If I knew what I know now, I might not have taken my toddler to the ER. I definitely would not have taken him a second time. He could have gone to an instacare or urgent care center instead, because all we really needed was a doctor and a blood test (see note 2). We stayed at the ER for about 3 hours. In that time I googled several medical websites to learn all I could about types of seizures in children, and first time seizures. This article is what I should have found.
Monday May 9th. Just as I start my day I receive a text from my wife, Anna:
Little-Man had a seizure the paramedics are here call me.
Twenty minutes later I’m with my family at the ER. My son is responsive but lethargic. He is not talking. The doctor, Anna, and myself are unsuccessful in getting him to talk. I’m secretly wondering if he has some type of brain damage. After a while he makes a sound. And then baby noises. I’m still secretly envisioning developmental brain damage because I have no idea what a seizure is. Eventually he starts talking in sentences, complaining that he wants to go home.
And he wants a lollipop.
When I return with his lollipop he is right as rain, his usual energetic, happy self.
My first question is what caused the seizure? I google a variety of potential causes relating to my son’s seizure. Every detail I research reveals correlated but ambiguous relationships:
To identify a cause, first I need to know what type of seizure he had. Identifying types of seizures is not easy. The ER, urgent care center, or pediatrician’s office isn’t able to diagnosis a seizure disorder. You are going to need a specialist (who will not be at any of these locations). Even with a specialist, it is not likely the doctor will observe the type of seizure. The doctor must rely on the parent’s observations. Well, the parents don’t know what to look for! Mix in fear with confounded memory; it’s a challenge. To help, I created an infographic to help parents better communicate with their medical providers about the type of seizure their children have had. It isn’t that the information I found was bad, it just wasn’t intended for a parent to read on a smartphone while waiting in an ER.
Lack of a fever rules out a febrile cause. It is unlikely he has a viral or bacterial infection without fever. Physical tests and the lack of additional symptoms rule out meningitis and cancer. The doctor can’t identify a cause but is satisfied with his analysis. Often a cause can’t be determined. The most likely outcome given Little-Man’s lack of other symptoms is that the cause will remain unknown because this will be a one time thing. One caveat: “A child that has had a first seizure is more likely than a child who hasn’t to have a second seizure.” I bite my tongue*. The second most likely outcome is that he has Epilepsy.
Two hours later we are at home finishing lunch. Little-Man is playing in his room. I am preparing to give him a blessing. He calls out, “Daddy! Help, you!”
At first I think he is trapped in the corner behind the rocker. His eyes are rolled back and I can see he is in the same position my wife described earlier. His hands are clenched in front of him. He is arching his back. His muscles are contracted like a full body charlie-horse. I pick him up and lay him on his side in his bed. It can’t have been more than 30 seconds. I am surprised that his lips are turning blue.
Anna is on the phone with 911. They want to know if we need an ambulance. I ask them to wait.
I have my hand on Little-Man’s chest. Calm as can be I tell him,
“If you can breath, take a breath but if not just try to relax. Buddy, I know this is scary but, sometimes we need to do scary things. I’m here with you, daddy has you, you are safe. I know this is really hard buddy, try to relax.”
It appears that he does. The seizure seems to dissipate.
“Take a deep breath!”
He takes his first visible breath. I pause.
“Take another breath!”
“Just focus on breathing, you are safe. Daddy is right here with you.”
He continues to breath. We hang up with the 911 operator. A minute later he is asleep, resting comfortably.
An hour later two friends meet us in the ER. They were originally coming to the house to give my son a blessing, but plans change. Earlier, as I prepared to give my son a blessing I teared up, power literally welled up in my eyes. I felt like everything base, impure, and negative had burned up leaving only good. I prepared to bless my son and found that I was blessed.
Is any sick among you? let him call for the elders of the church; and let them pray over him, anointing him with oil in the name of the Lord: And the prayer of faith shall save the sick, and the Lord shall raise him up; and if he have committed sins, they shall be forgiven him.
That is what we do. I call upon my wife’s faith, and my own, to bless our son.
The second ER visit goes a lot like the first. Little-Man recovers just like he did before. The only difference between the first and second visit is a blood test. Hopefully you will never have to draw blood from a little boy by force. The nurses try, but fail their first attempt. On the second attempt we restrain him with a blanket, and even then it takes four adults. Little-Man refuses to talk to the nurses after that. He only spits at them.
The blood test rules out nutritional imbalances as well as infection. After that ordeal, I can see why the staff was hesitant to draw blood the first time around. It was awful. I don’t know that there is another way (see note 1). One seizure just isn’t enough to warrant a blood test. Hindsight being what it is, we could have just made sure he drank some electrolytes: Powerade or something. But really, we wanted answers. Powerade wasn’t going to give us answers.
This time around the doctor tells us that we only need to come back to the ER if Little-Man seizes for more than 5 min, or if he has three seizures back to back in a 20 min time period. The ER has fast tracked our EEG appointment. Which means it will be scheduled within days, not weeks.
This is not good news.
More than that we are now at the end of a long day. I’m tired. I think about the coming sleepless night as we pack the kids into the car. I don’t do well without sleep. I struggle in the evenings . . . with healthy kids! I don’t know how we were going to do it. I just know it is going to suck. I am pretty sure I am not up to the task.
All i can do . . . is cry.
i am afraid.
Afraid for my son, that i will fail him. Afraid of my own limitations. I cry. These tears contrast vividly those I experienced earlier. My tears expose my fear for what it is, weakness. I resolve to be faithful. I believe both my son and I were blessed today. I am too tired to feel its effect, but I believe it endures. I am diminished, I trust the blessing is not.
Two days later Little Man had an EEG and saw the neurologist. We got our answers.
If you would like to know more details about the process, children’s seizures, or are just interested in updates on Little Man’s progress, subscribe here:
Because this is a sensitive topic, this will probably be the only public post I share. The rest will be through email.
These are a few of the takeaways I took from the experience:
I am not sure why the ER directed us to come back. Maybe they were playing the odds that Little-Man wouldn’t have another seizure. If I knew then what I know now, I would not have gone to the ER the second time. It is clear from this medical diagnostic aid, whether you go to the ER or a primary care doctor, the course of action is the same: referral to a specialist (see note 2). I expected to have an EEG during the second visit. But that was never an option.
This article is intended for informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
REFERENCES & NOTES:
Note 1: Since that day in the ER I have witnessed another way to place an IV on a toddler, night & day difference. If the need arises request a nurse from pediatrics. I have added details on my email list.
Note 2: I spoke with an EMT who I trust to give a straight answer. If we had taken my son to an instacare, in all likelihood we would have refereed to the ER.
*No pun intended.