Rejections, colds, and lonely travel

It’s been an action-packed summer for yours truly, and I’ve barely had time to breathe. Apparently aware of this time crunch, Monkey was kind enough to bring home the latest daycare plague and pass it on to me –>> initiating the worst sinus infection I think I’ve ever experienced. No time to breathe? No problem! Just shove a fuckton of viral and inflammatory nasty waaaaay up your nasal passages! Seriously, I can’t tell you how many times I’ve awaken at night this past week due to nearly asphyxiating in my sleep.

Oh, and I’ve officially received my first funding rejection at my new job. Not a bad score, but an outright rejection. Seriously, those words were written in red print in my notification email. What a way to kick a girl while she’s down. It wasn’t money I was counting on, but it was something I thought I legitimately had a shot at. BUT, because of my confidence, I kind of mailed it in, and got a brisk wake-up call while traveling. I’m playing with the big kids now, and I can assure you my next submission, just right around the corner, will be much tighter.

Speaking of travel, I never knew I could dislike it so much. But multiple meetings a summer, including a trip overseas without your family, dealing with jetlag while trying to prepare for a talk, falling asleep with your iPad on your lap and missing the first opportunity of the week to Skype with your son – it kind of sucks. Don’t get me wrong – the science was great, and the short break from motherhood was kind of nice. But I can definitely see how doing this multiple times a year is going to get old, real fast. Except for overseas travel, I probably need to start cutting meetings a little shorter than I’m used to.

In spite of the exhaustion and shortness of breath, science is moving forward in the lab, and I’m finding I really do love this job. There’s a metric ton of BS to wade through, but watching lablings get excited about the science, pick up where you left off and push your project forward – that’s absolutely priceless. A few of those moments just might get me through this first year.

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A de-lurking post: food poisoning sucks, come distract me!!

I don’t have much to blog about at this moment, unless you want to hear about my overwhelming urge to puke. Hopefully this all clears up before tomorrow morning, when we start our trek home to see family and friends for Christmas. On the bright side, I’ve fallen in love with a show that is absolutely fucking hilarious – Portlandia – in between visits to the bathroom.

In the meantime, I’m totally stealing a page from ProfLike’s blog with a de-lurking day on the blog. Instead of writing for you guys, I’m asking those of you who read but don’t comment to tell me about yourself – your career, family, hopes and dreams, why you keep reading, and what you’d like to read more about. Entertain me for a moment, while I attempt to drag myself off the floor.

Viral exanthems: what this microbiologist didn’t know about rashes

I’m a microbiologist by training, and I have developed a pretty strong interest in pathogenesis. But I am NOT a clinician. So when a rash appeared on Monkey’s forehead and torso yesterday afternoon, a couple of days after his fever and cold had begun to clear up, I completely. Freaked. OUT.

Thank God I work with doctors, and infectious disease specialists at that. These people have become my sanity check when it comes to stuffy noses, fevers, diarrhea – and now rashes. After a lengthy discussion with one of my favorite pediatricians, we pseudo-diagnosed Monkey, putting my mind at ease and saving Hubby and I another trip to the pediatrician. Before I share the diagnosis, however, I thought I’d impart my recently acquired knowledge on viral exanthems (a fancy-schmancy doctor word for rashes).

First, a disclaimer: please, oh please, keep in mind I am not a pediatrician. My doctorate is a PhD, not an MD. Do not use this post as a diagnostic tool; it is merely intended to help you along in a conversation with your family doctor, or provide you with some interesting trivia for your next dinner party (‘cuz who doesn’t like a nice dinnertime discussion on rashes?)

Alright, disclaimer aside, I’m going to tell you a little bit about three of the most common infections associated with rashes in children around Monkey’s age or older. Each of these infections is caused by a virus (another reason I shouldn’t be considered an expert in this area), so they cannot be treated with antibiotics. In each case, the rashes appear as the fever breaks and are caused by the immune reaction to the virus, so the child is most contagious prior to the appearance of the rash.

1. Fifth disease.Caused by human parvovirus, fifth disease is most common in school-age children during late winter and spring time. Symptoms include a mild fever (<102 °F), sore throat, and rash. As the fever subsides, the rash begins on the face, with bright red cheeks as if the face has been slapped, then spreads to the trunk, arms and legs, forming a lacey pattern. The rash may or may not itch. Additional note for pregnant mothers: fifth disease can cause problems for babies in utero, so if your child exhibits these symptoms and you’re pregnant, get yourself to the OB right away to check on your immune status.

Fifth disease rash. Click image for source.

2. Roseola: Caused by one of two human herpesviruses (HHV-6 and HHV-7), infection occurs throughout the year in infants and toddlers. Symptoms include irritability, swelling of the eyes, and a very high, sudden fever (>102 °F), followed by the development of pink non-itchy rash with raised or flat lesions on the trunk, arms and legs. Because of the high fever, febrile seizures can occur but are not common.

Roseola rash. Click image for source.

3. Hand, foot, and mouth disease (HFMD). Not to be confused with foot and mouth disease, which occurs in livestock, HFMD can be caused by one of many different enteroviruses, most commonly Coxsackie A and Enterovirus-71. Symptoms are variable due to diversity among the enteroviruses, but can include moderate fever, malaise, vomiting, sore throat, general cold-like symptoms, diarrhea, loss of appetite, and raised lesions on the hands, feet and mouth (hence the name). As the fever reduces, a pink non-itchy rash may also appear on the body and head. Perhaps the most notable trademark of HFMD is its prevalence in daycares and early school-age children during the summer and early fall. The viruses that cause HFMD can also cause cold-like symptoms and aseptic meningitis (with very bad headaches) in adults.

