Sunday, July 24, 2011
It all started 2 months ago when Hayley brought back the cough and cold bug. She had cough, runny nose and throat infection and was having fever as high as 39.6 over a couple of days which warranted an emergency visit to the 24 hours clinic nearby home one night. Her fever was consistently high especially in the middle of the night so we're constantly up sponging her and checking her temperature. She had no appetite and it was difficult to force food/medicine down her throat. She was basically on fluid for the 5 days.
This time she also passed on the bug to Zac. This was Zac's first time getting unwell since he was born. Zac also had the cough and runny nose. Although Zac didn't get the fever (thank God), his cough were horrible. He's got so much phlegm you could literally hear him wheezing when he breathes. Because the cough was so bad he didn't really get much sleep at night as he was constantly coughing. The child specialist said the phlegm were in his lungs and it would take a while for it to clear. She prescribed antibiotics as well so both my kids were heavily on drugs and antibiotics.
After about a week they were both getting better. Hayley's cough was improving and although Zac was still wheezing slightly, it didn't really disturb him as much. And then it was my turn. I too ended up with throat infection and fever and was out of order for about 3 days. I too had to rely on antibiotics.
As I was on the road to recovery, it was papa's turn. He's got the symptoms and suffered the same fate. Papa's condition was pretty bad. The first antibiotic prescribed by the doctor didn't work and he was still feverish on the 5th day (doctor suggested the dengue test). He went back and asked for a stronger one. Luckily the 2nd one worked.
I thought the nightmare was over when everyone was getting much better and then it started all over again. Sigh......
Hayley's cough and runny nose came back and because Zac have not recovered fully, he contracted it again as well. This time he ended up with the throat infection and his fever soared to 39.7 and his face was all red and shiny and scared the shit out of me. We gave him suppository and it only worked after about an hour! Doctor prescribed with him antibiotics again. He had fever for 3 days and requires lots of sponging and monitoring at night. The strange thing that we found out during his fever bout is that the side with the swelling is hotter than the other side. When we took his ear temperature, the right ear reads 38.5 and the left ear would read 39!
As for me, I got gastritis for the first time and was in pain the entire Sunday despite being on medication. Papa strangely was also feeling unwell on the same Sunday, fever and headache so can you imagine 2 sick adults watching over 2 sick kids?! It was really tough and time passed so slowly. The entire family was sleeping a lot on that Sunday.
It's been a week since the marathon and we're still recovering. Hayley's cough is gone but she's still sniffing slightly. Zac's cough is almost gone but his nose is still runny. Papa's fever is gone but occasionally still gets the headache. I am still on medication for my gastritis and is no longer in pain.
June and July was really tough on us. If I am not mistaken, I think the number of visits to child specialists and clinics in just that 2 months was somewhere between 10 - 15 times. Imagine that!
Friday, July 22, 2011
This morning I took Zac to see Dr Lee. Dr Lee gave him a thorough check and had a good look at the swelling. He said Zac is a very healthy boy with a very good weight. As for the swelling he didn't really comment much, he probably was puzzled too like all the other doctors. He did however say that since it didn't seem to bother him and it is not painful, we should just leave it and monitor it for a while. He adds that he has seen a lot of cases like these where some will go away after a while, some gets bigger and some becomes permanent. He did however add that Zac could probably have been born with it and it grew overtime without us realising. He said a child surgeon would probably be able to tell us the diagnostic and options better and suggest that we see a Dr Goon who is in a clinic next to his.
Since we were already there I wanted to meet with Dr Goon if he is available. Thankfuly he is. After waiting for a few mins, we went in to meet with the surgeon. Our hearts pounding. Dr Goon inspected the swelling and the ultrasound and the first thing he said was 'there is water inside here' referring to the swelling. Then he went on to explain about the complications of the area and what are our alternatives. He used a lot of medical terms and chinese words and we tried to understand as much as we can. The discussion went on for about 15 mins. So whatever I am writing here is based on layman terms, ie terms that I can understand and they are not exactly the terms/words he used.
Dr Goon said what's inside are fluid but whether it is blood or some clearer liquid (he said something about 'lymph' something which I could not remember) is something we cannot determine. He said the swelling is located right at the lymph nodes which is just next to the ear and he is also unable to determine if it is in the lymph nodes itself or if it is next to it or if they are actually connected/touching. I asked him if we could do some other scans to determine what it is exactly and he said even a CT Scan will not be able to give him an answer as they are really close.
