Sunday, April 15, 2001

the ER not the TV show

The picture is of me and my daughter at 17 months old, a few months after this ER Episode

I am sure every parent at one time or another has had a health emergency with their child. But, when it's you, you're the only person in the world who has ever had to go through something like it. When you’re in that moment you never think to yourself that this has happened to others, you are just dealing with the problem the best way you know how.

This may never happen to you, and yet again, maybe it will. You may not think about me or my daughter the next time your rushing off to the hospital, and I hope you never have to, but this is something all parents need to know.

My Husband and I recently had a horrible experience with our 16 month old daughter. It was the most scary, terrifying thing to date I have gone through, and I hope to never go through it again.

A few months back my daughter had a febrile seizure. The night before Valentine’s Day, we were sitting in the living room and eating some french fries and I put her in her high chair to let her have some with us. I sat back down in my chair just a few feet across from her, watching her while she was eating. All of a sudden she started to lean to one side and her eyes were rolling back in her head.

It was so sudden and fast, that for a long time, and even now, I could not stop thinking about how I may not even have noticed it if I had not have kept her up from her bedtime, and let her share some fries with us, since she was so wide awake. She at this age, doesn't co sleep through the night anymore, much to my displeasure and much to her liking.

All of a sudden, she just started to twitch her fingers, hands and her feet. Her head drooped to the left side, while she drooled and her eyes were widely dilated. I spoke her name a few times and asked her to look at me but she was non responsive, with her eyes rolling back in her head!!!

I had a high school friend who was epileptic so I knew immediately that she was having a seizure, but not knowing why she was having one sent my brain spinning thinking of all the possible reasons, and worrying about her future!!!!

Diabetes, epilepsy, brain tumours, stroke, heart problems which run in my family, and blood clots all went running through my head. I was so sacred at that moment, the room was spinning so fast, yet time seemed to stand still.

I cannot put words to the screaming my soul was doing as I watched my husband pick our daughter up in his arms and try to let the mucous fall from her mouth and nose so she could breathe, while I picked up the phone a dialled 911. I ran so fast for the phone I hurdled over the coffee table to the couch like an Olympian. for a 4 foot 11 woman who is considered "morbidly obese " by the BMI, that's a feat in and of itself.

She was limp in his arms and he talked to her and tried to get her to come out of it by saying her name and asking her to wake up. I can only imagine that the expression of concern and fear on his face was mirroring mine.

While I was on the phone with 911 waiting for the paramedics, her lips started to turn blue from lack of oxygen! Panic and fear ruled our actions as I yelled at the person on the phone to do something and to get to the house faster!

The dispatcher told us to lay her on the floor on her back, but we were concerned about the mucous she was bringing up and the fact that she was not breathing well. So, my husband, having St John’s Ambulance training, laid her in the recovery position on her side, facing downwards. The dispatcher was probably directing us step by step to get her to the recovery position, but he was not fast enough for me! When my husband laid her on the floor on her side, she came out of the seizure which was not related in any way to putting her on the floor, but at least it was over. It only lasted about two minutes, but it felt like an eternity!!!!

She coughed a lot and breathed a bit better, but she was very confused and upset. Her little face was getting color back, and her eyes showed how confused she was, while she looked up at us for an explanation and reassurance.

Just about then the paramedics showed up, and assessed her, and carried her out to the ambulance and off we went to the hospital. She was dazed and quiet when they were there in the house, but began crying immediately when they picked her up. They would not allow me to carry her to the ambulance because it was February and slippery outside.

In the ambulance they strapped her down to the gurney, and she wailed at the stranger trying to confine her. They told me that was a good sign; a strong vocal cry meant she was doing well. That didn;t really make me feel better. well in a way it did, but I was also upset becasue she was afraid of a stranger and being tied down to the bed. I sat in the back with her while she cried and screamed out of fear for being strapped down to the bed and getting an oxygen mask on her face, and I cried in fear, from relief that she was not seizing anymore, and concern for what was to come, while trying to comfort her.

