Unexplained Fevers in My Toddler: Pyelonephritis for Caitlyn (Part II)

Read Part I here.

Caitlyn’s fever was 104.6 when we checked into the emergency department at Nationwide Children’s Hospital. Her urine sample was nearly clean of infection (as expected, since she had been on antibiotics for close to 48 hours already) but still positive for blood.

She had refused to drink pedialyte or even lick a popsicle but thankfully peed in a urine-catching hat just fine when we balanced it between Scott’s knees and sat her bare bottom on his lap. We had brought books and just tried to keep her comfortable as best we could during the hours we waited in the small room for a verdict.

The first doctor to see her was a first year anesthesiologist who was doing his first rotation on pediatrics. His bedside manner was, regrettably, awful. He kept asking us ridiculous questions like “Has she told you that her flank was more tender on one side than the other?” until I finally looked him in the eye and said firmly, “She is TWO. All she knows is that she is miserable and in a lot of pain and it’s not getting better.”

He also kept repeating, “If it’s a UTI, we’d pretty much just treat it with antibiotics.” Well, yes. We had been treating it with antibiotics for two days already and yet there she sat, with a raging fever, lethargy, pain, and dehydration. I was impatient with him, but I mostly bit my tongue knowing that we’d get face time with an attending soon enough.

It was a night and day difference when a real pediatrician came in to examine Caitlyn and talk with us. Her questions were right on target and she relied on our observations and gut instincts as parents, realizing that a sick two year old’s ability to clearly communicate a problem is non-existent.

She decided to admit Caitlyn and said she had a clear case of pyelonephritis (an infection of the kidneys that starts out as a bladder infection). She started Caitlyn on IV fluids and IV antibiotics and asked us to bring the original urine sample we still had in our fridge at home so they could try to culture it.

We knew they’d admit her but the big shocker was that Daniel (my nursing baby) was strictly forbidden from going into the rest of the hospital because of the risk of infection for him. That meant Scott would need to stay with Caitlyn and I would be heading home with Daniel. This was an even bigger problem because Scott was supposed to start his last busy month as the senior resident of the inpatient Family Medicine service at Riverside the next day.

– Blessing #1: Scott’s chief resident came in during his week off to cover the service for Scott on Monday so Scott could be with Caitlyn at the hospital.

Before being taken upstairs, Caitlyn donned some darling pajamas and a team came in to place her IV.

It broke my heart to leave her, but I knew she was in good hands with Scott. I headed home with Daniel to pick up Mackenzie from the neighbor’s and put her to bed.

– Blessing #2: Knowing that our whole family had been sick the day before (but not knowing we had ended up at the hospital), our home teachers had dropped off dinner for our family and left it at our neighbor’s house, so I had food to come home to. They then came to the hospital to check on us and make sure that we were doing okay.

– Blessing #3: Our neighbors live close enough they were happy to “monitor-sit” Daniel and Mackenzie while they slept and I drove back to the hospital with the original urine sample packed in snow.

– Blessing #4: As I realized an extended hospital stay would mean childcare for Daniel, I e-mailed a plea to borrow a breastpump “as soon as possible” on my way back home at 11:30 pm. My friend checked her email and immediately texted me that I could come by right then and borrow her pump and bottles. I was able to pump a full feeding for him before even heading to bed that night.

Meanwhile, sweet Caitlyn was in an “isolation room” on the infectious disease unit because until they could positively culture a urine sample they were concerned she may have some sort of super bug resistant to antibiotics. That meant full gowns and gloves for everyone entering the room.

Part Three coming next…

1 comment

  1. denise

    you poor things. How scary. glad you are such a smart mama and knew when it was time to take her in. Hurry up and post the rest of the story!!

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