5yo coughing, puking, fever for 2 days

[tankgirl73]

My daughter has been coughing for over a week now (wet and productive, clear mucous) but was otherwise active and energetic so we've just been "meh it'll pass."

2 nights ago, after going to bed she spiked a fever.  Then puked all over her bed.  Her temp was 39.6 or so, which is about 103F.  She slept well most of the night, though her breathing was quicker than normal.

I'm very much of the 'fever is good, ride it out' camp.  I was also raised by a mom who was an RN, so we always just dealt with stuff at home and I don't panic about most things. DH is more of a worrier.  He understands about the fever thing, but he also hates to see his darling little girl suffering.  

Yesterday she spent most of the day in bed, temp ranging 39 to 39.7.  It never crossed 40, which would be 104.  She would drink a little water or juice, but usually threw it back up.  She tried some apple later in the day, which seemed to stay down.  Her fever also went down to 38 or so -- hovering around 100F.  She walked around a bit, sat on the couch to watch tv for awhile.  When she's awake, she's quite chatty and cheery, though obviously tired.

During the night she threw up again -- just a little orange juice.  Her breathing was better than the night before but still not 'normal'.  

Today her fever has gone back up to 39.  She's been a little more lethargic.  She still is accepting water and a little bit of orange juice or smoothies, though we'd like to see her take more.  Sleeping a lot.  In other words, what to ME is a normal progression of a bad sickness -- 'bad' meaning 'not just a little cold' but also not as bad as *serious*.  

But hubby is starting to say that so many days of high fever should mean it's time for the doctor.  And of course it's easter weekend, so all the regular offices will be closed and we're stuck with the ER.

Frankly, I'm more concerned about the cough than the fever, though still not concerned *enough* to warrant dragging her out to the hospital.  I know that pertussis is having a bit of an 'outbreak' but she's not 'whooping' at all.  The coughs don't seem out of control, they're just very frequent and productive.

But I've been known to be wrong before.  ;)  So I'm open to advice.  With *backup* -- not just personal opinions but with supporting info.  

DD is unvaccinated so far, usually very healthy, no known allergies.  

[springmum]

For me, what sways my decision is if I can easily "know" what is causing the fever, and it if it came with the start of the illness or if it came when the illness should have been improving. Personally if it were my child, as much as I would hate a trip to the ER, I would be going with what you're describing. I would much rather (and have) spend useless hours only to hear everything will be okay, then leave it and need to be hospitalized b/c I didn't catch it early. (A dear friend did that with her 18 month old, just thought the fever and cough were part of the illness, it went on too long, and he was hospitalized for a few days with pneumonia)

Sorry I don't have "evidence"- b/c every kid presents illnesses so differently, one can present very sick, one can present a little more robust with pneumonia setting in. (My personal story example that you weren't wanting, is that my friends son when he gets a cough in his chest and develops a fever AFTER a few days, can still get up and play and not seem so sick. When the fever doesn't subside she takes him in, and the last 4 times it's been the start of pneumonia.) The only time I had pnuemonia, I felt like I was on death's door and spent 3 days in the hospital b/c of it.

It sounds like I'm just focusing on the scary stories - sorry, I know it's not really helpful. I'm very natural minded, and treat things at home, naturally whenever I can. BUT when DS has a fever (which doesn't worry me) I just like to know WHY, so I know how/what to to treat it. There is a reason she has a fever- if it's just part of a bad illness, it will give you direction. If it is in fact part of something more, it's good to know now.

I do like to refer to the Dr Sears website - he's very natural minded, and gives good info on "when to worry" which may help you sort through the symptoms a little better.

Is there an after hours number or nurse line you could maybe call, to get an opinion before going in?

Anyway, I hope she turns a corner quickly and feels better soon :)

[springmum]

I just noticed your out east- do you guys have a Telehealth system out there (or is just in Ontario)? I've always found them helpful when I've called.

[tankgirl73]

We do have a version of telehealth here, yes.  I really enjoyed the telehealth service when we were living in Ontario.  However, the one here seems to be much more "if in doubt run to the ER right now" -- whereas in Ontario it was "if in doubt, these are the things to watch for and if you see one of those develop then go to the ER."  

Grandma -- my retired RN mom -- is also our personal version of telehealth.  ;)  

We are probably going to call her today.  My daughter's temp is still up, but what's concerning me is the cough.  I've been asking her about pains, ie, pain in the chest, remembering when I myself had pneumonia as a child, or pain in the neck to watch for meningitis.  The only pain she has is a little soreness in the tummy, understandable from the throwing up and the coughing.

