Ok DD (6) woke yesterday morning went to get herself a glass of water then came back to the living room and said "Mom, I'm shaking all over and I don't know why.". So I looked at her and she could not keep her hands steady, I made her lay down her feet were shaking as well. Every so often she would kind of twitch. I touched her heart and it was pounding terrible. I immediately grabbed the phone and the thermometer. She did NOT have a fever and I called the doctor. They said to get her to the ER.

She complained of dizziness, shaking and shortness of breath. She had not eaten a thing yet. For the last day or two she said her throat was starting to get soar but she was fine (no fever) and she seriously NEVER gets sick, she'll start to but always fights it off before it really sets in. Anyways on the way to ER she started vommiting in the car. I got her in and when we were finally seen she had vommited another time but had been laying for a bit and her heart rate and shaking wasn't quite as bad.

Heres the kicker he said she has and ear infection (she says there is no ear pain) and strep throat (her throat was soar) but he did not swab her for strep. So I ask why was she shaking and vommiting. He says because of a fever. I said she didn't have a fever, he said I could have not noticed. I kissed her at 1:30 am when I went to bed, again at 6:30 am when I got up. And her father kissed at 7:30 when he went to work. She was not feverish anytime, and when she woke she didnt' have a fever. I know my kids and I hardly think she had one.

Ok so and ear infection could cause dizziness, but don't you think if it was bad enough to do that it would hurt. And what about the shaking, heart rate and vommiting. I've never heard of ear or throat infections causing such things. He gave her antinausea medicine (regulin) and an antibiotic for home. When he checked her pulse he didn't even make her stand to see if activity made it skyrocket.

I don't know I'm just really upset I really want to know all of what happened. She's ok today but the whole episode is really bothering me. I had never seen her like that and it was so scary. Just feeling her little heart working like crazy. My "motherly instinct" just isn't fully comfortable with all of it.

As soon as she was allowed a popsicle color came back to her face, I was kind of worried about her sugar levels or something along those lines maybe I really don't know.

Among other things we had to see the ER doc. that I cannot stand. He was very careless with my younger DD when she was 2 and because of him not checking her for dehydration she ended up back at a higher level hospital on IV for 15 hrs. If he would have caught it none of that would have happened. So I'm just looking for some opinions, suggestions possible peace of mind or not. She goes to the family physician on Monday.

By Lauram on Friday, January 14, 2005 - 03:07 pm:

Can you see the ped today? Or tomorrow? I think that's what I'd try to do.

I have had an ear infection (inner ear) which caused vertigo and no ear pain. Strep could cause vomiting. I would get it checked out again though- especially because your gut instinct isn't right.

By Debbie on Friday, January 14, 2005 - 03:12 pm:

{{{Pixie}}} I don't know about the shaking and heart rate. But, I do know that you can have vomiting with strep throat. A few weeks ago, I thought my ds had a stomach bug and it turned out to be strep. He was vomiting for a few days and then his throat started hurting. My ped. did do a swab of his throat, but he knew by looking at it that he had it. He said that a regular sore throat and strep look totally different. Also, your daughter could have been dizzy from an ear infection if she had fluid in her ear canal. My youngest used to suffer from ear infections and he did get dizzy sometimes.

It is good that you are taking her to your family physician, especially if you feel something else is going on. If she is doing better then I would just try not to worry too much. But, definitely keep a close eye on her.

By Ginny~moderator on Friday, January 14, 2005 - 03:56 pm:

To say "strep" without a culture is irresponsible. To say "fever" without taking a temp and showing it to you when you say no fever, is equally irresponsible. Dizziness can indeed come from ear infections (it's known as vertigo when you get it at my age), and vertigo, if severe enough, can cause vomiting. The upset of vertigo and vomiting could cause the shaking and increased heart rate, especially if she hadn't eaten or kept anything down.

It is also, imo, irresponsible to prescribe antibiotics without knowing if there is an infection on which antibiotics will work. It is one thing to say, start her on this and call back for the results of the test, but he didn't do that. And that's how we get antibiotic resistant strains of bacteria, including strep.

If it were me, I'd take her to the pediatrician, describe what went on, and also remind the ped of your experience with your other dd being on IV because this idiot missed dehydration.

I think it is probably not wise for you to complain to the hospital administrator yourself, because you are probably going to be back in that ER again. But try to impress on your family doc how irresponsible this guy was and ask him if there is anything that can be done to make sure this guy does things like take a throat swab if he thinks it is strep, and have a temp taken before he talks about fever.

By Pamt on Friday, January 14, 2005 - 04:05 pm:

Yes, you can have dizziness and nausea with an ear infection and not necessarily severe pain, esp. since we all have different pain thresholds anyway. And I had a severe throat infection a couple of years ago with complete laryngitis and profuse vomiting. I was in so much pain I could not even swallow my own saliva and ended up having to get a shot and then liquid antibiotics so I could get them down. As for the shaky...no real ideas, but there isn't always a dx for eveything. Especially if the doctor didn't see the shaking as it occurred with associated symptoms he may have no idea what it was...and doctors don't like to tell you that they don't know (and a lot of times they don't).

Yes, he should have probably done a strep test, but there are also other clinical manifestations of strep. And since she had an ear infection anyway, a wide spectrum antibiotic will take care of all of it in one fell swoop so I wouldn't really fault him for that. It does sound like he needed to be a bit more thorough though and improve his bedside manner. I would definitely talk it over with your ped. and tell him how the ER visit went and your dissatisfaction with it.

