Week 36 – children’s ward

On Monday night Reindeer had his first, and I hope only, experience of the children’s ward at our local hospital.

Monday itself has been a good day; we began by going swimming and I was pleased to see that, despite a fortnight’s break, Reindeer really enjoyed himself. Even though he initially forgot the whole ‘water is wet’ thing and put his face in it he still became happily vocal after about 10 minutes.

He hadn’t slept especially peacefully on Sunday night and didn’t have a decent sleep all day either (two 20 minute naps) resulting in a clingy afternoon. But he ate and drank well so we blamed teething (again) and hoped he’d manage some good quality rest overnight.

After his bath I followed the usual routine of applying E45 lotion all over him. It was during this process that I noticed something which hadn’t been there when I dressed him after swimming earlier in the day: a pin prick rash. A double check revealed two small areas of this rash, and it didn’t go away under pressure.

The public health awareness campaigns for spotting meningitis have been high profile and to the point. During our antenatal class we were given information on the signs and what to do. The classic sign is the pin prick rash that doesn’t go away under pressure.

Whilst I recognised the rash on Reindeer I couldn’t see any of the other signs of illness. He was perfectly fine and had just settled for the evening. After a quick consult with my husband we decided to call 111 since our local extended hours care centre had closed for the day. I felt like I was wasting their time as our baby appeared well, but the ‘what to do if you see this rash’ information was too well ingrained to ignore.

The 111 staff were very helpful and asked me to wake Reindeer for a series of checks over the phone. The upshot was that we were sent to visit the out-of-hours service in the next town. The 111 staff felt the rash should be checked immediately rather than left until morning. A very disgruntled Reindeer was therefore semi-woken for the second time and bundled into the car.

I will say at this point that the travel gro-bag is akin to a miracle. When I initially saw the rash I put him to bed in the travel bag on the suspicion we would be heading out later. They’re great because there is a double zip on the front and a Velcro panel on the back so it can be worn in the car seat, giving a higher percentage chance you can keep your baby asleep during car transfers. The value of this is not to be underestimated!

Anyway, the out-of-hours service were great. There was no waiting and I felt strangely relieved when staff confirmed my suspicions about the rash. A non-blanching petechiae rash, to be exact. It probably sounds strange that I was relieved but I realised afterwards this was because (1) I was correct about the rash and therefore not wasting anyone’s time or precious resources and (2) I can trust my own judgement. Clearly I was still concerned about Reindeer but he was still OK, just very tired and miffed at being manhandled.

What I hadn’t known was that, because it is uncommon and potentially serious, there is a protocol for this type of rash presenting in a child. Having confirmed what we’d spotted, but being no closer to knowing why it had appeared in an obviously otherwise healthy baby, we were despatched to the children’s ward at the local hospital for the paediatricians to check him out.

It was very strange going to the hospital – the only time I’ve ever spent in hospital was eight days on the maternity ward here. I find hospitals at night are actually quite comfortable places though, calm and controlled, so although it was getting on for midnight we still weren’t overly worried about Reindeer (other than wanting to be able to get him somewhere comfortable to sleep), just puzzled about what might be going on.

The staff were lovely and we were shown to a cubicle which turned out to be a small room, similar in size and shape to a delivery room, with its own shower room, cot, fold down bed and chairs. After the initial history and checks were taken, anaesthetic cream was placed in the crooks of his arms, backs of his hands and tops of his feet in preparation for having a cannula fitted. As the cream takes 40 minutes to work we managed to get him down for a nap.

My husband especially found it difficult seeing him laying in the big hospital cot. Although the staff were very good and he still seemed otherwise well, there is a sense of seriousness that can’t quite be glossed over with the beautifully bright murals, mobiles and Frozen-themed displays.

The paediatricians took us to the treatment room to fit the cannula. As Reindeer is your typical chubby baby they were concerned about finding a vein, a problem exacerbated as he seems to take after me and my veins are hard to find too. Despite employing a small light-emitting machine designed to locate veins more easily, there was nothing easy about what followed. Reindeer cried and screamed through several attempts to fit the cannula and it was absolutely heartbreaking. We’ve never seen him cry like that before and I devoutly hope we never do again.

After what felt like an eternity of being asked to hold and distract a distraught Reindeer the paediatrician decided to take a break to consult with the registrar; as the cannula could not be fitted and he was still essentially well, perhaps a period of observation would be an adequate compromise? We were happy with this, not wanting to see him in any more distress, but the registrar wasn’t. He wanted to rule out thrombocytopenia and clotting disorders which can only be done via a blood test.

After a comfort feed and another rest for Reindeer, the registrar made a final attempt to fit the cannula. Reindeer was a degree less upset this time as he was laying down and could see what was happening but the procedure was no more successful. When he finally hit a vein, the registrar settled for filling a phial for testing rather than inserting the cannula, assuming from his observations that it would be unnecessary.

It was a huge relief to be told that we could now take Reindeer home and observe him there. If anything at all concerning was present in the blood test results the paediatrician would call us immediately. The tests would take 2-3 hours to return.

We arrived home just before 3am and put an exhausted Reindeer gently back to bed. We were incredibly grateful that (1) he was fine and (2) we live in a country with an excellent health service which works hard to ensure babies (and society at large) are as healthy as possible. Bruising from the attempted cannulation was, thankfully, the worst Reindeer had to show from his visit to children’s ward, and we’re very aware that it could have been so very much worse.

He’s been fine since and the rash disappeared again on its own within a couple more days. We’re thankful if was just ‘one of those things’.

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