Wednesday, February 6, 2013

CAT SCRATCH FEVER

 Everyone's heard of it,  but who knows someone actually treated for it??  Well,  I can now say that I do!!  I have been a nurse for 18+ years and had NEVER known anyone that had or had been treated for Cat Scratch Fever.  That's where we start our story:

Right after Christmas,  our 8 year old came to me complaining of her armpit hurting.  I kinda looked at her funny and she proceeded to explain to me that it DOES hurt because of the lump under her arm.  LUMP??? Well, of course that got my attention.  I checked her out and YES,  a lump about the size of a pea was present.  Being the nurse that I am,  I assumed a swollen lymph node since she had just gotten over some sickenss!!  So,  the watching stage began.

She continued to complain about the pain and a couple days later,  I checked the lump again and it is now the size of a large gumball.  Time to seek a MD opinion,

Friday Jan 4 - Off to the pediatricians we go.  My initial diagnosis was correct,  a swollen lymph node caused by Cat Scratch Fever.  WHAT????  I know I looked rather perplexed when he told us.  I was okay until he started talking about the bacteria getting into her blood stream and liver. Of course,  he also prefaced that with ,"she's young and healthy, so we don't expect that to happen".  Well,  I wouldn't have expected her to have Cat Scratch Fever either!!!  Again,  being a nurse can be a blessing and a curse!!!  I knew how bad a systemic blood infection could be.  Of course we DIDN'T want that to happen.  ROUND ONE of antibiotics ordered and started!!

My first reaction was,  "THERE'S A COUPLE OF KITTENS AT HOME THAT HAVE GOT TO GO!"  (the kittens are still here).
Here is my Princess girl and "the culprit".  Hard to believe such a cute little thing could cause such problems.  HUH???

After the first round of antibiotics (started on Friday - finished the following Wednesday),  we had not had the desired effect.  The pediatrician had told us that the lump might not go away,  BUT the pain and tenderness should.  WELL,  after round one,  the lump was still there as was the pain. After two days of no antibiotics,  the lump got larger (about the size of a golf ball) and red.  Plus,  it was even more painful.  So, Friday morning, January 11, we're off to the pediatrician's office AGAIN!!!

This time,  there's a little more concern on the pediatrician's face.  The antibiotics not only didn't work,  but now things are worse.  This time,  we are sent for blood work,  and a stronger more generalized antibiotic to cover WHATEVER might be going on.  He also told me to watch the lump carefully and give a call back on Monday.  If there isn't significant improvement over the three days of antibiotics,  he was calling a surgeon.  

Monday morning (Jan, 14) - The lump is still the same.  Plus,  now we have abdominal pain and a strange rash!!  Of course I called first thing that morning.  He referred us to a pediatric surgeon and got us an appointment for Thursday the same week. He thought the rash and possibly the stomach pain was a side effect of the medication.  He told us to continue to take it if she could handle it.  She couldn't seem to, so the medicine was stopped after the morning dose. 

By Tuesday afternoon, she was miserable.  I got 8 calls at work because she was lying on the couch crying from the pain in her stomach.   I called the Pediatrician's office and they got her in to be seen that evening.  The concern - possible liver involvement causing the pain and the petechial rash.  Fortunately,  they ruled that out at the office.  The did some blood work and checked her tummy out,  and decided it wasn't her liver.  Question was,  what then???  Maybe just a virus.  

Thursday (Jan, 17) - We're off to see the surgeon and get his opinion.  Finally some good news, an abscessed lymph node, most likely caused by the Cat Scratch Fever.  The antibiotics had kept the infection from spreading,  but anytime she was without the antibiotics,  the abscess would cause problems.  Bad news - it would require surgery to fix!! In his words,  "the sooner, the better".  Oh,  and while they're in there,  they'll just go ahead and biopsy things, "just to be sure".   He wanted to do the procedure the next day, but his schedule would not allow it.  The next available date was Friday Jan 25,  so more antibiotics as well.  He was super sweet to her and explained things very well,  but when he left,  the tears started.  She was scared.  

Waiting and praying,  waiting and praying.  For an entire week,  we had multiple people praying for her.  Praying that she would be brave and not scared,  and praying that the biopsy would be negative.  Praying that the surgery would fix the problems she had been having. 

Thursday night - Checked the lump under her arm and it was still there about the size of a gumball and very painful.  Again we prayed and put her to bed.

Friday morning - Up early and heading to the surgery center.  We had to be there at 7:30am.  Being that I am not a morning person,  we were up and out,  but I never once thought to check under her arm.  We were called back, they got her vitals, checked her in,  I signed the consent, the anesthesiologist had been in , and the resident was there to check on her.  They were ready to take her back to the OR, 


when the actual surgeon came out to do the right site/right patient check.  He felt around under her arm and asked me to show him again where the lump was,  he couldn't feel it.  I went over to check and sure enough,  NO LUMP.  NOTHING!!!  NOT EVEN ANY TENDERNESS!!  WELL,  "PRAISE THE LORD".   The lump was gone.  In a room full of medical professionals (me included)  God showed us His healing power!!  The surgery was cancelled and the surgeon himself said, "What we have here is a miracle."  

We didn't pray for the lump to disappear.  We figured the surgery was inevitable.  Oh we of little faith.  I'm so thankful God had a bigger plan!!  We simply asked for things to go well,  God said I'll just take the lump away.  Showed me how little faith I had.  I had placed my faith in the hands of the pediatrician and surgeon when it should have been in God who held it all in His hands the whole time.  

Takes me to the little song we teach to our children:
                He's able, He's able,  I know He's able
                I know my Lord is able to carry me through.
                He's able, He's able,  I know He's able
                I know my Lord is able to carry  me through.

               He healed the broken hearted
               and set the captives free.
               He made the lame to walk again
               and He caused the blind to see.

               He's able, He's able, I know He's able
               I know my Lord is able to carry me through.

We sing it,  but how often do we believe it, ask it, and live it????  I have to admit,  I failed, but God didn't!!   SO THANKFUL!!!!

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