30 May 2006

Rain, Rain, Go Away (hack, cough)

We've had maybe 2 semi-nice days in the last two to three weeks. We milked the nice day on Sunday for all it was worth, going to Landstuhl where they had a little outdoor fair and Sunday opening of the stores. (Sunday store openings are a big thing. Everything shuts down on Sundays. Even grocery stores. And no 7-11s. If you're out of milk, you're out of milk. Unless you're American and have base privileges.)

Other than just being sick of rain and cold (it's about 45 degrees F right now, with a high today of 55), I really want it to warm up so that Katrina has a chance to get rid of her chronic cough. Last Saturday night, after a pretty normal day and a visit to the base equivalent of a Chuck E. Cheese, Katrina suddenly developed a fever of almost 103. Since she was on day 3 of her third course of antibiotics since January, we were a bit more concerned than if she hadn't been taking the meds. After a dose of Ibuprofen and a call to the nurse line, we took her to the ER at Landstuhl Regional Medical Center. That's the big American hospital here. When you hear about soldiers being taken to Germany after being wounded on the battlefield? This is where they come.

Anyway, we saw in action how much more interventionist the American practice of medicine is over German practice. Of course, by the time the triage nurse looked at Katrina, the ibuprofen had brought her temperature back to normal. But the nurse was horrified that Katrina had been coughing since January and had not yet had a chest X-ray. So off we went to Radiology.

Katrina was absolutely calm and wonderfully cooperative through all of this, even though we had woken her and bundled her into the car after the nurse line put the fear of God into us. (The ER doc said that the nurse line should just have a recording saying "Please go directly to the emergency room." But when you tell a nurse your child's symptoms and that she's asleep in her bedroom, and the nurse tells you to go check that your child is still breathing, well, it freaks you out a little.)

The only complaint Katrina had through the whole ER visit was that she didn't get to see the X-ray of her chest. I think that girl is going to be in the medical field. There was a poster of the anatomy of the ear in the exam room, which fascinated Katrina. We had to tell her what every part was called and how it all worked (if we knew, that is). Then she wanted to know what all of the medical intruments/equipment was and what it was used for.

The doctor on duty said that the X-ray didn't show anything. But he also said he was going to get a colleague to look at it to make sure, so I wonder whether maybe there was a little something there. So he gave us a bottle of Tylenol and a bottle of Ibuprofen for the fever, and Zyrtec to try to dry up any drainage that could make her cough. He told us to overlap the Tylenol and the ibuprofen for 48 hours, which, truthfully, I thought was a bit of overkill. So I gave her ibuprofen at night and checked her temp throughout the day before giving her yet more medicine. But maybe the doc was right, since the fever did recur (though only to about 100).

So that was Saturday night a week ago. That Tuesday, when Katrina was still running a low-level fever off and on, I took her back to the pediatrician. This would be the third visit in three weeks, not counting the ER. You know you're in trouble when the doc comes in, looks at her record and info on the computer screen, and then sighs, rakes his hands through his hair, and mumbles to himself. Really, this doesn't inspire confidence.

"Obviously," the doc says, "her current antibiotic is not working." Um, yeah.

He examines Katrina and then starts talking in German to his nurse, who is at the computer typing in notes. What I hear, because of my woeful lack of anything approaching German comprehension is "blah, blah, blah, blah, chest X-ray, blah, blah." I pipe up to say that she got an X-ray at the ER but they said it didn't show anything. He explains something to me about what an X-ray might or might not show that I cannot recall at the moment.

Then, more notes to the nurse: "blah, blah, blah, pneumonia, blah, blah, blah."

Wha?! "She has pneumonia?!" I say.

"Yeah, I think so," says the doctor matter-of-factly. "What I'm going to do is give you a different antibiotic that is more broad spectrum than the one she's on right now."

Apparently, pneumonia is not the cause for concern I thought it was, because the visit ended exactly the way it did when she had "just a cold," and when she had "bronchitis," and when she had "some sort of viral infection like bronchitis that is going around." We got a prescription for yet another antibiotic and were sent on our way. Granted, the dosage seems to be a bit more aggressive.

About Wednesday afternoon, Katrina perked up and seemed to regain her energy. The fever's been gone since then, and she's been bopping around as usual. She has one more week to go on this, her fourth antibiotic. She's still coughing.


Wendy said...

Have they done any tests for asthma? Has she seen a respiratory therapist at all? If you remember I had what the doctors thought was the flu, then bronchitis, etc., when they finally did some tests and said it was asthma. Inhalers were the only things that made the cough go away. The fever, of course, shows that she did have an infection. But, what they told me, was that all of the allergies and stuff draining made me more prone to infections.

Carol said...

Ditto what Wendy said. Have any of the doctors asked Katrina to exhale quickly and strongly while they listen to her chest? (To listen for a wheeze.) Or have any of them said that she's wheezing? I totally concur with Wendy that all this could be secondary to an asthma or asthma-like issue. If you can see someone who specializes in asthma/respiratory issues, I would STRONGLY recommend it. There are also some really good meds (like Singulair) that can be taken daily which can keep Katrina's lungs clear so that when she does get the inevitable cold, it won't turn into a seaon-long sickness. Good luck!!!

Jennifer said...

No one has heard wheezing, or at least they haven't mentioned it. The cough seems to have reduced but not gone away completely. I'll give it a few days after the antibiotic is finished and then take her in again.

She was on Singulair for a week and it had no effect. But I don't know whether that is long enough to judge or not. I guess the doc thought so 'cause he didn't give her any more.

I'll be going to my doc this week myself, as I think my not-so-bad cold of last week has once again turned into bronchitis.

It was sunny and warm (63 deg.) for about half the day today. It clouded over and started to rain about 2:30. It might get up to 65 tomorrow. Hopefully, the weather will start to improve from there. Germany is colder than the Northeast U.S., but cold temps into June is unusual even for here.