Saturday, March 17, 2012

Viral Meningitis

This is going to be long, but I wanted to remember all of the details of what happened over the past few days.
On Thursday morning Dane woke up at 6 am to eat, like normal. But after he ate he went right back to bed. He usually would be awake at that time but I thought he was just a little sleepy. I wrapped him up in his blanket and put him in our bed and he was already in a deep sleep. After a few hours I thought it was strange he was still asleep so I went to check on him. It wasn’t until 11 am that I thought he really needed to wake up because it had been so long. I kind of had to force him awake and then I noticed that he felt a little warm. I thought maybe he just got overheated from being wrapped up in his blankie, so I took it off and then I stripped him down to put him in the bath to cool off.
Dane has always loved the bath. Always. But this time I put him in his tub and he looked like he was in pain. He just whimpered and had his face all scrunched up. So I quickly finished his bath and got him all dried and dressed and he immediately fell asleep again. Al was home that day and I commented on how sleepy Dane was being, but at that time I think we still didn’t really think anything of it.
I left a couple of hours later for a doctor’s appointment and Dane was still asleep. I told Al that he surely would wake up really soon and that he would be starving and for Al to give him a bottle. I was gone for a couple of hours. When I got home I saw that Dane was asleep in his bouncy seat. I said to Al, “Oh, he went back to bed?” And Al replied, “He never woke up.” I just looked at Al and told him that wasn’t normal. I grabbed Dane and he felt warm again so I took his temperature with the only thermometer we have, an ear one, and it said it was about 101 degrees. I told Al we needed to call the pediatrician. And so I did and they said bring him in right now.
When I got to the pediatrician they got us right in. Dr. Kagan came in, asked me a few questions, and started examining Dane. Dane even slept through this. He checked his ears, throat, etc. Then he checked his pulse. Dr. Kagan looked at me and he said that Dane’s pulse was going so quickly that he couldn’t even track it. Too fast to count. I just kind of stood there with a blank stare and then Dr. Kagan said, “I don’t want to scare you, but this isn’t good.” He started to rush around, calling a nurse to come and get another temperature while he called the hospital to say we were on our way. The nurse came in with a rectal thermometer and Dane’s temperature came in at 102.5 degrees. Too high for a 6 week old. Dr. Kagan told me again that I needed to leave right then and go straight to the ER.
I ran by the house since it was on the way, grabbed my phone charger instinctively, ran up and grabbed a few onesies and jammies for Dane, kissed Avery and James, and then I was on my way. We were in the pediatric ER at Hermann by 3:30 and by just after 4:00 we had been seen by a nurse there and were put in a private room. After that it was a parade of residents and nurses asking questions, explaining what the plan of attack was, taking vitals and so on. I think Dane’s resting heart beat was about 178 bpm. And if he was crying then it went over 200 bpm. Sometimes when I held him and stroked his cheek it would go down to the 160’s. Some time that night the nurse came in to get a urine and blood sample and to put in an IV for antibiotics. They had me leave the room, but I could hear Dane crying so hard. I was kind of peeking through the blinds and I told Al they had the lights off and I could see a red light. Al explained that they were using the red light to find a vein.
After a while the blood sample came back normal. I thought this was a good thing…but I guess it wasn’t. There has to be a reason for the fever. And so far they didn’t have one. There wasn’t any cough, or congestion, ear infection, etc. and that was a bad sign. And when the blood came back normal that was even more of a bad sign. They were still waiting on the urine sample. That’s when they said they needed to do a lumbar puncture and they brought in the consent form, explained risks, etc. I think I still wasn’t fully aware of how sick Dane was and I remember wondering if they really needed this test. I even asked the resident, “So…you think you need this lumbar puncture?” And he just replied that yes, they really need to do it. The attending came back with the resident after I had signed consent and she explained that they were going to hunch him over and go in between a couple of vertebrae and get some CSF. Then the attending said, “This needs to be a sterile environment, and you shouldn’t watch this, so we need to ask you to leave.” She told me to come back in about 15 minutes.
I called Al and tried to make plans for Avery and James for the night. And I wandered down to the cafeteria. Now it was 10:30 and I hadn’t eaten dinner yet and I was starving. I grabbed a few random things and headed back to Dane’s room. I had to pass the ER to get back to the pediatric ER, and it was packed. I made the mistake of glancing outside and saw two paramedics hosing down a backboard that was covered in blood. And then I got all queasy and the food seemed like a big mistake. I told Al that I didn’t belong there. It wasn’t my thing. When I got back to Dane’s room a nurse was holding him and he was pretty calm. Every time they had to do any kind of poke or procedure on Dane they gave him ‘sweeties.’ That is when they take a paci and dip it in a sugary solution and then hold it in Dane’s mouth. The babies like it so much that it distracts them for a second while everything is being done. Dane had a ton of sweeties that night. It was sad. There were open containers of sweeties all over the room.
After the lumbar puncture the doctors could proceed with antibiotics, so they quickly pushed two different types of antibiotics through the IV and then they moved us upstairs to a room. The pediatric ER was so busy that night that there were kids and parents lining the halls. As we were taking Dane upstairs the nurses were trying to decide who should get Dane’s empty ER room. Sad again. Kids shouldn’t have to be that sick.
We arrived on the 8th floor, and it was beautiful! At least if kids have to be in the hospital they get the nicest part of the hospital! Everything was brand new and sparkling clean. The entire floor is decked out in a baseball theme, and despite it being a hospital, it was really cute! By the time we were settled in the room it was 1:30 am. The nurses were trying to decide if people had to wear masks to be around Dane, to come into his room, etc. They didn’t want me to feed him until the doctor gave the go ahead, but luckily Dane wasn’t alert anyway. Shortly after, a doctor that was on call came in to check on Dane. We went over all of the information and questions again and then he looked at Dane in my arms, fast asleep. He did a little sternal rub on Dane and Dane didn’t move. He tried again, with no response. Then the doctor got a little panicked and said, “Hey, I need you to go put him in the crib for a second.” So I placed Dane there and the doctor did the rub again, a little more forceful. Finally Dane’s arms started flailing a bit. The doctor looked relieved and then said that he wanted to start some fluids and so the nurses came and hung a bag of electrolytes. It wasn’t too long before Dane started to wake up more and then he finally ate. By the time this was all over and the nurses had been in and out a few times it was 3:00. I called Al at home and started to cry. I hadn’t cried until then. I had prayed for Heavenly Father to please make me strong. I am usually a crier…and I was strong. But I knew I couldn’t leave Dane here and go home to the other kids so Al could go to work. The thought made me sick to my stomach and panicked. So I just cried to Al and said I couldn’t leave. I just couldn’t. Al made a few calls and arranged to go into work a bit later. Thankfully his coworkers were very understanding.
I finally was alone in the hospital room with Dane, in my clothes from the day before, and I just sat there feeling like I had been hit with a ton of bricks, wondering what had happened. I lay down in the bench in Dane’s room, in my clothes, and closed my eyes. I slept for about an hour before the rounds started.
It was a day full of rounds. Nurses taking vitals, residents scouting things out, the infectious disease team, the pediatric team, etc. And also the texts were coming in like crazy, from the ward members, from family members, friends, etc. I tried to keep up with all of them, and it was good because it kept me busy.
The pediatric team was intimidating. It was a team of about 6 doctors that came in to check on Dane. They were talking about him right in front of me, but not to or at me. Weird. Then the attending started talking to me. She was intense. They had just poked and prodded Dane and he was crying so hard. She was telling me that they didn’t know exactly what was wrong, but they knew he had meningitis. At the time they were rounding, my good friend Kim was at the hospital picking up my house keys so she could go home to get some things for me. The attending launched into this speech about how we didn’t know exactly what was wrong with Dane and how we shouldn’t have visitors and that the hospital was full of infectious disease, and so on and so forth. Right after the speech a paci fell out of Dane’s mouth on to the hospital floor. I was horrified when she went and rinsed it off in the sink for a couple of seconds and then put it back in Dane’s mouth. I wanted to scream. That is something I wouldn’t do at my own house! Let alone, the hospital!! Then she went on about how she didn’t think Avery or James should come to the hospital. We needed to be really careful about not contaminating Dane with any other germs.
As the day went on and tests results started coming in, it was looking like Dane had bacterial meningitis. His CSF had a really high white blood count. Usually it would be around 10-80. Dane’s was almost 1000. He also had low glucose and high protein in his CSF. This usually points to bacterial meningitis as well. The attending explained to me that the bacteria like to feed on the glucose, which is why the low glucose was giving them the impression of bacterial.
As the day went on I anxiously awaited more news about the test results. The infectious disease resident, and then the team, both told me that it was leaning towards bacterial meningitis as well. They just were waiting for more conclusive tests to be completed. It takes a couple of days to grow the cultures that would confirm a diagnosis. In the meantime they were quickly working the antibiotics into Dane’s system, aggressively treating for bacterial meningitis. There is no time to waste when it comes to bacterial and even a couple of hours could make all of the difference. So they had to start treating it as bacterial just to cover all of the bases.

It wasn’t until the evening when the tests results came back as positive for viral meningitis. I was on the phone with my mom at the time when Al came in to tell me the news. I was so numb to everything at that point that I didn’t really react at all. Just kind of nodded and mumbled the words to my mom. My mom on the other hand started to sob and had to get off of the phone.
A while later a nurse came in and said we were being moved to the 10th floor. We had been on the surgery floor for some reason, but they were moving us to the normal pediatric floor. A couple of men from our ward showed up at that time. They were going to help Al give Dane a blessing. We got settled in on the 10th floor, after the nurse had to fix Dane’s IV that was coming out of his arm. That was sad too. Poor little guy. When we were left in quiet Al and our friends were able to give Dane a very nice blessing. Then everybody left and it was just me and Dane. I put Dane down on the hospital bed and I curled up around him and we both drifted off to sleep for a bit. Our bishop and his wife came to visit that night, which was so nice of them, and I had a good visit with them. That night was a little bit more calm, but we still had nurses in and out taking vitals. Dane’s fever went up again, and he was given more medicine, but overall the night was much better.
We were really happy when they said we could go home Saturday morning. I thought they were going to make us wait until Sunday, to give the bacterial tests the full 48 hours. But the fact that the viral test came back positive was almost assurance that the bacterial would be negative. There are more details to all of this, but this account is already so long. I had to take Dane in to his pediatrician the following Monday and Dane looked really good. He had gained back the wait he had lost in the hospital (almost ½ a pound) and had put on a few more ounces. The doctor again just talked about how scary meningitis is, how he was so glad that Dane was okay, and to keep Dane away from people for another week. It just wouldn’t be good for little Dane to get sick again. We have another appointment next week and then Dane should be given a clean bill of health.
I have had time to reflect on everything now that Dane is better and I don’t have to worry as much anymore. Now I just feel sad and panicked when I think about it. Things I didn’t allow myself to feel while I was going through it. Today I was folding Dane’s laundry and I came across one of the pairs of pajamas he wore in the hospital. I almost cried and I felt a tightness in my chest. It is too sad to have a sick 6 week old baby. I still feel like I am decompressing from it all. I need to go shopping!!! I know there are much worse things out there and I am so very grateful that he is okay. We have truly been blessed. We have had so much love and support from friends, ward members, and family. In that way it’s been an awesome experience. Heavenly Father really helped us out through this one.