T Rex Family

T Rex Family

Thursday, May 27, 2010

Let the Punishment Fit the Crime

We've all been struggling with a virus around here. It's really not too bad but there are some non-desirable symptoms - fatigue, aches, sore throat, occasional fever. I can always tell when T Rex is not feeling well because he melts down at the drop of a hat. Or at the drop of a toy. Or sometimes for no reason.

That's how it's been the past couple days. Tantrum after tantrum. And generally for no reason. I've kind of just started ignoring it because I figured it did not merit any kind of disciplinary action. I've been working really hard at making the punishment fit the crime.

Well, today at lunch I just could not take any more food flinging. He never does that and I decided it was not time to start - virus or no virus. After a stern "no thank you" that merited no results, T Rex was given two choices - sit and eat his bread or go to time out. He chose time out - yes, he really does verbally choose time out sometimes and he will even walk there himself. Even when he's acting out, he's still such a good kid. He sat in time out on and off for probably 20 minutes. When he finally decided to sit at the table and eat his food he was rubbing his eyes.

I thought the eye rubbing and swelling was due to his endless crying while in time out. However, it just seemed to be getting worse. After he declared he was "all done" with his lunch, I took him to the bathroom to wash his face thinking something was irritating his eyes.

Then in addition to the swelling eyes I noticed small hives appearing all over his face and neck along with lip swelling. Now I was certain he was having some kind of allergic reaction. I grabbed the children's Zyrtec (antihistamine) and gave half a teaspoon of it. I went to the locked medicine closet and there happened to be a bottle of children's Benadryl so I gave a teaspoon of that. We also keep epinephrine (or adrenaline) for emergencies and I grabbed that and my antihistamine eye drops.

You're probably wondering why I have all this stuff. It is all prescribed by a qualified physician - some I keep on hand for emergencies and some I have because I have horrible unpredictable allergies. T Rex has allergies too but they have never manifested like this.

Poor guy, since I was by myself at home with the kids, I had to hold him down with my knees to administer the eye drops. Luckily he happily took the liquid meds. I called T Rex Dad and asked him to come home since we might be making a trip to the ER. He raced home.

At the beginning of his nap - note the hives, swollen lips, and minimal eye area swelling.

When T Rex Dad showed up 20 minutes later, T Rex had settled down and was quietly napping in his bed snuggled up to my stethoscope that I had used to check his lungs for wheezing and airway compromise. Lungs sounded good - no epi was needed.

With all those antihistamines, he slept for 3+ hours. T Rex Dad laid down with him during the rest of his nap making sure he didn't start coughing or wheezing. I took this opportunity to take care of T Rex Princess - what a good baby! She either slept or patiently watched all this happening even though it was her lunch time.

After nap time - hives gone, lips back to normal - eyes severely swollen.

When T Rex woke up, the hives and lip swelling were gone but his eyes were swelled nearly completed shut. The first thing he said to me was, "Eat bread?" I completely broke down. T Rex Dad had to hug and hold me. I had felt like all this was my fault. If I had just overlooked the flying food, he would not have been sent to time out where he would not have rubbed his face on the wall that led to an allergic reaction. I am thinking maybe it was the latex in the paint? Regardless, I still felt like I was partially to blame.

I sobbed for a few moments and then realized I had to call his allergist to determine if we needed to be seem, go to the ER, or wait/watch. I did everything I felt I could possibly do within my scope of practice. Even if I was a full fledged nurse practitioner I could not prescribe anything for my own child. The only other thing I could think he might possibly need was some oral prednisone (steroid) but when we used to have to give that for his asthma he would get "roid rages" - that's probably the last time he did fling food!

I spoke with the on-call physician who knows me well and may very well be my boss some day. He said I did everything right including the eye drops which are not indicated for kids but he would have done the same thing. And he would not have given the epi either - his airway was never compromised. What I did learn is that it takes the eyes several hours longer to un-swell than the other areas of the face/head. He said I could administer another dose of Benadryl and call if anything worsened but the worst was most likely over.

After bath time - eyes starting to look a little more normal.

Right before bed - starting to look like my T Rex again.

