Sickness and Diarrhoea

 

(Note for American Readers: NHS Direct is a helpline manned 24/7 which gives health advice and support. Nigel is a seven year old boy)

 

There was a wail in the middle of the night from Nigel's bedroom. His mum woke up at once as mothers do when their offspring need them. She came rushing into Nigel's bedroom to discover that he'd been sick in bed and he'd had diarrhoea as well. She helped him to the bathroom where she cleaned him up and sat him in the chair while she dealt with his soiled bedding. Fortunately Nigel's bed had a waterproof cover on the mattress 'just in case' of accidents such as that night. After rinsing out the sheets in the bath, she put them in a bucket to soak, gave Nigel a drink of water and put him back into a clean freshly made bed. She'd put a draw sheet across the mattress with a plastic sheet beneath to try to stop having to change everything. He'd also got a bowl to try to be sick into, if possible, rather than all over his bed. Her husband was away from home on a course he'd been sent on by his firm and her daughter was at university, so it was just the two of them. There had been an item on the news about the bug with the advice to phone NHS Direct if anyone in the family showed the signs and symptoms.

 

She phoned NHS Direct and, after a long wait, spoke to an advisor who took her name and address and gave her some instructions. Nigel's mother was asked his waist and hip measurements and as well as hers, which surprised her, their address and was told to stay at home until the bug had run its course, seeking more advice only if things became worse. She was told to expect a delivery shortly of necessary supplies. About an hour later, there was a ring on the doorbell and, when she opened the door, there were two large boxes on the doorstep delivered by a community nurse who was standing well back. “The instructions are in each box. If you have any questions or problems, please ring NHS Direct again for help. I won't come near as I'm afraid I can't afford to catch it from you.”

 

Nigel's mum took the boxes inside and opened the first one. Inside at the top was an instruction leaflet as promised. She sat down to read it. This is what she read.

 

Important! Please read carefully and follow these instructions. You have been delivered this package(s) because a member of your family or yourself has got the sickness and diarrhoea infection. This is highly infectious (contagious) and you are asked not to leave the house until all members of your family have recovered fully. This means that they have resumed a normal diet and have not had an episode of sickness or diarrhoea for seven days.

 

Inside this box you will find the following:

·         Oral rehydration sachets. It is important to drink plenty and these sachets should be made up according to the instructions on the box and drunk every six hours. The supply you have been given should last for two weeks. Do not eat or drink anything except water or these rehydration drinks until the sickness and diarrhoea has stopped. Usually the sickness will stop soon after the first day, but the diarrhoea may take up to a week or more to end. See attached sheet for details of what to eat as you build up to a normal diet.

·         Disposable nappies in the correct size. As the diarrhoea is very liquid and frequent, it is recommended that every family member wears these all-in-one disposable nappies until the infection has run its course. If you need more, please telephone 0954 8686261

·         Silicone based nappy rash cream. Apply to the area covered by the nappy after washing and drying thoroughly. Rub well in until none remains visible.

·         Clinical waste disposal bags (large yellow plastic bag) with black disposal bags for individual nappies. Please wrap the soiled nappy in the black plastic bag and tie securely. Put the black bag into the yellow bag. Please tie the top of the yellow bag on Wednesday morning and leave it outside your front door from there it will be collected.

·         If any of the following occur, please phone NHS Direct immediately:

Blood in the stool (diarrhoea)

Blood in any vomit

Rigor (uncontrollable shaking)

High temperature

Collapse

If you are unsure then please phone. It is better to phone than to have problems!

 

Nigel's mum had opened the larger box, which had the nappies in her size. She opened the smaller box to find that the nappies were for Nigel's waist and hip measurements. She took the box up to Nigel's room and read him the leaflet. She explained that she would probably be ill as well and that she was going to follow the advice to use the nappies rather than risk having an accident. She go the pot of cream out of the box and removed his pyjama bottoms. She read the instructions on the jar, taking out a suitably sized dollop of cream and rubbed it well in to his nappy area. Once she was happy that it was rubbed well in, she opened the packet of nappies. They were Tenaslips in the 'super' absorbency. She took one out and opened it up as she read the instructions on the packet as to how to put it on. The nappy had light green plastic as the waterproof cover with a shiny area at the front which, she learned as she read, was to stick the adhesive tabs to, and they could be unstuck and repositioned if necessary. The nappy was in the shape of a letter 'H' on its side. The inside of the nappy was lined with a soft fabric type material covering what she guessed was the absorbent padding. There were elastics around the sides of the nappy around where the legs would go so that the nappy would fit snugly. Inside the nappy running from front to back either side were elasticated fabric type guards which the pack of nappies said was to contain stool and to allow urine to soak up in the padding rather than leaking out the legs. They were called 'leg guards' by the makers.

