We were unlucky enough to endure a pretty rough monthlong series of medical incidents and illnesses in March. Of course this occurred alongside the birth of our latest child, thus adding a layer of chaos into a situation already in major flux. These sort of things happen when you have children, with the likelihood increasingly exponentially with each child added. Picture a Norovirus outbreak on a cruise ship, but with less waitstaff.
Here are a few things we observed over the course of this hard four weeks, in no particular order. I don’t know if I have to preface this with some crap about not being a medical doctor or whatever, but I’m not a medical doctor, so take my advice with whatever grains of salt you take all advice on important matters from strangers online.
Fevers. Few things send parents into roiling anxiety more than a child’s fever. I don’t know if this is a strictly American thing or if it’s more generalized throughout the Western countries, or maybe the world. But at least here, in the U.S., if a child pops even a mild fever, parents usually can’t rush quickly enough to suppress it with medication. It’s just reflexive. Fevers, of course, are good. They’re an immune response. You don’t want to suppress them unless they get dangerously high. And children are overwhelmingly able to tolerate fevers at much higher temperatures than adults. A 103º fever that would be cause for serious alarm in an adult is pretty par for the course for a child hit with a viral infection.
We actually knew all this. We’re not reflexive fever medicators. But in March all of our older children came down with very high fevers one after the other—sustained temperatures of 103º, 104º, at times 105º. This was alarming for us: they’d never popped anything this high, let alone for days on end. We were at times quite worried. But here’s the thing: It turns out that even these high numbers are not, in principle, anything to reflexively worry about. We spoke to our GP and some doctors at a Patient First and all of them stressed that when a child’s fever gets that high, you really want to consider secondary symptoms as much as primary ones. For instance: Your child has a 104º fever and he is completely lethargic, limp, incapable of movement or interaction, maybe even delirious—it’s time for a hospital trip. Your child has a 104º fever and he’s merely tired, has a low appetite but is drinking plenty of fluids, mostly just wants to sit around watching TV but is able to normally interact with and engage with you—he’s likely fine. A fever generally only tells half the story of a child’s illness. You have to consider the totality of the situation. Don’t panic.
We did medicate each of these high fevers, but only very sparingly, generally at night to help them get much-needed sleep when they were struggling to do so. But it’s worth noting: The fever we medicated the most, with several doses of Tylenol over a few days, lasted the longest. The fevers we medicated the least were done nearly 50% faster. Fevers do good work. If your kids are otherwise fine, let the fevers go and it’ll all be done much quicker.The U.S. healthcare system is often redundant and sometimes maddening. We all know this already of course. This is not new. Still. At one point in March our second-youngest chomped down on a dog pill. We called poison control right away; they suggested he be taken into an emergency room for monitoring. Given that emergency rooms are just comically expensive and endlessly time-consuming, I decided to take him to one of those outpatient “urgent care” clinics. They told me they couldn’t treat him there and that we should go to the emergency room. I don’t know why. There was plainly nothing wrong with him and he only needed to be hooked up to a vital signs monitor and observed for a while before being cleared. I guess that’s out of the bailiwick of an “urgent care” facility, but I’m not sure why that’s the case. I guess they only, what, give COVID vaccines and splint broken pinkies there? I don’t know.
At the hospital we got a room and they gave him a chocolate-milk-and-charcoal shake. He liked that. They said poison control told them he should be observed for a few hours and if his vital signs were good then we could go home. Okay, great. They were all very nice. Then the timing kept getting moved up. One nurse would come in and say: “You should be out of here by 8pm.” Thirty minutes later a new nurse would come in: “We’re looking at 10pm.” An hour later the attending came in: “Maybe midnight.” Someone new, later: “We’re going to admit you for an overnight observation.” Nobody really seemed to be aware of the information that anyone else had about anything. There was just no lateral communication between people or groups.
They eventually said the additional time was partly because his heart rate seemed to drop just a few bpm too much when he was asleep, although none of them really seemed all that worried about that, either, and that wasn’t even an indicator of the pill he had munched, so it wasn’t immediately obvious why those decisions were getting made.
We got admitted and sent up to a private room in the pediatric ward. At this point I’m pretty nervous although everything really was fine. The doctor making the rounds up there was warmly sympathetic and very proactively reassured me that there was nothing at all wrong, that he was fine, it was just for observation’s sake and we’d go home first thing in the morning. That was nice although I really wasn’t sure why we were staying overnight if that was the case. Around 10:30 he was having lots of trouble sleeping so I just asked the doctor if we could go home. She immediately said it was fine. We were home by after midnight. The sum total of it felt like a profound and chaotic overuse of nine hours. I get that it’s better to be safe than sorry. I get it. Still, I was impressed by both the sort of opaque uncertainty in which they all seemed to be operating, as well as the lack of consistency between the front-facing workers themselves. On the ground floor they said we had to stay overnight; a few floors up and the doctor said we did not.
