Thursday, May 26, 2011

An Unexpected Hospital Visit

Remember how I said that Lamictal can cause a pretty severe allergic reaction in an extremely small percentage of those taking the medication? Well, guess what happened? Those little patches on her hand and chest turned into a full body rash over the weekend of May 14th. That was her last day of this new medication, and Sunday the rash was even worse and she was showing signs of a lot of distress. On Monday morning, I called the neurologist as well as her pediatrician to get her checked out.

Ironically, Dr. Mower called right before I left to take her to the appointment, and was pretty concerned about what I was describing to him. He said to keep giving her the Benadryl, and if the pediatrician detected hives inside Raquel's eyes or the inside of her mouth, we needed to get her to the hospital ASAP.

Of course she had blisters inside her mouth - which explained why she wasn't eating and drinking as usual. Her pediatrician called Dr. Mower a couple of times throughout her examination of Raquel, and Dr. Mower decided to admit her at Children's Hospital that afternoon. I seriously thought I'd get an antibiotic and some ointment and be on my way, so I was pretty shocked - and scared - when the admission department called my cell phone when I was leaving the pediatrician to give me her room number. But I knew that if anything was to happen, we really needed to be at the hospital instead of home.

I assumed they'd just monitor her for the night and we'd be leaving in the morning. Nurses were coming in and taking vitals every 3 hours, and the on-call doctors would come in here and there to check on her, and then Dr. Mower would come himself. Our overnight stay turned out to be 4 days and 3 nights, and I cannot tell you how happy I was when we were finally discharged.

It turned out that Raquel developed the worst kind of allergic reaction Lamictal offers, a condition called Stephen Johnson's Syndrome, which can be fatal. She was given an IV of a heavy dose of Prednisolone - which she was just previously weaned off of - because in order to get rid of the rash, steroids were needed. Ointments weren't an option - it had to be treated from the inside out. She was on Tylenol every 6 hours, Benadryl every 4, plus needed her usual dose of Keppra 3 times a day. I was actually happy after the first day when they decided to put an IV in for the steriod. I was having to give that to her twice and between that and all the other stuff I was giving her, she was becoming very aggitated and I'd have to call a nurse in to help me force it in her some of the time. Fortunately, the Benadryl made her very tired, and she mostly slept the first couple days. Giving her the oral Prednisolone wasn't clearing up the rash fast enough, which is why the IV was needed.

Of course I took pictures - they just aren't the most fun to look at. Here she is all checked in with IV in place, holding the stuffed animal Gabby brought for her to sleep with. They put this velcro cast thing over it and would just hook her up to the machine when they needed to give her the steroid. That was nice because she was able to walk around the room if she felt like it. We'd also do laps around our floor to pass the time.




Here she is kicking back with Dad.


Sleeping soundly during the day. If you look close, you can see the rash on the back of her arm. This was the worst area - and is still the last part remaining. Although faint now, it's still pretty noticable. They say that it will continue to fade over time and that there shouldn't be any scarring.




Resting comfortably at night. We were directly above the Emergency Department, but she slept right through the ambulances/sirens. And our floor was anything but quiet - doors constantly slamming, equipment & beds being moved around. I didn't sleep much, so I took pictures and played games on my cell phone.



On the positive side, Raquel has been seizure free since the day she was admitted to the hospital on the 16th. She is eating and drinking well, sleeping like usual, and doing great at school. The only change we've made is adding the Prednisolone back in her system. She's supposed to be weaned off of it again, but I've been enjoying no seizures and have kept her on a very small dose. Today I spoke with Dr. Mower about that, and he, again, stressed the importance of her being off of steroids - even at a lower doseage. He said besides the organ damage, it can also stunt her growth and cause osteoporosis, and asked me to stop giving it to her today. If seizures resume, we'll go from there.

Here's a picture Gabby took of them in the car on the way home from school. See the chubby steroid face she's sporting? Her stomach looks like that, too.



But besides the chub, she's a happy little thing. I love her so much!



