We’ve been lying low this weekend as BB#2 recovers from his recent day-surgery. He’s coping remarkably well! But it’s looking like we probably should have gone for a tonsillectomy two-for-one (or is that four-for-one?) because BB#1 is sick. Though it’s believed PFAPA is neither contagious nor genetic, it’s now pretty clear to us that both boys have it.
It was fairly easy the past several years to assume BB#1 was just regular-kid-sick from time to time. After all, his fevers haven’t been as alarmingly high, as frequent, or as predictable as BB#2’s. There was never a period where he was sick every two weeks, I don’t recall him missing birthday parties or many major holidays, and just when we’d start to get suspicious that something more was going on, he’d suddenly be fine for several months, while his brother continued to suffer regular episodes.
But the fact is, BB#1’s symptoms are the same as his brother’s: strep-like, but he never tests positive for strep. In between episodes, he’s healthy, and (on the plus-side of this syndrome) he rarely gets actual colds or flu. The episodes last about 48 hours, and in his case happen every four-to-six weeks (he’s probably been sick once for every two times his brother has had a fever this past year).
So though it’s taken us a while to connect the dots here, we’re now waiting on a referral to the same children’s hospital BB#2 is seen at for PFAPA. The question is, what if anything do we do if he is officially diagnosed? Apparently, most kids grow out of it by age ten—BB#1 is already nine. Waiting another four years for BB#2 to outgrow this syndrome was no longer feasible, but maybe it is in the case of his big brother. But is it worth treating him with Prednisone when his fevers aren’t scary-high and the episodes are relatively short and infrequent, knowing from past experience it may work immediately on the symptoms but result in him being sick more often? And how often is too often for a child to be ill—how many episodes before tonsillectomy is the next step?
But I guess first things first—waiting to see if the procedure has worked for BB#2.