Someday I will use guilt to my advantage with Edward, but for today, the guilt is all mine. Saturday night he woke up screaming at about 10:30. He would not take the pacifier and nursing only soothed him momentarily. Then back to screaming. In the past this has meant one thing--ear infection. We gave him Tylenol and called the 24-hour nurse advice line to see if there was any way to resolve this without a trip to the emergency room. Unfortunately we do not have an urgent care clinic in the area so on weekends and after hours the ER is the only option. In a college town, the ER on a Saturday toward midnight is not fit for man or beast, and certainly not for a baby!

It took a long time on hold but I finally talked to a nurse who listened to all the things we'd done (Tylenol, rocking, holding upright, warm compress) as well as Edward's behavior pattern (normally a solid sleeper--only wakes up screaming with an ear infection, which has happened twice before) and seemed convinced that the ear was the problem. She decided to page the doctor on call to see what could be done without coming to the ER. But when the doctor called back there was no negotiating--she could not, would not provide any medicine without seeing him. I understand this, but that doesn't make it any less frustrating at midnight with a screaming kid.

John had an inspiration to put Edward in his carseat and rock him that way. Eureka! He fell asleep so we left him in the carseat in our bedroom and went back to bed hoping for an hour or two. We got four, which was an unexpected treat. At 4 a.m. he woke up, but soon settled back to sleep propped up on John's arm in our bed. We made it until about 6:45 that way, though Edward was pretty restless and I got kicked in the head several times. Not restorative sleep, but better than wide awake.

On Sunday he seemed better and we even got him to take a 2+-hour nap laying in his crib, so we started to think maybe we were wrong about the ear. Maybe it was mouth pain? Oh, the drool in this kid! We went back and forth about the wisdom of a daytime ER trip on Sunday but since he did not seem uncomfortable we decided against it, vowing to kick ourselves if we had another midnight screamfest. There was no kicking. Edward slept through the night with one or two coughing fits and one 4 a.m. meal.

He was cheerful this morning and ate breakfast as usual. We felt we'd made the right choice, but I decided to call the doctor once the office opened to see if he could just get checked to be sure. They got us in by 10:45 a.m. The doctor looked in the left ear, which is where his other two infections have been. There was quite a bit of wax, so she said she thought it looked red (i.e. infected) but couldn't be sure. Then she looked in the right ear. "Woah!" she exclaimed. "That's not just red, it's bulging and opaque."

Stab me right in the heart with the guilt knife! He could have started getting better a full 36 hours sooner if we'd gone in on Saturday night. Well, given how long we might have languished in the ER waiting room, maybe only 34 or 35, but still.

So now he's back on the antibiotics, which have worked quickly the last two times so we'll hope for the same this time. Now that he's had three ear infections in the first eight months of life, all in the summer, there is cause for concern about this becoming a pattern. We will have to follow up with our doctor in a month so she can see how the healing is progressing. Then a few weeks after that he'll have his regular 9-month well-baby check so they can look again. By then we'll be into October and heading into the worst part of the year for colds, which of course are the precursor to ear infections. But by then he'll be spending even more time upright than he is now, so maybe that will help keep things drained.

I can't stand to see him in pain and be powerless to fix it. But I also can't stand the thought of him having surgery--even as simple a procedure as placing ear tubes. We are very lucky to have immediate access to such great medical care, but I really hope we won't need it.