Two Sundays ago, a local park hosted "Kids Day on the Farm", a full day of baby animal feeding, pony riding, face painting, tractor riding & other such farm-o-licious activities. Needless to say, the kids loved it. But it was HOT. When we finally returned home --red-faced and sticky-- we all just wanted to plop down on the couch and veg. So it wasn't a surprise that Josh just wanted to lay around all evening. It was odd that he put himself to bed before 8pm... but who am I to look a gift horse in the mouth? The next day the kids and I met friends at the beach and spent the day splashing in the water, building sandcastles, searching for shells... but not Josh. He curled up on one towel, covered himself with another, and wanted to be left alone. Then he crawled into my lap --an everyday occurrence for Cara or Yao, but not Josh. He burst into tears when a friend's daughter touched his pine cone. Still only mildly concerned, we went home where Josh sat idly staring into space while I unpacked the car, then fell asleep on the dining room floor. I put him on the couch. Where he fell immediately asleep. Also, he had started incessantly sucking at his lower lip. I started googling "lethargy"...and that's when it crossed my mind that he had been hit in the head by a heavy door on a friend's boat the week prior. Lump, ice, back to swimming, no-big-deal. But when my search of lethargy+blunt force trauma to the head+personality changes = things such as brain bleeding, then I called the doctor. Who said to bring him in right away.
At the pediatrician's office, we saw a different doctor in the practice. The doctor was concerned about the lip sucking most of all. He asked if Josh was developmentally typical. He said Josh was resorting to "primitive behaviors" (um, doctor, want to see primitive behaviors, come check out my house any day of the week!) He was sure Josh was having a seizure, was bleeding internally, or had meningitis. By now, our regular pediatrician came in and was asking Josh cognitive questions, which Josh was responding to with a mix of blank stare and lip sucking. We were sent to the adjacent hospital for a CT scan (ok.) and a spinal tap (YIKES!) I said I preferred him to be seen at Johns Hopkins instead and the doctor said we didn't have time to get to Hopkins (DOUBLE YIKES!) He said to enter through the ER and they would be expecting us.
So off we went for tests. I have to say that Josh's lethargy certainly came in handy --he was relatively calm through receiving his first IV, sat perfectly still for his CT scan & didn't bat an eye when, at about 1am two crazed teenagers were admitted who spent the night screaming, attempting escape and being restrained by the police. He even slept quietly when, at 3am, they sent us to Johns Hopkins by ambulance to be seen by the pediatric neuro team. He never woke until he was in his new room.
By the time he woke at Hopkins, Josh was showing signs of getting back to himself. His primary concern was that there was no remote for the tv like there had been at our local hospital. He was still quiet and compliant (so not completely back to normal ;) Concern lessened over the hours --at one point the doctor was asking Josh questions and asked if he liked Dora the Explorer. I said, "Oh, Cara does, huh?" to which my 4 year old wise acre replied, "Cara? Who's Cara?... Oh... is she the small one who likes pink and eats Band Aids?" Um, messing with the neuro team --not funny, mister. Josh was back and within a half hour he was breakdancing in the hospital cafeteria to prove it.
So after all of that, it was likely just a quick virus combined with a little nervous lip sucking. Josh is back in full force --bouncing, yelling, laughing, running, bothering his siblings. Still primitive, but oh, so wonderfully four.