BUMP IN THE NIGHT

A picture of the little trickster the day after our ER visit – looking not very sick at all!

A few months ago, I had an incident that happened where, really, all my medical knowledge went out the window, and I ruminated in my concerns as a worried parent.  Maybe this happened because our newest addition to the family “B” is likely our last baby, and I am worried more about anything that might happen to him.

A few weeks after he turned one year old, I was changing his diaper and noticed a bulge in his left inguinal area. It seemed tender to touch, and I immediately called my husband to come look – I told him it looked like an inguinal hernia.  It was soft, and B wasn’t overly fussy, so I put a new diaper on him and decided I would monitor it as the day went on.   It was of course on a weekend, but I decided first thing Monday I would schedule an appointment with a urologist.

As the day went on, I noticed B was fussier than usual and was not eating as well either.  I became increasingly worried about him, and the bulge was large on his left side and looked blueish in color.  I searched online for signs of an incarcerated or strangulated inguinal hernia, and all the symptoms matched what he had.  I ticked off all the symptoms from the Mayo Clinic website:

Nausea, vomiting or both – His appetite has been down all day and the day before.  Maybe because he felt nauseous??

Fever – He DID have a fever the day before and the day before that. I had thought it was after his 12 month shots, but could it actually be related to a hernia??

Sudden pain – When I changed his diaper again and I lightly touched the bulge, he winced and pulled away – is it because it is so painful??

A hernia bulge that turns red, purple or dark – It looks blue on top of the area that has the bulge!!

Inability to move your bowels or pass gas – When was the last time he pooped?  It wasn’t today…did he even poop yesterday??

The more I read about it, the more I was sure B had an inguinal hernia – and that it was likely incarcerated.  I spent most of the day staring at B and looking for any sign to confirm my suspicion and trying to find more information online about whether my suspicion was correct.  I could not focus on anything else during the day.  The toys I had just cleaned up, the girls now had quite literally thrown in the air and the room was a disaster again, but I was too distracted by B’s symptoms to care.

The evening approached and I finally told my husband that we needed to take B to the emergency room.  I mentally prepared myself for a long night and possibly overnight stay, since, if my suspicion was confirmed, B would need surgery right away.

We waited for hours in the waiting room, where B suddenly was happy as can be, crawling all over my husband and me, talking and laughing, waving to other people around us.  Was I crazy for being here?  But at this point we had waited for hours; I had to finish it out and put my mind at ease.

We finally went back to a room, first to get B’s vital signs which were all perfect, and again, he was chatty and smiling with the staff, and I started thinking in my head, “what am I thinking??” Babies in pain do not act like this!

When we went into a room, a resident came in to get the history, and I explained the bulge I found today, the fever the past 2 days, the shots he had had before, the poor appetite and fussiness. But B was making me look like a fool as he sat there quietly watching me talk. The resident left, and I sat waiting with my silly baby boy.  I looked him in the eye and said, “B, seriously? Are you kidding me?”

Soon the attending ER doctor came in and I briefly repeated my story and concern as I undressed B down.  I was getting to the part about the fever when I saw a rash all over his body. “This rash was not here before.” I told the doctor.  “Roseola, maybe?”  He agreed.  Then I uncovered his diaper area and pointed out the bulge, which suddenly looked smaller and a lot less blue.  The doctor looked and said, “Oh, those are lymph nodes”.  I stared and said, baffled, “I am so embarrassed, I am a general pediatrician, and I should know that.”  The doctor was INCREDIBLY patient and kind and just continued.  He examined B’s lower half of his body looking for a source for the enlarged lymph nodes. “Does he have a diaper rash?” the doctor asked. “No,” I replied. “When did you say he got his shots again?” he asked.  I told him last week. “Where were the shots?” he asked.  

“In his thighs.”  

Right by the lymph nodes that appropriately reacted to the vaccines.

If ever there was a smack my head moment, this was it.  Everything suddenly clicked.

I was so entrenched in my worries and had convinced myself of the symptoms, that I could not look at it objectively.  I was a worried parent.  

And you know what?  That’s okay.  My job as a parent is to worry about my child and advocate for him if I think there is something wrong.  And I knew if I continued to ruminate at home, I would not get closure, and I would have still worried about B that I would not be able to eat or sleep that night, wondering if he was okay.

Now I will say, as a pediatrician, my job is to be more objective.  I have no doubt that if I saw a patient with the exact same symptoms, I would have recognized that the bulge I saw was a lymph node and not a hernia.  

So, even as a pediatrician, I worry about my children and sometimes (fine, often) disproportionately to the actual problem.  As a parent, I am just advocating for my child’s well being.  So to the parents out there, do not be apologetic when you want to make sure your little one is okay by having the doctor examine them.  We both know you’ll sleep better at night if someone else takes a look.  And that night, I slept great.

Medical Mommy Musings:

  1. As a parent, I am the best advocate for my child. It is okay to push for an evaluation if I am worried about my child.
  2. Try not to Google diagnoses or symptoms.  Okay, fine, it is hard to resist, but I need to remember to look at the whole picture when I’m thinking about my child.
  3. When in doubt, get them checked out! I would not have been able to sleep that night if I didn’t know for sure what was going with my son.  And I probably would have continued to see concerning symptoms to support my suspicions. Having someone else lay eyes on him put my mind at ease.

Leave a Reply

Your email address will not be published. Required fields are marked *

Follow by Email
Instagram
error: Content is protected !!