We subsequently received two bills for the services rendered. This is how hospitals in the U.S. work: There are like multiple business entities operating in individual hospitals, you don’t know who’s doing what, and they all want to bill you. The total cost of the bills came to around $4000, a rate of over $450 per hour. It seems like there should be an easier, cheaper way to monitor a child in a non-critical context for an afternoon and evening—like, I don’t know, a purpose-built facility separate from a larger expensive hospital environment, one that can provide non-lifesaving medical treatment without charging you five Gs for it. We could call it an “urgent care” center, or something like that.The BRAT diet is kind of a folk myth. Whenever I got a barf bug as a child, I followed the BRAT diet. So did Mrs. Morris the Elder. The proposal is simple: You feed a barfing kid—or one recovering from a barf bug—bananas, rice, applesauce and toast until their stomach returns to something resembling normal. The idea is to satiate them with bland foods that provide some nutrient inflow without overwhelming their shriveled, ruined guts all over again. For years we’ve done that for our children. But it turns out it’s kind of a myth.
To be sure it makes sense on its face: When you have a barf bug, the thought of anything rich or flavorful is just unbearable, absolutely nightmarish. You don’t want smoked brisket, you want dry toast. Seems like a slam-dunk proposal. But the truth is actually a lot more quotidian and boring than that: You really just kinda want to feed them normal stuff after they get sick. Nothing crazy but nothing radically spartan either. WebMD’s advice is emblematic of this new wisdom: the BRAT diet “lacks enough nutrition to help a child's gastrointestinal tract recover,” and most doctors now recommend that “kids resume eating a normal, well-balanced diet appropriate for their age within 24 hours of getting sick,” including “fruits, vegetables, meat, yogurt, and complex carbohydrates.”
Again, this kind of plan isn’t immediately intuitive. You really can understand why something like the BRAT diet started and gained traction. But it doesn’t make a whole lot of sense on its face. Lots of things are like this. Consider the bizarre oldtime dictum that you should “feed a cold” but “starve a fever.” Of course you should never do the latter: Quite obviously one of the worst things you could do for someone who is ill is starve them. Likewise it’s not really a great idea to give someone empty calories and carbohydrates after they’ve vomited up all the nutrients they would have normally been absorbing.Parents: Use Reddit, not Google. Google was once a fantastic collator of the best things the Internet had to offer. Now it’s a cesspool of sponsored content and boring, standard-ass Top 125 websites that all say the exact same things. If you’re a parent and you’re searching for some answers to your medical questions, well, you should probably first talk to the doctor to whom you pay money for just these sorts of things. But if you’re going to go digging on the Internet, don’t use Google. Use Reddit.
You know why? Because Reddit at its best is basically the Internet at its finest: pure information, undiluted exchange. It’s full of people just sharing the stuff they know. When it comes to kids and illness, there are a ton of parents sharing information on Reddit. And many of them are actually very helpful. I know these days we’re all supposed to view the Internet through this jaded sort of semi-ironic lens of contempt, like nothing good ever happens on here. But actually there’s a lot of good stuff out there, useful knowledge from good people who are motivated by nothing more than a sincere desire to share useful knowledge with other people. It’s refreshing. I’m not saying there’s not the standard sort of social media-style sniping and snarling and infighting on Reddit. But on the forums that matter—the technical/vocational forums, the cooking forums, the creative forums, and yes, the parenting forums—the ratio of stupid social media stuff to useful information is often considerably more favorable than it is on just about any other website.
In this case, can Reddit take the place of an actual medical official in a dire time of need? No. But it can help you to contextualize what may or may not be happening when your child is sick. For instance: If about 95% of Reddit parents are saying, “Oh, 104º fever isn’t terrible so long as they’re not seriously debilitated by it, if you go to the emergency room they’ll just send you home, that’s what happened to us,” well, that’s useful information to have. It never hurts to have more useful information. There’s lots of it to be found on Reddit, more than you would think.It’s just a whole lot harder when it’s your kid. Parents, you know this. It’s hard stuff when it’s your kid. When someone else’s kid is laid up with it, it’s far, far easier to recognize that it’s not a big deal. When your kid has it, meanwhile, it’s painful and frightening. There’s a reason for that, and to be fair it’s a good reason. You’re hard-wired to respond that way. It’s a good thing. It’s also worth remembering that much of the response you’re feeling might be the sort of thing that’s sort of supra-rational—it’s an instinctual thing, guided by feelings rather than coherent thought. Again, that’s not bad. But it’s worth reminding yourself to stop, take a moment, breathe, and look at stuff like this through in a rational light. Take care of your child, make sure he’s healthy or on the road to health, and seek emergency care for him when necessary, but don’t panic. In most cases there’s no need to panic. In most cases, even after a month of awful hardships, everything will be just fine.
Notes from a month of illnesses
This is such a sensible and heartening post! Bravo for your honesty, rationality, tender (if sometimes understandably anxious) concern for your family, and for reminding us that, in the end, in most cases 'everything will be just fine.'