Yesterday, I had decided I was going to call the doctor. I got a chance to read the very speedy first two comments from from LJ friends before I heard Morella stirring and went to wake her up. She was crying pathetically — the soft "eh eh eh’ cry and I gave her some milk to drink which she drank as much of before stopping and crying some more. I realized she was hot so I checked her temperature while I changed her. Under the arm – 102.1 (add one degree to 103.1) I gave her some tylenol, and carried her a little — but she looked like she wanted to go back to sleep. Then I thought "Hey, her ear STILL looks funny.
You see, the night before we noticed that her right hear was sort of sticking out. We figured she had just slept on it wrong since she took such a massive nap. After "ear infection" entered my morning vocabulary and "sick" I noticed that it was sticking out even more, and swollen behind it to the point of turning purple. I called the pediatrician right away. She got me an appointment for Urgent Care in a 1/2 an hour. I called Tim and asked to go with me. We got to the appointment, she was weighed – 16lb 2 oz — she lost 10 ounces and was mildly dehydrated. The attending Urgent Care woman looked in her ear and confirmed it was an ear infection, however she got a second opinion from Morella’s pediatrician who said the swelling behind the ear was cause for concern. The said to go to ER at the UW Hospital so that an ENT could take a look at her. The pediatrician said that they might want a CT scan to see if she had an abscess and that if that is the case then they might want to do surgery. Mostly she tried to assure us, the trip to ER was just to assess how bad the infection is to determine the right dose of antibiotics.
Of course what she really meant to say, and was later asked and commented to us a thousand times by all the folks in ER was that she might have Mastoiditis. What’s that, you ask?
Mastoiditis is an infection of the mastoid process, the portion of the temporal bone of the skull that is behind the ear. It is usually caused by untreated acute otitis media (middle ear infection) and used to be a leading cause of child mortality. With the development of antibiotics, however, mastoiditis has become quite rare in developed countries, most likely due to antibiotic treatment of otitis media before it can spread. It is treated with medications and/or surgery. If untreated, the infection can spread to surrounding structures, including the brain, causing serious complications.
While in the ER, she was hooked up to IV to start fluids, take blood, administer antibiotics, a mild sedative, etc. She had a rectal temperature of 104.7. The temp alone would have assured her an over night stay. However, the CT scan (after a visit to the sedation clinic) revealed that she DID have Mastoiditis and surgery was scheduled for that night. They explained that they were going to make a cut in her timpanic membrane and suction all the puss and blood out as best at they could, followed up by antibiotics, ear drops and supervision to see if the swelling, fevers and white blood cell counts go down. If they don’t, she may have a follow up surgery where they cut the outside of her ear (versus going through the ear canal) to clean the infection up more. I am a little worried this might happen because the Surgeon said that they didn’t get *as* much blood and puss as he would have expected. He also mentioned that it appeared to have started to burst own with a little leaking starting. But nothing was coming out. And for the record, I would like to point out that she never pulled her ears or rubbed her head or anything. The only thing she ever did was rub her mouth.
So that is where we are at folks.
Oh she is awake!