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rash

ParentsMarch 6, 2018

The least fun parenting game there is: Guess that rash!

rash

It’s almost a rite of passage when you’re parenting small ones – what caused the violent rash spreading over your child’s hands and face? Donnelle Belanger-Taylor was surprised to find the source of her child’s week-long rash might be in your backyard. 

Send your kids outside, they said. It’ll be good for them, they said. Get them out doing those old-fashioned, hands-on things, and they’ll be better for it. So when our fibre install required the neighbour’s tree to be cut back, we did so (with permission), and then helped our eight-year-old twins, Finn and Genevieve, to build a hut with the branches.

It started with a scratch. A simple red line on Finn’s chest, the sort of thing you expect on a kid who climbs trees and makes huts. He had a few red spots on his arms, too. We thought they were probably insect bites, which he does mildly react to. My Facebook post on Monday afternoon reads “Who’s up for a round of everyone’s favourite parenting game, ‘Guess that Rash’?”

By the evening, the red had started to spread, and it looked inflamed. The red spots had been scratched raw. We gave him antihistamine and applied antiseptic cream.

On Tuesday morning, the line on his chest was surrounded by an angry red patch. His twin sister made him breakfast in bed, and surrounded him with soft toys as I organised a doctor’s appointment.

Finn after and before.

By 9am, his eye had started going puffy. The GP contemplated him for a while, before concluding that “it looks like lots of things going on.” Too sudden for scabies, and the balance between allergic reaction and infection was too unclear to risk a steroid cream. We went home with more antihistamine, and some antibiotics.

A few hours later, red spots were creeping up the side of his face. Friends in the US swore it was poison ivy, but we don’t have poison ivy in New Zealand.

On Wednesday morning, I took him immediately back to our GP clinic, with a puffy face and rash spreading down his torso and arms. This second GP was also perplexed, and referred us on to Middlemore Hospital. I spent 30 minutes driving around the carpark in vain, while more and more cars joined the circling hordes, before parking a kilometre away and piggy-backing him in. Multiple doctors, including a paediatric specialist, threw around theories like penicillin reaction, a virus, bacterial infection, and so on. They distracted him with Minecraft while they stuck an IV in his hand to take blood samples, kept an eye on his breathing (which was fine), and sent us home 10 hours later with a stronger antihistamine, emollient cream…  and a puffier face.

They said it was most likely an allergic reaction, and to come back early on Friday for the dermatology rounds.

Genevieve fussed over him from the second we arrived home, telling him off every time he scratched. He was frantic with itching, so we gave him a Pinetarsol bath as the doctors had suggested. I listened as they debriefed each other.

Genevieve: So what was hospital like?
Finn: Lots of nurses…. TVs!
Genevieve: When daddy said you were at hospital, I nearly cried because I missed you so much.
Finn: I missed you so much too. That’s why I didn’t want to go to hospital.
Genevieve: You look so cute with your chubby cheeks.
Finn: I look terrible.
Genevieve: No, you look cute! Like a chipmunk!
Finn: I hate chipmunks.

It was adorable.

On Thursday, his face was puffier still. When he vomited, I called Healthline to check if that was a possible side-effect of the new antihistamine. The nurse sounded concerned as she said that it was an anti-emetic, and after assessing his general condition, sent us back to Middlemore. Stuck at the ramp lights as he vomited, I pulled over for a quick clean-up. My phone rang. His twin sister had been sick at school.

I’ve never been so glad to hear that we had a tummy bug going through the family. His general condition was still concerning, so once he was cleaned up, we went on to Middlemore. Another round of multiple doctors expressed confusion at what was going on, despite his repeated insistence that the problem was that he was turning into a chipmunk, but we got him rehydrated before they sent us home again in the afternoon.

By bedtime, his face was significantly puffier than when we were discharged, especially around his jaw line. His breathing was not affected at all, so after a lengthy phone consultation with a friend who is a paediatrician, we decided to monitor him overnight. Finn got the couch; I got a mattress on the floor, and I lay and listened to him breathe.

Finn

On Friday morning, the puffiness had finally started to recede – but the redness was spreading across his stomach and down his legs. I chronicled the progress on Facebook, and received a message from an online friend.

“Does he climb trees a lot? When I was his age I had a reaction like that. It was a rhys tree or something, and it’s only poisonous at certain times of the year.”

I googled, and discovered that the tree branches we’d so stupidly made his hut out of were from a rhus tree, Toxicodendron succedaneum, also known as sumac. It’s related to poison ivy and poison oak, and has the same allergen (urishiol). Susceptible people can have delayed reactions to it, and because urishiol is an oil, it sticks to the skin and needs to be removed with soap and a firm flannel. We’d probably been spreading it across wider areas every time we applied the emollient cream.

(In a further piece of joyous news, urishiol also sticks to fabric, and so we needed to wash all the bedding he’d used. After so many unsettled nights, that included his bed, our bed, the couch, and the mattress on the floor. Saturday was busy.)

At last we had an answer. Since we were confident now that it was an allergic reaction, not an infection, it would be OK to use a steroid cream. I took him back to the GP clinic, where we had a new doctor.

She took one look at him. “Is that a rhus tree reaction?”

Where was she four days ago?! We went home with hydrocortisone and hope. I offered him a celebratory ice cream.

“No. I’m not in the mood.”

“Oh dear. What would you like to do?”

“Go to Antarctica, find an active volcano, and jump in.”

Oh dear.

Since rhus tree had been such an unpleasant surprise for us, I posted in a local Facebook group. Multiple people exclaimed that their kids had had a reaction to something in the past, and they recognised the tree. I suspect there will be a few trees coming down in the neighbourhood, but they’ll face the same issue as us with our hut branches: too poisonous to chip, too poisonous to burn, so what do you do? I’m waiting for advice from Auckland Council.

It’s now been over a week since he first started reacting. The earliest patches on chest and face are slightly pink, a little raised, and rough to the touch. We’re slathering him in emollient to combat the dryness. His thighs, arms and puku are still blotchy and red, but the itchiness has subsided, and we know that it’s just a matter of time before his skin clears up.

We’re fortunate that his allergen is relatively obscure and easy to avoid. I only wish we’d known there was a tree like this in New Zealand. At least now you know!

Donnelle Belanger-Taylor is a mum, a software developer, and a mediocre tuba player. She suffers from a near-terminal case of chronic volunteerism, and is an ardent supporter of adult learner musicians. 

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