My husband rode in the front calling his mother two provinces away on our cell phone. We were calling to tell her about the emergency as well and to see what she had to say since she is a RN. She told us to hang in there, and to keep her informed and to let her know if she had a fever at all, because that would be a good sign.

When we got to the ER we found she had a fever of 103 degrees. They gave her Tylenol right away, and we changed her bum, because she pooped and peed during the seizure badly. After that, she was slowly beginning to get back to herself, looking around at all the things in the assessment area she was in.

We were in the ER for about 3 hours while they did a CBC, chest x-rays, and blood and urine cultures ruling out things like meningitis. In between the tests she was happily running all over the ER floor, checking things out, and playing with the bear that the paramedics gave her. The blood tests were the most traumatic for her, and it killed me to have to hold her own while they stuck her for the second time, because they had dropped the vile they had collected and smashed the container, making the sample useless.

After they gave her stickers for her teddy bear it was like nothing even happened as far as she was concerned. I, on the other hand was a basket cases trying to hold it together for my baby, while my husband who understood medical speak tried to reassure me.

Everything appeared to be fine, and she was ordered to stay on baby Tylenol for the fever to keep it down, and they signed her into stay on the paediatrics floor over night for observation.

They assessed her with having had a febrile seizure, due to a flu virus that my husband and I had been fighting off the last week, and said it was not really serious or life threatening. That didn’t make me feel much better at the time since we had to wait for the blood and urine results for a few days, and were basically sitting there with only speculation and no knowledge of why she had had the seizure. I felt even worse when they told me that not much is known about why some children have them and others do not, but they were fairly sure she would never have one again.

We had a terrible time in the Paediatrics Ward. When we got there they knew we were coming up from the ER, but had no clue as to why, and asked us silly questions. I am sure they were just trying to fill out their charts and get caught up on the situation, but they thought she had the seizure earlier in the day and only brought her in at midnight and were rather rude to us. ( same hospital she was looked at after she was born, seemed that the "great" staff are all the same regardless of what ward they are in.)

Since my daughter was scared and tired without her natural surroundings to be comfortable she slept for all of 30 minutes out of pure exhaustion and cried hysterically the rest of the time until almost six a.m.

I finally had enough of them not doing anything for her but giving baby Tylenol. they never offered her a drink, a cool towel, or anything to comfort her. I finally lost my patience for the whole situation and signed her out of the hospital against medical advice, since they were not doing anything for her that I could not do for her at home anyway.

I felt the traumatic experience of being in the hospital was worse for her then the actual seizure. They told us she could not see her own paediatrician until 10 am and they didn’t even offer her a drink of juice which I felt was common sense that a child with a fever should be kept well hydrated, but they just ignored us mostly until we were trying to sign out.

We got her home, checked her temperature, gave her more Tylenol at the next four hour interval, and a big cup of orange juice, and she slept until the early afternoon peacefully, with me and my husband nervously checking in on her every 10 minutes.

We were very tired, but relieved a bit, that she was back to her normal little self.

I didn’t know anything about febrile seizures so off to the Internet I went seeking information. I had to search it more to ease my mind.

I had been so scared to death that I was losing my beautiful little baby, the explanations I got from the ER doctor was not enough for me to feel better, since I had never heard of this happening before.

I found out from reading and talking to lots of other parents that febrile seizures are a lot more common than I thought they were, and I now know about five families who have had their child have a febrile seizure or even more then one.

It turns out that Febrile Seizure means “fever seizure”, which simply is when the body gets a fever very fast and it causes the body to start convulsing. It is thought to be caused more from how fast the fever comes on then the actual temperature the fever reaches.

Generally the child will lose consciousness and their body will twitch, be very limp and will be moving the limbs on both sides of the body. Although it is less common to see, some can become rigid or have twitches on one side only, such as a twitching arm or leg on one side only. I didn’t understand that at the time they were asking how she acted in the seizure, but it was important to know because grand maul Seizures are different in appearance and can last much longer.

