Friday, March 04, 2011

Setbacks

This has been a week full of setbacks.

First the motherhood ones:

I haven't written anything on here about John's recent fainting episodes, because in all honesty, I just wanted to put the first one out of my mind and never think of it again. After the second, I sought help, and things were just a whirlwind and I never found the time... But back to the beginning...

A month or so ago, Tom and I and the boys were all sitting in our respective chairs at the dinner table. Everything was totally normal. Then John gave a little yelp and toppled off his chair. He hit the ground with a thud, but didn't cry or make any noise at all, actually. I jumped up and ran to him and he was completely unconscious, limp, unresponsive, but was breathing and had good color. I picked him up and took him to the couch and he came to shortly thereafter. We asked him his name, to count fingers, to walk around the room. He seemed fine. We thought he might have lost consciousness due to the blow on the head, but didn't take him to the ER because he seemed fine. We just watched him for signs of concussion--vomiting, headache, crying, etc. And there was none of that. So we moved on with our lilfe.

Then last Thursday, the boys and I were upstairs. I was sitting on the bed, writing or surfing the internet--I can't remember--and the boys were chasing each other around the room, wrestling, jumping on each other, laughing their heads off and having a great time. It ended with John laying on his stomach with Sam sitting on his back riding him like a horse. Both boys thought this was hilarious until Sam came down too hard and John started to cry. Sam got off him and John walked over to me, doing a silent cry. I pulled him up on the bed to cuddle and he went limp as a dishrag, curled into the fetal position, eyes rolled back in his head, all the color in his face blached out, and his lips started turning blue. When I tried to lay him down, he seemed to have a small seizure (but I didn't panic because it would be an involuntary muscle spasm like the kind I've had many, many times myself--more about this later). I was more worried about his blue lips. I could tell he was breathing, so I didn't know what was going on, and my mind was racing with all sorts of possibilities, like a severed spinal chord or who knows what. I waited for him to come to for what seemed like forever, but was probably less than a minute, and called 911. It took about 5 rings for the operator to answer, and I was in the process of giving her a detailed account of what happened when John finally came to. I would say he was out for at least 2 minutes (which is an eternity when you're a freaked out mother). By the time the paramedics arrived, John was fine. Alert, seemingly back to normal. While I was down letting the paramedics in the house, he hopped off the bed and was looking out the window with Sam at the paramedics' truck and asking us why it didn't make noise like an ambulance. Since his vitals were good, they let me drive him myself to the ER, and after leaving us in a room alone for two hours where John got into all kind of typical two-year-old mischief, the doctor on call prounounced him fine and didn't order any further testing, the general opinion being that he'd either hit his head and had a small concussion, or had the wind knocked out of him. (I didn't mention the prior incident because it didn't seem somehow relevent at the time--although I did mention family history, which was roundly dismissed by everybody.)* I was told to take him to the pediatrician in the next couple of days.

*I have "suffered" (although it's hard to suffer from something when you're unconscious) from vasovagal syncope since childhood. Vasovagal syncope is a common type of fainting disorder resulting from an abnormal circulatory reflex. The heart pumps more forcefully and the blood vessels relax, but the heart rate does not compensate fast enough to maintain blood flow (from WebMD.com). . So I faint. A lot.The things that trigger my fainting episodes are completely arbitrary and out of my control. I passed out during the pushing phase of labor with Sam, but made it through my wide-awake c-section without a twinge. I've broken my pinkie toe twice without going out, but once passed out when I scraped my heel on a brick. I have lots and lots of exciting stories about Brittany's Adventures in LaLa Land. These are just the tip of the iceberg.

Also vasovagal syncope tends to run in families. I've had it since childhood, and now my mom is also starting to have "spells". And Tom also has a propensity for fainting whenever needles are involved. Plus, according to a couple of phlebotomists I've talked, to it also affects fairer skinned people most often (and mine and John's skin is off-the-charts fair). So if John is a fainter, he's just following his genetic destiny.

Yesterday I took John to the pediatrician and told him about John's two fainting episodes, figuring that as soon as I started talking about family history the doctor would confirm that yes, John had vasovagal syncope too and we could all go on with our lives.

I would get to spend the rest of my morning shopping with Kira and then today, I'd take John to swim lessons while Tom went to school with Sam and acted as helping parent.

But no.