The lymph nodes is where the main vein is controlling the facial movement and it is very dangerous to operate anywhere near there as the chances of it being affected during surgery is usually very high. If the main vein gets affected, he will end up with facial deformities, unable to control his eyes/nose/mouth are some of the effects. He went on and listed out for us the possibilities:
Worst case scenario
He said some will continue growing until it begin to affect the child. Some child's face will tilt to one side to accomodate the growth or the lumps will begin causing issues to the nodes and veins. In cases like these we will need to discuss again and determine the suitable course of action. Surgery might be an option but not without the risks. Even with a surgery, we might also need to consider whether to extract the whole thing or have it partially removed. 'Septated' in the earlier report by the radiologist means that it is a clutter, not just one :-(
Middle case scenario
Dr Goon went on and said that some might just grow to a certain size and then stopped growing. In cases like these we might decide to just leave the lump as it is as it is not life threatening but it means he will have to live the rest of his life with an ugly lump on one side of his cheek. For cases like these we can also consider (if the child is older) to extract the fluid out using a syringe and get it tested to confirm what it is. The test results might also help us to decide what's next ie whether to leave it alone or figure out if it's safe to be surgically removed.
Happily ever after scenario
There are also chances that the lump will decide to go away on its own just like how it magically appeared over a period of time. How long no one knows. It might take days, months or even years.
So what's next?
We will need to continue to monitor the swelling for any growth. Dr Goon did say that it is common for the swelling to subside for a day or 2 and then return bigger for a few days etc. So we should not be alarmed if there are sudden changes in a few days. We should monitor it closely over a longer period and if it constantly gets bigger over a few days, then we need to bring him back for a check up.
We also need to monitor for fever or redness in the swollen area. As the lumps are made of fluid, Dr Goon said he might get infections. When that happens he will need to take antibiotics to control the infection.
We will need to return for a follow up in 6 months.
It really broke my heart to think and imagine what he 'might' need to go through in the near future. Although things are still uncertain for now, like most mothers, I will not stop worrying and blamimg myself for whatever will happen to my child. If given a choice, I would like to take his place and go through whatever he is going through. If given a choice, I would take the lumps and put it in my cheeks. If given a choice, I would ask God to please spare him and let him grow up healthy and normal.
Unfortunately the choice is not in my hands. All I can do now is hope and pray that the lumps will go away on its own very very soon. In the meantime, I will never stop kissing and hugging and loving him and of course his sister too!
The monetary damage today is RM205.
Wednesday, July 20, 2011
The radiologist at SDMC scanned his swollen cheek (as well as the other side to compare) and wrote this in her report "The left parotid gland is grossly swollen and heterogeneous. It is generally hypodense and appears septated. No obvious upper cervical nodes seen".
I can't really digest what she's trying to say medically but I do know that 'grossly swollen' means I should probably be worried. She concluded her report by saying "This may be post-inflammatory".
So I asked her if this is dangerous and what's next? She said she doesn't really know as she's not a child specialist and suggest that I revisit the child specialist and show her the imaging report and the ultrasound printout and seek further recommendations. I suspect the child specialist will refer me to a ENT specialist. I will need to find time to pay the child specialist another visit soon.
Anyway, the monetary damage at SDMC is RM97.80.
I just hope this is nothing serious and it will go away on its own VERY VERY soon.
Spoke to the child specialist Dr Chia who referred us for the ultrasound and told her about the imaging report. She said "no nodes seen" is a good sign but she is still puzzled as to why the swelling and what causes it. She said since it is not pus, not painful and doesn't seem to bother him, it is probably not dangerous and we should wait 2 more weeks to see if it will go away. If it's still there and still the same size by then, she suggests that we consult a surgeon and see if it should be removed surgically. There is no medication to treat it.
Anyway, I am going to get a second opinion from Dr Lee Eng Lam, SDMC since 2 of my friends recommended him [read comments to this post]. Hopefully he will be able to solve this mystery. Maybe I should also see Dr Choy, SDMC who is Zac's paed since he was born for a 3rd opinion? Anyway, I'll decide after meeting with Dr Lee.
Monday, July 18, 2011
- he didn't have fever so there is no need to worry
- the swell is not tender and not red so it's not an infection
- it doesn't hurt when we touch or press it
He's got a bad case of cough, flu and phlegm in the last few weeks which might have cause some lymph nodes on his cheeks to swell (you know just like how our throat would sometimes swell if we have sore throat?!, yes like that)
They did however ask me to monitor for growth. Over the past few weeks (I think almost a month), it remained the same and this morning it does seem to look a little bit smaller - or maybe it was just psychological. Anyway, I have decided that if the swelling is still around this Friday, I am going to bring him back to his paediatrician at SDMC for a scan just to be sure.
See it for yourself and tell me if you'll be worried: