Wednesday, November 24, 2010

1st (and hopefully the last!) convulsion scare

It was a lesson learned the hard way. I had to admit that I was largely at fault for what turned out to be the scariest weekend I’ve ever had in my life so far.

Thursday, November 18

I came home that night and found Aren and tatay watching tv as usual. Around 7pm, we felt that he was a little feverish, but he did not seem pale or weak. We decided not to give him his nightly shower, not even sponge bath. At 9pm after his pre-sleep milk, we took his temperature and recorded 39.1. Rands asked me, “Di pa ba natin bibigyan ng gamot?” I said, “Observe muna natin,” and recorded his temperature in a notebook. Aren fell asleep then.

At around 10pm when we were about to sleep, we took his temp again and this time recorded a 38.6. I don’t know what the hell came over me that I did not even bother to give him paracetamol! I still just recorded that in the notebook and went to sleep, probably half-thinking that it would still go down that night.


Friday, November 19

I woke up suddenly and Rands was hovering over Aren. Then I saw a horrifying scene: my almost two-year-old baby still lying on the bed, had his shaking arms stretched up in the air, fists clenched, whole body shaking, eyes rolling up, making soft grunting sounds. Rands was calling to him, in an effort to make the shaking stop. My instinct made me pick him up and hold him close to me, then I felt his body was very very hot. I glanced at the clock: it was 1:30am.

Rands woke my parents up and ran to get a basin of water and a spoon to put in Aren’s mouth. The shaking stopped after a few minutes (it could’ve been seconds, I don’t remember), and we decided to rush him to the hospital. I was holding him while Rands ran to get a taxi and my mom put his bag together and my dad was wiping his arms with cold towel. I was hugging him and talking to him, practically begging him to respond, but his eyes were a blank stare.

When the taxi came, my mom took Aren and wrapped him in a blanket while Rands and I got dressed and put together a bag. We decided to take him to UDMC, where my pregnancy and childbirth records were. At the taxi, we were trying to stimulate his reaction by talking to him the whole time, but he was still staring. Then he vomited in the blanket.

In the emergency room, when I put him down on the bed, he started to cry and shouted “Mommy!” It was my first smile since the incident! It only meant that he was well enough to react to stimulus already! They inserted a suppository for his fever and it immediately went down. I removed the puke-stained shirt and blanket, and they gave me a hospital gown. It was my first time to see a hospital gown so small, and it was on my baby!

Aren in the ER in a small hospital gown and oxygen mask


While Rands filled out forms, the residents were asking us routine questions about the incident. Somebody asked, “Anong oras yung huling paracetamol nya?” I was horrified! I hadn’t given him paracetamol at all! I realized at that point that I could’ve prevented the whole thing if I had listened to Rands about giving it! I felt so guilty!

We were told that usually when it was the first episode of convulsion, they advised admitting the patient for monitoring. We did not think twice, Rands secured us a room using Aren’s healthcard. Then they said they had to attach an IV to his little hand! I did not dare look while they did, I was just whispering calmly to Aren the whole time. The resident asked for a spare diaper to put over his hand so he would not play with the needle. We called it his Manny Pacquiao glove.



Aren's Manny Pacquiao glove (a diaper over his IV)

Aren was so cranky that I put him to sleep while waiting for our turn in the x-ray. They also asked us to put the oxygen mask on him. After only a few minutes of sleep, we had to be wheeled to the x-ray. Rands and I were asked to wear blue heavy suits for protection, while we restrained Aren on the flat surface (I wouldn’t call it a bed at all!). We were just telling him that it will be one big camera and he had to smile. As expected, we could not hold him still, so the procedure had to be repeated. To think that a front and lateral x-ray had to be taken! Aren was so stressed! Luckily, he was calmer during the second take, so the technician was able to get a better shot.

After that, we were wheeled to the 6th floor. Our room was a small private, and we were told that we were in priority waitlist for the big private. For the hours that followed, Aren would be able to fall asleep, but then had to be woken up for temp-taking or an oral dose of paracetamol, which had to be given round the clock. He was also given a regular dose of diazepam, an anti-seizure drug, through his IV.

We were told that Aren was not supposed to be given any food or drink because he would be due for a blood test at 8am. But he woke up again at around 5am, his usual milk time. He was crying uncontrollably, so we tried to distract him. I went to the nurse station to ask if it was possible for us to give him just a small amount, and the resident conceded, but to 4oz only, which was enough to put him back to sleep.

