Wednesday 14 March 2012

The pox, it cometh.

All that glib talk of chicken pox parties, wanting your kid to get the pox, starts to look really stupid when your kid actually HAS the pox, because Chicken Pox, despite the fluffy name, is NO FUN AT ALL. A few posts ago, I wrote that daughter was feeling ill, feverish. Many days after, lo! The pox, it cometh. And here we are , 5 days in, still popping out new spots and feeling dreadful. Her, because she's itchy, some spots hurt, she's up all night, itching, and she's coughing, and me, because i'm up all night pasting on various ungents and comforting, inadequately.

Pox is hideous. Deprived of the ability to mix with other humans, a chess game of getting the other kid to school has taken up many hours, not least because he doesn't WANT to go now he knows his sister is sitting on the sofa watching Disney. She cannot mix with other kids or pregnant ladies and this means no mixing at the school gate while I drop son off, or evil looks result. So friends have to step in and relay between me and her at the outside entrance. General advice at the outside entrance to school has ranged from the unhelpful to the wise. The general belief is, I find, that Chicken Pox is a relatively harmless, almost fun week or so off of school, with a bit of a snivelly nose. This is far from the truth. Whilst some children may be rendered only slightly annoyed by it, others may be completely floored. In my case, 30 years ago, I managed to make my mother awestruck in silence (no mean feat) with my huge array of spots, which even, I recall, patterned the inside of my nose, mouth and eyelids. I was in bed for days.  My sister on the other hand, had about 20 spots and persisted in riding her trike up and down outside the bedroom door.

Fact is, that chicken pox is vaccinated against in many countries (but not this) for very good reasons. Firstly, for the harm it can do to pregnant women and their unborn children. Like German measles, the chicken pox sufferer may be relatively unbothered, but the recipient of the pox may not be, and it can result in babies being born with the pox, and various problems. So, it follows , that you should avoid pregnant women and newborns when you have it, or may be carrying it. But herein lies the problem. The incubation period of this very effective virus is such that it initially manifests as a cold, or flu like symptoms. Nobody keeps off of work or school for a snotty nose.Very unpopular you would be if you did. And yet this is exactly when the virus is at it's most contagious, BEFORE the spots appear. Hence, this week, son has been miserably attending school, resenting his sisters' placement in front of a Disney DVD while he learns more phonics, probably spreading far and wide the virus. But school policy doesn't say that he shouldn't attend. And he may not be carrying the virus. No point in him missing learning time and knackering the classes attendence figures for no reason. So you can see why vaccination is an attractive prospect to head this dilemma off.

The pox can also lead to complications in the case of children and adults with immune deficiencies, and, those with asthma who are regularly treated with streoids. As this includes most of  the children with asthma, this is quite a serious thought. Although having chicken pox in childhood has been linked to reducing your chances of the onset of asthma and related skin conditions, it's also been linked to worsening of asthma and severe complications if you catch it after a course of steroid tablets, or after an asthma attack or period of intense steroid use. Which means it's a risk to a lot of kids. And it's very nasty to get it as an adult, too.

After trawling around looking at various bits of research, I've found that the pox isn't as straightforward as you might think. For every kid who is biking about with it, there's one who ends up very poorly. There is conflicting advice about medication (ibuprofen, for example, has been shown to lead to complication with chicken pox,  leading to worsening asthma and possibly a link with necrotising skin disorders, and the advice as to whether to continue with steroid asthma medication is confused). Everybody has an idea about the best way to sort it out. Everyone has an idea about when it's contagious, before, after, during the spots. Everyone believes one or more myths about it. I was surprised to find out, for example, that yes, you can get it again. More than twice, even. No limit in fact. And no, the second time you get it, it isn't always shingles.  A good friend has racked up 4 counts of chicken pox. 13% of people have been reported to get it more than once. It seems that some people don't make those antibodies against it. And the incubation period is MASSIVE, 10-21 days from that snivelly cold. Daughter took 12 days to pop her first spot, and during that time, she was merrily away at playgroup, breathing it at people.  After being exposed to someone with the virus for 15 minutes, you are at risk. Playgroup can look forward to being quieter for a bit. It is not possible to catch shingles from chicken pox, and vice versa. Shingles is basically the remains of the childhood chicken pox virus re-activated at some point in your lilfe, possbly because your immune defences are low.You should never give your child aspirin when they have chicken pox as this has been linked to them getting Reyes Syndrome.And so on. For an everyday childhood disease, which is common, there's a lot of humming, hawing, and misinformation out there.