Again, I find myself reflecting on why I'm in this position, why my daughter (and family) have to suffer through this, and what the life lesson is. Maybe I'm educating people through her blog. Maybe I'm finding inner strength I never knew existed. I don't know. But what I do know is that it could be a lot worse. I've thought about the families we've shared our room with throughout our stay and find it very humbling. From the tricycles on the patio with IV equipment hooked up for chemo, seeing the little bald kids in the playroom, the husband and wife learning how to sponge bathe their cerebal palsy child that just had to have a feeding tube surgically implanted, to the new mom of 5-day old twins who had one of them stop breathing. How can I possibly complain? I can't, because I'm blessed.

Monday, May 9, 2011

More Seizures, More Medication Changes

Raquel did really well adjusting to splitting up the Keppra dose once we started doing that. She seemed to be getting back into a regular routine and was still doing great in school - and not napping in class as much.

Then the Monday after Easter - when she was on Spring Break from school - the seizure activity resumed. She had 7-10 clusters of seizures that day in probably a 20-minute period. These were brief, but just kept coming one right after the other. I gave her the dose of valium as instructed, hoping this would calm her down so she could get some much needed rest. The valium stopped the seizures from happening, but besides walking a little clumbsy, did not make her tired at all. She didn't nap all day, and I couldn't get her to sleep that night until close to midnight. Good times.

She had a seizure the next morning when she woke up, but besides that, was happy and playful - until Thursday night. She went to sleep at her usual time but woke up at 10pm and wouldn't go back to sleep. A little after midnight, she had another seizure and then finally went back to sleep, although she was very restless. She had two more seizures the next day, so I put a call in to her neurologist.

Dr. Mower obviously didn't like hearing all of this and said that because she is at her maximum doseage of Keppra, it was time to start weaning her off of that and on to Lamictal. This is the medication I was hesitant to start previously because of the side effects of skin rashes (one can be very serious).

We are in week one of the weaning process, which will take a total of 6 weeks. The good thing about the Lamactil is that it is a tiny, chewable pill, so it's super easy to give to her. I can even put it in food if needed. I'm so tired of having to force the liquid meds in her. The bad news is that after taking the Lamictil for only 2 days - with a very low dose - she has developed a rash on one of her hands as well as a small area on her chest. Nothing is ever simple, is it? So, again, I call her neurologist.

Dr. Mower says that typically with a Lamactil rash, it doesn't get better over the course of a couple days - it gets worse. And today, it looks much better than it did over the weekend. What he would like me to do at this point is not increase the dose just yet, to monitor the situation over the next week and go from there. He said that if the rash gets worse, give her Benadryl and see if that clears it up. If it doesn't, then I'll need to bring her in so he can take a look at it. If it turns out that she is having a reaction to it, then we'll have to try another medication. It's pretty much trial and error at this point.

As far as school goes, she's been doing great! Last week they had a "teddy bear picnic", which was adorable. It was Raquel's first boy/girl party. :-)

Here are some pictures:



Raquel sitting contently for circle time before we went outside to play. I need to get one of these chairs - they are very sturdy and don't tip backwards like most do.



Sitting with Dad, having some juice & cookies, while listening to Miss Sara read their teddy bear story book. She like the parachute so much...



... she needed to lay on top of it!



And here are a couple Mike and Gabby took on Saturday that I felt deserve posting:



Posing with Dad in her new wagon. And, of course, big sister Gabby was there to enjoy the fun!



Modeling Dad's hat in the tennis courts.



How 'bout that hair? It's absolutely gorgeous!



My happy girl...



Her smile just melts my heart.



Taking things day-by-day, often minute-by-minute, but I'm not complaining. I was reminded by a dear friend on Mother's Day that since I was on this Earth first, my kids chose me to be their Mom because they knew I would give them what they need to learn and accomplish things in life, and to just keep doing my best and let God do the rest. She said I should feel especially honored by that. Thank you, Jodi. xoxo