Immunology

Bear with me on this one. I have a lot of thoughts to try to get out there and I'm not quite sure where to start. Penny has an appointment with an immunologist in Birmingham at Children's on January 14. We feel very conflicted about it. Before Penny had pneumonia, I had spoken to her doctor about the possibility of an immune issue. This was doctor visit number 8 or 9 I believe and she understood where I was coming from by asking. She told me though that it was probably just a tough fall and that usually they would not refer to an immunologist unless a child had had one meningitis or two cases of pneumonia requiring hospitalization.  And then she got pneumonia requiring hospitalization. With sepsis. Again, I find it difficult to write about specifics, but hers was an unusual case of pneumonia. It was in both lungs which I was told is actually not common and other characteristics were atypical as well. So, even though she has only had one case and not two (knock wood), it was very strong and she'd had all those other illnesses back to back to back leading up to it (all of which she'd also presented atypically). That, plus the Kawasaki disease, which is totally unrelated as far as anyone can tell, but which is also a very rare disease, led Penny's pediatrician to make the referral.

Her pediatrician's office called and made the appointment and the nurse called and gave me the date and time. It was for toward the end of February because that was the first available, but he's a really good doctor - one of the best. I said thank you, wrote the date on the calendar, and that was that. A couple hours later, the nurse called me back and said Penny's doctor had called up there and spoken to the doctor directly and they'd moved the appointment to January 14. Which makes me kind of feel like, jeez, they must really want to see her.

So here's the conflict. I really, really, reeeeeeally don't want to make Penny have her blood drawn again. I just don't even want to tell her she has to go to the doctor again. Seriously, I'd probably drive her to Birmingham, to the doctor's office and be in the parking lot before I even told her what we were there doing. Probably not wise to spring things on her like that, but then also not good to let her stew in her own anxiety for any length of time (being her mother's daughter after all). Ugh. I suppose too the further we get away from the hospitalization, the more we think well, she's okay now. Nothing to worry about. Head in sand. Fingers in ears. Lalalalala.

The immune system is so much more complex than I ever thought. There are many elements to it, and numerous diseases that you can be born with in which one or more element is missing in some way. Congenital immune deficiencies (as opposed to acquired).

The one thing that this is not though, is a result of her not having attended daycare. After the Kawasaki's and again with the current round of stuff I've had people (well meaning) imply that that was the case. The thing is, the "hygiene hypothesis" isn't about exposure to illness. Studies have shown that day care kids get sicker earlier on, and non day care kids get sicker later on, but around age 13 they get sick exactly the same thereafter, and it is has no bearing on long term immunity issues. What the hygiene hypothesis actually applies to is exposure to animals. Kids who live on farms or have exposure to farm animals have stronger immune systems than "city" kids. I read one article where the doctor said, "get two dogs and a cat" and your child will be fine. I remember that line because we had two dogs and a cat at that time. And four chickens. And semi-regular exposure to cows. And my house is anything but clean - lol! And in terms of other kids, I took her to library story time and kindermusic and dance and gymnastics and playdates. And as for Kawasaki's, there's a genetic component. Oh, I just get so frustrated at the implication that her illnesses are the result of something we've done "wrong" - namely not sending her to daycare or preschool sooner than age 4. The implication has little basis in scientific research, and is just plain insulting to me as a parent.

I really hope she did just have a "tough fall" though and this isn't a immune deficiency issue. However, I do think testing is justified on the basis of genetics. My father and his younger sister both had meningitis, and my great aunt on my mom's side had bronchiectasis. I think there's enough history there to be suspicious. I just -- I don't know. I just don't want to take her up there. Maybe I'm scared to find out anything. Maybe I'm sure they won't find anything and I don't want to put her through it. And Tray really hates the city of Birmingham (no offense to those of you who live there) and I don't want to put him through it. And I just don't want to worry about my little girl being sick.