So what works?
  • Well, people told me calamine cream, which was as much use as, well, co-co-pops would have been. Aside from smearing itself over the bedsheets, it seems to have done little. Likewise calamine lotion. Piriton worked, but the dosage instructions ban you from using it as frequently as I found she has needed it. So I had recourse to other action. 
  • Baking powder is your friend. Tepid baths with 3-4 tablespoons of bicarb in, as often as you can. 
  • Make up a paste of bicarb and water, keep it in the fridge, paste it on particularly nasty spots.
  • Keep cool. Radiators, clothes, off. No waistbands, no pants. Spots appear where it is warm, in the nether regions and hairline, for example, so strip your child. Keep them out of the sun.
  • Witchazel for spots on the face. I found calamine too greasy, and annoying for the face. Witchazel works nicely and can be kept cool in the fridge. 
  • Peppermint tea in the bath, or as a cool solution to dab on spots. It also gives your child the satisfactory experience of bathing in what looks like wee. If, as below, they are having trouble weeing, this may be the best place to get them to do it.
  • Sudocrem. You know that big pot you got when your kid was a baby that you still have half of? It's that big for a reason. Add some tea-tree oil or lavender oil (only a few drops) to some, and dab on.
  • Keep cool inside. Ice pops, ice tea, cold drinks. Cotton sheets.
  • All natural fibres when you do get dressed. 
  • It's worse at night. Keep the room as cool as you can.
  • Cut your nails (they will be filled with sudocrem) and cut theirs. Right down.
  • The piriton makes them sleep. This is good.
  • Their appetite will vanish, particularly if they have spots in the mouth (yes, you can get them).

And here I am, 4 days into the spot appearing section (they can continue from between 5-10 days), and they show no signs of stopping. I found it enormously hard to find decent pictures of spots online, that were not too small or textbook. Here's my guide to the spot spotting.
  • The first spots will look like heat bumps. Daughter started with 5 or 6, round the neck. I thought it was heat rash.
  • After a time (10 hours in my case) the first signs will have developed into water carrying blisters. There will be more of them. 
  • They can vary in size. Enormously. One on daughter is the size of a 5p. Most are the size of a matchead. 
  • After the first few days, you will notice that the older spots are crusting over, but new spots will still be popping up. So you'll have some pink blistery ones alongside crustier, darker ones.
  • I'm on day 4. I have a wide range of heat rash-to-be spots, blistery spots, and crusty spots. The crusty ones itch. They also bleed REALLY easily. If you pick the kid up without due care, easily.  Be on guard to slap cream on, and hadle with sensitivity.
  • And a note. These spots go EVERYWHERE. Daughter has them on the scalp (washing hair with bicarb water helps, leave it to dry naturally), eyelids, inner ears, and down there. Going to the toilet is painful, so be sure to keep the child well watered, as dehydrated pee is painful. If you see a spot appearing on the actual eyeball, or if any get infected, go to the GP, as it's dangerous. But however nasty the spots "down there" may be to consider, they are normal.

So, I no longer, after a long three nights of hourly wakings plastering on cream and bicarb paste, and listening to daughter wee crying, think of chicken pox as a painless childhood illness. Be prepared.  As one child crawls out of the poxy tunnel, the other one wanders in. He has a runny nose. See you after Easter.And if anyone can tell me why kids fall like flies from chicken pox round Easter, you win a half used tub of calamine cream.
Picture shows daughter unimpressed by Princess Jasmine, sleeping, IN THE DAY, which she hasn't done since she was 12 months. AND she went to sleep tonight. She's ill. Note the spots round the ears, hairline, sweat lines.

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