June 24, 2015 "ER"

Rayden was not really himself today. He practically slept all day and wanted me to hold him. When I sat him up he would scream. He has been spitting up his milk pretty bad too. I thought he had a belly ache because we stopped warming his bottles yesterday. Then I noticed he had a fever of 100.7 around 12:30. Thinking it was probably just teething, I gave him tylenol and waited two hours to see if it would go down. At 3:00 it was still 100.5. Rayden's pediatrician was out of town so we were told to just go to the ER. By the time Michael got home at 5:00 his fever was up to 101.5 and I noticed his fontanelle was full. I couldn't feel the bones around his soft spot, and the veins in his head were darker. It was definitely time to go to the ER. On the way there Rayden continued to throw up and his fontanelle was getting higher! I couldn't believe something was wrong with his shunt again!!! Why does this keep happening?

We arrived at the UNC ER around 7:00pm. They looked for signs of infection by doing a urine culture (catheter) and blood work. They also examined the shunt by doing a MRI and XRay. Around 11:00 pm the pediatric neurologist on call reported that the urine came back clean, MRI and XRay showed the shunt was working fine, but his blood work showed that his white count had TRIPLED!!! There was obviously a huge problem somewhere. In order to see if the infection was in the cerebral spinal fluid (CSF) he needed to tap the shunt. (kinda like a spinal tap) Rayden was so agitated that he asked me to suit up and stay in the room while he completed the tap. He made the room as sterile as possible and we got started.

He inserted a small butterfly needle into the shunt reservoir. CSF started flowing into the manometer (a tall test tube looking instrument that uses liquid to measure pressure). The more agitated Rayden would get, the more fluid shot up the manometer. The neurologist asked me to give Rayden some pedialyte to calm him down long enough to draw about 12 ml. of fluid. When he got finished, around 2:00 am, he stated that they were going to admit Rayden into the hospital for observation at least until the culture came back.