(I think I am missing a day or two...)
Today we had our final full day here, and what a day it was... Hubby went for a morning surf. Little M and I ate yogurt and granola for breakfast and began to clean up our apartment.
We went down and visited with Chica and the kids, and Ali and Kate for a while, and then hubby took Little M on a fantastic bike ride hunting for howler monkeys, swimming in two different pools, spotting termite nests in trees, checking the surf breaks... Those two have such incredible adventures together. I also had some really nice time just hanging with the girls, as their hubbies had gone on a day trip to get groceries and take BamBam back. I wish I could stay longer, they are a great pack.
In the evening, the gals held down the homefront as their hubbies were having some auto difficulties and could not return home. We had no more dinner supplies, so Hubby, Little M and myself decided to go out for dinner one last time. Little M seemed tired, but still wanted to go.
We arrived at the little sports bar, outdoor restaurant. We ordered pizza and a fish entre. Little M had a tummy issue, and then fell asleep, curled up on my lap before the food arrived. Hubby and I ate our dinner, having a nice chat about the close of our trip. Then when it was time to go and I went to pick her up, I noticed that she was burning up. No sweat, just burning up and her heart was racing. We got her to the car in to the air-conditioning. We made it back home, fully undressed her, put her in to an air-conditioned room, in bed and began packing up.
As we continued to check in on her, her temp continued to rise. Around 9pm, it just seemed not right. With Little M having had a febrile seizure in the past, I went to Chica to see if she had any fever meds to head it off at the pass. She gave me Children's Acetaminophen. I went back and administered it to Little M. Within minutes, she wanted to go to the bathroom. She threw up and continued throwing up. She broke down saying her arm and leg hurt, her head was so sore. We'd never seen her like that. Even when she was sick in the past, she was always such a trooper and so resilient, at worst, just falling asleep, even directly preceding her seizure and when she had pneumonia. Her strength has the ability to fool us in to thinking she is better than we find out she is and we've been mindful of that when issues come up with her. This time, what she was expressing was beyond what we'd seen of her before.
She was keeping nothing down. I knew I needed to lower her temperature. She and I climbed in the coolest shower a tropical shower will offer, and did my best to cool her head, neck, back. She cried inconsolably, saying she was too cold. "I just want my momma! I want to go home now. Can we go home now please? I want my momma!"... My heart leapt. Was she delusional? I was right there with her with her eyes open, but seeming to just look beyond. I just kept reassuring her.
The hours passed, with vomiting, diarrhea, fever diminishing, then going back up to 38.8'C armpit (internal temp of 39.3'C). Our concern was because the day was so incredibly hot and she had been
out and about quite a bit. Did she get enough hydration? Everyone was feeling the affects of the sun that day, but no one seemed to have any gastro issues etc.. She was incredibly hot, but still not sweating. Her temperature was measuring just below the 40'C mark, after
her temp began to drop (heat stroke is defined by a body temperature of
40'C or higher). All of her symptoms were symptoms of Heat Stroke,
which is beyond heat exhaustion. Unlike heat exhaustion, heat stroke
includes damage to the nervous system function and can cause organ
damage, or be fatal if untreated.
At around 3:30am, her fever started going back up quickly and she began
vomiting again. She couldn't keep anything down. When I gave her the
showers, or put cool cloths on her burning skin, she cried out "I'm too cold momma! Please stop! Please stop!". To that point in her life, I'd never heard her wail like that. My heart was in my throat. I told her to look at me. I asked her to
trust me, and she did. Fighting back tears and horrible discomfort on the
cold shower floor, wrapped in icy towels being drenched with cold
water, she just trembled and whimpered.
When her temperature hit 39'C again, I asked Hubby to talk to the property manager about where to go for help. He woke him as well as Chica, Kate and Ali. I think he woke everyone, but the kids. I was kind of miffed with him. Amidst my storm of thoughts, I didn't want to wake them again too. He responded that Chica would kick my ass if I didn't ask for help. She affirmed that when she came up. The three of them rallied around us and our little girl. Kate, the pharmacist, was checking meds and potential issues if it were heatstroke. Chica was just there reassuring, supporting. They brought Gatorade to replenish her electrolytes. Ali stayed with Chica's sleeping little ones.
Things were not getting better. Every time she drank sips of gatorade, she threw it up. Considering the potential for things to go really wrong if it were heat stroke, we decided it was time to go. We packed up, drenched Little M in cool water, brought a bag of ice to keep icing her, wet towels, gatorade, and we flew down the dirt roads in the 4am darkness, to the Roberto Clemente Health Clinic - the same small, local clinic I'd been to days before to stitch up my leg. We had also, coincidentally been there earlier in the day, to drop off school supplies to donate to the children. Hubby had chatted with the ambulance driver while we were there. We knew if things were really bad, we would be seeing him again to take us to Managua, hours away to the country's main hospital. We were becoming very familiar with this clinic. In between those moments that keep a mother doing what needs to be done in situations like this, I ached to just be home, but having this clinic here meant the world.
We pulled up and the glass door to darkened clinic opened as we unloaded from the car. The man went to get Dr. Flores, the same doctor who attended me. He came in to the florescent lit room shaking the heavy sleep from his mind. He looked and spoke to me as her momma, but I couldn't understand enough Spanish to get the technical stuff. Hubby took the reigns and Kate inserted concise questions including some meds she had brought with her.
Dr. Flores examined Little M. She seemingly began to perk up a bit. Dr. Flores deciphered it to be a gastrointestinal bug, rather than heatstroke. At the time, I really wished I could get more clarity as to why he thought it was a gastro bug, rather than heat stroke, so I could erase the urgency from my mind. He did not have a readable thermometer (only an old glass mercury thermometer, that he couldn't find the reading mark on), so that chunk of info was not apparent to him. He prescribed a suppository to help bring her fever down, and one other med. Very quickly she began to respond. We went to pay, but he insisted we just leave it, and to come back in the morning when things were a bit better to check in. He was incredibly kind.
The four of us returned as the new day found its light. As the sun rose, so too did Little M's spirit. We pulled up one last time, to the complex weary and exhausted. Hubby walked Kate back to Chica's and gave our huge thanks. I took Little M back up to our apartment. She was already feeling better though incredibly tired. She had just been through a relentless storm.
It is 7am now. Hubby is sleeping with Little M, keeping an eye on her and trying to get much needed sleep for our navigation back to Managua to start our journey home. I am packing up all our things, eager to just be in the comforts of our own home. I checked in with www.justanswer.com Pediatrics and got a
'second opinion' that validated the course of action we were put on. One symptom that did not fit with heat stroke was her diarrhea. Who knew diarrhea was so fantastic?...
We are so incredibly thankful Chica, Kate and Ali, for being right there with us getting no sleep to rally around our little girl, and us. They were a force of maternal strength that meant the world in those moments. We are also thankful (again) to the Roberto Clemente Clinica for their wonderful care and for being there 24/7 for all those who need it. It is a tiny clinic with a huge heart. Most of all, of course, we are thankful Little M is safe, and on the mend.
This trip has not been everything I was expecting (ha ha...). It's had some great ups and some bummers. But the bummers, in the days to come, will show their silver-lining. Five hours till we begin our journey home... "home..."
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