I know that hindsight is 20-20, but I really was convinced that the incredibly sick, lethargic boy lying on our couch these past 10 days or so had mono. I was pretty nearly convinced of this last Sunday, when I knew I’d have to get him to a doctor the next day. He was a mere shadow of himself day after day and was stuck in gear – a gear in which he was exhausted, miserable and unable to eat. Every mothering instinct in me knew that something wasn’t right and wouldn’t be right until he could get medical attention.
I mean, for Pete’s sake, in the space of just a few days he went from whipping crazily down our snow hill with a huge grin, to looking worse than death warmed over.
On Monday our family doctor’s office was closed and so we had to go to the ER (our doctor’s office is based at the hospital in our small town and so this is an acceptable next step). We bundled his tired, lanky frame into the car and made our way through the wintry streets to the hospital. After registering we sat down in the waiting area and he drifted in and out of sleep until his name was called. The doctor on call did a swab for strep throat and acknowledged that mono was a possibility when I mentioned it (even citing the fact that he’d seen three cases in recent weeks), but said it was too early to do bloodwork to test for it. Sighing, he indicated that there was nothing we could do but to continue to look after him and get him to a doctor at the end of the week if he still hadn’t improved. Reluctantly I left, even though I knew we’d just struck out at the hands of the wrong doctor, bad timing or a bit of both.
By Wednesday he was still the same – exactly the same level of fatigue and misery, his prospects only worsening by his loss of appetite (a sore throat and swollen glands will do that to you). I called the doctor’s office and got an appointment to have him seen the next day. I felt awful having to insist that he get dressed and into the car again – the whole exercise clearly demanded reserves he barely had. But we made it there and he nodded off, snoring lightly, in the waiting room. Even though I really like our family doctor and feel she is very good, I was nervous about having him seen. Nervous that we’d end up with an inconclusive outcome once again and be stuck in the same place as a result.
I was wrong. Our doctor diagnosed mono within 60 seconds of laying eyes on my son and was quickly writing up prescriptions for morphine and dexamethasone. The m-word has shocked quite a few people with whom I’ve spoken about our son’s condition, but it’s very much indicated for mono when the swollen glands, which are a particular feature of the illness, are more severely affected, making swallowing (and therefore eating) too painful. Dexamethasone is a steroid and is used in cases like this when the swelling is serious and threatens to obstruct breathing. Both of these drugs are dealing only with symptoms, as there is no externally applicable ‘cure’ for mono apart from rest, but in our case they are heaven-sent.
Within three hours of having his first dose of the ratio-morphine, my son had reappeared. The previous nine to ten days had been a period in which he had effectively disappeared – there was no light in his face and he had almost nothing to say apart from pathetically garbled requests for more water or tissues. Suddenly, on the evening of his first dose, he was chatting from the sofa while we ate supper at the adjacent dining table, and even beginning to crack jokes (my son is a wise guy when he’s well).
Now, two days later, he has benefited hugely from just two excellent nights when he slept for a solid eight or nine hours (previously he had grown to dread the night, as he knew it would be a rough time spent dozing fitfully and wondering when the morning would come) and the first several doses of his steroid medication. He triumphantly opened his mouth for the whole family to see this evening, eager to show how much wider he could open it thanks to the steroid drug he takes twice a day.
For nine or ten days this boy spent his days on the sofa and his nights in bed (often waking me when he needed company), sleeping for periods of time around the clock, and watching movies, reading or being read to when he was awake. He couldn’t keep himself awake the two times we had to venture out of the house for medical attention. He frankly looked depressed. Now, because he can sleep soundly through the night, isn’t in pain, and has fuel in his body once more, he has re-entered the world.
He can’t do anything strenuous and won’t be going about his life in the usual way for a good while yet, but he feels positively well compared to the boy he was just a few days ago. It annoys me that he could have felt this way as early as Monday, had the doctor who first saw him picked up on his symptoms as our family doctor did, but there’s that 20-20 thing again. Doctoring is done on the fly as much as parenting, and I suppose our doctor had the benefit of knowing that (a) he didn’t have strep throat and (b) his condition hadn’t improved in several days, and (c) perhaps she just had another piece of the puzzle from experience that helped her to feel confident in diagnosing mono.
This is the boy I’m looking forward to seeing again, when he gets through the worst of this illness and can build up his strength again. He already looks so much more like himself, and just needs time and rest and any help we can give him in boosting his immune system. We have no idea how long the affects of mono will linger in his case, but we’ve done the reading and we’ll keep watching and learning and doing the best that we can so that he can get back to being his best again.