Friday, August 21, 2009

Febrile Seizure

I now know what it looks like for a human to go into full seizure. It's terrifying. And when that person is your own child, the fear is so palpable it seizes you by the throat and gut (no pun intended).

My post yesterday mentioned Lily had a mild fever and was super cranky. From the time I put her to bed (at which point I didn't think she felt warm enough for Motrin) to about an hour later, her fever spiked so quickly and so high (she never got to 104 degrees, but she was just under that mark) that she went into a full 8-10 minute febrile seizure.

I heard a weird hiccuping noise sometime after 9pm last night, and after pausing a bit, I checked in on the babies to find Lily convulsing, eyes rolled back in her head and fully dilated, and barely breathing other than the hiccuping sound. I screamed and screamed for Kyle's help (to dial 911) but he was nowhere to be found (he was outside taking out the trash). That meant I had to leave Lily, grab the phone myself, and dial 911 while continuing to yell for Kyle. Claire ended up locating him and in fact his addition to the chaos was not necessarily a positive development - he instead raced downstairs with a then rigid, blue, and barely breathing Lily and was so scared he would not listen to the directions I was yelling to him from the 911 guy. While Kyle was trying to give Lily unneeded mouth-to-mouth, the 911 guy was telling us to have her on her side, put nothing in her mouth, and not give her mouth-to-mouth as long as she was still breathing. Kyle heard none of this. He was in his own frantic world. I was just frantic to get him to listen and follow directions.

Lily's seizure broke just as the EMTs showed up at the house (so, yes, this was quite a long seizure). They checked her over, gave her oxygen, checked her blood sugar levels, checked her temperature and then we decided to transport her in the ambulance (read: pricey trip) to Children's Mercy downtown. Four sets of neighbors offered to stay with Molly and Claire, but with both kids wound up, I felt it would be best if Kyle stayed home to calm them while I went with Lily. He also needed to regain his own wits. I've read many times about febrile seizures and was confident that was what she was having, so this knowledge allowed me to be less frightened than Kyle (though admittedly still terrified myself). My mind was already racing to determine the root cause of the fever - virus, or something more dangerous? Like a staph infection from that mosquito bite Lily had picked to death?

Debating the ride to the hospital, I decided to follow in my own car. I had a sense we'd end up back home late in the night, so in taking my car I knew we wouldn't get stuck at the hospital in the middle of the night. I'm glad I had this foresight.

After a seemingly endless trip to the hospital, we were admitted the normal way (read: not a real emergency) until Lily had another minor seizure in the waiting room. They grabbed her off the ambulance stretcher and we rushed back to find her a room. She continued to have these little seizures until they finally brought her temperature down at nearly midnight. One of the worst parts about a person who has had a seizure is that they become disoriented and confused for hours afterwards. Lily barely recognized me and was barely tracking. The doctor said seizures are really hard on the brain for a while.

The doctors did a routine exam (ears, throat, etc.) and a UTI test (where they had to catheterize her for the urine sample, and it came back negative), but they didn't run any other tests and we just observed her for a while. As I mentioned, they had a SNAFU where the Tylenol was not delivered for too many hours, but once Lily's temperature was in the normal range she fell asleep (and I took this one non-gratuitous photo of her to calm Kyle's fears) ...

... but she was unfortunately awakened not long after this picture mail photo by the 4-year-old in the next bay who was getting stitches on her face from a dog bite. The one time I cried last night was over this unseen little girl's terrified whining and the amazing way the nurses handled her fears ... what empathetic, incredible people staff that hospital. Odd that my emotions found refuge in some other child's emergency, but by that stage the adrenaline was wearing off and I was realizing Lily was likely just fine (but now more prone to febrile seizures, as are one in 20 children apparently).

With the UTI test negative and no other thought as to root cause for the fever, we were sent on our way after they provided Lily with some Gatorade. What a fateful choice that was. After getting lost in the worst parts of Kansas City at 2am, I got on the highway and minutes later heard dinner and Gatorade gurgling back up. We had a 30-minute drive home in an enclosed car with vomit smell (first time in nearly five years of having kids that someone has ever thrown up in my car). The smell was putrid, I gagged the whole way home, and Kyle fortunately agreed to clean up Lily and the car. At 3am.

After racking up about two hours of sleep last night, I kept it as low-key as possible today. With a little help from Motrin, Lily was mostly fine all day long. Molly feels a little warm today so I proactively gave her Motrin tonight at bedtime. We'll need to wake up Lily tonight to give her another dose just to be extra careful. Going forward, we will always have to be vigilant about Lily and fevers, although the doctor did tell me that even with proactive Motrin doses and cool baths sometimes a kid will still seize. I'd rather not have a repeat of last night, so my stock of Motrin will never run out, and I won't lose hope that this will be a one-off situation for us.

As a postscript, if you are ever around someone in seizure, do not ... I repeat, do not ... put your fingers in her mouth. When she hits the part of the seizure where she clamps down on your fingers she will do significant damage to your digits. That is the situation I find myself in after thinking I could somehow help Lily breathe by opening her mouth wider for her. She clamped down, and even her small jaws have left me with intense pain which now needs to be watched for serious damage.

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