Robin and the private health system

Well, I've learned a bit about hives this week (it's hives, by the way) and the ice cream has been exonerated, in my mind at least.

Apparently, although the causes are known, most people never know what causes them. By which I mean that researchers doing "aggressive detective work" have been known to identify the cause of hives up to 50% of the time, but in normal life it's more like 25%. They can be an allergic reaction to food, topical irritants, inhaled stuff or bug bites. They can also be caused by a virus. Or a bacteria. Or heat. Or cold. Or stress. Or tight clothing. (For general information click here, here, or here.)

The fact that they can usually not identify a cause makes some doctors believe that most cases are caused by a virus.

So back to Robin. She had cleared up dramatically by Monday night. Everything was normal until Wednesday after dinner, when she started to break out again. They started small and just kept coming, and by the time I was ready for bed she was covered again. I moved her to my bed so I could tell if she started having any respiratory symptoms, and woke up every time she moved. In the morning I decided to go back to the clinic, but to get an appointment this time so the doctor could spend a few minutes paying actual attention to her.

We got there at 6:30 a.m. this time - just 18 people ahead of me. The person behind me kept my place in line while I ran Robin down to school at 7:00, but to no avail; they gave out the last appointment to someone about six places ahead of me in the line. I didn't see the point in having them see her on an emergency basis again, because I wanted to be able to talk to the doctor, not just get more drugs, so I went home and opened up the yellow pages.

There were three dermatologists listed in Heredia. I called the one with the biggest ad (including "private parking lot") and got an appointment for 2:45 that afternoon ($42).

I also took some time to get a little more information online, and in addition to the stuff about not being able to identify the cause, I also found out that respiratory problems are less common in children, and usually occur right at the outset, not hours or days after the hives appear. So I was feeling a little better about that by the time we went to the doctor.

He told me to discontinue the steroids, saying they make it worse. He approved the antihistamine syrup, and added a second one. He looked at her feet for fungus and her teeth for decay because either of those conditions can trigger hives. He gave her a shot in the forearm ($21) which she says was horrible, and he said to bring her back in 10 days.

The hives began to fade noticeably within an hour after the shot. We had a sundae at McDonald's and got a little toy at the store before going back to pick up Julia. Life was good. Until bedtime. Then they started breaking out again, including on her face. So I brought her back to my bed and checked her through the night. In the morning all her hives were better looking - lighter in color and maybe not so raised, but she had them from head to foot, including much of her face. The ones on her face weren't very noticeable, although they made her look a little different because she was a little puffy. I kept her home from school so I could keep an eye on her, and there were a few minutes where she said she was having trouble swallowing and I started envisioning emergency trips to somewhere, but it subsided and they continued to fade.

I called the doctor and he said that even with hives on the face, respiratory problems are very extremely unlikely. But I still don't like it.

The one good thing in all of this is that even when she looks awful, Robin seems to feel just fine. Probably because of the anthihistamines, she's hardly had any itching at all. Her take on the situation: "I like being like this because I get all the tension." Not all of it, child. Not all of it.