By Pixie on Friday, January 14, 2005 - 04:18 pm:

She did not have a fever, they did check. And the shaking came way prior to the vommiting.

By Kaye on Friday, January 14, 2005 - 05:31 pm:

Okay well my thought is, talk to your ped. Ask what she thinks could have caused the shaking. Mention to her you felt like it was almost a seizure, but without the eyes rolling back. Also ask if you can do some bloodwork just to check her sugar levels, etc. Ear infections can cause dizziness without pain, strep can cause vomiting. I have three kids, one has had a febrile seizure (which is what I bet the er doc wa trying to say), they normally don't happen until they are over 103 temp. Curious what antibiotic your were given. Typically for ears they give amoxicilian, but sometimes they give that shorter one (I think it starts with a Z), anyway you only give it for 5 days. Anyway, strep is resistant to it. Also I can't imagine he would call strep and not swap a throat. It would have been more responsible to say well she has an ear infection, she also has a red throat that might be strep, since she needs an antibiotic anyway we don't need to swab.

By Dawnk777 on Friday, January 14, 2005 - 09:08 pm:

Zithromax is the 5-day antibiotic. Sometimes the docs I work with think that someone has strep throat and will treat, even if the swab is negative. They have seen lots of sore throats. Or else, if someone comes in with a sore throat and someone else in the house has recently had strep, they will treat without a throat swab.

By Pixie on Saturday, January 15, 2005 - 02:33 pm:

They just gave her Amoxil, is that ok for strep?

By Amecmom on Saturday, January 15, 2005 - 04:35 pm:

Yes, they gave my little one Amoxil for strep. But they did a culture to determine that it was strep and another culture to determine it was gone.

Take her to your doc. Ask your doc what he/she thinks of the examination. Most docs won't say anything against other docs, but you can try. I had a very unsatisfactory ER visit for my child - they couldn't diagnose the ear infection he had because they didn't have a small enough tip for the otoscope. I sent letters complaining. I'm sure it did nothing, but I felt better.

I do think you should complain to the administration simply because you will be back there again and you want to be sure this experience will not be repeated and you recieve a better level of care.

The ultimate answer is that because of your prior experience with this doc you have no confidence in him. He could tell you that the sky is blue and you would not believe him without seeing it for yourself.

Since you have no confidence in him, always request that you see a different doc in the ER. Hard to remember in an emergency, but probably worth it.
Hope your daughter feels better. Hugs to you.

By Katiesmommy on Sunday, January 16, 2005 - 05:58 pm:

I am a nurse (worked 5 years in ER). I am appalled they did not check her blood sugar and run blood tests! I would almost bank it was her sugar level. It can be common for little ones to have a touch of hypoglycemia if they haven't eaten breakfast and have been up and about. It sounds like the popsicle gave her some sugar to make her feel better. I know some of those ER doctors are pretty scary. Our hospital contracted them out from other areas and they stayed for a few years..it was a means to an end for them. I would call her regular Pediatrician and explain the episode and your concerns. Unless she has type 1 juvenile diabetes (which I doubt..don't worry) the doctor will probably not need to see her, since her blood levels will have returned back to normal. Keep an eye on her for further episodes, but just make sure she eats a little something or has a glass of juice when she gets up.
Amy

By Pixie on Sunday, January 16, 2005 - 11:18 pm:

I will keep you all posted, we see the family Doc. tommorrow. Thanks for you responses! Amecmom, I would ask for another doc. but this is a small town many times there isn't one!

By Paulas on Monday, January 17, 2005 - 09:16 pm:

So, how did it go?

By Pixie on Tuesday, January 18, 2005 - 12:26 pm:

Well the doc. wasn't satisfied that there wasn't a Strep culture done. He said they may not have given her a strong enough antibiotic (progress wasn't what it should be) but that she should finish this one (4 days left) and see what happens. He did not want to switch her in the middle of her meds.

About her episode he just told me to keep and eye on her for that sort of thing. He said her body may have had a reaction just because she was so sick. Because she is sick next to never - we really don't know how she is going to react.
He did say in that instance its always good to take the trip to the E.R. just in case, could be anything.

Good News, my other daughter was examined as well, precautionary since she had been expose to the Strep. and she is fine.

By Mvmc on Thursday, January 20, 2005 - 06:23 pm:

My daughter has had ear infections that cause no pain, but she does vomit from them. Ear infections can also cause shaking and fever. Her body may have just been responding to the infection, but I would still be worried because it is not normal for her to react this way.

Always go with the gut instinct, dont worry about being over protective, I know this from experience with my daughter who has had 3 open heart surgeries.mvmc www.mtacc.net

By Children03 on Monday, January 24, 2005 - 06:14 am:

I have heard that it is normal to have a racing heart if you have an infection or fever. I was sick a few months ago and I called in to my doctor because my heart had been racing and the nurse explained that it was normal when your sick like that. I hope the pediatrician can explain it to you better. Also, two of my daughters had over 12 - 14 ear infections in about 12 months and they both had to have tubes in their ears. They always ran fevers when they had ear infections and they were always in pain. Sometimes, their ears wouldn't be what hurt - it would sometimes feel like their throat was hurting but that is because when they swallow it also affects the ears.