Saturday, August 25, 2007

Post Traumatic Stress Disorder..

I've seen and managed it many times ; during my paeds house officership and locum. But you will only truly know how a parent feels when it happened to you.
Febrile seizure is something I'd warn my patients if they don't control their child's temperature well. It can be really traumatic and I am telling all of you , it is very traumatic even for me and especially ; who's educated and knows how to manage such condition.

Qaisya will turn 6 months next Tuesday..

When we picked qaisya up from the nursery on Wednesday evening , the carers told us that she was not feeling well ; a bit of temperature late afternoon. We took Qaisya back , and did the normal tepid sponging with PCM . Compared to Dzaeff , she recovers better with her 2 - 3 previous fever episodes that she had. She's a good baby where she seems to be so cool about her condition and not too irritated.

We gave her the last PCM dose at 10pm that night , her temperature was a mere 37.5 ( borderline fever ) and she immediately went to sleep after that. We had the wet piece of cloth on her forehead to cool her down. I was fast asleep by midninght but wifey was still awake doing some work. At about 2 am , wifey heard Qaisya's leg bracelet shaking and she immediately went to her court. To her surprise , Qaisya was fitting ; eyeballs uprolling with a generalized shaking of both hands and feet.

She panicked and shouted out loud to wake me up.

I was still dozy at that time and looked for the suppository PCM for her and at the same time asking wifey to stay calm and sponge her down. Wifey was in a severe panic state that she started to blow the baby ( ie mouth to mouth ) as she saw qaisya turning blue. I quickly inserted the medicine and auscultated her.. Her heart rate was racingly high > 180 per minute and her lungs were fairly clear. The episode lasted for only 30 seconds but my god , how long it felt seeing your baby in such despair. Qaisya became very lethargic ( post ictal drowsiness ) but wifey was crying in pain. Seeing her baby fitting in front of her eyes certainly dropped her heart down so low that she felt desperately useless.

We quickly brought her to the hospital at 3 am , and a friend of mine was on duty in the emergency. He advised for admission as she was still not 6 months and by right , no febrile seizure should occur before 6 months old. The main thing to rule out is meningitis which can be detrimental.

Qaisya woke up then , and cried out irritably . She looked lethargic and Zaqrul quickly inserted IV access to run in fluids for my baby. We were warded to the paediatric ward and was reassessed again ; as qaisya was obviously hungry. She was clinically assessed and the specialist thought that it may just be a simple febrile fit and not meningitis , and even lumbar puncture was witheld.

There was no more fits after that episode , eventhough Qaisya did not look really well. She was still sick and she started coughing . Then again , her cough was not normal ; sounding a lot like croup. She was however never breathless and her lungs were always clear on auscultation.

We were discharged within 24 hours ; though Qaisya has not fully recovered. I was not happy though with the nursing and management as i thought it was crap! ( I will not go into the details ; but this was my observation compared to my previous hospitals.. ) LUckily wifey and I were on leave ; therefore we were more confident of nursing her at home . ( imagine , wifey had to crawl into the baby's court to sleep as there was no bed prepared for her. It was not about the fascilities, but more of the attitude and work ethics which i find it to be really really pathetic )

Both wifey and I are still in the state of shock ; worried if she might fit again. 2am the next morning was an agony , neither of us were asleep then because of the trauma.

Qaisya is slowly recovering back to her old self. Her feeding is improving and we are praying that it is just a minor infection. She's smiling back at me this morning and I am glad that she is recovering.

Thank you to Zaqrul for taking care of her in our most desperate hour. Thank you to those who came to visit , in the hospital and back home and please do pray for her to recover well.


pak long said...

Get well soon Qaisya!!

zaiti said...

Hope she is better. Love to Niza. PS Have fun studying.. I got my finals in a few months time too so know the feeling xx

Azad said...

That must be a really scary experience, man!

Alhamdulillah, Qaisya is recovering.

Shah said...

Praying that Qaisya makes a speedy and full recovery...

~Just a guest~ said...

Will be praying for Qaisya ... hopefully she gets well soon quick ...

Dr.M said...

Thank you for your thoughts.. :)