But her coughing is so wet, she's bringing up tons of goo and liquid.  It's just white, not green, not bloody, but lots of it. That doesn't seem to be improving and that's what's triggering my alarm bells now.

My plan today is to let her have a warm bath -- she's looking forward to this -- and try some natural congestion remedies.  If they don't seem to help though, then it's time for professional help, methinks.

Thanks!  :)

[tankgirl73]

Well grandma concurred with the court of public opinion, so it was off to the er we went, the after-hours clinics were all closed.

Remarkably, it was completely UN-busy and we got right in!  The dr did want to get an x-ray for pneumonia... and it turned out to be pneumonia.  

And she thought dd was "a little dry" so they've admitted her.  Estimated 2 day stay for IV fluids and abx.  

She's had a good day, her fever is already almost gone, she's coughing less, she hates the IV but is otherwise in good spirits.  Still not eating -- she managed to eat about 3 french fries for supper.  But she seems a little better already.  

Ugh, what a way to spend her Easter weekend!

[springmum]

Hospitals stays are not fun, but good thing she's getting treatment. These things always have a way of creeping up at tough times, and it's hard second guessing yourself wondering what your kid is sick with. 

I will say, that when I was on deaths door with pneumonia I was surprised how quickly I started feeling better after they started my fluids and abx - like amazingly fast, and every day I woke up it was even better. Hopefully you'll see a quick turn around in her as well. You'll need to get your probiotics ready for sure too.

One thing to know that I was told, that once you get pneumonia once you can have a bit of a weakness in your lungs for a while. Meaning that it may be easier for her to get pneumonia again - so be aware with chest illnesses in the future just in case (not that you wouldn't anyway, but it's info that I didn't know)

Extra easter hugs to her, hope everyone gets some rest :)

[tankgirl73]

She is getting better!  Daddy stayed with her overnight and he just called me with an update.  Her pulse ox is up to almost normal, heart rate is down, fever is *gone*, nurse says she's doing great.  Hopefully she'll eat something for breakfast, that will be a real sign that she's turned the corner.

I've been reading up on pneumonia and yeah it can come on really fast.  The usual advice though is to seek treatment if the bad cough and fever is worsening or not improving after 3-4 days, so we weren't "late" getting her checked or anything.  

And yes, we knew about it causing 'weak lungs'. :(  My mother says she used to get pneumonia whenever she turned around. She's had bronchitic asthma her whole life.  I had it once when I was around 8, I think, then when I was in university I had serious bronchitis which finally got diagnosed as asthma.  After treating for that for a few years, it's now so mild that it rarely is even an issue, but hubby still teases me for my 'weak lungs'!

So she comes by it honestly, anyway.  :p

Oh and as for the probiotics -- I make our own homemade yogurt.  :)  Add in our homemade granola and some fresh-frozen fruit, it's one of her favorite breakfasts.  :)  So she's going to be SO miserable that she HAS to eat a lot of yogurt for the next little while.  ;)

Edited by tankgirl73 - 4/7/12 at 2:45am

[carfreemama]

I just wanted to see how you all are doing. I also wanted to add that my dd, who is 8, had pneumonia right around Easter last year. It came on INCREDIBLY fast. As in, riding her bike with DH at 8 pm after a full day of music and playdates...and a fever of 104 and vomiting by the middle of the night. One thing that threw me off the pneumonia trail was that DD was complaining of pain only in her stomach and then vomiting. I found out from the doc that if the pneumonia is deep down, it can feel to a child like a stomachache and that's how they describe it. She also had the cough like you describe, only it had gone on much longer. Since ALL the kids had it and there was no fever and she was energetic, I just didn't think anything of it; except a nagging feeling that the cough just didn't "sound right." I wish I had listened to that.

The good news, though, is that it's been a little over a year and she has had the best year health-wise ever. She never was a kid who got sick much; no asthma, no frequent colds or anything--but I was worried about the repeated pneumonia thing. She's had nothing in an entire year except a little stomach bug that was going around. And she recovered fully and completely in less than 2 weeks; no lingering tiredness, no nothing. It was scary, though; she has definitely never been as sick as she was then. I hope you are all doing great now.

[tankgirl73]

That's great, carfreemama!  And sounds so much like our experience.  It came on so fast, and she never had any chest pain and that threw me off from thinking 'maybe pneumonia'.  The pneumonia was in both lungs and might have been low down, she was throwing up a lot, so maybe that's what was going on with her too.  But I also had the same little niggling instinct about her cough just not 'sounding right', and also wished I'd listened to it, in hindsight.  But at the same time, even in hindsight, there's not much we would have done differently except maybe go to the dr one day sooner.  She might have been less dehydrated and not needed hospital admission.  But actually, that's not necessarily a better thing -- they gave us antibiotics to take home after she was released, to take for 2 more days at home.  She HATED it.  Screamed and yelled "STOP!  STOP!" and cried... honestly, she responded less negatively to the IV needle getting poked around in both her elbows before they found a good vein.  So if we had only been given meds and told to go home, which is what I'd been expecting, it actually might have been much harder to get her better, to get her to take it for 5 whole days!

Anyway, she was released from hospital on Sunday, with armloads of swag like any birthday party.  Including a HUGE stuffed lion and a stuffed bunny, some books, some chocolate, a basket of easter eggs (filled with chocolates), some crafts, and some toys.  To her, it was like a big vacation, or a field trip.  She's 99% back to herself.  The doctor said she could resume all her usual activities, and in fact the exercise would be good for her lungs, just not to be surprised if her endurance was lower and let her stop and sit out if she got tired.  She went to her dance class on Monday, a full hour class and her teacher said she showed no signs of fatigue!  Danced her heart out the whole time.

They said to expect a cough to linger for a few weeks.  This could be a problem, since she's supposed to SING in the music festival next week.  We're going to play that by ear and see how her lungs are doing next week, whether or not she'll be able to get through a song without coughing.  She's getting better really fast now, so we're hopeful...

Her appetite on Sunday and Monday was still almost nil -- we weren't sure though if the constant feeding of IV fluids was making her "full", so we were curious if her appetite would return when that 'wore off'.  Monday morning she ate only half her bowl of yogurt, then during the day had a little easter candy and a couple other LITTLE things, but even her favourite foods she'd say "yuck" so her taste buds were still kind of off.  Tuesday morning, she WOLFED down her entire yogurt, and ate like a horse all day.  Well, a little horse.  ;)  But she was eating much better and not complaining anymore that everything was yucky.

She's skipping around the house, playing freely with her dolls and her new toys... we think that as fun as the hospital was for her, she never had a chance to go off by herself and fully absorb herself in some creative imaginative own-little-world play.  Sunday evening after we got home, she disappeared into that kind of play for a good 2 hours.  So she's making up for lost time... really intriguing to see how she NEEDS that solo time!

[carfreemama]

Just saw your reply. That's GREAT!!  The rapid recovery sounds like DD, too. I wouldn't be surprised if she's just fine to sing in the music festival. Really, I felt almost silly telling people how sick she was, when there she was running around the picture of health just 2 weeks later.

As for the medicine, HA! Maybe you're right. DD WASN'T admitted and the medicine was a NIGHTMARE. It was a nasty, strong antibiotic that was so potent it gave her diarrhea and nausea and made her feel as bad as the pneumonia itself, I think. I have NEVER met a kid who hates medicine as much as mine. She needed some dental work once and no one would do it without sedation. I kept trying to tell them she'd be fine with the procedures, just not the medicine. SEVEN dentists later and one of them finally believed me. She had 2 caps and 2 extractions in one sitting and was "the best little patient." I TOLD them so! So yeah, I think you probably were better off in that regard. Also, I remember being so scared being home with DD while she was so sick those first few days. It would have been reassuring to have doctors and nurses around, I think; not that I'm wishing it was worse than it was! I did find that for several months after the pneumonia, I was very antsy about re-infection; paranoid, really. I'm pretty paranoid to start with, though.

I'm so glad she's better!

[tankgirl73]

My girl actually ASKS for cod liver oil.  So it's not like she's just opposed to strong tastes lol... 

You might be right about her singing in the music festival.  She's hardly coughing at all.  We'll still play it by ear of course but we're hopeful she'll be fine.  And I know what you mean about talking about how sick she was when she's running around... She missed church on Sunday while in the hospital, and all the old folks at church just love her and they were SO concerned.  At choir practice on Wednesday, one lovely lady brought a gift for her because she felt so bad that DD had 'missed Easter' (she got more Easter swag in the hospital than you can believe!)  Everyone is asking "is the poor sweetie home yet?" and I'm realizing that from their perspective, she's still sick as a dog in the hospital if they hadn't heard otherwise, but from my perspective, that's practically ancient history and she's as vivacious and active as ever.

Although she did show one visitor we had today that she still has the 'spot' on her elbow that shows where the IV was -- just the little red mark where it's healing!  She showed it off proudly, just part of her grand adventure.