In August, just after Tess's fifth birthday and (I believe) on her second day of kindergarten, I took Kate to Valley Children's Hospital for an MRI on both of her feet. We hoped to find out what was causing the mystery swelling in her right foot (top, metatarsal area) and her fat toe (left foot, second toe). We'd had a conventional x-ray that showed no sign of a fracture or break, and a digital x-ray at the podiatrist's office that couldn't detect any sign of a stress or hairline fracture. Plus, Kate was still walking just fine and not complaining about any pain in either foot.
Conducting an MRI on a toddler requires full anesthesia, so it wasn't a short or minor appointment. She had to be knocked out completely in order to lay still enough for the imaging and not freak out by the small space of the machine. This was our first experience at VCH, where we got a taste of the wonderful people who work there and are trained to interact so delightfully with children. Miss Kate looked adorable in her tiny scrubs and there were plenty of toys available to keep her entertained. Looking back, I can't remember what I did (or where I waited) while the MRI was happening; just the surprising events when it was finished!
When the MRI was done, I was asked to wait around while the radiologist read the images to get an idea of what might be going on. Kate continued to play and interact with other kids being seen, although by that time we'd been there a few hours already. She was already dressed back into her clothes when the radiologist came out to speak to me and looked concerned. He said there were areas on the MRI results that "glowed" and indicated a bone infection in both of Kate's feet. "Okay," I thought. "That's odd... no idea where that came from... give me a prescription so we can get out of here and get home!" He went on to explain that the treatment for a bone infection is IV antibiotics and that Kate would need to be admitted to the hospital immediately. She would also need to have an urgent consultation with an orthopedist who would determine if surgery was necessary to clean out the infection in her toe and/or foot! At the idea of surgery an hospital admission, I began to panic and called Chad, who was in the middle of teaching class. I asked him to come to the hospital immediately because I was about to break down.
By the time he arrived, Kate and I were waiting in triage in the emergency room, hoping to hear good news from the ortho. It's all hazy to me now, because it was such a shock to think my normal day was turning into my baby being admitted to the hospital. I think I called my parents, and Chad's parents, and they were there for a bit? Ultimately, the ortho said the infection and swelling was not severe enough to warrant surgery, but Kate did need IV antibiotics immediately and would be in the hospital at least overnight.
We learned that bone infections really can only be treated by IV antibiotics -- they are the only way to get the medication deep into the bone tissue where it can work on healing. The doctors would be monitoring her closely for any signs that the swelling was going own, and drawing blood to test for other issues that might be going on. The detailed questions about Kate's activities and medical history continued from everyone we spoke with... we were confused, the doctors were confused, and the only thing that helped us feel "stable" in that environment was the kindness and attentiveness of everyone who worked at VCH.
Typically a bone infection happens as the result of a wound -- whether a surgery or puncture wound -- where bacteria has gotten in and reached the bone. We couldn't come up with ANYTHING that might have happened to Kate that would allow an infection to get into her feet. The best supposition we could come up with -- and it was a rare occurrence -- was that the multiple ear infections she'd had as a toddler left some lingering bacteria somewhere in her system, and as a result of her insignificant (or so we thought) tumble down our stairs at home, that bacteria had traveled into her foot and toe (which may have been slightly traumatized?) and landed around the bone to cause an infection there. It was a big stretch, but the most plausible answer that anyone could come up with at the time. Little did we know, we were just getting started on this medical mystery!
SKH
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