Influenza A

Quicksilver drank 150ml (about six ounces) of Gatorade, the kind with real sugar, at 7:15 a.m.

She was pretty perky until about 8:00 a.m. Then she started to wilt. Her temp was 102.1 F.

She turned up her nose at the Gatorade. SB keeps her on a short leash for sweets, so she readily guzzles sweet drinks. I was concerned about dehydration. She had not urinated for more than 12 hours.

She told me that her throat hurt. I gave her 160mg of acetaminophen (5ml or one teaspoon of suspension) at approximately 8:30 a.m. By weight, I could have given her 250 mg (8ml of suspension).

At 9:30 her temp was up to 103.3 and she refused to drink the Gatorade. Having her temperature rise that quickly was spooky. I called her family doctor and they had a time slot for 10:15. 

I informed Mrs ERJ and she magically found a popsicle.

I felt foolish as Quicksilver rallied on the way to the doctor. The popsicle was like magic.

She wilted again in the waiting room.

They used an IR contact-free thermometer in the exam room and she had a fever of 100. Again, I felt foolish. I guess it took the acetaminophen more than an hour to work its magic.

They took swabs. Fifteen minutes later the doctor came into the room. She was wearing a mask and rubber gloves. "Influenza, type A. The swab turned color instantly. No uncertainty. Oh, by the way, both of you already have it but don't have symptoms, yet."

The instructions include:

-Alternate ibuprofen and acetaminophen with dosing every three hours at the 7.5ml dose for each.

-Dehydration is a major concern. Pedialyte makes a popsicle that has electrolytes. Get some. Especially since popsicles seem to be the only fluid that QS is eagerly accepting.

-If O2 saturation drops below 92% for a pediatrics case, haul anatomy for the emergency room. If it drops into the 80s, call 9-1-1 (for peds cases). Those numbers are significantly higher than for adults.

--If breathing becomes labored (and the doctor lifted QS's nightshirt and showed us where her abdomen would go concave when she was laboring), head for the ER.

-Pay attention to her behaviors. In kids, behavior changes happen before objective symptoms like temps and O2 levels change. That aligns with what Reltney McFee writes on his blog,"Treat the patient, not numbers".

-Nebulizing with saline is OK. It moistens nasal passages and helps mucus flow. NO ALBUTEROL unless viral pneumonia is diagnosed or there is whistling suggesting closing air passages. Albuterol will increase heart-rate which is not helpful.

-She will eat when she feels like it. The important things are to keep her hydrated and comfortable and to take care of ourselves. Being over 50 (!!!) means that we are in a high-risk category and we already had a non-trivial exposure.

The good news is that Quicksilver needed to use the restroom while we were there. At 12-noon, she produced copious amounts of evidence that she was adequately hydrated, at least for the moment.