Thursday, May 29, 2008

The suspicious rash, part deux

So, before I was talking about Reagan's school birthday party and how the school wanted to send her home from school that day because she had a few little raised dots on her arm. They said, "we just can't have unexplained rashes at our school." There was lots of drama, we went back and forth between the school and the doctor, emailing pictures, and ending with the doctor saying the rash is no big deal, let her stay. So they did. But not content with the doctor's say so, they covered the suspicious bumps with a big bandage and said if it still looked that way on Monday we would need a formal written note from the doctor.

Here she is with said suspicious bumps the morning of her birthday party. Look closely on her forearm.

As it turned out, we still had to take Bailey to the doctor that day because she was running a high fever. So we toted Reagan along and the doctor said once again no big deal it is some generic reaction to something, put some cortisone cream on it and call it a day. She gave Reagan a note that said, "Reagan can attend school on Monday." and told Reagan, "you hand them this note and tell them to leave you alone." I thought that was the end of the story.

Monday comes, Reagan still has the rash and we hand the school the note. They were not happy in the least. They said, "It doesn't say what she has, or how to treat her, or if she is contagious." Bill said she isn't contagious, the doctor wouldn't be irresponsible and let her back if she was. And we aren't asking you to treat her. So the giant bandage goes back on her arm and the school tells Bill we must have a note from the doctor saying she isn't contagious and must explain what she has. After exchanging a few words with the executive director Bill leaves in a huff and relays the message. I remind Bill that it doesn't matter what she has, it is none of their business as long as we aren't asking them to treat her or she is not contagious. That is a HIPAA law and doctors aren't allowed to say what a patient has on a note. The school was asking for something illegal.

So Bill rehearses what he is going to say to the school with me and every time he tries again he ends with, "and if you don't like it we'll get a lawyer and sue your arse." After a few goes at that, I suggest that is probably not the tone we want to use and why don't I talk to them. I give the school a call and try to reason with them, and after a 20 minute conversation she agrees that if we have the words "NOT CONTAGIOUS" in a note, Reagan stays and the conversation is over. So I call my doctor and explain that apparently the school thinks you might be irresponsible and allow Reagan to go back to school so that she can infect 200 kids with some mysterious rash. Can I please get a note saying she is NOT CONTAGIOUS so we can end this? My offended doctor begrudgingly agrees and faxes it over. I call the school, they are satisfied enough that Reagan can stay and we can stop fighting about this. Which is good because by this point it was Tuesday and we had been fighting about it for three days. I thought that was the end of the story.

So Tuesday evening Reagan comes home. This is just hours after the school gets their note and they are finally content that she isn't contagious. I took off her stupid bandage and inspect the rash. I'll be darned if the stupid thing wasn't looking exactly like RINGWORM! Oh, crap! That's CONTAGIOUS! Sadly, my first reaction wasn't "oh no, my baby has ringworm!" My first reaction was, "I wonder if has a good recipe for eating crow. How on earth am I going to spin this with the school?"

Here is Reagan's rash the day we discovered it was Ringworm. This was actually taken by Bill on Reagan's camera.

It has been several weeks now and I sent Reagan in long sleeves to daycare all that time. She still has a very faint marking of it but we are still putting medicine on it and it should be gone soon. Good thing because the water park at her school just opened.

I learned some things out of this:
There are only two things that cause a circular rash: ringworm or Lyme disease. If you don't see a site of a tick bite, it is probably ringworm. Reagan's was very atypical in that is was small little spots in a vague circular pattern. That is what threw the doctor off. It generally looks like a big dark circle with white or clear patches in the center. As time went on, that is what Reagan's rash started to look like. If I had put medicine on it when it was just the dots, it probably wouldn't have gotten that far. If I ever again see anything remotely like a vague circular rash, the Lotrimin is coming out. I figure it can't hurt.