About only 3 to 5% of Children between the ages of 6 months and 5 years can be prone to having them if they get a fever that causes the body to become over heated within a short period of time. There seems to be an unknown reason for children to stop having fever induced seizures after the age of five, but the medical society speculates it is due to some unknown maturation of the brain, that was not present before at a younger age when they would have had the febrile seizure.

The National Institute of Neurological Disorders and Stroke funded scientists are looking at what environmental and genetic risk factors cause children to be susceptible to febrile seizures. Some studies suggest that women who smoke or drink alcohol during their pregnancies are more likely to have children with febrile seizures, but more research needs to be done before this can be clearly established as a direct link. They have determined that children who are prone to febrile seizures could have a genetic pre-disposition to them if they had a parent or grandparent who had them as a child. But they can occur in children with no genetic predisposition for them at all, as our daughter was.

They are also working to locate factors that can help predict which children are likely to have recurrent or long-lasting febrile seizures, while they continue to monitor the long-term impact that febrile seizures might have on intelligence, behaviour, school achievement, and the development of epilepsy. At this time there seems to be no evidence of long lasting effects of them, and it is not a determining factor for children who develop epilepsy

A febrile seizure usually lasts no longer than 1 to 3 minutes, and is not harmful and leaves no long lasting effects to the child, that has been detected so far. Usually the only cause for concern with a febrile seizure is if the seizure lasts longer then fifteen minutes. They do not need to be treated with anti convulsion medications, and there have been some indications of the medications being more harmful to the child the seizure itself. If your child is not diagnosed with a condition and has only had a febrile seizure, it is recommended that seeking a second opinion, if the doctor suggests it, is a good idea.

A week later we had an appointment with our daughter’s paedatrition and he recommended the course of action with a febrile seizure is to treat the fever with keeping her well hydrated and using an over the counter children fever medicine. It will not allow the body temperature to spike fast again, possibly causing another one. He said since our daughter had the seizure for the first time, it was a good idea that we took her to the hospital and got tests to rule out serious problems like meningitis, roseola, upper respiratory viral infections or epilepsy, but if she had them again with a fever present, there is usually no need to rush off to the hospital each time for tests.

Our paediatrician recommended laying the child on their side in the recovery position, making sure the mouth is clear of any food, or objects, and allowing the seizure to run its course. You should track how long the seizure lasts if you can remember to look at a watch, so you can tell your doctor. If it lasts longer than ten minutes you should take them to the hospital. Once the seizure is over, helping your child understand that they are ok, and comforting them and you, and treating the fever is the next step. The child’s doctor should be informed of the reoccurrence, and they may wish to run some tests the next day, but the emergency room is unnecessary unless it lasted for a long time.

Health Canada and the World Health Organization says that you should never hold or restrain a child during a convulsion, and to prevent choking, gently remove all objects in the child's mouth. The parent should never place anything in the child's mouth during a seizure, as was once thought many years ago.

The majority of children with febrile seizures have rectal temperatures greater than 102 degrees F. and that most febrile seizures occur during the first day of a child's fever.

The chance of a child having another seizure is 25% to 30%. And the more febrile seizures a child has, the higher the chance of them having repeat ones increases. Most children won't have a second seizure and the risk of another febrile seizure is slightly higher if your child is younger than 18 months when they had the first one, if there's a family history of febrile seizures, or if the fever wasn't very high when the seizure occurred.

It was a scary thing to experience as a parent, and still even to this day, many months later, I keep an eye on her if she has signs of a flu or cold with a slight fever, for that fear still in the back of my mind. She has remained seizure free since then, and continues to grow and become a very exploitative happy toddler.

I held her so close for days after that ER episode, just hugging and kissing her forehead and thanking the powers that be for allowing her to still be with us and remaining a healthy child, I think I've made her crazy

No comments: