And Then Baby Got Sick

We all got colds on our trip (yes, the big story about that is still to come). And then we all developed lingering chest coughs, that I'm reasonably certain indicate bronchitis. We all still have those coughs. So, when I took Alec to our shiny new pediatrician the day after his first birthday to see about his one year immunizations, she listened to his chest and said she wouldn't vaccinate until he got over the cough. She prescribed pediatric cough syrup and infant ibuprofen, and sent us on our way. That was a week ago today.

For three days, Alec took his meds and coughed anyway. Then Monday morning at 4, he sat up in bed and vomited. And kept vomiting. At first I wasn't too worried, because he has always had a sensitive tummy and and has already puked far more in one year than Joffre has in 3.5. Heck, he had three nights in a row after we got back from our trip where he was throwing up every night. But, by about 10 am Monday, when he started throwing up chemical-yellow bile, I got a bit worried and called the pediatrician's office. The pediatrician herself was not in (because of the paro, according to the receptionist), but I could call her on her cellphone. So, thinking that was pretty cool, I called her on her cellphone. She answered, and told me that she was in LIMA. Now, it's enough of a stretch to think that you might call your doctor's office in Vancouver on, say, a Storm Day (see post on same), be told by the receptionist that she wasn't coming in, and be given her pager number, let alone her cell number. But if that doctor had travelled to Calgary, would she still take a call from a patient? I don't think so. Anyway, the doctor told me to give Alec Children's Gravol suppositories to stop the vomiting and Pedialyte to rehydrate him. She also told me to take him off the medication we'd been giving him for the cough. She said to take him to the clinic if the vomiting didn't stop. After I got off the phone, I thought, "Gravol suppositories? Really?" Being me, I looked Gravol up online and found absolutely nothing to suggest that the suppositories were meant to be used on babies.

So, I cracked out our supply of rehydration salts, mixed some up, and discovered that - surprise! - the baby thought they were vile and wouldn't drink them. I decided to keep a close eye on him, and if he showed signs of really being sick, or of dehydration, I would get some of this Gravol. I got clear Gatorade and cut it with water, and that he drank. He threw up less frequently over the course of the day, so I thought we were in the clear. However, at ten Monday night, he started seriously vomiting again. Fearing another sleepless night, I gave him one quarter of a Children's Gravol that we had in our medicine kit - the tablets have the same amount of drug as the suppositories, so I felt I was being cautious enough - and he slept through until about 4 am, when he started throwing up again. Oh, and that was our anniversary.

Tuesday now, and I felt that Alec was basically doing okay. Plus, the paro was over, so I knew we could get wherever we needed to. He seemed fine for most of the morning, and then around noon it all went sideways and the vomiting began again in earnest. Our power also went out at about two in the afternoon, and at five showed no signs of returning. The whole district was out. I went out to buy the dreaded suppositories, and candles, and while out I ran into a fellow expat who told me that in her opinion I should be taking this kid to the hospital. So, I called up our lady at the company, and asked her where I should take him. Bless her heart, she came to our house at 6 - shortly after the power came back on - and took me to the clinic. In the clinic parking lot, however, she decided that it would take too long to go through admitting and a general doctor before getting through to pediatrics, so she called up her own pediatrician, confirmed that he was seeing patients, and took us over there. This doctor, who was at least eighty years old and completely unintelligible in Spanish or English, checked Alec over very thoroughly - there are no digital, under-the-arm baby thermometers here, I tell you - and pronounced him fever-free, not dehydrated, and suffering from bronchitis. He advised me to put baby back on the cough syrup, give him tylenol should a fever develop, and give him ten drops of Children's Gravol liquid every eight hours to stop the vomiting. He recommended rice water to keep him hydrated, which Alec miraculously enjoyed. He also gave us a form asking for various tests and gave us instructions to take a diaper in to a lab downtown for stool analysis the next day. Alec had a messy diaper at 3:00 Wednesday morning, and then seemed fine. He would not, however, take the Gravol drops. We ended up mixing it into a teaspoon of honey to get it in there. This tactic backfired, as now he won't take any medicine at all that isn't mixed with honey.

Wednesday I took the stool sample in to the lab. As with the doctors' offices, I was required to pay cash - in advance - for this service, so I now have a little stack of receipts from various consults and prescriptions waiting to be submitted to our health insurance company. The lab told me they would have the results for me to pick up after two pm. Sure enough, at 2:30 there was a little envelope waiting for me with Alec's name on it. His diaper had shown that he had no parasites or abnormalities, but that he was suffering from rotavirus. Which sounds scary, but is in fact the leading cause of vomiting and diarrhea in children three and under in developed countries, and common as dirt. By now, Alec was eating some solids again, and hadn't thrown up in 12 hours. We went to the playground with friends for a while, and that evening went back to the pediatrician's office to show him the test results. He said, "well, the kid seems better, so keep doing what you're doing, and everything should be fine."

Thursday - yesterday - Alec was cranky and restless all day, but didn't throw up. He didn't want to nurse and didn't want to sleep, and this was strange, as throughout his tummy illness he had remained happy, playful, and cuddly. He fell asleep well last night, by 8:00, and slept till about 11 before he started to toss and turn. He slept fitfully, waking us up regularly but not waking up himself, until about 3. He hadn't nursed since around four in the afternoon, and now he had a fever. So, I got some ibuprofen into him, stripped off the outer layer of pyjamas the housekeeper had bundled him into, and fed him a couple of ounces of Gatorade/water. At 4:30 he decided to nurse, and at 5:30 someone on the street started incessantly honking a horn.

Throughout all of this, I have had some kind of bronchitis - or at least, lingering chest cough - and am now painfully exhausted from a week of Very Bad Sleep. So, I will likely be going to the doctor too. Fortunately, my take on doctors here is that they are friendly, knowledgeable, and efficient, even if they are not using all the fancy electronic equipment that we know from home. Unfortunately, I think that my scepticism about the Gravol and my hesitance in taking him to the doctor at all has branded me a "bad and rebellious patient" in the eyes of the medical professionals here, who are accustomed to being able to say, "I'm going to give you a shot for that," or "take this three times a day for five days" without being questioned as to the exact nature of the drug.

Peruvians, like many Canadians, seem to feel that the slightest sign of illness with a cold or a flu is the cue to get oneself to the doctor's office post haste. The doctors, though, seem far more likely to recommend cough and cold pills and syrups that we can buy over the counter in Canada than Canadian doctors are. I'm tired of hearing everyone, from people on the street to the doctors and nurses themselves, blaming the rash of coughs and sniffly noses on the "change in the weather" and the "extreme cold" (never below 7-8 degrees C), even when they also talk about viruses.

And, of course, here as elsewhere, the average person seems to think that antibiotics are a magic bullet that will eradicate any and all illness. The tired resignation in the doctor's voice when he said, "rotavirus is a virus and can't be treated with antibiotics" suggested that he had said it several hundred times before, and had generally met with protest from patients. I hope I gained a few points back, after my anti-Gravol performance, when I said I understood that and was happy to continue treating symptoms till the virus had run its course.

Now, as long and the darned fever doesn't repeat itself. I could really use a good night's sleep.