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This is the email I sent to my moms' group after our ER adventure. It's organized to try to provide useful information to anyone who has to take a baby to the ER or just deal with a stomach virus or fever.
-M

1. Oliver is fine.

2. We spent 4 hours in the LICH ER yesterday, since we were very worried about Oliver as he had become listless after 8 days of a stomach virus including the last two days with a high fever

3. I thought it would be a good idea to pass on the details to those of you with babies, in case you can learn from what we went through - in fact, here's a handy list of key points to start the email off with:
* Acetaminophen comes in suppository form, infant Feverall. keep some in the house
* High fever can cause listlessness
* If you have to go to the ER, having your ped call ahead doesn't get you through any faster, you have to be triaged and wait for hours no matter what
* Bring blankets to the ER with you to cover the chairs with, because they don't get wiped down between patients
* Bring toys to the ER too, because it's a long wait. And extra pacifiers, because they'll get dropped
and try to bring food for yourself too, because the vending machines just have candy
* There's something called a "night terror" often triggered by teething pain and being overtired - your baby will be screaming in terror but asleep - there's nothing you can do but hold him, and he won't remember it in the morning
* A sick baby and a very sick baby don't present any differently, so you have to go get the work-up to find out if you have something serious. You can't know the difference, so don't feel like an insane new parent if you end up in the ER for a routine virus
* Switch to soy formula from dairy when baby gets a stomach virus, because they become lactose intolerant
* Keep your sick baby away from other babies until he's been fever-free for 24 hours and he's not blowing out diapers with diarrhea

So here's what happened:
Oliver came down with a stomach virus over a week ago - last Sunday. it started out with diarrhea on day one, then progressed to vomiting on day two. They both conitnued through the week, though the diarrhea got less severe, and the vomiting got worse, and then a little better - he was vomiting once or twice a day. He eats about half of his normal food intake when he's sick, and he's cranky. We kept trying to get formula and Pedialyte into him, but he wouldn't take much, so we were really worried about dehydration.

We were watching him closely for dehydration signs - listlessless, no tears, dry mouth, sunken eyes and fontanel, etc - but saw none of them. He was still happy and playing a lot of the time, even though he was having trouble sleeping. He definitely had tears, and a very runny nose and tons of drool. He consistently passed the Oliver-Dog Test - whenever he sees a dog, he busts a gut laughing. he was running a low-grade fever, but nothing to worry about - I measured it Monday at 100.8, and didn't take it again for days because he didn't feel warm.

Then, at 3:30am Saturday night he spiked a high fever - 104.6. Greg and i spent the rest of the night trying to bring it down with Tylenol and a lukewarm bath (not cold - the baby has to be able to tolerate the bath). It came down to 103.4. I spent the morning with the baby and he seemed OK but basically just slept on and off for hours - I didn't worry about it too much, since I figured he was really tired. I passed him to Greg around 3pm, so i could go to a wedding. Greg called me half an hour later, en route to the wedding, very scared because Oliver was listless - barely responsive, out of it, not moving much, utterly failed the Dog Test.

I called the pediatrician on call at our practice who said to take him to the ER. She was concerned both about possible dehydration, and that he may have developed a urinary infection because normally a baby gets better as a disease progresses, but he had gotten worse and spiked a fever over a week into it. I met Greg at the LICH ER, which was, of course, full of sick people. By the time i got there Oliver had been seen by the triage nurse, and then brought in a second time to be weighed and be given a Tylenol suppository. At that time his fever was 102.8. We hadn't managed to successfully give him Tylenol ourselves since the night before, since he had thrown up the Tylenol we gave him by mouth.

Another hour or two after that (it's all a blur - we spent 4 hours total in the emergency room), Oliver was brought back in. By then he had really perked up and was doing a lot better - bringing the fever down made all the difference. The ER attending pediatrician asked for a chest x-ray because "his lungs sounded junky", and checked him for dehydration and an ear infection. All clear on all counts. At the request of the ped from our practice he also performed a urine culture. To get the urine they catheterized Oliver, which meant threading a tube up his urethra into his bladder to drain whatever urine was in there immediately - it probably took about a minute total. That was also fine, and the ER doc clearly wouldn't have done it if our doc hadn't asked for it. He felt that this was a standard virus that had just lingered for a bit, but that was normal, and that the roller coaster course of it was common as well.

We were released with orders to give Tylenol every four hours for the first 24 hours, and then as needed. Neergaard on 5th Ave, by the way, is open 24 hours and carries the acetaminophen suppositories over the counter. I think they deliver too. Oliver is better now, but still cranky, and he did vomit this morning, but we've got his fever under control.

To cap off the adventure, he had two night terrors last night - the first was just a few minutes, but the second went on for 30 minutes. He was screaming and screaming - very very loud, very very high pitched, sounding utterly terrified, completely inconsolable no matter what we did. It's like we weren't even there. His eyes were closed most of the time and he was totally unaware of us or his surroundings. We had never heard of night terrors before and had no idea what was going on. Basically, he was asleep. Docs say they're harmless and the baby doesn't remember them in the morning. They're often triggered by teething and being overtired. You can't do anything other than hold your baby and wait for it to pass. Usually when they're over the baby wants to be held really closely, so co-sleeping is the way to go there.

About two hours ago i gave Oliver a suppository, and he totally took a dump ten minutes later. The doc said not to re-dose him - the suppository is absorbed very quickly, and you definitely don't want a Tylenol overdose. As i was changing his diaper and had him lying down i noticed - HE GOT A NEW TOOTH. So he was teething this whole time, which probably worsened his fever and his pain and his diarrhea and his night terrors. Poor kid.

On the one hand, I feel a little like the silly new parent who took her kid to the ER because he had a fever and was teething. On the other hand, when I tell this story I keep hearing about babies who were diagnosed with much more severe infections and ended up admitted, but who didn't present any differently. You just can't know without the work-up. I do wish, though, that I'd know about the suppository option, because if we could have brought his fever down, he wouldn't have been scary listless, and then we could have taken him to our doc on Monday morning instead of the ER on Sunday night.

Oliver and Greg are back from their walk now, and I can hear the baby laughing.

Hope you all survive cold and flu season - it will be over soon
-Michelle