I don't like playing doctor.
Eleanor started up her immunizations again on Thursday morning. She's now 6+ months past treatment and got the go ahead to begin catching up (all her previous ones are null and void due to chemo). She got three shots with 6-8 different vaccines. It was a lot and she took the injections really well, all things considered. We had a snack in the waiting room and went on with our day. No big deal.
My first inkling that something was wrong was at 8:30 that night, when she started crying. Eleanor goes to bed around 7-7:30 and usually sleeps straight through to 6:30 the next day. Crying was unusual for her. It was intermittent and I had the white noise app blaring. Baby Penelope hasn't been sleeping great so I have been trying everything to give mama a few uninterrupted hours of sleep! Kris was attending to Eleanor so I went to sleep.
At 2:30am I awoke to a knocking on the wall (our bedrooms share a wall). I leapt out of bed and found Kris holding Eleanor and pacing around her room. She had a fever and dry heaved after taking some Tylenol. Kris was quite upset but I reassured him that this was normal, and that lots of kids have reactions to immunizations. We made a bed on the floor so the two of them could sleep together.
I got up at 6:30 and found a very anxious Kris in the living room.
"She's not up. She's always up by this time"
"Let her sleep. She had a big night and is probably feeling a bit crummy"
"The door is open and Elmo is on tv. She should be up. How is she sleeping through this?"
"Shhhh"
"Can you check her?"
"No. Let her sleep"
This went on for ten minutes until Kris just went and woke her up. He carried her out onto the couch and I checked her over. No fever, but elevated temperature (fever probably coming) and not really herself. We gave her meds and Tylenol and some water. Kris's anxiety continued while I felt confident in my relaxed "this happens to everyone" approach. I sent her endocrinologist an email and phoned the pediatrician on-call at the hospital to appease him. During this time she started to crash pretty hard. She began crying/moaning and her temp climbed despite the Tylenol. The light was starting to flicker in brain that she was not okay.
My thoughts were confirmed when her endocrinologist phoned me and gave me explicit instructions to administer her emergency stress dose or risk a hospital stay. Alrighty. I'll just assemble this giant needle with 45mg of solu-cortef (her usual dose is high at 2.5mg!) and inject it into her thigh. Normal day.
I have been trained twice for this procedure. The first time I was skeptical that a) we would ever leave the hospital and b) she would ever need it. I learned pretty quickly that yes, we would someday live in a world beyond the hospital and YES she would need a stress dose. In the two years since that training she has had this stress dose at least a half-dozen times. Every time, however, I have had the good fortune of having trained professionals nearby and they have done it for me. And usually they have an IV in place so they don't have to stick it in her leg. Anyways, I went over it again about a year ago when I realized that this is going to be a regular occurrence.
I popped the safety off the solution and pressed the cap down firmly. The cork descended into the liquid and took the powder with it. I carefully swirled it until all the powder had dissolved. I removed the needle from its packaging and drew up exactly 0.9ml, making sure all the air bubbles were gone. I grabbed an alcohol swab and all my courage and headed into Eleanor's bedroom. My mum had arrived and the baby was on the makeshift bed with Els and her lullaby cd was still playing everything felt really cozy.
I instructed everyone to hold that child down because she WILL fight you! Kris held one side and my mum held the other. Outer third, middle third. Outer third, middle third. I focused on the fleshy part of her thigh, gave it a wipe with the swab and inserted the needle. She screamed and flailed which surprised me as she had been so lethargic two seconds before. I depressed the contents steadily and replaced it with a face cloth (I forgot a swab). Within fifteen minutes she was up and running around - totally back to normal.
I did the right thing. Eventually. Kris and I talked about it afterwards and realized that while his paranoia is generally wrong 80% of the time, he definitely gets it right some times. I need to remember that she's not a normal kid and when she can't sit up, something is horribly wrong. It's like something switched in my brain and my heart. I got all mushy and wanted to sit with her and rub her back and watch cartoons with her. I guess it's because I spent so much time with her when she was crazy sick, but had the backup of a huge team of health professionals! It's been a long time since she's had an adrenal crisis, so it took me (and all of us) by surprise.
The important thing is that she's feeling much, much better.
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