A nurse checked his IV and discovered that his arm was swelling due to the vein. Imagine my horror when they said they had to transfer the IV to his other hand! I was about to protest but they said the swelling might cause a fever, so they removed the needle from his left hand and he was temporarily IV-free. Lola Nits came with his Simba, books, and more supplies. Simba would help alleviate his anxiety during procedures, and reading books will pass the time as we did not have TV in the room.

Aren reading one of his favorite books


At around 8:30am, laboratory came to our room to draw blood. Again, it was just a little prick on the left ring finger, but I did not dare look. A little later, they asked me to take him to the nurse station treatment room so they can attach the IV to his right hand. When I put him on the bed, they asked me to leave the room!! Again I was about to protest, but good thing, there was a small gap in the glass, so I was able to see what they were doing inside. Apart from the prick, Aren was behaved, and the resident told me so. I was smiling as I watched.

Where the first IV used to be, and the prick on his fingertip for blood test

That day, it was mostly routine temperature checks and administration of medicines. Some of our relatives came, and we were able to take a short nap. Aren was irritable most of the day. It was so hard to restrain him especially with the IV; it would backflow often. In the afternoon, he asked for pancit and we fed him for as long as he was eating! We didn’t know when he would have such an appetite again!

Very hungry but very groggy (very cute)


He was given his last dose of diazepam and paracetamol before we went to sleep that night. The temp checks were the funniest --- Aren did not register higher than 37 degrees at all! Rands slept beside him on the bed and I on the bench which I pulled near the bed.

Saturday, November 20

The routine checks went on throughout the night, and at one point, a nurse informed me that she had to put Aren under a drop light, much like incubating chicks, because his body was undergoing hypothermia. She even turned the aircon down to fan.

Aren under a drop light to heat up his body

I asked for several changes of hospital gown because Aren would be drenched in sweat often. The shirts we had were no good because the IV bottle did not fit the armhole. In the morning, Aren and tatay woke up late and had a few bites to eat. The residents told us that the x-ray was negative for respiratory problems, the blood test was negative for infection, and his urine was cleared too. After reading his books, Aren was napping again. This gave us time to fix the billing.

When the pedia came in, I asked if we could be discharged already. We were running out of supplies. Besides, his fever did not rise and all his tests were negative. She prescribed us with paracetamol for temp of 37.5, and ibuprofen for temp of 38.5. Needless to say, we had to take his temperature round the clock.

We came home to Ate Ria and Lola’s spaghetti waiting for us. As soon as he saw the TV and his toys, he went wild with excitement! But we had to hold him because he was still a bit groggy from the meds. It was as if he was not well-coordinated yet. Tatay researched for sites on febrile convulsion, and we learned a lot of many things about it.

Sunday, November 21

Aren’s temp registered between 35 -36 plus throughout the night and the following day. We did not leave the house to even go to church because we wanted him to rest. We did not even allow him out of the house. We noticed that his balance has not returned to normal pre-seizure. We started to worry because he was irritable as he was in the hospital. When he threw tantrums, it was as if the meds made him mutant! We could hardly contain him!


As of this writing, Aren’s balance has returned. We excitedly greeted him, “Welcome back!” We sent him out of the house to play. We had given him a bath. I myself was able to take my much needed bath (my last was Thursday morning! That was why the shampoo did not lather at all! Hahahahha)

Once again, the lessons…. The very important learnings from the experience:
- NUMBER 1: a temperature of 37 plus is already high for toddlers! Give paracetamol at the onset of fever! By all means, do everything to keep the fever down, including spongebath with cold water, not with alcohol that may raise the fever.
- Do not attempt to stop the seizure while it is occurring (yes, we did this!) because it will subside naturally, just make sure that your baby does not injure himself: clear his surroundings of heavy or sharp objects, support his head from a hard surface, do not put a spoon in his mouth (yes we did this too!) because he might bite it hard and break his teeth.
- If your baby vomits or mucus or saliva accumulates in his mouth, turn him to his side so he doesn’t choke on it. This is also to let his tongue drop and not block his airway.
- Rush him to the nearest hospital. Always have an emergency bag prepared, with baby’s clothes, diapers, burp clothes, etc. Always put water in your feeding bottles and milk in your dispensers (if you’re not exclusively breastfeeding).
- Always keep important documents in your wallet and bag (such as healthcard and emergency phone numbers). Always keep your phone charged (yes both of our phones were drained, as in drained…). Always keep a small amount of extra cash at home.
- There is a history of convulsions in Rands' side of the family, and boys are more prone to them than girls. We can have another episode of fever-induced seizure until he is around 6 years old.
- We will have him checked for any symptom of seizures that is not fever-induced, which are more fatal.

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