something that made her want to get a CT Scan. At this point, we are so clueless! Dante is acting fine- not even complaining of any pain after the initial day of the fall. Dr. P says it could be infection, but it could be something like lymphoma. WHAT?!! But, that she didn't think he showed any signs of it being lymphoma. At this point Chris recalled that Dante's white blood cell count came back normal while in the ER.

On August 20th, Dr. Patranella notices that the left lymph node is now growing significantly. Our appointment for the CT scan isn't until the 25th. So, she calls ACH and talks to Dr. Barbosa who says it is OK to wait until Friday, but that they will make sure someone reads the scan that day.

On August 25th, we have the CT scan done - traumatic experience for us all that I don't feel like writing about. Suffice it to say, that they were not thinking of how to treat a 2 year old that day. We were then sent home to await the results...

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