Tuesday, August 7, 2012

A.'s allergic reaction to amoxicillin

I got a reminder in the mail that A. needs to go for his yearly allergy check up. Which reminded me that I've never told the story about when A. had a life threatening allergic reaction to amoxicillin. So here goes...

I mentioned a long time ago that A. had a deathly allergic reaction to amoxicillin right after he turned 2. As melodramatic as it may sound, I haven't wrote about it until now because I'm still very upset about it. It was by far the scariest day of my entire life. I have never been that scared or shaken to the very depths of my soul. Thinking about him being in the ER still sends my stomach for a loop and rattles my nerves. But I think it's important to retell the story if only for my own piece of mind to put it out of my mind. Be warned, this is long and has pictures...

It all began when A. came down with a cold that October. He was given a course of amoxicillin for a cough that just wouldn't go away and it seemed to help a bit. But by the end of December he still seemed to have a cough some nights that he just couldn't shake. So I brought him in and he was given another course of amoxicillin. This was by the way, the third time he had had amoxicillin, the first when he was very young for a urinary tract infection.

He was on day seven of ten of the amoxicillin when I noticed that morning that he seemed to have a diaper rash, but it was at the top of the diaper where the band is. I thought this was odd but kept an eye on it. At the next diaper change I noticed it had crawled up to his belly. I called my mom who said to call the doctor. The doctor couldn't see him so he suggested we bring him into urgent care.
By the time I brought him to urgent care, within the hour, A. had big red hives all over his belly. The doctor explained that A. had had a mild reaction to amoxicillin but he should be fine, granted as long as he didn't run a fever or the rash changed colors or shape. They sent us home with a dose of steroids and told us to give him benadryl. We gave him a bath in oatmeal and covered him in anti-itch lotion.

The next morning A. started to have a fever, a low one, 101.1 but still a fever. We called his doctor and we went in right away. His doctor said it was still fine and suspected that A. still had the infection from the cough and gave us a new antibiotic, zithromax. He said as long as A.'s hives didn't get worse or he started to swell up, he would be fine. So we went home again and settled in for the night.

That night A. was restless and slept poorly. I spent most of the night rocking him and gave him a dose of ibuprofen at midnight to keep his fever down. A. finally fell asleep but woke up around 5am crying. The kind of cry that makes your heart beat so fast it feels like it's going to explode out of your chest. The Husband had left for work already so I ran into his room. I picked him up and noticed he was red hot and slightly puffy on his fingers. He had a fever of 103.7 and his hives had started to turn purple in the centers. I called his doctor and was told to give him another dose of ibuprofen and wait a bit to see if his fever went down.

I decided to trust that advice despite my instinct otherwise. I should have listened to my mom instinct. I should have brought him then. I still feel immense guilt. Instead I called my mom who came over. She got there around 6am and she suggested we give A. a luke warm bath, to see if we could comfort him. A. bawled. I wrapped him in the towel and rocked him for the next two hours. I called his doctor again but was put on hold. I decided that I didn't care what the doctor said and my mother and I got A. dressed and drove to the ER. I have never felt so much panic in my entire life. The drive to the ER which takes 4 minutes from our house felt like it took four hours. I was shaking by the time we got there.

A. was brought back to the ER instantly. I learned that nothing gets you into the ER faster than a bright pink, swollen and crying toddler. The next hour is a blur of having to restrain A. along with four nurses for blood tests, putting in an IV and retelling what had happened the days before.

I kept reassuring myself that everything was fine, they could get this under control and it was all okay. I believed this until the moment when I overheard on the hospital communication system the alert going off for a possible pediatric administration. I heard the nurses outside the room ask if the heli-pad was ready and had someone informed the local children's hospital. I began silently sobbing.

The thought still brings tears to my eyes. It became real at that moment how serous it was. The Husband, who I had left messages at work for, showed up shortly after that. I will always remember the pure fear I saw in his eyes when he came into that room. My in-laws and sister-in-law showed up shortly after that.

The doctor in the ER decided that A. had to be admitted to the peds floor at the least  to be observed to assure that the swelling didn't close off his airway but they had stopped the swelling just in time. They believed it was a life threatening allergic reaction to the amoxicillin and prepared us that if things became any worse or didn't become better within the next few hours, they would need to air lift A. to the children's hospital 45 minutes away. I remember feeling like I could vomit.

