Stomach Flu or My Worst Day in the Clinic...

About a day or so after the first day of school, we start seeing vomiting and diarrhea in the clinic. Typically, these are self-limiting viral infections, such as rotavirus, but troubling nonetheless. As soon as toddlers poop up their backs in day-care, they are excluded. When the 3rd grader barfs in his desk, they are sent home. And, working parents who have used all of their sick days for the next ten years already, will need to stay home and take care of them until they are better.

Like most viruses, the symptoms will last a week if you agressively treat them, and seven days if just leave it alone. The first three days of this "stomach flu" as it is often called (even though it is unrelated to the feared influenza) are the worst. Now, that gets me to my Worst Day in the Clinic story.

As I entered the examination room, I saw a very concerned Hispanic mother clinging to her obviously-ill two year old lying on her lap. This kid immediately failed the "eyeball test" -- if they LOOK sick, they are more likely to be sick. Vomiting is always the biggest concern since dehydration can occur rapidly in these little people. When you are losing fluid from both ends, as well as perspiration from a fever, a child can become seriously dehydrated in a matter of hours.

After my examination, I informed the worried mother that her child would need some medication to control the vomiting; and that this medication will need to be administered in the form of a rectal suppository (If you give medication by mouth, they will usually just vomit it back up). She stared and horror at the thought of inserting something up her little boy's butt. I carefully explained the procedure, but her "deer in a headlight" facial expression did not change. "Would you like me to show you how to do it?" She smiled and said, "Yes, please."

No problem. I went to our medication refrigerator and got a Tigan pediatric suppository and some K-Y Jelly. I greased up the suppository, told the mother to lay the child across her lap. We pulled down his Pamper and I started to explain the procedure in detail.

"First, you lubricate the suppository in your gloved hand". "Next, you spread their little butt cheeks............................

Apparently, the words "Spread those little butt cheeks" was the secret body signal for an explosive release of diarrhea. That innocent little butt absolutely erupted like Mt. St Helen's, covering me, the walls, the floors, and Mom with the most disgusting diarrhea you can imagine. I sat their for a moment in shock, as watery poop dripped from my glasses, and my formerly-white beard. In a malordorous stupor, I emerged from the examining room and called for some help. The nurses ran to my assistance, only to be startled by what they saw. Instead of help, I was greated by laughter...laughter that attracted more nurses. Once they had their fill of amusement at my expense, I was offer a pair of scrub pants...a size that would have been more appropriate for the sick two year old.

So, Rod Moser, PA, PhD, respected clinician, walked to his car, clad in one of those white paper gowns with the open back. Destination: Home to a shower and thorough decontamination.

Related Links: Child too sick for school, Germs in the classroom

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