Thursday and the nurse

When we arrived home from A and E sometime around 5/ 5.30 am, I made Evelyn comfortable on the spare double bed so that I could lie next to her.  She wasn’t comfortable lying flat, so I used several pillows to keep her propped up.

I explained to Trevor that I had been told that Evelyn had croup and that she had been given a steroid.  I don’t remember saying this, but Trevor recalled it clearly, that I was not convinced about the doctor and that she seemed rather unsure of herself.  This is certainly what I was thinking and I was very dubious about this being just a viral infection.  However, I also recognised that I had never seen croup before.  At that stage, I did not know that there was such a thing as Bacterial Tracheitis.

I lay down on the bed next to Evelyn and remained awake until I got up to get Ed ready to go to school.  I sent a text to my neighbour C, to ask if she could take him with her daughter who was at the same school.

I went back upstairs and lay on the bed, but could not sleep as I was worried about Evelyn.  I can still picture her lying on her side, facing away from me and propped up with pillows, her little frame dressed in a pretty nightie with her beautiful curls.

I don’t know how long she slept for, but she woke and wanted to go downstairs.  I made her comfortable on the sofa with light blankets, pillows and her favourite soft toys.  I monitored her temperature over the next few hours and recorded doses of Ibuprofen and Paracetamol.  In the afternoon, I felt at a loss because her temperature was sky high, despite alternate doses of Ibuprofen and Paracetamol.

I phoned our GP practice and waited for the doctor to return my call.  I find this part of the story painful to relate because for months afterwards I had the crazy idea that perhaps I had not given the doctor the important information.  When I finally obtained the records, however, it is documented exactly as I had recalled.

I told the doctor that I had taken her to A and E at 2 am because she was struggling to breathe and had burst into our room . She had been diagnosed and treated for croup and discharged home.  Her temperature was still hovering around 40 degrees, with the lowest that day 39.6.  I was not convinced that she had got only a virus and I wondered whether she might have a secondary bacterial infection such as tonsillitis.  The record says “Mum wondered re antibiotics.”

She asked about whether her breathing had improved.  I was unsure, although I said that it was clearly better than when she had a severe problem at 2 am.  I said that she was very poorly with a high temperature and she was feeling sick.  The doctor said that a high temperature was nothing to worry about in a child of Evelyn’s age (7  3/4) because she was not at risk from febrile convulsions and it showed that her body was fighting infection.

She said that she had made an appointment with the nurse practitioner for later that afternoon.  I was stunned for a moment.  I thought that the information I had given her would have triggered either an appointment with a doctor or instruction to return to A and E.  She evidently sensed my surprise when I just said “oh!”, but she reassured me that the nurse was qualified to administer antibiotics and that she was very experienced.  I knew the nurse and I thought that she will have seen thousands of kids with croup in her career and would know if there was anything to worry about.

I arranged for Ed to be collected from school by my neighbour and went to the surgery with Evelyn.  She looked white and really poorly and I can picture her sat in the chair in the reception area whilst I booked her in.  We we seen very quickly and the nurse took Evelyn’s temperature.  I explained that she had been in A and E this morning and diagnosed with croup and administered with Dexamethazone.  I explained that I was giving Ibuprofen and paracetamol and yet her temperature was really high.  She measured 40.1 degrees.  She looked down Evelyn’s throat and declared that the tonsils were covered in white spots (exudate) and that she needed penicillin.  I was surprised because I could not see anything other than a bit of swelling, but I supposed that she had the benefit of a spatula and powerful light to get a better view.  Later, I found out that this was an extremely  dangerous thing to do, butting a spatula into the throat of a child with croup.

I felt massively relieved when she produced an prescription for penicillin.  We went straight to the pharmacy to collect it and I gave her a dose immediately.  I could give her a dose again before bed and I would set my alarm to give a third dose early in the morning.  Hopefully, it would kick in soon and she would improve.

Even after the first dose she seemed happier.  Perhaps it was partly the fact that she knew that she had the medication to make her better.  That evening, we continued with the paracetamol and Ibuprofen and I added the antibiotics to my record sheet.  I left Trevor at home with the kids whilst I popped to the school for the curriculum evening for our son’s year group.  It was only an hour and I hurried home.  After antibiotics and ibuprofen, I took Evelyn to bed and lay next to her.  I did not get any sleep until the early hours, when her breathing gradually became less noisy and her temperature was falling.  I thought that everything was going to be OK and by now I was exhausted, having little sleep for two nights in a row.

 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s