More pictures

November fun at the Houston Zoo, following a stellar cardiology visit.














Riding the Hermann Park rails








Running from Daddy at school







Bath time at Grandma Sharon's










Fun at Holiday Happening










Reindeer!



Cowboy Santa!




Grumpy Santa




I love my horse






I love my cat brother



I am not sure about my human brother




Fun with cousins













ECI Christmas Party













Our Christmas Tree

Pictures!

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!