Meningitis

If you are like me, meningitis is something you have heard of, you know it is bad, you know neck pain is a sign of it and that is all you know about it.  Until this weekend.

Kayley came home from daycare on Wednesday night not feeling well and when we asked her what hurt, she kind of pointed to the back of her head and we thought maybe she had fallen down and hit her head, but we didn't see any bumps.  She was also running a low-grade fever.  We put her to bed and she woke up once during the night and just seemed generally uncomfortable, but nothing terrible. 

Her fever was over 101 on Thursday morning when Andy got her up.  She came into our room when I was getting ready and just looked miserable so I put her up on the counter and asked her again what hurt.  She pointed to the back of her head and again I looked for some sign of a fall.  Then she said that wasn't where it hurt and she pointed more clearly to her neck.  Now, if you know me, I have a slight tendency to think the worst.  I went from relief that she doesn't have a brain tumor to fear that she had meningitis!  I mentioned meningitis to Andy and he kind of shook his head.  Andy stayed home with her and I called the pediatrician as soon as they opened.  They wanted her to come in because she was having the neck pain.  Unfortunately for Andy, she started throwing up right as they were leaving for the appointment.  The pediatrician couldn't rule out meningitis and to call back on Friday morning with an update, but if the neck pain got worse, we should take her to the ER immediately.  The thing that is hard is that she is THREE.  You aren't sure if what she is telling you is true!  If you ask if it hurts worse, she says yes.  Five minutes later if you ask if it is getting better, she says yes.   

She continued vomiting on Thursday, through the night and Friday morning.  She continued to complain that her neck hurt and also said her head hurt.  I called the pediatrician and they said to take her to the ER because she was likely dehydrated from all of the vomiting and they wanted her seen because of the neck pain. 

Friday morning

I have to say, when you show up at the ER with a bad allergic reaction (Drew last year) or apparent meningitis, you get right in.  We never sat down.  The nurses and doctors were really nice, but they had a terrible time getting an IV going because she was so dehydrated.  It took 4 tries.  I thought Kayley was going to explode she was so mad.  They tried to distract her and they also tried to involve her by asking if she wanted to hold the different instruments.  Her response?  Screaming, "No!  I don't want to hold that!"  I can't blame her.  They tried, but she was miserable and having nothing to do with it!

Sitting with Daddy in the ER waiting for x-rays

I am going to forget all of the tests that they ran, but they wanted to rule out everything they could before they did a spinal tap to check for meningitis.  She had a chest x-ray, soft tissue x-ray of her neck, swab of her throat for strep throat, etc.  We were all hoping it was strep throat because nobody wanted to have to do the spinal tap.  All came back negative. 

That left the spinal tap.  They wanted to try without sedation.  I thought they were crazy.  Three nurses tried to hold her down and it was a joke.  They got her on her side and in the fetal position, but she immediately straightened her legs out of that position.  That plan was quickly abandoned.  They explained that they were going to use "conscious sedation."  I think it was called ketamine.  The doctor warned me that she would act strangely and appear to look past me, etc.  Because she was still going to be awake, I asked whether it would be enough to make her stay still and the doctor smiled and said they use this drug to amputate limbs on the battlefield.  I smiled back and said I guess it should be good enough!  They also brought in extra doctors and nurses and certain life saving equipment because they are using sedation and they have to be prepared in case she would have a bad reaction.  I would not have wanted to know what my blood pressure was at that moment!  Andy had left to pick up Drew from daycare so it was just me with her. 

The doctors were right on with how she acted.  No parent should have to watch their child like that.  I am sure it is safer than knocking them out, but I almost would have preferred for her to be sleeping.  She just stared off into space and said, "Mommy" a few times in a very pained voiced, but never moved.  She started to come out of it within 10 minutes and she said the strangest things.  She talked about how the doctor didn't listen to her because he took her pillow.  She said she was going to tell him to listen to her next time.  The nurse and I laughed, but it was still a little unsettling to hear her so out of it.  She also said that I had two eyes.  The nurse laughed and said they see double for awhile.  They also gave her something to dry up her saliva and she kept forcing coughs.  It was very strange.  I was very happy when she appeared to be back to normal after about 30 minutes! 

An hour later the initial results were back.  The results are somewhat confusing because they test two things - the white blood cell count was consistent with viral meningitis or early stages of bacterial meningitis and the other thing was consistent with bacterial meningitis or early stages of viral meningitis.  Basically, it means her results were consistent with early onset of either viral or bacterial meningitis.  The doctors felt very strongly that it was viral, but out of precaution they started antibiotics and admitted her.  Her ER doctor told us he would be shocked if it turned out to be bacterial because she seemed doing too well for it to be bacterial (this was the sickest I have ever seen her so I can't imagine seeing anyone with bacterial meningitis).  Also, she had what appeared at the time to be an allergic reaction to the ketamine so they wanted to treat that and watch it.  Later, they attributed the rash to the meningitis because it cleared up too fast for an allergic reaction. 

She was in the hospital Friday night and Saturday night and was released this afternoon.  The biggest thing when she was in the hospital was getting all the fluids.  That seemed to help with her neck pain and the headache she developed.  The headache was either directly from the meningitis or a nice little side effect of the spinal tap.  The doctor said some people develop chronic headaches after a spinal tap.  I sure hope she isn't one of them!  She also twitched constantly while she slept.  We pointed it out to the doctor and he said we should watch her for seizures, but the twitching is nothing concerning considering that the fluid around her brain was inflamed.  She slept for over 4 hours when we got home and I noticed she was still twitching.  The doctor said that may continue for awhile.

Saturday afternoon. "I want to go home" was
what she said whenever anyone talked to her.

Today after the doctor told her she can go home!

Discharged!

First stoplight after we left the hospital! 
She might have passed out from being overheated...
it was cold when we went to the ER on Friday,
but 70s today when we left and I didn't
realize it until we got outside!

We are happy to be home and relieved she appears to be on the mend.  The doctor said she will take awhile to get back to normal.  The biggest thing we have noticed since she has been home is that she is really unsteady on her feet.  She walks like a drunken sailor.  I assume that is related to the fact that she hasn't walked at all since Friday? 

I'm pretty sure we will never get this child back to a doctor.  She was slightly traumatized when she had to stay in the hospital after having her tonsils and adenoids out.  I am pretty sure the four attempts at an IV, the first attempt at a spinal tap without sedation, and all of the blood draws might have sent her over the edge!  She has been through way more than most kids her age and I think she deserves a break!  She is a tough one though!