This morning John has an appointment with a pediatric cardiologist, because the pediatrician wants to rule out some more serious cardiac issues that can cause fainting in children. He scared me a lilttle bit asking about family history of sudden death or cardiac issues in children (no and no), giving John an EKG right there in the office, and then telling me, flat out, "I DO NOT like what I'm hearing from you." He feels like John's fainting episodes were largely unprovoked and based on his previous issues with heart rate in utero, isn't ruling out the possibility of some kind of underlying issue.

I'm happy to have good medical care available to us, I just wish we didn't have to use it so often.

To complicate things, this morning I woke up sick as a dog, and I'm writing this all between absolutely gut twisting stomach cramps, chills, the sensation I might pass out (anyone surprised?), throwing up, and the general feeling of wanting someone to put me out of my misery. I'm spending the day in bed, Tom had to take both boys to the cardiologist (Sam insisted on going) and I had to get a substitute in the classroom. What a crappy day all the way around.

In the middle of writhing around in the bed, the cardiologist called. He'd heard Tom's side of the story, but since I was the only witness to the second episode, he called me personally to hear what had happened. I described the whole thing, and mentioned that John had what looked like a seizure, but since I pass out (frequently) and am always told that I look the same way (and that it's really involuntary muscle spasms) I didn't fixate on that. Then the doctor asked me about my medical history--Did I see a cardiologist for my condition? (No) Had I ever had an EKG? (Yes-in the ER--mid faint even--and it was totally normal) Any family history of sudden death? (No) How many times had I passed out in my life? (More than 20, for sure.) What were my triggers? (You name it, it's probably triggered one.)

After talking to me, he said they'd ruled out any of the serious causes of his fainting, and it was his opinion that little John has inherited a hybrid type of vasovagal syncope--inheriting my propensity for fainting at the drop of a hat, and Tom's not-breathing-then-passing out version (you know, just to make life interesting for everyone...).

I'm very happy that it's not a serious condition. But I really feel for John, because it is a lifelong condition, and will be a potentially embarrassing one--especially for an active little boy. When I was in middle school, I was playing basketball, ran into another kid, got whiplash, which triggered a succession of faints. The first one I fell off a stone wall onto the basketball court, the next was in the grass next to wall in front of my entire class, and then, for good measure, I passed out again on my teacher (I sat up too quickly. I know now to get down and stay down). It effected my ability to do sports and be physically active because a fainting spell could be triggered by practically anything. Vasovagal syncope is worse up to adolescence and then tapers off, but I still have an episode every year or so. I always have to warn everybody I spend any time with at all, "Oh, by the way, I may suddenly lose consciousness and look like I'm having a seizure while I'm with you. It's nothing. Ignore it. And DO NOT call 911 no matter how scary it looks unless I've actually fallen and suffered a head injury. I will come to. I will be fine." This is a fun conversation to have with new people, as you might imagine.

I try to keep a sense of humor about it, but I would not wish this condition on my child. Hopefully we can work with him and I can teach him some of the techniques I've learned over the years. For example, I no longer pass out suring blood draws or injections, and made it through an epidural and a spinal block, because many years ago, a phlebotomist told me to say the alphabet outloud as I'm being stuck. It seems to override the incorrect circulatory reflex, keeping me conscious.

I also know how I feel when I'm about to go out (my face feels tingly, the rooms gets dark, and I feel like I'm whoosing down an out-of-control elevator). I usually have just enough time to tell whoever I'm with that I'm going to pass out and sit. And then it's lights out for Brittany until I wake up in a strange position on the ground, with people saying my name in freaked out voices.

Since my mom never passed out until after I started, she couldn't give me a head's up about any of this. But not so for John. I've been there, done that, bought the souvenir t-shirt, and the mouse ears.

I'll try to get him through this without too much grief.

4 comments:

  1. gosh Brittany, I'm sorry to hear all that. I can't imagine :( hang in there. Keep us updated on how everything goes.

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  2. wow. i'm glad it seems like not too big of a deal, but holy smokes! that's a lot of feinting!

    hugs.

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  3. How scary for you all. I'm so glad it is nothing too serious. With an awesome mommy like you he will grow up just fine! :-)

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  4. I'm so glad to hear it isn't anything life-threatening, but I can imagine you're still not relieved. It's hard to think of our kids dealing with something for life. The "bright" spot, as you say, is that you can help him cope.

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