Raised lesions on the mouth from HFMD. Click image for source

Raised lesions on the hands from HFMD. Click image for source.

Body rash proceeding fever with HFMD. Click image for source.

So here’s a case study for all you wannabe clinicians. Monkey began experiencing a runny nose and mild cough last week, and became especially fussy as the weekend inched closer. By Saturday evening, he had a very mild fever (~100 °F), was VERY fussy, constantly wanted to be held by mama or dada, and would lay his head on the floor of his nursery while trying to play (seriously pathetic to watch). Motrin helped his fussiness some, mainly by helping him fall asleep. By late Sunday night, Monkey’s fever had risen to ~102 °F, and he had snot constantly pouring out of his nose. He had a few lose stools on Sunday and Monday, but only one that I would have characterized as diarrhea.

Monday was Monkey’s 9-month check-up, so we got a complete look-over from the pediatrician. His weight was lower than expected, but it was assumed this was possibly due to him recently starting table foods (only a small portion of food actually makes it to his mouth right now, but his coordination is slowly improving) and mama’s milk supply taking a hit due to travel and stress from job interviews. Monkey’s ears were clear, but he had a very red throat. I was starting to come down with a stuffy nose and slight cough, very common after I travel, so we all assumed this was just a little cold virus making its way through the Dr. O family. By Monday evening, Monkey’s fever was all but gone, and Tuesday morning, Hubby and I woke up to a perfectly happy baby boy. He returned to daycare Wednesday, fever free. Wednesday afternoon, I noticed a rash all over his head and body when I picked him up from daycare. I proceeded to freak out, microbiologist mama style, and called the help line at our local children’s hospital.

Today I’m feeling much better, as is Monkey, although he still has a rash lingering on his legs, arms and cheeks this morning. So what do you think Monkey had/has? Leave your probing questions and diagnoses in the comments!

Our diagnosis is here. Let me know if you think we’re way off base. 😉

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Post-rapture blogging break

It seems the rapture did occur this past weekend, in the form of the eleventh plague overtaking the Dr. O household. I never realized the rapture would involve bowing down to a porcelain throne.

While Hubby and I are feeling better today, Monkey started experiencing symptoms of a stomach bug AND ear infection last night. Good thing he already has a doctor appointment lined up this morning.

Since I normally prepare most of my posts over the weekend, blogging activity will be a bit sparse this week. No worries though – I’ll catch up as soon as I find a way to keep down food again.

Avoiding antibiotic resistance

Monkey has yet another ear infection. This makes three ear infections in the past three months. As soon as Monkey so much as sneezes these days, Hubby and I start waiting for him to bat at his ears (a skill he’s just now beginning to hone). We’re talking to our pediatrician next week at his 6-month appointment about putting a tube in his right ear (the only one that seems to ever be afflicted). In the meantime, I’m struggling with the treatment regimen for his current infection. Continue reading

Daycare or Doctor

It can be hard to know when to send your sick child to daycare and when to keep them home (just ask PLS). It’s even harder when your child seems to feel alright, and both parents have their plates full at work. Our daycare’s rule of thumb is no kids with fever, diarrhea, or rash. If none of those are present, we can (technically) continue to bring Monkey in. It gets complicated, however, when none of these symptoms are present, but an illness has lasted a week, seems to be getting worse, or if Monkey is actually *acting* sick.

Monkey’s had a stuffy, runny nose for a week now. It had started to get better over the weekend, and we were preparing to move him out of his infant seat and back into the crib this week. Then Hubby was informed last night that another infant in the infant room at daycare had been diagnosed with RSV. Since Monkey appeared to be getting better, I thought no biggie. Then Monkey woke me up at 5am to nurse, with a much deeper cough than I’ve heard from him before. Hmmm, is that what croup sounds like?

Monkey seemed fine otherwise, and didn’t fuss at all when I put him back down after nursing. But I woke Hubby up, informed him we might need to keep Monkey home, then begin working on my coffee and next week’s poster. Monkey was still coughing every few minutes or so when he woke a little later this morning, but he seemed content and had no fever, rash, or diarrhea. I have a hellish week at work, and Hubby is preparing an invited talk for a conference he’s attending next week. After a long discussion, we decided to take Monkey to daycare, but Hubby stayed home to work.

I put in a call to the doctor when the office opened (after I got to work). The nurse called back an hour later, and asked us to bring Monkey in after I used the phrase “coughing spells”. I have a hair appointment this afternoon for the first time since last August, and it will take at least another month to get one scheduled if I cancel. Hubby said it was fine; he’d pick Monkey up from daycare this afternoon and take him to the doctor. I’ll be racing between work (and a symposium) and daycare while Hubby’s out of town next week, so I’m trying to relieve myself from the guilt of Hubby doing this one on his own.

What I’m most worried about is whether we were completely awful parents taking Monkey to daycare in the first place. Were we being selfish? We can’t keep Monkey home every time he has a runny nose or mild cough – we don’t have that much sick leave combined. But croup? Am I an awful parent?

Suggestions pleeeezz!?!?!

We’re supposed to give Monkey 3cc’s of this thick Pepto-like amoxicillin suspension twice a day for his ear infection. He doesn’t seem to hate the stuff, but he does this thing with his tongue that leads to a large portion of it ending up on his face and neck instead of in his tummy. So we end up with a partially-medicated circus baby.

Figure 1. My rendition of Monkey after his amoxicillin treatment. (Please forgive my remedial Adobe skills; I clearly need to pay more attention to PlS’s Ilustrator tutorials.)

We spent 20 minutes this morning giving Monkey his antibiotics through a dropper, half a cc at a time, and we still ended up with a good portion of it on him and us. How the hell is anybody supposed to get all that medicine down a little infant’s throat?

Suggestions, please.