The 'Mother' of all blogs: Raising kids in Westchester without losing your mind

Nov 19, 2009

10:59 AM

Dealing With a Swine Flu Diagnosis

Last week, I heard the words all parents are dreading this season: “Your child has swine flu.” The diagnosis came at the climax of an absolutely awful day. I knew something was amiss when my usually talkative daughter was virtually silent during the train ride into Manhattan for her weekly visit to her grandmother’s house. Then she fell asleep during a 10-minute taxi ride. I had a sinking feeling after dropping her off that she was getting sick. And I was right.

At 5:00 that afternoon, I wound up in my pediatrician’s New York office (because I knew I couldn’t make it home to Scarsdale before the Westchester office closed). As luck would have it, this was the first day the office was dispensing the H1N1 vaccine and the waiting room—no lie—must have had 50 kids and an equal number of parents in it.

Since my daughter’s cheeks were beet-red and her eyes were rolling in the back of her head, I knew I couldn’t wait long and told the receptionist just that. Thankfully, a nurse appeared to take her temperature (102˚F) and dispense some Motrin. “It’s going to be a while because we still haven’t seen the people that had 2:45 appointments,” she warned me.

My groggy, feverish daughter curled up in my lap and half-slept while I anxiously mulled over the possible diagnosis of her condition. She’d gotten the flu mist for the seasonal flu (because my doctor had run out of the shot) and I had been reassured that there were some studies that found the mist was more effective in fighting more strains of the flu. But not swine.

Her illness coincided with the four-year anniversary of her adoption—a coincidence that was not lost on me as I realized she’d never been as sick before as she appeared to be now.

After a little over an hour, while we listened to the children who were getting the vaccine scream and wail, we were ushered into an examination room. A young doctor came in and, within two minutes, told me she suspected this was the swine flu as they had been seeing a rash of “mild cases” in the past week. She took a swab from my daughter’s nose and said someone would be back in ten minutes with the diagnosis.

A short time afterward, a nurse appeared. “She’s positive,” she said without offering anything else, and shut the door.

I have to admit I was a bit panicked. With everything that I’d been reading since August when USA Today first started reporting the cases that had broken out in California schools, I was pretty anxious about this. Then I got mad. I had been calling my pediatrician since September about getting this shot for her. First, I was told they would be getting the shots in October, and then it was November. I was told to keep checking their website. It was the same everywhere. No doctor I talked to seemed to really know when the vaccine would be available. Then, the very day the shots started being given by our doctor, she was diagnosed as having the virus.

The near-riot that was going on outside in the waiting room made me think this is the result of a campaign of panic that was launched by the government instilling fear in parents everywhere without having the proper measures for prevention in place. Now my kid was sicker than she had ever been because I could not get the vaccine in time to prevent her illness. I couldn’t believe this was happening.

When the doctor returned and I asked her to explain what my daughter was actually “positive” with, she told me she had tested positive for the Influenza A, which is what the standard test checks for, because the other test for swine flu “is too expensive and no one, including the insurance companies, wants to pay for it.” She wrote me a prescription for Tamiflu and said, “If she still has a high fever in five days, you need to come in.”

By the time I got back to Westchester, it was close to 9 pm and I had to try three different pharmacies until the CVS on White Plains Road in Eastchester could fill the prescription. It turns out the Tamiflu prescribed for children is not widely available and the pharmacist would have to make the liquid form using the capsules given to adults. This, of course, required tracking down the doctor so someone could give approval for this. All I knew was that we were now going on 13 hours of my daughter being ill, away from home, and without the medicine she needed. Trooper that she is, she sat quietly in the waiting area coloring with the crayons and book that a CVS staffer had kindly given her. Surprisingly, when we got home at 9:30, she ate a bit of dinner and went to bed, getting up only once that night.

The next morning, her fever had gone down slightly and she was stuffed up, but clearly not as ill as she’d been last night. Two days later, she was back to her chipper self, but still had a low-grade fever. She was eating a bit less, but eating. I kept her hydrated with lots of water and tried as best I could to get her to rest. Based on all that I’d read about other cases, I felt extremely fortunate that she was doing as well as she was.

I also called her preschool to notify them of her diagnosis and confirm the protocol for her return. I was told I needed a doctor’s note and that she had to be fever-free for 24 hours before she could be readmitted.

By Friday, her fever was below 100˚F and she was back to her talkative, active self—save for a few sniffles and a bit of a cough. Although the doctor cleared her to return, I was glad I had the weekend before she would be going back into the Petri dish of her preschool class—where I was sure she got the virus in the first place. “She will have a residual cough,” warned my doctor. “But as long as her temperature stays below one hundred and is going down, she’s fine to go back to school.” But then he added: “Is she still contagious? Possibly. It’s very hard to know with this strain of flu.”

On Sunday, when the temperature outside rose to an unseasonable 70 degrees, my daughter seemed to be more sniffly than before and was coughing a bit. I got worried all over again. I called into the practice and spoke to another doctor who basically reiterated the advice of my daughter’s doctor. She also told me it was not uncharacteristic for this virus to flare up a bit—but, she reassured me, the only real cause of alarm is a high fever over 102. “Anything less than that isn’t even considered a fever in an infant.” That was news to me. I was worried because my daughter still had symptoms and asked if I should let her partake in all school activities including swimming. “Is that really okay?” I asked. “Yes, it is.” I was told.

Perhaps I should have taped that conversation because when I returned to school with my daughter on Monday, her teacher seemed less than happy to see us. I conveyed what my doctor had told me and added that I would be picking her up after lunch rather than let her spend the whole day, so as to ease her back into the schedule.

I was more than mildly annoyed at the reception we got, and the inference that I was bringing her back too soon. I’d checked with several doctors, consulted a few friends, and followed the school’s protocol. When I said as much to another mom on the way out the door, her reply stopped me dead in my tracks. “That’s why I didn’t say anything when my kids—our whole family, actually—got it a while back.”

Her child is in my child’s class. Gee, thanks. If I had known this information, I most definitely would have pursued other avenues to try to get my daughter the vaccine rather than wait for my pediatrician to get it. This woman basically told me she didn’t want to deal with people’s reactions so she’d kept things to herself.

Thankfully, my daughter’s case was a mild one and she seems to be on the road to recovery. But between the apparent shortage of the vaccine and people’s paranoia about keeping the illness a secret, we’ve got a real problem on our hands. I don’t have the solution,
but I do want to share some tips about dealing with an outbreak in your home that might keep your own fears in check:

• If a child has a high fever, get to a doctor, pronto. That symptom seems to be the leading indicator of the virus.
• Ask your doctor to explain anything that seems unclear. Healthcare providers are new to handling this and you should not hesitate to get all your questions answered.
• At this point, virtually all flu is being diagnosed as swine. For more information and clarification on this, check the Center For Disease Control’s website www.cdc.gov
• Although there are a reported 114 million doses available nationwide, the H1N1 vaccine is most definitely in short supply in this area. Regularly call your pediatrician (daily if necessary) and check other resources, including major drug stores and retailers.
• Do the right thing and alert your child’s school so that other parents can act on the information as they see fit.
• Don’t panic your child. I felt my four-and-a-half-year-old did not need to know she has “swine flu” and deal with people’s wide-ranging reactions. She was sick, Mommy took care of her, and she’s better now. That’s it.
• Perhaps the most important bit of advice: follow your own intuition about your child. You know him or her better than anyone. If you think something is wrong, it likely is. And, if you know your kid is getting better because you’re doing all the right things and taking the necessary steps back towards wellness, don’t let other people’s paranoia take hold.
 

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