A little more information should you need to know:
  • Ringworm isn't worms, it's a fungus like athlete's foot.
  • Never cover ringworm with a bandage. It needs to stay dry. It will get bigger if it is moist. (darned school)
  • Good old Lotrimin AF, over the counter athlete's foot medicine, is all you need to put on it twice a day
  • Keep putting the medicine on at least one week after you no longer feel a raised rash or it might come back
  • You can get ringworm from other people or pets (pets are huge carriers). We don't know where Reagan got it since it hadn't been at her daycare, we suspect from her swimming lessons that she started just a few days before.
  • As long as you keep medicating it, it shouldn't leave that white ring scar that I remember kids having when I was growing up.
  • It shouldn't be contagious 24 hours after treatment begins. But as a precaution if possible I'd recommend covering the area with loose clothing if there is a possibility of direct contact with others.
  • If you don't treat it, it will spread to other areas of the body. The upper arm is the most typical place but it could actually appear anywhere.

So in the famous words of Paul Harvey, "...and now you know the rest of the story. Good day."


LauraC said...

OMG that has to be the worst feeling to argue with day care about that and be wrong! We had that happen with pink eye with Alex one time. We even took Alex to the doctor and they said "not pink eye" and we got them to write a note. When I picked him up at the end of the day, it was so clearly pink eye.

PS. I had impetigo in a perfect circle covering my CHEEK one time. Everyone thought it was ringworm. Nothing like having suspected ringworm on your face to really make people smile.

Karla said...

Don't you just hate being wrong?!?!?! Grrr...I would have been so mad!!! I hope that Reagan is doing better now!!

American Girl in Japan said...

If I laughed any harder about your HIPAA arguement I would have spit coke all over my screen. My God you sound just like me. This post was hilarious.

Deanna said...

Poor Reagan!! Ringworm is a pain and can be so itchy! Way to go on sending her in long sleeves. I hate arguing with daycare. I had ringworm about 4 years ago. Got it from a kitten I "saved". It appeared on the side of my neck and looked like the most horrible hickey ever!!! The vet told me I was hopeless catching ringworm from a cat! Thanks for the lotrimin tip. I finally resorted to vinegar and got it cleared, but man oh man did that sting!

cristie said...

OMG--I'm a nurse and didn't even know ringworm was simply a fungus that could be treated with lotrimin. I've been wondering what "part 2" of this story was. I'm so sorry you had to eat crow. I'm angry at your daycare on your behalf just for putting you through so much hassle about everything!

I know what you mean though--I kept taking Noah around Amy's family swearing he wasn't contagious with something and then he infected all her kids and I felt terrible about it.

Maria said...

Don't you hate winning an argument only to find out later that you are, infact, wrong? It's gotta be the worst. I am sorry Reagan has ringworm (why do they have to give it such a gross name?) and hope it doesn't return. We are still hoping to be done with the "hair bugs" from school over here. Here's to a yuck free summer.

MrsMoma said...

Oh goodness!!! I bet you were so mad.. lol!!

I'm glad to know all the pointers on ringworm though. Hope it's clearing up now.

Fullerton Family said...

Oh man, poor Reagan! My brother got that from a cat once, poor kid! It's nasty looking! Glad she's doing better!

Janet said...

I hope that Reagan is doing better. What a nightmare to deal with the daycare! I would have been so frustrated!

Suzanne's Blog, Jane's Blog said...

Sorry that you daughter had ringworm but it is not too bad. Don't let the school get you down think of all the times that they are wrong about things. Also don't let the other moms bug you about ringworm it can happen to anyone like you already know, just like lice happens to anyone usually after summer vacation from camps.
Have a great day and enjoyed your blog. Suzanne

Joanna said...

LMAO! I think it's great that you can win an argument even when you are wrong. Now just hope none of the other kids got it.

Mama Mia said...

I have been dying to know the end..thanks

ugagirl30 said...

My son had a suspected ringworm behind his ear. I took him to the doctor and she gave me a prescription cream. This cream was tried religiously for about two weeks with no change. I finally started treating it like eczema and it went away within a few days. But this eczema patch actually was perfectly circular. He has horrible allergies which is what made me suspect.

Your children are absolutely beautiful! Thanks for sharing your blog!