Wednesday, February 22, 2006

The Longest Night

When Raphael (4-year-old son) was born, my sister Rachelle bought me The American Academy of Pediatrics Caring for your Baby and Young Child - Birth to Age 5. An invaluable resource, the Fever chapter is particularly well worn because kids tend to have fevers in multiples and in the early years it's a worry.

When first reading over the section on febrile seizures I was like: Excuse me? He could what if the fever spikes? No way. I wouldn't be able to deal with that. But it won't happen.

As my previous entry shows, it did happen and I did deal without freaking too severely. However, the most terrifying moments of my life used to be those sandwiched between first hearing the air raid sirens start up and feeling missiles thud into Tel Aviv in 1991. Rapha's seizure night has been added to the list.

After a day of up and down fever and incessant vomiting, mother's instinct awakened me at 03:00 to find a sweating and shivering Rapha beside me in bed. With an armpit temp of 103.5 F/39.72 C, I administered a fever reducer and applied cold wet compresses to cool him off. We spoke softly and even chuckled over the kitty's attempts at sneaking beneath the blanket. Then, without warning, his eyes rolled back and he began convulsing and gurgling as his tongue blocked his airway.

I screamed for Tonny to call an ambulance, grabbed a phone to call myself and watched in horror and desperation as the most precious person in my life flailed and struggled to breathe. As I took instructions from the ambulance dispatch, I dressed, threw underwear and clothing for Rapha into a bag and then whispered "I love you" into his ear when he lapsed into unconsciousness a few moments later.

Rapha came to in the emergency room of Tel Aviv's Sourasky Medical Center and was admitted to the children's ward after blood and urine samples were drawn and vitals and a chest x-ray taken. His temperature was registered at 41.2C/106 Fahrenheit.

As a parent this was the hardest thing I've endured thus far. I get weepy when the images flash through my mind and I experience anew the comprehension of my son's (and my own) mortality. Rapha is home now and a virus has been deemed the culprit. His threshold for fever treatment has been lowered meaning in common-speak that he needs swift treatment when the fever starts. Medically it isn't as horrible as it sounds; personally, it is.

A few bits of information, factoids and things learned to pass along:
  1. 2% of children under age 5 experience febrile seizures. The general rule is one seizure per bout of illness; More frequent seizures may signal a more serious condition. Normal range seizures last for several minutes max
  2. If a child is seizing, ensure his/her head and body are safe from hard or sharp objects but don't attempt to hold the child down or stop the convulsions - a fracture may result.
  3. NEVER put anything - especially a finger - into a seizing child's mouth. You WILL lose it as the biting down instinct is particularly strong during episodes. DO, however, move the child's head to the side so that the tongue falls sideways away from the throat and saliva doesn't block the airways
  4. Underarm temperature taking is inaccurate. For a good reading purchase a high end digital ear instrument or use the standard under-the-tongue or rectal modes
  5. When sponge bathing a child to bring down a fever make sure the water is warm. Overly cold temps will cause chills in turn signaling the body to raise temps even higher
  6. If a feverish child has a vacant, "zombie" look in his/her eyes or begins talking or behaving in bizarre fashion seek medical help right away
  7. Try not to panic. Your child needs you to be calm and be there for him or her.
  8. Note the time so you're aware of how long the seizure lasted

Good health to us all


Judy said...

Oh, Stephanie, what a description. I don't know how you managed to make it through all that and write the advice down so calmly.

I had a few experiences of that sort of intense panic, of feeling that my daughter was on the edge of mortal danger during her childhood, and I don't let myself think about them now.

I'm glad so many people were there to help you through it, and that the medical services were there for you and Raph in time.

I am so glad he was given the gift of a loving mother's care.

Refuah shleimah to him.

And I hope you treat yourself and take good care of yourself too.

Hadas said...

Oh my god! I just read it out loud to Uri and we're both feeling weak just thinking about how it must have felt. Glad Rapha is feeling better, send him best wishes from us and from his bro Superhero (Batman nowadays).

Gavriel said...

Wow. All of us parents have had our emergencies, but that's a pretty serious one. Sounds like you handled it amazingly well. Is it a continuing risk for the future? Or a one-time event?

Stephanie said...

I actually don't feel like I handled it well; I made numerous mistakes from sponging him with cold water to not realizing how serious the temp was (41.2/106 in the emergency room!!!) to not placing his head to the side while he was convulsing..As for the future, statistics show a 25-30% risk of repeat. I simply have to jump on the fever the moment it starts to rise because his jumps very quickly - always has, now that I think about it...AHHHH!!!!

Yael K said...

Oh good l-rd Stephanie! I just got around to adding in your blog and popped over to check the link and ACK. Poor Rapha, poor you. Do you know how strong and capable you are?! I would be a useless lunatic on the floor if something like that happened to my (future)child. Sending you huge hugs. If you need anything, please please call.

Stephanie said...

thanks again and again to everyone...!!

andy said...

Found you via "An Unsealed Room":

Our now 11 year old daughter had a febrile seizure just as we'd ended a paediatrician appointment; her eyes rolled back, she spasmed, and she then went unconscious in my arms. Thank God I was in the doctor's office, and they sprang into action; by the time she was stabilized and I drove her to the ER to double-check that she was OK, I was pretty calm.

They'd explained that this was scary, but not dangerous any more, so I was capable of coping. But seeing it on your own for the first time is very scary.

My experience was helpful when our youngest daughter, now 5, did the same thing at home ... my wife hadn't seen the first daughter's seizure (she met us at the ER) so this was her first time. It was very frightening for her, and she was actually a bit weirded out that I could talk to the emergency services phone so calmly: "Yes, her lips are blue. Yes, she's still breathing, but she's unconscious." Oy.

We were told that it wasn't so much that the fever got very high; the problem was that it shot up so quickly.

Thank God, they're both fine now and it never recurred. But we're still very quick to shove Tylenol or Motrin in all our kids at the first sign of a fever.

I'm so glad that everything worked out OK for you guys, and I trust that you'll see nothing so scary in the future.

Stephanie said...

Thanks for the encouragement, Andy. You're lucky to have been at the doctor's for the first incident. I only hope that it doesn't happen again but as one hospital nurse said, if it's going to happen there's nothing you can do to stop it. It's very much about coming face to face with the illusion of "controlling" our own lives. slf