[This is still in the draft state as I write it in the hospital while Little E is sleeping. Will add in more details when everything settles..]
It is the 8th day we are in the hospital, where Little E was admitted for Kawasaki Disease.
It started with a fever on 27 April. My wife brought him to see the PD. She was told to give Little E paracetamol and bring him to a hospital if the fever hits 38.5degC.
The fever reached that level that very night. Little E looked more sleepy than usual. We rushed him to KKH at 3am the following day.
It was the wee hour, there wasnt a crowd, so i thought it would be fast. I saw a sign saying the waiting hour was 2 hour, I thought they did not update. It turned out that we indeed waited for 2 hours before a doctor saw us.
The doctor told us it could be a viral infection. Little E had no signs of HFMD or dengue. We were to give him higher dosage of paracetamol. We gave him 2.5ml of it, following the post-vaccination jab dose. This was not enough given Little E's weight. He was given 4ml of paracetmol, and we waited another hour or so before seeing the doctor again. Groan. Little E's temperature went down to 36.9 degC and he was discharged subsequently, at qbout 7am. We were told to go back to KKH if the fever persisted for more than 5 days. And no, teething was not the cause of the fever.
We did not doubt the competency of the doctor, but we felt something was still not right and that bothered us. We got home, and I went to get whatever I could to cool him down, including a cooling mat. Little E slept throughout the day.
That night, we noticed rashes had developed around his mouth. Could be the drool, we thought. The fever persisted. During the night, he was having fits and his hands and feet turned blue periodically. We covered him up, thinking that it was the fever's doing. By 10am, 28 Apr, there was no signs that Little E was getting better. Instead, his rashes worsened. The fever was measuring between 38 and 39 degC. The highest temperature we measured was 39.4 degC. We decided to go Mt. Alvernia Hospital.
At the MAH Emergency hospital, we waited at the isolation waiting room for a few hours. Ethan had his blood tested and was sponged while waiting for the blood test results. We were told there was no room, so we waited again.
The results were finally out. Little E's C-Reactive Protein is 10 fold of the normal range. I had no idea what it is, but the doctor said Little E could have a respiratory infection. He was not sure as he is not a PD, so he referred us to the International Children and Adoloscents Clinic (ICAC), also located in MAH, while waiting for a room.
Dr. Koh Poh Khian attended to Little E at ICAC. He is knowledgeable and detailed in his practise. He looked at Little E, who was irritable and drowsy, and told us Ethan could have Kawasaki Disease.
Kawasaki what?
He said from the blood tests he was quite sure Little E had KD. He went on to explain what the KD is.
KD is an autoimmune disease that could affect the heart, by dilating the artery (or is it aorta?). It is a relatively new disease, only formally described in the 1970s. The diseased is named after the doctor who discovered it. The cause of KD is unclear. Most cases of KD are left undiscovered and treated. Its treatment is equally uncertain and varied, with the best treatment observed with the immunoglublin (IVIG), an expensive blood product, so far. Steroids are sometimes used.
We were at loss. We intended to admit Little E in MAH, but there was no bed for him. Knowing this, Dr Koh referred us to NUH, and called Dr. Quek Swee Chye, the head of pediatric cardiology in NUH. He wrote a note to Dr. Quek, and told us to show the note to the staff in the NUH's Children's A&E. Before we left, Dr. Koh reassured us that Little E would be fine, given that NUH is an 'academic' hospital with a small but dedicated pediatric team, and Dr. Quek has been studying and seeing KD cases for many years.
One of his staff advised us to go back home and bring the necessities, but we did not heed that because we felt that it was more urgent to get Ethan to professional care as soon as possible. On hindsight, it was a good decision because along the way Little E's had fit and his face was turning blue.
It was about 6pm. Ethan was quickly attended to. Blood and urine samples were taken to test for infection. The staff were frantically trying to stabilise his pulse and blood pressure, and trying to IV him. It was difficult to find a vein on Ethan. An Indian lady doctor, we were too upset to capture any name, kept explaining to us the situation and reassuring us. It pained us to see this innocent little baby going through all the pricking. We broke down at the bed, and were eventually escorted out to wait.
About 30min later, the lady doctor came out to tell us they managed to stabilise Ethan, and his colour wad better. We went in to see him and he was sleepy. Probably too exhausted, but it was a relieved to see our baby in a better shape. We noticed his lips was bright red, we were not sure if it was the infection. We hanged around in the A&E for awhile before we were transferred to a ward. It was already 9pm then. I returned home to prepare the necessities while my wife stayed with the boy.
The following day, Dr. Quek saw the boy and felt that treatment for KD should not be delayed and Little E was put up for KD treatment, 1 dose (3 bottles) of IVIG wad administered over a course of 1.5 days, together with some antibiotics.
Ethan responded well to the treatment. On 2 May, when the IVIG was completed, the rashes and fever subsided, he became more alert.
Right now, Ethan is still warded under observation as the fever keeps coming back. Little E is a fighter. He is fighting hard to recover.
I am grateful for the dedicated doctors and nurses in NUH.
I hope our personal account of KD helps to gain awareness of this mysterious disease, and also hope parents who are affected by this disease, like us, will find solace in our experience. Our Little Ones are fighters. We have to have faith in them and be with them.
I really hope we can go home soon, but I'll let Little E take his time to recover.
~ZF
