Would you insist on an xray?

fricksgirl · April 2011

Alex has had a fever since Sunday (yes, for five full days). he has no other symptoms and when he is on Motrin or Tylenol you would never know he's sick. It's just when it starts to wear off he gets all slow and "I'm cold" and "I want to rest", then he has meds and a sleep and he's a-ok again.

The dr said if it remains low grade it's a virus, that if it was something serious (bacterial) or pneumonia it would not be masked by the Motrin/Tylenol regimen.

He has had no meds since midnight and now he's holding about 99.4. I know that's low grade so I am letting him go to see if it gets higher.

Of course one of my FB friends told me last night that the same thing happened to her son and they did the chest xray for kicks and he had "patchy pneumonia". He also had no other symptoms. Of course this freaks me out.

If his fever goes up I'm going to ask for the xray today.

Of course my DH has to work OT today and it's the first day of my spring break, which I had high happy plans for and now I'm stuck watching for a rise on the thermometer. Hello, I'm Heather, Pity Part of 1. Sucks.

Anyway just wondering your opinions... isn't that a LONG time to have a fever?!?!?

risysmama · April 2011

It sounds like a long time to me, but how high was the fever? Is there an advice nurse you can call?

MommySteph2009 · April 2011

I consider it a long time. I hope Amy will chime in. I'm overly paranoid about illness (hypochondriac) so I would ask for a follow up, not sure about an x-ray, but ask to be seen again. Did they check his lungs when you went to listen for fluids?

fricksgirl · April 2011

He's up to 101.8 this morning at 8 AM, I gave him Motrin, wasn't interested in seeing how much higher it would go.

They say it's been "low grade", but this is the thing- I'm crazy worried about his febrile seizures- so we medicate him as soon as he hits 100ish. We don't let it get higher than that really so I don't know how high it's been. I do know that it has been responding to the meds, so that's good I guess.

This #$%&% blows. Really truly.

I have a call in to the doc, she's so laid back (and I know she's on call today) I know she's going to try to convince me that nothing is necessary. I just don't feel that way. I hate fighting with these people. Not to mention how radically STUPID the chick on the phone that took the message was. Ugh. Not good.

kittylove · April 2011

I am not sure I would ask for a chest x-ray but I would ask for someone to listen to his lungs. The other child's Dr wouldn't have just ordered a chest x-ray unless he heard something IMHO. I hope he feels better.

Mrs.BoomBoom · April 2011

There's a lot of radiation exposure from a chest x-ray so I wouldn't want to go there without some really strong other evidence. I would ask for him to be seen again though

SarahCee · April 2011

It seems to me like all of his symptoms are just dragging on- which could very well be viral. But if your gut is telling you that something else is going on I would push for the x-ray. It does suck that you are dealing with this on your own. Trust your mama instincts on this one. When you do talk to the doctor ask her about the risks of an x-ray vs. waiting to see this thing out.

Mrs.K&C · April 2011

Sabrina had one for 7 days in February. And it got high, like 104-105 at the end (when it turned into a double ear infection). But for the first 5+ days, it was just a virus (possibly more than one, you never know what these kids are carrying around). They were going to do the chest xray on day 7, but because she had a double ear infection we didn't do it as the treatment for the ear infection is the same as the treatment for pneumonia. She was in again last week for her puking/cough and other fun stuff and they offered to do a chest xray to rule out pneumonia but she didn't have any symptoms that were concerning enough so I declined.

Hang in there, it is NOT fun!!!

amyfelice · April 2011

I'm so sorry. Has anyone examined him? I would hope so. The statement that if the medication is masking the fever then it's viral has no basis in fact. Any fever can be relieved by Motrin or Tylenol, It makes no difference if the fever can or cannot be brought down as to whether the bug is viral or bacterial. That is proven by research.

Is he coughing at all? Is he having any fast breathing, particularly when he is NOT having fever? Is he complaining of any chest or belly pain? If the answer to any of those questions is yes, then he could possibly have pneumonia. A careful exam helps to rule that out but it can be easy to miss. I have supervised residents that say the lungs are clear and I find the pneumonia so it depends on the patience and experience of the examiner.

I Have been seeing an annoying viral illness that lasts a week or more at work in several children so it is possible that it is still a virus but he should really be checked out fully again.

fricksgirl · April 2011

amyfelice:
I'm so sorry. Has anyone examined him? I would hope so. The statement that if the medication is masking the fever then it's viral has no basis in fact. Any fever can be relieved by Motrin or Tylenol, It makes no difference if the fever can or cannot be brought down as to whether the bug is viral or bacterial. That is proven by research.
Is he coughing at all? Is he having any fast breathing, particularly when he is NOT having fever? Is he complaining of any chest or belly pain? If the answer to any of those questions is yes, then he could possibly have pneumonia. A careful exam helps to rule that out but it can be easy to miss. I have supervised residents that say the lungs are clear and I find the pneumonia so it depends on the patience and experience of the examiner.
I Have been seeing an annoying viral illness that lasts a week or more at work in several children so it is possible that it is still a virus but he should really be checked out fully again.

Thank you, Amy! Yes, I've taken him in- first Monday, then Wednesday, then again today. I rushed to the office right away after he got the fever Sunday note b.c I wanted to make sure everything was good with his ear tubes. Back Wed, back this morning.

This morning she did NOT want to give me that chest x-ray order, but I did insist on it. She said IHO it's viral but I said I can't take it I need to know if it could be pneumonia. So, off we went to the hospital and now I'm home waiting for the call.

He has been complaining of belly pain and I told her that.

I'll keep you guys posted. And the bonus was that the xray tech was HAWT. So, silver lining, right, at least that's something!!

tiki_t · April 2011

What does your gut say? I've insisted on a chest x-ray before because DD had a fever and a really hard time breathing when she coughed and after. It turns out she didn't have anything to worry about but it was more piece of mind for me that I did everything that I could. Something just didn't seem right and we were able to rule that out. I wouldn't expose my kids to excess radiation unless I thought it was absolutely necessary.

Celyn · April 2011

Wouldn't the little blood oxygen meter on the finger be able to tell if an x-ray is necessary? That's what happened when Aaron had it.

Mrs.K&C · April 2011

Celyn:
Wouldn't the little blood oxygen meter on the finger be able to tell if an x-ray is necessary? That's what happened when Aaron had it.

Ditto, that's why we've declined them in the past when they gave us the option.

amyfelice · April 2011

Mrs.K&C:
Celyn:
Wouldn't the little blood oxygen meter on the finger be able to tell if an x-ray is necessary? That's what happened when Aaron had it.
Ditto, that's why we've declined them in the past when they gave us the option.

Not always. If it's small, then the pulse ox can still be 98-99%. If it's significantly large it may be 95-96% but you have a lot of lung reserve. You can even lose a whole lung and still have normal lung function.

Celyn · April 2011

Thanks for the extra info, Amy. Aaron popped 95% and they made it sound like they were just being super cautious to x-ray him. It did show on the xray, I guess because it was more significant than they let on, eh?

amyfelice · April 2011

95% is in the range of acceptable but not really normal if you know what I mean. Normal should be 99-100%. If it is lower than 94-95% that means the person really should be admitted and on oxygen. So, yes, by saying they were being super cautious they were sort of minimizing it probably not to worry you too much. Pneumonia can be viral too so they don't want to make it sound like it's always going to be bacterial either.

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