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Friday, September 9, 2016

Mystery Solved

He had been running and playing, he was talking and acting normal, and then his body started to tighten up and he started to shake.  He slept for a while and then it happened again, and again and again.  When he was brought to the ER, he had been having seizures for most of the day and he looked really really sick.  Dr. Bill was called to assess him and knew this kid was in trouble.  The nurses got an IV going and he ordered some medicines, and then tried to figure out what had happened.  He attempted to get the history from those who brought him up, but all he knew was that he had been well and now he was close to death.  Bill's mind went to poisoning, he asked the family if the kids ate wild beans (which can cause cyanide poisoning), asked if he had taken any medicine, but got "No" to each question.

With no clear cause, Bill admitted him to the pediatric ward, praying the medicine he gave him would keep him from seizing again overnight, and that something might be clearer the next day.  I was rounding on the pediatric ward and so Bill filled me in on what had happened the night before.  As I looked at the ward, I saw this 2yo boy (Jordan) laying still as can be on the bed, IV fluid running into his arm. Mom reported he had only one more seizure overnight and had just slept.  I explained that I needed to try and figure out why he was seizing and needed to take some fluid from his back, she was okay with that.  As I did the lumbar puncture, he didn't move - not even a flinch.  He just was still as can be - this was a bad sign.  No movement from a kid when a needle is put into their body is never a good sign.  The fluid looked clear, but I wasn't very optimistic about his prognosis, thinking he had some sort of brain tumor or other horrible condition causing him to be this sick.

The next day, I came onto the ward and started seeing the kids on the opposite side of the ward first.  As I was rounding, I kept hearing a little boy talking, yelling at times, but I didn't think much of it.  Then I started to get closer to his bed, and heard the talking and yelling louder and as I looked up to see which kid was making all the noise, I realized it was Jordan.  I smiled, enjoying hearing him talking, thankful he was better.

When I got to his bed, he got quiet and wouldn't talk to me.  I asked his mom why he was yelling and she said he wanted the IV out and wanted to get off the bed.  WOW - yesterday he laid as still as could be when I poked a needle in his back and today he wants to run and play.  I asked if he had any seizures, nope, he woke up the afternoon before and started talking and eating and was back to normal.  I was speechless and thankful.

Grandma was there and she had a bottle in her hand and wanted to show it to me.  She said that Jordan had gone with her to the river and had carried her medicine with him.  When they got to the river, she was busy washing the kaukau and Jordan was playing with another child, and later on when she got closer to him she found her medicine on the ground and picked it back up and put it in the bottle and they came home.  He started having seizures the next day, but it wasn't until he woke up and started talking that he told her that he took her medicine.

The mystery was solved.  Jordan didn't have a horrible brain tumor or infection causing his seizures, he just took his grandma's medicine which caused the seizures and once it was out of his body, he was better.  Our pharmacy doesn't have childproof bottles, we have plastic bags and small glass bottles with rubber stoppers that we put medicines in.  Like all hospitals in PNG, we do the best we can with what we have, even if it isn't ideal.  We will continue to instruct patients to keep the medicines away from their kids in hopes that this doesn't happen again.