ER = hospital stay

On a day-to-day basis our kids are really healthy.  However, when they get sick, they get sick!  We've been to the ER twice and both times ended in a pretty serious hospital stay.  This was Evie's turn.

Friday afternoon when I changed Evie's diaper she had what appeared to be a good sized pimple on her behind.  I thought it was odd, but both she and Samuel have had 'baby acne' at some point, so I didn't think much of it.  I pushed at it a little bit and it did what you'd expect a pimple to do - pop with yucky stuff coming out.  The next diaper change it was still there, although changed a little.  The area around it was red and was getting hard.  I pushed some more and more yuckiness came out.  By bedtime, she had a slight fever - about 100.5.  We gave her some Tylenol and she woke once during the night, but otherwise slept okay.

By Saturday morning's diaper change it was a deeper red, larger, harder and pus still coming out but mixed with a little blood now.  I called her doctor's exchange and spoke with him.  He agreed it was probably an abscess and that we should come in Monday morning, unless her fever spiked or it physically changed that worried us.  By mid-day you could tell she was becoming uncomfortable and spent most of the afternoon/evening laying on her belly on my chest.  She started to feel hot by evening and when Dan took her temperature at 8pm it was a little over 102.  With this we decided it was time to pack up and head to the ER.  As I was packing her diaper bag, I told Dan that I should go ahead and pack a bag for myself since it seems that every time they go to a hospital they end up staying.  Not wanting to make a mountain out of a mole hill though, I left with only a few essentials for myself.

I took her to the same Regional hospital that she stayed at for her jaundice.  They were packed and we had a 3 hour wait.  When we finally got into the ER room, they squeezed and took a swab of the pus to run cultures.  About 20 minutes later they said they think we're dealing with a Staph infection and that it will need to be cut to be drained.  They however, are not equipped to sedate an infant, so we packed up and drove straight to Cardinal Glennon Children's Hospital in St. Louis.  We arrived around 2:30am.  The Regional hospital had called ahead so Cardinal Glennon was expecting us and walked straight in without a wait.

The first thing they did was check her temperature.  It was now up to 103.8 so they gave her some Tylenol.  All the doctors and nurses left the room for a minute while I was holding Evie.  She immediately threw up the contents of her last bottle all over me and the floor.  Note to self: when taking the kids to the ER, always pack a hospital bag for myself.  Needless to say, when the doctors came back in they wondered what the heck happened. 
The second thing they wanted to do was squeeze her little behind again and do a culture themselves.  Except they squeezed HARD trying to get as much out as possible and open any extra pockets that the infection might be hiding in.  This sent Evie into hysterics and wouldn't settle down.  They ended up giving her a dose of morphine for pain, but also to calm her down.  After that kicked in, they put in an IV for fluids, antibiotics and anti-nausea medicine (a little too late though).  The ER docs decided to wait to cut and drain the abscess to see if the antibiotics could do it alone.

On Sunday morning, around 11am the Assistant Professor of the surgery team came in to examine Evie.  She didn't like the redness or hardness of her behind, which by now was her entire right cheek and going down her thigh.  She immediately decided surgery was in order.  She said she would do an 'add on' surgery (that is sneak it in ASAP) and get it done that same day.   Dan and Samuel arrived around noon to keep me company as well as bearing a stocked bag for me to shower, change clothes, etc.

Around 3:30pm we were told it was time to go in for surgery.  The procedure itself only took about 10 minutes, but then we had an hour wait for her to come out of recovery.  We were told that they ended up draining almost 15ml's (aka 1 tablespoon) of fluid from her poor behind, which is more than they were expecting.  Due to obvious pain, she was given another dose of morphine at 11pm so she (and I) could sleep.

Monday morning, around 11am, another member of the surgery team came into to examine Evie.  He was happy with the way her cut looked so he took her packing out.  You can imagine my surprise when he pulled about about 2 feet of packing from her behind!  What's interesting about an infection like this is that it needs to remain open so any remaining infection can drain out.  If it was sealed, any remaining pus would form new pockets and we'd have the same issue all over again.  However, having a 6 month old with an open wound on her behind presents it's own problems - mainly poop.  A surgery nurse came in to show me how to care for the wound and how to insert a little section of packing into it to keep it from sealing - this way the wound can heal and close from the inside out, pushing any infection out with it.  After the doctors checked with me to make sure I was comfortable with everything going on, we were released at 4pm.

Now that we're home, Evie takes antibiotics 3 times per day.  At each diaper change, her wound is flushed out with water and a new piece of packing is inserted with the help of a Q-tip to push it in.  She also gets several warm bathes each day to help it heal.  All said, she's doing really well and doesn't even mind being held under her behind anymore.  The only part she still balks at is when we insert the packing, but heck, so would I!

We have a follow up with her Pediatrician tomorrow and will be sure to keep everyone updated!