This is part two of Autumn’s story, part one can be found here.
If only medical problems could be solved as easily as the mystery shows on TV. The kind where the detective deftly finds clues, even those everyone else missed. And gathers up all the seemingly random, inconsequential bits of information – like a jigsaw puzzle, and puts them together to solve the mystery in a simple, methodical and timely fashion.
Naturally, doctors aren’t looking for motive, means and opportunity when they’re trying to solve medical issues. But they are looking for the most common, least invasive explanation. As mentioned in part one of Autumn’s story, it’s called hearing hoofbeats and thinking horses not zebras. And in the vast majority of cases, this method of treatment is effective. Unfortunately, it becomes problematic if the condition is actually a zebra. This is what happened with Autumn’s son, and unlike TV detectives, the doctors kept missing clues, starting from his birth.
Misdiagnosis
Everything about Autumn’s second pregnancy, labor and delivery went according to plan with no complications. Her son was born full-term and healthy. The only unusual issue was he was born with a red, scaly rash that covered his body.
Since the doctors were seeing rash and thinking horses, they diagnosed her son with erythema toxicum (ETN), the most common form of newborn rash. It’s a logical diagnosis, except for one little hiccup, ETN generally appears the first few days AFTER birth (KidsHealth).
Missed clues
The fact Autumn’s son was BORN with the rash, hinted it may not be ETN. But since no one was thinking zebras, it was easy to miss this clue.
ETN generally clears up on it’s own within 5 to 10 days (Cleveland Clinic). However, when Autumn brought her son in for his well-baby appointments and he continued to have the rash, the pediatrician should’ve realized it wasn’t ETN: But she didn’t.
Default to trust
Autumn had no reason to question the pediatrician. After all, by definition a pediatrician is the expert on children’s health. If she didn’t seem concerned then what reason did Autumn have to be worried?
So Autumn set aside her doubts, believing if this was a serious condition, the pediatrician would’ve mentioned it.
Another clue
The next clue appeared when her son was six weeks old. It was a tradition in their family that her husband does one feeding, generally it’s the 11:00 pm. This was what they had done with their first child, and Autumn and her husband wanted to do the same with their second.
To make sure there would be no issues transitioning to a bottle, Autumn did a trial run at the 8:00 pm feeding. She bottle-fed the baby using the formula given by the hospital.
He had no problems taking the bottle but what happened next was disconcerting. As Autumn described it, he started non-stop screaming. He was so inconsolable, her husband rushed him to urgent care to make sure everything was alright.
Another misdiagnosis
The urgent care doctor sees how distressed the baby is and notices the angry red rash all over his body. He surmises the baby has a dairy allergy and the rash is not ETN but an allergic reaction. Another logical conclusion. Unfortunately, this is when thinking horses becomes problematic. The doctor’s treatment plan would’ve worked great if this was the typical dairy allergy, but it wasn’t. As a result, his remedy would make the symptoms so much worse.