Friday, October 02, 2009
Yesterday Marin was jumping on Claire’s bed and yelling, “Jumping! Me jumping!”
Then she said, “Help me.” Evidently she thought it was my job to assist her with jumping on the bed. She forgot that my job is to try to prevent kids from jumping on the bed, which leads to falling off the bed and then someone is crying. Mothers can predict the future.
A few days ago I was in the kitchen cooking with my friend Andrea and Marin fell off the couch and hit her head. Everyone knows that toddlers are always having minor mishaps due to the fact that coordination and good judgment are outweighed by pure enthusiasm.
I went to check on the extent of the injury since triage is also a big part of parenting. Marin was crying so I picked her up to try and determine where she was hurt. She passed out in my arms. Andrea wanted to rush her to the hospital but then Marin woke up. She remained very sleepy and I got on the phone with the pediatrician’s answering service. The first one to call back was a nurse. She wanted Marin to go to the ER but I explained that Katie had the same episodes when she was a toddler. I didn’t think that Marin had lost consciousness because it was a severe injury, just that she comes from a family of fainters.
When Katie had it happen the first time, she was about 18 months old. She had stopped breathing and her lips were turning blue. I was trying to dial 911 but couldn’t because my hands were shaking too badly. By the time I could dial she was already waking up. Katie was checked out at the ER but we declined the CT scan since she didn’t even have much of a bump on her head. We took her home and watched her closely and she was fine.
She went on to have another episode, which terrified me again. Her doctor scheduled her for testing. She had an MRI, EEG, EKG, and an echocardiogram. That was a difficult day. Katie had to be drugged so she would hold still for the EEG. They had her drink chloral hydrate, which should have made her really sleepy. Instead it made her really combative. My toddler resembled a mean drunk. Then she had to have the IV sedation prior to the MRI and it took an entire team to hold her down for that. She finally went to sleep for the MRI but woke up disoriented and angry. I could not even carry her. I had to sit in a wheelchair and restrain her while a nurse wheeled us out to the car. It took both of us to strap her into her car seat and she screamed for the entire forty-minute drive home.
Katie’s most likely diagnosis is something called Reflex Anoxic Seizures. She went on to have more episodes, terrorizing all of us that witnessed them. She has grown out of it now and hasn’t had one for two years. I had almost forgot about it and then Marin passed out.
Most of you are probably unfamiliar with RAS. It is fairly uncommon affecting about 2 in a 1000 pre-schoolers. RAS is not epilepsy and it is not a true seizure. It affects more girls than boys. It is most commonly brought on by pain but in some cases in can be brought on by fear, etc. What typically happens is that the child has an injury, their eyes roll up in their head, the arms and legs might jerk a bit, they become very pale and they lose consciousness. They wake up within a minute or two but it seems like forever when it happens to your baby. The scariest part is that their heart actually stops briefly and that is the cause of the pale appearance. After they wake up they tend to be very sleepy.
Not all doctors are familiar with the condition. One of the most important things a parent can do is accurately describe what happens. This is mostly a diagnosis made by ruling out other conditions and the history of the event will lead a good doctor to suspect RAS. Children with RAS for the most part will simply outgrow it. There is a danger of a well-intention doctor prescribing anti-convulsants which will not be of any benefit to a child with RAS. Children with frequent episodes can be treated with a pacemaker or atropine. Neither are without risks and both are reserved for severe cases.
If Marin keeps it up I’ll see if they can just go ahead and fit me with the pacemaker.