New Jen's Horde

Saturday, July 23, 2005

Pediatric Dehydration, or Why I'm Glad I Live in a First World Country...

I haven't been blogging for a few days, because I haven't been home. On Thursday morning, my three year old son, Tiernan, woke up and was listless and began vomiting. He couldn't keep anything down, even water was coming back up. With four kids, we've seen this before, so we followed the standard protocol of giving a teaspoon of clear fluid every five minutes. This usually gives their system enough liquid to keep going, without causing the stomach to start churning again.

No dice.

He was throwing up all night. By the next morning his eyes were sunken, and he was just laying there, which is really unusual for my chandelier monkey. I called the doctor and went in.

The doctor sent us to the ER, who promptly started giving him a bolus of fluid through an IV. They expected to give him a bag or two of IV fluid and send him home. But, when his bloodwork came back it was apparent his was even more severely dehydrated than we'd thought.

The ER doc explained that Tiernan had reached a point where his electrolytes were so far off, and his kidney function was so impaired they they needed to admit him. He was going to be OK, but not without a lot of fluids, and they wanted to watch him and make sure he was going to tolerate it well. He told me that little kids can very quickly pass this threshhold, and that it's virtually impossible to get them rehydrated without using IV fluids.


How does that happen? In 24 hours, my child went from being totally fine to being a kid who wouldn't survive without medical intervention. If we didn't have access to a hospital, he could die. That line is crossed every day, all the time, I know. But this seemed so mundane, my kids throw up ALL THE TIME.

From quizzing all of the doctors and nurses we came into contact with during our stay, it seems that it was a cross between the hot weather (everyone's running around a little bit on the low side for hydration) and one of a couple of really nasty viral gastroenterological bugs that are going around right now that caused Tiernan to "tank" (the ER doc's terminology) so quickly. One doctor mentioned the Norwalk virus, which recently sickened a campful of Boy Scouts near here as a possible culprit. He said it was possible for an enterprising three year old to catch it just about anywhere. That was why they kept asking me if he'd been drinking from mud puddles, etc. (Tasty!)

As it was, they ran the fluid boluses for about 9 hours(!), then switched to a lower rate on his IV fluid for the rest of the time he was in the hospital. Dehydration causes your heart to race, and they got his heart rate from over 170 to under 120 after 14 hours of fluid. Then it just became a matter of seeing whether his food would stay down and that he didn't develop diarrhea from the virus and the extra fluids before we could go home. They released us in the early afternoon. Tiernan's at about 75%, which is pretty good. If he were at this level of activity all the time we'd probably visit more museums and other quiet places ;-) It looks like he'll continue to do well, but if not we can take him right back and pick up where we left off.

Thanks to Sara for watching our girls while we stayed in the hospital, and for all of the folks at Five in a Row and everyone else for your prayers!

Wow. That's scary stuff going from healthy to the hospital in 24 hours. I'm glad he's better now.

I love your Jen's Horde pictures. You look like a fun family.
Good God!!!! I am so sorry to hear this. How FRIGGIN' SCARY!!! I hope he is running around soon.;)
i'm glad your son (sun) is okay.
I hope he just continues to get better and better.
So glad he's okay now Jen!! I missed the whole trauma!
Goodness that is scary to know that dehydration can reach that critical of a level. I know it's been a few days since you wrote this and I hope he is doing much better.
Thank you all for your comments and well-wishes. Tiernan's well on this way to being mended now. :-)
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