So, we'll probably be going to the allergist soon and seeing if we can pinpoint what caused his reaction. The only thing he has thus far tested positive for is dog dander. We do have a dog but she is a low-dander producer and has not caused this magnitude of problems before. Plus, I'm sure it has something to do with rubbing his face on the wall. That he has never done.

Regardless, it was extremely scary and I just feel awful for my little guy. However, he could not have been too traumatized from it because he ate all his bread for dinner! I didn't mean for my punishment to be so extreme. I'll try and tone it down next food flinging - if there is one!

Update: T Rex is back to normal today (the next morning) and we'll be going in for a scratch test next week. It is possible he was rubbing his face on the wall because it already itched. In the adrenaline rush of the event I didn't think about that.


Caitlin said...

Oh no! Poor guy- I felt like crying looking at those pictures!
Really though you should cut yourself some slack- there is NO way that you could have known that something that extreme could have happened! I don't think that your punishment was off-base, it is just unfortunate that it brought about such a bad, mysterious reaction.
Here's hoping for a better day tomorrow!

Erin said...

PHEW....I held my breath through that whole post!

I am so glad you know what you are doing and can do everything you can for him!

With Christopher I am getting better...but I would FREAK if he got all swollen! It's bad enough with his breathing and wheezing!

shell said...

I thought it was interesting that small traces of antibiotics in milk, etc.. can do it (such as PCN). Any insect bites?

From Merck:
Hives, also called urticaria, is a skin reaction characterized by pale, slightly elevated swellings (wheals) that are surrounded by a red area and have clearly defined borders. Angioedema is swelling of larger areas of tissue under the skin, sometimes affecting the face and throat.

Common triggers include insect bites or stings and foods such as eggs, shellfish, peanuts, and nuts.
Hives may itch, and angioedema may involve swelling in the face, throat, and airways.
Seeing a doctor is particularly important when insect bites or stings trigger a reaction.
Antihistamines can relieve mild symptoms, but if angioedema makes swallowing or breathing difficult, prompt emergency treatment is needed.

Hives and angioedema, which may occur together, can be severe. Common triggers are drugs, insect stings or bites, allergy injections (allergen immunotherapy), and certain foods—particularly eggs, fish, shellfish, nuts, and fruits. Eating even a tiny amount of some foods can suddenly result in hives or angioedema. But with other foods (such as strawberries), these reactions occur only after a large amount is eaten. Also, hives sometimes follow viral infections such as hepatitis, infectious mononucleosis, and German measles.

Hives or angioedema can be chronic, recurring over weeks or months. In most cases, no specific cause is identified. The cause may be habitual, unintentional intake of a substance, such as penicillin in milk or a preservative or dye in foods. Hives often occur in people with an autoimmune thyroid disorder. Use of certain drugs, such as aspirin Some Trade Names
or other nonsteroidal anti-inflammatory drugs (NSAIDs—see Pain: Nonsteroidal Anti-Inflammatory Drugs), can also cause chronic hives or angioedema. Chronic angioedema that occurs without hives may be hereditary angioedema.

shell said...

Oh.. and viral infections can cause hives...

septembermom said...

I'm so glad that he's better now. The poor little guy. He was a trooper to take the eye drops. My guys are not as cooperative. I hope you guys have a less stressful weekend. Hugs.

Jenners said...

First of all ... stop blaming yourself!!!! It is not like you did this to him on purpose. Give yourself a break.

Second, poor poor guy. He looks so awful in those photos. I'm glad he is back to his regular self.

I hope you can find out what caused this reaction ... it seems pretty extreme!! But it certainly wasn't caused by you!!!

Emily said...

He is so lucky to have you for a mom. I am so glad he is back to his old self again.

It's no fun when kids are sick.

Nina said...

Oh the poor little guy. Sounds like my week. I know it is so hard when you punish and the result ends like this. Don't feel so bad, you were doing your job as a parent and teaching him right from wrong. It just happened to have a bad effect this one time.

Hopefully you will be able to pinpoint an answer with the scratch test next week or is that now this week. Oh I am so far behind in all my blogs.