to keep my thoughts together

Ben had an abscess in his ear canal so they gave him Septra (Sulfamethoxazole/Trimethoprim).  On day 10 (his last day) we gave it to him in the morning and after a couple of hours, he broke out in a rash all over his body.  He had red splotches on his face and small red dots all over his body.  It wasn’t particularly itchy and it wasn’t raised.   I gave him Benadryl and it didn’t do anything other than make him tired.   I called the nurses line and they said it didn’t really sounds like hives so assume he was contagious and still give him Benadryl anyways.  It ended up getting bad enough that I went ahead and took him into the urgent care near our house.  The PA there said it was just an allergic reaction to the Septra and the reason the Benadryl didn’t work was because it had been building in his system for 9 days.  She gave him Prednisone.  He took it Saturday (Feb 15), Sunday, and Monday.  By Monday night, the rash was gone.  Gilbert Pediatrics called on Monday because they had received the note from the nurses line.  They said that it still didn’t sound like an allergy and I should have taken him to a pediatric urgent care because they can identify 100s of rashes.  Oops.

weird possible allergic reaction

weird possible allergic reaction

Thursday (2/20) he developed a cough and a fever (Brynna had one the 14^th and 15^th and still had the lingering cough) so I kept him home.  Friday afternoon, he started getting a rash again.  This time it was just on his face, arms, and legs.  I decided that since it was a Friday afternoon, I would just take him into his Pediatrician to  look at before I freaked out over the weekend.  Dr Jacks said it was just a virus and sometimes with a virus kids can get a rash.  It wasn’t scarlet fever or measles or anything serious.  It wouldn’t get worse but no telling how long it would take to get better. 

friday night (he's asleep)

doesn't approve of me waking him up in the middle of the night

By Friday night he was worse.  By Saturday morning he was way worse.  He had even developed petechiae on his arm.  I saw it and freaked out.  All I could see was Brynna with her ITP.  I called Ben (who was helping Rick at the new office) and told him to get home now and give Ben a blessing.  I also gave Ben some Benadryl because he said it itched.  This time it did look like hives, raised and splotchy.  Also, his ears were very red and swollen.  The Benadryl did nothing but put him to sleep.  (When he got a blessing I noticed it said there wouldn’t be any complications and I couldn’t help but think “Brynna didn’t have complications from ITP.  It went just how it was supposed to go.”)  The rash continued to get worse throughout the day.  He even got a few petechiae on his stomach.  He also was coughing a ton.  So much so that it was hard to breathe for him.  Then I gave him some more Ibuprofen around 6:30ish and an hour later his fever spiked to 104.5 (previously never above 101 and always went down with meds).  So I said that’s it and took him to Twilight Pediatrics. 

sat am.  def worse

had a heart attack when i saw this

again, freak out!

poor guy's ears were twice the normal size

later that day after getting some benedryl.  it did nothing

few hours later

sat night right before i took him in

glad the rash wasn't going to get any worse

not asleep.  the light was just hurting his eyes

The Dr there looked at him, asked a ton of questions, hmmmed and haaaed, then said “Well, frankly, I’m stumped!”  Then she went to get a dermatology book to look at the pics in there to see if he matched anything.  The strange thing was that there was no rash on his trunk.  Just his face, arms, and legs.  The petechiae worry her the most.  She thinks he has something related to what Brynna had (the ITP) but without blood work, there would be no way to know and she didn’t think we needed to spend the night waiting in the ER.  I’m not sure I agree with her since nothing in her book matched what he looked like.  Also, she kept calling his hives purpura one moment and hives the next, but those don’t mean the same thing.  Purpura is like bruises.  Hives are called urticaria.  Anyways, she gave him prednisone for the hives and the swollen ears and told me to get him rechecked on Monday.  I suppose, if it is a mild case of something like ITP, the prednisone should help anyways.

Sunday he looked better.  He still had a rash but it was going away and his ears were no longer swollen.  But as his rash went away, we realized just how much petichiae he had.  It was all over his bum down to his feet and his elbows down to his hands.  He even had some on his ears.  Monday, before the  Drs office even officially opened, the Dr we had seen at Twilight Pediatrics was calling to make an appointment for him.  Then I got a call from the office we usually go to wanting to schedule an appointment.  I guess the Dr really wanted to make sure we got him rechecked. 

I took him in and Dr Jacks looked at him and said that he didn’t really know what he had.  HSP (like ITP but instead of the body attacking plattletes causing thin blood and therefore petechiae, it attacks the blood vessels causing them to be weak and therefore petechiae) is what he was leaning towards, but usually they only have the rash on their legs.  ITP usually has a lot more bruising.  So he ordered a CBC but said that since he was already on Prednisone, we may never find out what was wrong.  Either way, he wasn’t contagious anymore so we could send him to school and just not let him run around until we get a blood count.

The labs came back normal and he continued to go to school.  However, on Thursday, I had been volunteering in Ethan’s class and was just going out to my car to get something when another mom stopped me and told me that I probably wanted to go check on Ben.  He was in a lot of pain and was complaining that it felt like his arms and legs were going to explode.  I ran down to his classroom but the teacher said she had already sent him to the nurse.  I ran back up to the nurse and he was there being checked out by her.  Now, I should mention that I don’t think she is an actual nurse.  When I tried to explain ITP and HSP to her earlier in the week, she didn’t seem to get it.  I take over and check for more petechiae.  There was no new spots but he was complaining that he couldn’t even stand it hurt so bad.  When I had him lay down to look at his legs, he cried that his stomach hurt so bad that he was going to throw up.  OK that’s it!  I’m taking him home.  I ran to get his stuff while trying to stay calm.  I called the Drs and made an appointment.  The nurse on the line asked if the school nurse took his blood pressure.  Nope.  (Remember the part where I don’t think she is a real nurse.)  After eating lunch and sitting in the car, his pain started to lessen, but I still wanted to take him in just in case. 

The dr decided that with the pain it definitely sounded like HSP, but a mild case, probably since he went on the prednisone so early.  He checked his urine to make sure there was no blood or protein (indications that it was attacking his kidneys).  Everything checked out though so he just told me about HSP, which means his body was attacking his own blood vessels. It can cause joint and belly pain. As long as it doesn't start attacking his kidneys, he will be fine. It usually lasts a month so he might have these episodes for another 3 weeks. The pain is probably coming because the prednisone is no longer in his system. He can just take Tylenol and rest. The rash may come back but the dr doesn't think it will. He doesn't need to restrict his activities (unless he is in too much pain) but he may be a little tired over this time. 

He definitely was tired for another week or so and would complain about pain off and on, but everything has cleared up so we are out of the woods.  This makes the second child to have a scary auto immune response to a virus.  Hopefully we never have to do this again, but with my genes, it is always a risk.  At least this time we didn’t have to make any hospital trips and he was mostly just fine.  Yea for early prednisone and dr who are smart.  And double yea for priesthood blessings!