I hate rash week.

Here's a riddle for all of you that are epidemiology junkies:
6/25- Elliott is given the following vaccines: HepA, MMR, Prevnar 13, VAR (Varicella)
7/3- Elliott has a fever of 102.5, lethargic, fussy. CBC indicates likely viral infection.
7/5- Elliott has a red, pin prick- like flat rash on his trunk and genitals that spread to entire body within hours. Fever of 100.6.
7/7- Rash and fever are gone.
7/11- E has diarrhea with awful diaper burn and is fussy buns (as one would expect).
7/12- Diarrhea continues, now with fever. See new pedi. Diagnoses him with gastroenteritis.
7/14- Fever gone, diaper burn gone, no more big D.
7/17- Elliott slept all day. Very irregular. No fever.
7/18- Fever returns, lethargic, Rash- begins as tiny pin prick- like raised dots on lower abdomen and groin. Within hours, it had spread to chest, back and upper thighs. Pedi examines him and gives diagnosis of Enterovirus.
7/19- Fever spikes to 103F. Rash worsens. Dots are now raised and all over body, including face.
7/20- Fever continues to run 102. Drops to 99.5-100 with Tylenol. Back to pedi. Blood work indicates: Elevated hemoglobin and hematocrit, elevated white blood count, normal electrolytes. Blood culture to be completed by morning. Pedi noted blood work corroborates enterovirus. suggested Benedryl for rash, continue Tylenol.
7/21- E is miserable and rash worsens. He is refusing liquids, and solids (hasn't eaten much in terms of solids for weeks- during all of these bouts). Here are pictures of the rash:

You can really see the topography in the below picture. I should also note that the rash does turn white upon pressure.

Is this really just part of enterovirus? It looks nothing like examples I have seen of enteroviral rashes. It looks a lot like measles. Reactions to MMR are typically within 14 days, but can occur up to 28 days following the vaccine. Is it typical to have 2 separate reactions to MMR? His symptoms are:
-Fever (now down to 99-100)
-Discomfort, picking and scratching at rash
-seemingly sore throat- red and irritated on exam
-refusal to eat or drink (has had maybe 12 oz of fluids-water, formula, Gatorade G2- since midnight)
-irritable
He doesn't have any other symptoms. Respiratory rate is fine, Heart rate is in 120s (fine), no diarrhea during this particular spell.
Any ideas?

Rash Wednesday-Updated

Can we make it one week without needing medical attention? Fat chance, these days. Though I am grateful, these are "small potatoes" bugs and viruses, rather than a much bigger ball of yarn that we won't begin to unravel. Yesterday, this kid took two (TWO) near 2 (TWO) hour naps. Before you dismiss that as typical, you must understand that little toot is just like his mama- he is NOT a big sleeper. He is certainly not much of a day sleeper. This morning he woke up with a fever and another rash, little red pin pricks all over his mid section and back. He was awake for about 45 minutes, wanted a bottle (which he doesn't usually have until 10), and passed out. So back to the doc we go.

Well, he has an enterovirus. I am only marginally satisfied with this Dx, as enterovirus is a group of viruses that includes a wide range of villains, from Coxsackie to Polio. Treatment includes Tylenol and fluids. So, we are home cuddling, pushing fluids and appropriate doses of Tylenol.
Elliott decided it was amusing and thus therapeutic to pull my hair. He protested when I removed my tendrils from his clammy, iron grasp, "but I feel awful! You have to let me pull your hair! It's the only effective treatment!"

Mr.Elliott rebounded very quickly, when I informed him that his toes were the perfect size for a wee snack.



We are now up to 103 with the fever. Gave a cool bath and called the Houston pedi. The triage nurse agreed that is odd to have 3 viruses back to back and that she would like to have seen a CBC to rule out bacterial infection, such as Strep. Tomorrow, I will find someone to do a CBC.
Snuggling with daddy makes me feel so much better.


Poor baby!

Changes

Where to begin? Elliott started pre-school. I am using the term "started" very lightly. He has been twice. He loved it. My mom watched him on "Elliott TV" nearly the entire time. He played with their collection of blocks and balls, created beautiful paintings, took stroller tours around the property, and ate lunch with his friends! He also picked up a nasty virus that kept him out of school the following week. He actually topped off his little virus with a measles- like rash all over his body. Was is the virus, or a reaction to the MMR vaccine? We aren't sure, but the rash was gone within 24 hours. Little E had a few days of fever- free bliss and then came down with another fever and tummy trouble. Poor little dude! He seems to be on the mend, though!
He has two more teeth! Hooray for better mastication! He has been a tricky toot to feed lately. Of course, much of the difficulty is likely due to recent illness, teething, and developing "personality." Sometimes, it is hard being a heart mama and not having a reference for delineating the differences between normal and abnormal. Is he not eating secondary to reduced blood flow and a need for additional intervention? Or is he not eating as well as in the recent past because he is making choices and going through a finicky stage? I am reasonably certain that in this case, it is the latter, as he doesn't have any of the other signs (e.g., reduced blood flow to extremities) to indicate acute hemodynamic issues. Anyway, it's a journey, right?
What a terrific segue way. Speaking of journeys, we are moving back to Lubbock! I am so excited to have my little family together, at last! I know Mark is thrilled to have us back at home, and likely equally as thrilled to have fewer 1200 mile roundtrip drives in his future! We are leaving an amazing network of family and friends in Houston, and to whom we are forever indebted. Elliott's medical care will remain chiefly with his amazing team at Texas Children's. We will be returning to Houston for 6 month visits, as well as visits with our family and friends.
This has been a tumultuous year, filled with love, joy, stress, fear, and plain craziness. As always, we are so grateful for all of you that have offered love, encouragement, prayers, and support throughout our adventure!
Here are a few pictures of our sweet E:
(to be uploaded once on laptop- blog entries won't load with pics on app)

Recovery from Orchiopexy- written 6/10

I had to uninstall and reinstall blogpress- so this post is long overdue! I will be playing catch up on the blog, now that the app seems to be working.

Wow! You would never know this kid had surgery on such delicate parts less than a week ago- unless you change his diapers. We have traveled across the state so that we can spend a couple of weeks as a family under one roof. Many of you may not know that Elliott's daddy and I have spent the past year living in different cities, over 600 miles apart. It has been especially trying for both of us. It has been so wonderful to be able to spend the past few weeks together! Here are some pictures for those of you not on Facebook.
Elliott loves to bathe in the sink! It's just the right size.

Here is the red yucca we planted the summer before e was born- so nice to finally see it bloom in person!

Elliott and Andrea making phone calls

Our 1st significant nectarine harvest! They are so sweet!

E and his sweet cousin, Emma

Jessica loving on two sweet boys, Luke and Elliott!

"I'm on my way guys, see you in a few!"

E love to play his Papa Mike's guitars!

Surprise mini pre-birthday party in Dalhart! Lowly Worm was a special character to both Mark and me.