our first er trip

We took L to the ER for the first time tonight.  She was a little crabby two nights ago, and she started running a fever yesterday afternoon or evening.  I figured it was most likely caused by the MMR vaccine and assumed it would pass in 24 hours.  Today, though, her fever was in the 102s, and while Tylenol seemed to help, it didn’t really bring it down to normal, just a degree or two, and not for long.  At around 7:30 pm, I took her temperature and it was 104.  This was consistent across both our rec.tal thermometer and our forehead scan.   I’d just given her Tylenol at 7 pm, so I figured in 30 minutes it should have started to kick in if it was going to.  My threshold for mild panic was 103.5, per the internets.  Anyway, I called the two local urgent care places that were open.  The first told me there was an hour and a half wait and had no further advice.  The second told me their waiting room was packed, and the nurse spoke to the doctor and told me he recommended we take her to the ER.  I was skeptical, but the nurse was insistent that this was the doctor’s recommendation.  (My skepticism arose from the fact that the waiting room was packed and my feeling that L was not really seriously ill.)  Complicating matters, all our local urgent care places close at 8 pm.  Since it was 7:30, we didn’t have much time to figure out what to do.

We decided to go to the ER.  I wasn’t too happy about it for a couple reasons.  First, I was afraid we could be sitting there waiting for a long time with L miserable.  I thought the best thing for her was probably a good night’s sleep and feared we could be a long time in the ER.  Second, I was worried about tests they might want to do.  Things which are trivial on an adult, such as a blood test, can be very difficult with a baby, especially a sick baby.

In the end, it went about as well as it possibly could have.  I took her in, and in triage, they weighed her, took her blood pressure and took her temperature.  Well, I stripped her down for the weight check, which made her cry passionately, then dressed her again.  Then they were like, oh, I forgot, we need to do a temperature.  Could you strip her down again?  They then decided to do the BP first.  They tried and failed to do it with her finger, and finally managed it with her foot.  After that, they did a rec.tal temperature.  They did not hurt her at all, and despite some inefficiency, I really can’t fault the personnel at all.  However, the fact of the matter is that L had a 103+ temperature and it was past her bedtime, so the above items led to sustained, near-hysterical crying.  Not fun for anybody.  She was crying so loud it was very difficult to communicate with the doctor and nurse.    Her temperature at this point was 103.3.  I think it’s most likely that the Tylenol we gave at 7 pm had kicked in a bit more.

Anyway, they then moved out of triage to a room.  I dressed her in a gown, and we saw a nurse, then another doctor.  The doctor looked her over, concluded she looked good, all things considered, advised Ibuprofen, and told us to bring her back if she cried inconsolably or just looked bad.  A nurse came in and we induced more hysterical crying dosing her with the meds.  She was just way past her breaking point.

Now, I feel like a complete idiot, because I hadn’t thought to give her Ibuprofen earlier.  Seriously – two major fails on my part.  1.) Should have taken her to the pediatrician or urgent care earlier in the day.  I always hesitate because I don’t want to expose her to waiting room germs, but that was a very bad decision on my part.  2.) I should have obviously dosed her with Ibuprofen earlier.

All in all, the experience was pretty painless.  The Ibuprofen kicked in, and her fever is truly down for the first time all day and she’s much, much happier (though not what I’d call happy.)   Hopefully the night will go well and her fever will break tomorrow.  I really wish I knew whether this was vaccine induced or just a virus she caught somewhere.  We don’t get out much, but we did have dinner with friends who have kids a couple nights ago, so she could have caught something then.

Update – I’ve reconsidered my opinion, and I now think it’s most likely that the fever is caused by the vaccine.  From the NYT (http://health.nytimes.com/health/guides/specialtopic/immunizations-general-overview/measles,-mumps,-and-rubella.html):

“About 5 – 15% of people who are vaccinated with any live measles virus vaccine develop a fever of 103 °F or greater, usually between 5 and 15 days after the vaccination. It usually lasts 1 or 2 days but can persist up to 5 days. In very young children, seizures can occur from high fever 8 – 14 days after vaccination, but they are rare and almost never have any long-term effects.”

From CDC:

“Mild Problems

• Fever (up to 1 person out of 6)
• Mild rash (about 1 person out of 20)
• Swelling of glands in the cheeks or neck (about 1
person out of 75)
If these problems occur, it is usually within 6-14 days
after the shot. They occur less often after the second
dose.”

Given our lifestyle and the extremely  low likelihood of exposure to M, M, or R by L, I really regret giving her the vaccine at 12 months at this point.  I wish that I had waited until she was a bit older (maybe 2 years.)   Ironically, I highest fever I ever remember having as a child was at age 4 — 104 degrees from the measles.

On an unrelated note, great article on Sony’s new cameras.  Add the RX1 to the list of things I’d buy if I was a billionaire.

3 thoughts on “our first er trip

  1. Karen

    Don’t be too hard on yourself. When I was around 6 months old, I spiked a 103 fever. My mother took me in, the docs were so concerned they thought I had meningitis. I stayed in overnight (poor mom) and in the end it was just teething.

  2. Sarah

    What Karen said. Don’t be too hard on yourself. She may not be exposed to MMR, but she’s gonna get exposed to all sorts of other crap at some point no matter what you do. Emma’s basically had a constant cold since November thanks to daycare. I figure it’s either now or when she starts kindergarten. 🙂

    Anyway, I know the ER is no fun, but I’m glad she’s fine.

  3. Jen M

    Ditto what Sarah said – Carina’s kindergarten friends that weren’t in daycare have been sick all year and she has only had one small cold that didn’t even make her miss school. The first 3 years of daycare were a bear, though. Also, since L hasn’t been exposed to a lot of germs yet, you probably don’t have a great reference for how high her fevers tend to run. Two of our kids tended to very high fevers, especially when they were very young and 104 wasn’t all that uncommon. A 104 deg fever to me in a 1 year old is only concerning if you can’t bring it down a couple degrees in a few hours. (I always go straight to Ibuprofin, Tylenol never seemed to do much for my kids.)

    And it is certainly a risk balance, but M/M/R in a very young child can be VERY dangerous. So even if the liklihood is low, IMO it is worth the risk of a couple days of feeling sick to be protected.

    It took me 4 years and 3 kids to figure out, but now I give them Ibuprofin proactively for the 24 -36 hours after a vaccination. Don’t know how many times I had to pick a kid up at daycare the day after a shot before I figured that out. 🙂

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