Before we were transferred up to the children's floor all of the ER doctors came into the room to examine A. and his back. My sister-in-law thought to take a picture of his back. I warn you, even as his mother, it makes my stomach turn.

Now, in case someone runs across this by a random search for children with life threatening allergic reactions to amoxicillin, this was A.'s back an hour after two oral doses from the days before and an IV dose of steroids in the ER. The picture actually dulls the color because in real life it looked like we had colored him with a pink highlighter. As you can see, A. presented with raised bright pink splotches with dark purple in the inside of many of them. The pink splotches covered his entire little body. The nurses and doctors were all perplexed by his spots. His allergist he sees who is one of a hand full of allergist on our side of the state who specializes in very young children with life threatening allergies said his hives where the worst reaction she has seen in her entire practice, ever.

By the time we got up to the peds floor, A. was exhausted and asleep from screaming and crying. I felt drunk. The Husband looked like he had aged 10 years in an hour.

Eventually we got settled into his room and after explaining the story, again, to the doctor on the floor and the nurses who came in to stare at his hives, we got something to eat and settled in.

The next few days were blurs or crying, toddler rage fueled by massive steroids and disapproving looks from nurses who didn't like that I was co-sleeping with A. I even had to sign a waiver releasing the hospital in case A. fell out of the bed. I signed it with no problem. I understand logically and legally why I made them nervous. They like children in those cribs. But A. bawled when I put him in it. He and I slept better together.

He had many visitors and got to watch lots of TV. I think out of everyone, he took and handled it the best.

Every day they ran more tests. The pictures above are on the 2nd or 3rd day of his 5 day stay. You can see what looks like dark bruising or birth marks on his thighs. By the 3rd day the swelling and redness had went away only to leave horrible purple marks.

By the 4th day they took his IV out and had him on oral doses of everything. They had a little car he would zoom around the halls. He was rather upset when I told him it had to stay there.

The little gowns they had him wear, green trim with tigers on them, annoyed him. They were scratchy he complained, but erm, liquid IV drugs do yucky things to bowel systems so I kept him in them. I'm sorry to the nurses who had to help me a few times clean him up.

Nurses really and truly rock. The hospital as a whole was very nice. They made special food for A. and made sure that they had snacks he liked, cheese sticks, crackers, yogurts, popsicle and apple juice always stocked up in the little fridge families have access too. They also made sure that I got to pick out a meal on top of A.'s meal. I know it seems dumb or silly to be thankful for something I know I was billed for anyways, but the simple fact of not having to worry about my meals made a huge difference.

I just felt bad for everyone else. Everyone else still had to go to work. I didn't. I couldn't. I know that I could have left him at the hospital and went to work but I was working at Target. Target.

Every day after work The Husband would come and snuggle with A. while I would run home and take a shower or run a quick errand.

In the end, A. was discharged on day 5 and was told that he should never be given amoxicillin, penicillin or any antibiotics.

His allergist feels his body doesn't know what to do with antibiotics. She was even more highly concerned that his reaction got worse, not better, with steroids. She reviewed his chart and was amazed at how much steroids they had had to use in order to get his body under control. She has found that with her patients who have had reactions similar to his, later have reactions to all other antibiotics. The idea that he shouldn't get sick was a startling one.  Eventually his allergist agreed he could take zithromax, due to some chemical compound reasoning I didn't follow, but only if absolutely necessary. He has had zithromaxonce since his reaction. He did fine.

In the end, he's fine. But at the time it was terrifying. I would never wish that kind of pain on anyone.


Selvi said...

This blog is good.

Lauren Hammond said...

Hello. I just read your story. My daughter will be 2.5 and a month before her first birthday she expirenced a severe allergic reaction like your son. It was the most horrific experience I have ever been through. As this is an older post, is there and words of advice or recommendations your could give for the future. Has he had any other reactions to anything since?

Thank you.

Jolene said...

Thank you for posting your story. It sounds eerily like what my husband and I went through this past weekend with our 16 month old. Luckily he didn't need to be admitted, but I was surprised, we had prepared ourselves for it. Your description of his rash, right down to the purple centers, is exactly like my son's. This was also the second time he had taken amoxicillin. The first time, nothing, second time, on day 7 he got that rash around his waist at the diaper and then what I first thought were bug bites on his legs and tummy. It very rapidly spread and got worse. Thank God both our babies are okay.