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Saturday, February 11, 2012

Cautionary Tales with Our Kids: Oversight NEVER ends

Our Cautionary Tale with Our Kids:
Michigan State Student dies of suspected infection

This is a true story with a happy ending.  I can say that now, because after returning home from a fantastic trip to Toronto Public Library, my last few hours picking up Dan at Michigan State were a parents' worst nightmare.

It all started when I went to pick up Dan at Michigan State to bring him home for a weekend of rest and relaxation.  His past few weeks at school had been demanding, and included late nights with little sleep.  He expressed worries that he might even have mono. (I didn't press him for details.)

When I arrived on campus he was still crashed in his room, and I had to call him a few times, but thought little of it. We decided to eat lunch in the cafeteria at Brody Hall, and I was overwhelmed—it is an incredibly impressive operation. Great food, great staff, great service as North America's largest non-military food operation.

I noticed Dan was eating very little, some bland cereal, and a juice drink.  As we drove home to Ann Arbor, Dan suddenly began complaining about feeling really sick.  When pressed for details, he said he was just achy, nauseous and feeling really tired, this after sleeping 12 hours the night before.

We were picking up his car at the dealer in Ann Arbor, and as I dropped him off, I noticed he was looking pretty sallow, and very lethargic. I pressed him a few times about whether he was well enough to drive home, and he assured me he could, and we live just a mile away.

As I got into my car, I checked my Blackberry and saw I had an email from the Provost's Office at Michigan State.  The subject line said: "Student dies of suspected bacterial infection."

I read on: "Late last evening, a 19-year-old Michigan State University student living in Snyder-Phillips residence hall was taken to Sparrow Hospital and passed away a few hours later. At this time, officials with the Health Department are investigatingthe possible cause of death as a bacterial infection, with one of the suspects being meningococcal disease. Health department officials are working to identify those people who may have been in close contact with the student and could be at risk. Those individuals identified as being at risk are receiving antibiotic prophylaxis.

Meningococcal disease can cause both a systemic (rapidly progressing flu-like) illness, and an inflammation of the membranes that cover the brain and spinal cord, commonly known as bacterial meningitis. The spread of meningococcal disease typically requires close contact with an infected person. Common symptoms include flu-like symptoms, sore throat and a fever that rapidly becomes more severe, unlike most respiratory illnesses. These symptoms can develop over several hours, or they may take one to two days. Other symptoms may include nausea, vomiting, and discomfort looking into bright lights, confusion and sleepiness. Students who are experiencing symptoms should contact the Olin Student Health Center or their health care provider. If one is getting rapidly ill, one should go to the emergency room."

I was now in full alert mode.  I called Dan, and he had just hopped into bed as I reached him.  He was barely talking at this point, and didn't want to be on the phone.  He all but hung up on me.

"Dan, by any chance were you at Snyder-Philips yesterday?"

"Yes, I had dinner in the dorm there."

A pit in my stomach formed. "I want you to meet me immediately at the UM Health center on Jackson Road."

He protested, was just really tired. He tried to assure me everything was fine.  I emphasized why he needed to get to UM Healthcare immediately "Dan, meet me at the health clinic immediately. I just need you to get there right away, can you do it?"

He was lethargic and the severity of the circumstance was only slowly beginning to dawn on him.  It became clearer when he arrived, and the triage nurse immediately put a mask on him, and isolated him from everyone in the reception room while we waited for the doctor.

We shared the Provost's email and the entire story with the doctor as she fired questions and examined him.  She seemed concerned, and when I pressed her she said, "I've seen a lot as a doctor over the last 25 years.  Nothing scares me.  But I have to tell you, this strikes fear in me. You did the right think getting right over here."

As she completed her exam, she explained that rapid decline actually presents with far more severity than Dan was exhibiting.  Since MSU didn't share the student's identity, it was impossible to know if the student had actually been in contact with Dan. The doctor decided to treat Dan as an at-risk candidate, and had a nurse immediately administer Rosephin prophylactically.

As the nurse was doing so, the doctor left the room only to return a moment later extremely agitated. She had asked if Dan had any allergies to medication and we said 'Keflex and Amoxicillin.' Her original research showed this wasn't a problem, but upon further investigation, she had discovered he might be allergic to the antibiotic he just received.  They immediately administered a dose of Benedryl, and kept him under observation for 20 minutes to make sure he didn't go into anaphylaxis.

When the doctor returned, she had good news on several fronts.  Although Dan was sick and his symptoms came on fast, they were not severe.  In addition, because of Dan's mission trip to Costa Rica in '08, he had been vaccinated for meningitis, and was more than likelyprotected, even without specifics on the strain of bacteria. And as an additional precaution, he now had a strong dose of antibiotics in his system.

At this point, I resumed my normal breathing and heart rate.  Dan took some soup when we got home, and went to bed immediately.  He had a good night's rest, and this morning appears to be on the mend altogether.  At this point, while Dan sleeps in the other room, I am contemplating the discussion that follows when he gets up.

As a parent, how do I explain to him how serious this could have been?  This is a reminder that our children our always at risk and require our vigilance even from afar.

As Dan's doctor explained, meningitis strikes fear for good reason—those who are lucky enough to survive it often do so without their limbs! Last year Dan and Will's scout friend Jeremy died from meningitis after a rapid onset.

I am thankful to Michigan State for their proactive communication blitz, and their health mobilization efforts.  I am thankful Dan appears to be better already.  I am thankful that mission work in a third world country proved to be a fortuitous and good thing for other reasons.  I am thankful I don't have to amplify another word about risks.  We've encountered and addressed risk together first hand.

We're aware of the reality of how fragile our health can be, and down the road, I may even smile at the picture Dan asked me to take of him while we waited for the doctor with that mask on.

But not just yet!


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