Month: August 2009

There is a Neve in New Orleans
And another in Timbuctoo
But there is no Neve in this wide world
That we love as much as you.

(Buckets available on application)

No, this is Annie’s bed. Oh; who’s Annie. I think he’s the snanky whos
lives at the same door.

Is Neve going to be left handed? She seems greatly to favour using her
left hand, almost to the point of exclusion of the right. When she’s
practising her Karate moves, it’s always the left that is slicing the
air in front of her eyes. And when little cat gets one on the nose, it’s
always Neve’s fast left hand that delivers.

Unfortunately. We’ve all had a 36-hour bug that the NHS (via the pandemic flu website) decided it would be appropriate to take Tamiflu for (we declined). Lola first, with a one-day fever of 39 and no other symptoms she could vocalise, followed by Isa on Wednesday, who added a sore throat and true-flu aches and pains, and your humble author the day after who threw a horrid headache into the mix.

Then, at about 2 am on Friday, Neve’s temperature started going up and she entered a three-hour crying spell after which she assumed a calmer, unusually torpid, mode and maintained a fever between 37.5 and 38. Which calm statement belies the fraught nature of the experience. Isa was extremely worried, especially with regard to the bulging fontanelle, which is potentially a sign of meningitis. We rang NHS Direct; they said we’ll call you back — give us eight hours. “Does that imply you think we need take no immediate action?” “Sorry, I can’t offer an opinion on that.”

Super. By now it was 5:30 and Neve, though still with a fever, seemed happier. We elected to extract some solace from this and the fact that the NHS Direct conversation hadn’t triggered any immediate “Take her to hospital!” response and wait until our local surgery opened so we could speak to the doctor there.

We rang the surgery when it opened, and the receptionist referred us to the NHS Pandemic Flu service, who referred us back to our GP, where the receptionist apologised for misdirecting us and said she’d talk to the doctor and get back to us. Meanwhile, an NHS Direct nurse rang back and recommended that, due to her being only 3 months old, we should take her to A&E.

Which we did and let the various helpful nurses triage her then send us up to the paediatric day ward where we saw a doctor who, essentially, gave Neve a thorough-looking examination and declared her to have no complications and recommended they kept an eye on her for a few hours.

So we hung out in a room off the day ward and they stuck a sign on the door saying we were infectious and left us alone. Four hours later, we decided we might as well monitor her at home as her temperature, though high, was under 38 and she seemed otherwise happy. The hospital was only five minutes away in the car, and it wasn’t like they had a close eye on her…

So I went to get the car and Isa told the nurses we were going to toddle off. That woke them up. Half an hour later and I’d parked the car again and was back in the day ward where a small but powerful vortex of outraged opinion had formed. A senior registrar had been called, Neve’s temperature had tickled the 38C trigger, and she was outraged that we would want to remove Neve from their care given the potential risks. Isa was outraged at the inconsistent messages we had been given and the woeful lack of communication between staff and patients, and staff and staff. Steely blades of will clashed; at climax, the registrar claimed that yes, actually, she *could* keep Neve against our will.

I backed up Isa’s outrage and then helped forge a compromise where we agreed to let them run blood tests on Neve to look for indicators of infection and that she (and Isa) would stay in overnight so Neve could be kept under observation. They reluctantly agreed *not* to pump Neve full of antibiotics (“but, if her temperature rises over 38C, we *will*”) or Tamifluâ„¢

If I’d been more with it, I’d have realised how utterly exhausted and frayed Isa was at this point and taken Neve to get the bloods done on my own. But I wasn’t, and the nurse’s various attempts to locate a point to insert a cannula while Neve cried were more than Isa could take and she walked off with Neve insisting that they were going home.

Well, when the shock dissipated, we agreed I’d go with Neve to do the blood. That done, Lola and I went to the Haelan Centre and then home to get some bits and pieces for Isa and Neve. Lola, I should mention, was fantastic all day, quite enjoying the hospital with its corridors, doors, siderooms, nurses, toys, books and the cafe. She was a bit less keen, once we’d returned to the hospital with an overnight bag, actually to leave her mother and sister for the night but a bit of discussion as to why they were staying and how we’d soon be back to see them in the morning and she left quite happily.

That night, after Lola was asleep, I sat up and read the NICE Guidelines for Feverish Illness in Children. I wish I’d done that earlier as it gave me a much better perspective on Neve’s symptoms and their appropriate management. I ended up glad she was being monitored in hospital but upset at the way Neve’s case was initially handled, at the poor communication (both inter-staff and between staff and parents), and at the lack of credence given to our own description of Neve’s symptoms (particualarly her high temperature).

Well, all’s well that ends well and Neve passed the night without incident and the registrar was happy to let her go in the afternoon. I think letting slip that I’d read the NICE guidelines helped convince her that we had some clue; as ever, it provoked the ‘who do you work for’ question.

As an addendum (yes, these paragraphs are getting shorter as I tire of writing this), the BMJ was in the news the next day for publishing a study that suggested that Tamifluâ„¢ should not be given to children. Which made us go, “Ha!”.