When a child is referred to my clinic I have one job. I have to prove that they have cancer or not. That’s my job. Is childhood cancer rare? In the grand scheme of diseases yes..but 1 in 285 children will develop cancer before they reach age 20 (0.3% chance to save you from the math). Every day the hospital and clinic are packed with kids getting cancer treatment. So to me , cancer doesn’t seem that rare.
The other part of my job as a physician is to look at a problem and anticipate what is the worst thing that could happen – and then try to prevent that from happening or at least be prepared for it. Well, herein lies a little problem. Sometimes when my own children are sick, my mind will automatically jump to the worst case scenario. It’s second nature and it can be anxiety provoking.
When my daughter was a baby she had petechiae around her eyes. Petechiae are tiny little blood vessels that have ruptured and results in little micro-bleeds into the skin. Here is a picture of petechiae around the eyes of a child.
Now, in my rational head, I knew that petechiae could be caused by a lot of things and the most common cause of facial petechiae in children is from forceful vomiting. At the time my daughter was maybe 7 months old and she sure wasn’t experiencing forceful vomiting, so my mind jumped to the worst case scenario. At worst, she could have had leukemia, as petechiae are common in children with leukemia because the platelets (blood cells that help stop bleeding) are often very low. At best case I figured she had ITP which is an immune mediated disorder that destroys platelets. The next day she had more petechiae around her eyes and I caved and emailed my pediatrician for her thoughts because she has the luxury of seeing “normal” kids every day that don’t have cancer. Her response to me was a simple question.
“Does she rub her eyes when she’s tired?”
Ummm…well didn’t I feel silly? She did indeed rub her eyes all of the time when she was tired. The delicate skin around the eyes is easy to damage and the rubbing along with her alabaster skin caused the petechiae to form and be seen quite easily. Thank goodness for good pediatricians.
This “knowing too much” phenomenon can be detrimental as above, but sometimes it can also be very helpful. When my son was an infant, my husband, myself, and my daughter all caught a nasty summer cold. I tried very hard to keep him separate from the rest of us because as I commented to my husband, “I don’t want him to get meningitis”. {my husband thought I was crazy} August 21st, the day my daughter started preschool and about a week and half before Hurricane Harvey hit, he just didn’t seem right. He was sleeping more and he seemed to be in pain when I picked him up. I took his temperature at it was 100.6 F – not terribly high. I immediately started packing things up to go to the hospital, including clothes for an overnight stay. Indeed, he had the same virus we had all had, and his poor little body couldn’t keep it out of his brain. He had viral meningitis. He spent a week in the hospital and seems to have no lasting effects.
This is the life of a Doctor Mom.
