Petunia had a great day on Saturday. She was funny and playful, and on the go. She mastered the stairs on our little outdoor jungle gym, and slid down the slide all by herself- grinning and laughing her big belly laugh at the end.
On Sunday, she got sick again. She was clingy, and by the end of the day, she was whining, shivering, and just wanting to be held until the Tylenol kicked in and she was able to really go to sleep.
She wouldn't go down in her crib at bedtime, so I sat in my rocking chair, holding her and trying again to figure out what we should do.
Everyone agrees that Petunia's frequent fevers aren't just the normal routine for a day care kid. Something else is going on. But what? And what should we do?
Her core symptoms are remarkably consistent: a high fever, refusing to eat, a strong preference for cold milk, and red, inflamed tonsils. Around that core, there is variability: she may or may not have a runny nose or a cough, for instance. She's usually better in about three days, but one time, she was sick for a full week.
She's had throat cultures, which have always come back negative. But on the other hand, she generally is healthy when she's on antibiotics, so maybe there is some sort of persistent infection that is not showing up in the standard culture.
She's had her immune system checked (it is fine), her adenoids x-rayed (also fine), and blood drawn enough times that she now cries if she sees a nurse in a pink shirt (because that's what the technicians who draw blood wear).
We recently took her to an ear, nose and throat specialist, who prescribed another course of antibiotics (which we finished last Thursday) and decongestant (which knocked her out so strongly that we had to cut the dosage to one quarter of what was initially prescribed). Hubby took her back for the follow up today, and came back with the recommendation from the doctor that we could try a tonsillectomy.
I wasn't surprised by this, but I'm not sure I want to do it, either. There is evidence that this sort of problem with recurrent tonsillitis will resolve on its own with time- some doctors argue that we should just wait. But it might take until puberty for the problem to resolve on its own, and right now, puberty seems a long way away. On Sunday, as I sat there rocking my miserable little girl, I kept saying "we have to do something"- but is surgery really our only option?
We've considered getting a nanny and taking her out of day care- but since her fevers are so consistent, there is a good chance that this won't do any good. The problem could be in how her tonsils respond to germs, not in the number of germs she's being exposed to. And, as my husband points out, it is not like we'd be able to keep her in a bubble if we took her out of day care. Her older sister would still go to day care. We'd still go out and about on the weekends. She'd still run across germs. So we could disrupt her routine (she loves day care and is visibly excited to go back after having to stay home for a few days while sick) and increase our child care expenses and get nothing from it.
We could push for more antibiotics, or perhaps for the next line of antibiotics- so far, she's had nothing but amoxicillin (and augmentin, which is sort of like amoxicillin plus). I've read some interesting things recently about persistent bacterial infections. But since the throat cultures keep coming back negative, that might not do anything but upset her tummy. "Interesting" is a fine criteria for choosing which science papers to read, but it is not such a good criteria for choosing how to handle a sick kid.
Or we could do the surgery. It is fairly safe, but it is still surgery. There are risks. And even if all goes well, the post-op recovery sounds like it would be two solid weeks of hell in which Petunia wold have a very sore throat, probably wouldn't want to eat much, and we'd need to work hard to keep her hydrated. However, as my husband points out, that isn't all that different than what we have now. She's been sick three of the last six weeks, and when she's sick, she has a sore throat and won't eat much. Still, there is no guarantee that surgery would solve the problem, either.
So I'm a bit stuck. I know that we have to try something different for Petunia. The difference between Saturday and Sunday was too stark to leave me any doubt on that point, but I really have no idea what we should do. I don't like any of our options.