Kawasaki

It started off with fever. One morning I woke up and felt Keston feverish. His temperature was over 38 deg. I was reluctant to give him any paracetamol at first cos I've read some articles which discouraged dosing paracetamol. Anyways, after a day or so, I relented as watering and sponging him did not bring down the fever at all. He was slightly cranky but pretty much ate, drank and played as normal.

After a day or 2 of paracetamol, the fever was still high....higher in fact. And he started developing a couple of red rash on his chest and face, which we thought were mozzie bites.

The next day, Keston did not drink much milk for his morning feed and his fever shot up to over 40 degrees. That's when we pressed the panic buton. Rushed down to KKH and being a Tuesday morning, the A&E was virtually deserted. Probably also partly because of his high fever, Keston got to see a doctor immediately. By then, his chest and stomache had developed a full rash and the area above his eyes were red. His hands and feet were also reddish and cold. We did a blood test and collected urine sample. (Interesting point: How on earth do you collect urine samples for a baby? They stick this plastic bag thingumy over his penis inside the diaper and you have to constantly check to see if there's any pee in the bag.) In the time we were waiting for the test results, the rash had spread down his thighs....and his hands became redder still.

The doctor suspected Urinary Tract Infection from the urine test, but that further tests would have to be done to be conclusive. During admission, I even told HW how mafan UTI is and hope it's not UTI. Thankfully we got a 1-bedder immediately, and back in our old ward. By this time Keston was super cranky and whiney. His rashes had gotten worse and his eyes were red and swollen. His face, hands and feet were puffy and did not look like him at all! This time we had to collect 2 fresh urine samples. Fresh meaning he has to pee straight into the collection bottle and not that plastic bag thingy. It was no mean feat but HW stood by opening and closing K's diaper every few seconds, armed with the sample bottle. He got the 2 samples fairly quickly.

Afternoon came and more doctors came. They eliminated the possibility of UTI based on the new urine samples, and suspected Kawasaki Disease instead. That's when I started going "Oh please let it be UTI, not Kawasaki!" I'd heard vaguely of Kawasaki a few months back during one of those random surfings I like to do. I did not know (still don't actually) anything about it, except that it is strange, elusive and dangerous. In comparisson, UTI sounded pretty ok!

Keston would have to be put on drip again as he's gotta have antibiotics and also cos he's refusing ALL food, ALL milk. This is very very painful cos they always have to poke him several times before finding a vein and we have to stand outside the door hearing him scream and cry. With the puffiness of his limbs, this task would be even harder. As expected, the first Dr did not manage to locate a vein.....so a more senior Dr was called upon. The 2nd Dr, took a fairly short time and confidently told me "It's difficult but we manged to locate a vein". Keston emerged with a splint to his foot. Come night time, his foot had swelled into a pig trotter! That's when we realise the plug was not installed properly and all the drip was pumped into dunno what part of his body. They quickly removed it and prepared another insertion. This time the plug was inserted into his right hand. The whole day, Keston had only energy for crying and whining. He hardly moved and never smiled. You could put the rail guards of the cot down and he wouldn't even try to roll, crawl or move. His fever was still consistent in the range of 39-40+ degrees. Sponging him and making him sleep on a coolmat did not help. Even after paracetamol, the fever never went down....well, it did....but to a 38+ range which is still a fever.

Wednesday, we were still waiting for the Culture test and Blood test results to be in. Our senior consultant came in to explain about Kawasaki. See? It's so elusive that after yonks of reading and explanations, I still don't quite get it. Anyway, Keston was to be observed for another 24 hours to see if his fever would go down. He would be given high dosage of Aspirin and if his fever did subside, then it probably isn't Kawasaki. We were not so lucky, his fever was still consistently high despite the regular meds, baths and water parade. Keston's face became so swollen and his eyes were small and bloody. He was almost beyond recognition. On my part, I did read up on the symptoms of Kawasaki and Keston pretty much displayed 90% of the symptoms.

Thursday, the Consultant advised us to start on the Intravenous immune globulin (IVIG) treatment. As this is a form of blood transfusion, there were certain risks involved. Although we were assured the risks would be minimal since the blood donors were screened very carefully, I could not help but worry.....especially as I had to sign the bloody consent form! It's like if anything happened, it would be my fault cos I consented to it!!!

The IVIG was administered through the drip along with Aspirin. He was wired up to the Electrocardiography machine to check if he'd have any adverse reaction. The poor baby was wired up everywhere. One hand to the drip, 1 leg to a blood pressure pump, another foot to some other test....and 3 electrodes on his body. He was super uncomfortable to look at. He had only his left hand available and he really didn't have much energy to move it anyway. This was to go on for 12hrs. Thankfully (in a way), he was so weak that he was groggy all the time...so aside from whining and crying, he did fall asleep pretty quickly and pretty often.

By evening time, he really looked much better! Most of the rashes on his face had cleared and the puffiness had cleared abit so his eyes were abit wider. He could smile a little. The fever was still there, which was abit worrying.

The IVIG was completed around 1am and the ECG and stuff were removed an hour later. Keston finally got to sleep at around 2am...but was awakened at 3am by a nurse coming in to take some measurements/readings. After that was done and he fell asleep again...I was awakened at around 4am by his persistent crying...somehow the plug had come loose and the drip was flooding his bed. His hand was swelling up. Sigh~ Back to finding a new vein to insert the plug. Thank God it didn't take too long and I was able to put him back to bed at around 4.30am. Then he was awakened at 7.30am again for aspirin. Sigh~ Not enough sleep (both Keston and I)!

On a positive note, Keston did not have any bad reaction to the IVIG. And his fever went down after the IVIG was completed. As of now, 12 hours later, he still does not have a fever. His fever has to stay down for the next 24 hours, or....I can't remember or what. But let's just pray his fever will not come back for awhile. After which, the dosage of aspirin will be lowered and he should hopefully be discharged on Sunday.

On a negative note, we'll never have an all-clear from the disease. It may relapse anytime. We have to come back in a week's time to do tests on his heart...and another one in 3 months' time. In the meantime he will have to be on aspirin daily...until the cows come home.

Please keep Keston in your prayers. Pray for his full recovery and that he won't develop any heart conditions. Thank you from the bottom of my heart.