 

She asked Nigel to lift his bottom, explaining that she'd be wearing them herself as it probably wouldn't be long before she came down with the bug too. She pulled the front up between his legs and brought the sides round. She unpeeled one of the tapes from an adhesive tab and stuck one leg closed. She repeated the same at the other side, pleased that she'd managed a good fit first time. The top tapes were done up for a close fit around Nigel's waist where there was an elastic across the back to allow movement, but prevent leaks.

 

“Now, Nigel, rather than my having to come to help you if you need the toilet, I suggest that you use your nappies when you need to go to the toilet and I'll change you when they are wet. There's a wetness indicator on the front so I'll keep an eye on them for you. I'll leave you without pyjama bottoms as there'll be less to wash if you do have an accident.” With that, she went to a cupboard where she'd kept the old baby stuff, which she'd kept meaning to give away. She found a baby bottle and a still usable teat, so filled the bottle and took it to Nigel. “Drink from this as you need to keep drinking.” She then made up another bottle with the rehydration salts and brought it to him to drink there and then. Afterwards she went into her own room and tried to put the nappy on herself. She found it wasn't as easy as it looked. In the end, she backed into the wall to hold the nappy in place as she fastened the tapes first at thighs then waist. She noticed as she walked that the plastic cover on the nappy rustled somewhat. She fetched herself a bowl and a glass of water just in case, then settled down to sleep wearing just an old tee shirt and the disposable nappy: what was proper for her son was good enough for her.

 

From the sounds, it seemed as if they woke up about the same time- mum to be sick and find that she'd already filled her nappy with the horrible slimy diarrhoea and Nigel to be sick again and, as she guessed and was proved right, fill his nappy too. Mum cleaned herself up and went to Nigel. She cleaned him up again, changed his soiled nappy and gave him some more water to drink. Nigel noticed with surprise that his mum was only wearing a tee shirt and nappy. She didn't look well either. They both went back to bed.

 

Nigel woke in the early hours of the morning desperate to go to the toilet. He suddenly remembered an put his hand between his legs where he felt the smooth plastic covering of his disposable nappy. Remembering what his mum had said, he concentrated on letting the warm stream of urine escape from him, only to be rapidly absorbed by the super-absorbents in the nappy. As he was doing this, his bowels heaved and dumped their load into his nappy where the leg cuffs were just about able to cope. The liquid stool immediately started to become thicker as the absorbent padding started to soak the liquid into the nappy's absorbent core. The bug had left him feeling really tired to he just fell back into the sleep of exhaustion.

 

He was woken up by his mum still in tee shirt and green disposable nappy just like him. She had brought him a drink before she was planning on putting him through the shower and changing him. He noticed that the wetness indicator on her nappy had disappeared and the brown stains visible through the plastic showed him that his mum had also had an 'accident' when she was asleep. Now he thought about it, it couldn't be babyish to wear nappies if his mum was wearing them too.

 

After he'd drunk from the bottle of rehydration solution, his mum came back after having showered and changed herself. He could see the different tee shirt and the clear blue of the wetness indicator on her nappy showing that her nappy wasn't wet at all. She helped him to the bathroom where she turned on the shower, stood him in it and peeled off his nappy, placing it in the disposal bag which had been provided, then in the yellow polythene clinical waste sack with the bio-hazard warnings printed on the outside. She showered him off thoroughly with soap and warm water, rinsed him and towelled him dry. She herself was too weak to carry him back to his bed, so she held his hand while they supported each other as she took him to his bed to cream him and apply a shiny new disposable nappy.

 

They were both fortunate that they weren't badly affected by the sickness side of the bug. They were only sick the once each. Soon they were empty of food residue and the diarrhoea was just liquid pouring through them. After three days on the oral rehydration sachets, they felt well enough to get up together to watch television. Mum spread a plastic sheet over the settee and they sat there together in nappies and tee shirts. Mum had left the curtains drawn across the windows to stop people looking at them dressed that way and had also turned up the room thermostat a little to make sure they didn't add a chill to their woes. Nigel loved it, curled up against his mum being hugged and loved by her. Their nappies crinkled audibly as they moved on the settee. Mum continued to give him bottle of water or oral rehydration drinks and he would lie on her lap smiling up at her as he sucked from the teat on the bottle. She changed them both as they needed it, with the toilet effectively being out of use for both of them while they still had the diarrhoea.

 

One day they both went through the day without diarrhoea. The next day they both started on the food programme starting off with light food in small portions to see if it stayed down and if it caused further diarrhoea. To their delight, they both seemed cured. That night, Nigel's mum, with a twinkle in her eye, said, “Nigel, you've got loads of nappies left. It seems a shame to waste them. Would you like to wear them still at night, then you won't have to get up if you're still wobbly? I can also give you a bed-time drink in a bottle with a cuddle too, if you like?” “Oh mum, please, could I?” came Nigel's swift reply.

 

Nigel was sad when the last of the nappies had been used up. The packet of his mother's was still half full and he wondered if, one day, he'd grow into those so he could wear disposable nappies again. He thought to himself that the sickness bug had been quite fun, once the worst of it was over!