One thing about becoming a new parent is you learn that babies and toddlers are messy. They excrete fluids in ways that a boggles the mind of any former young professional intelligent person. Often for no apparent reason. I learned early on to never, ever, and I mean never hold a baby or toddler above your head while laughing at cute kid smiles and laughter. It is not pleasant to get a mouthful of vomit.
Then “it” happened. First is was the kind of messy diaper, which had happened a few times but had resolved fairly quickly. Except this time it got worse. The diarrhea became more fluid and frequent.
The diapers leaked, and it was all over the place. I was using cloth diapers from a diaper service, and velcro diaper covers… which were obviously inadequate. So I got out the emergency supply of plastic diapers, but they were also inadequate. I then tried a cloth diaper covered with the plastic diaper, covered with another cloth diaper and topped it off it a pair of plastic pants (which I bought from the diaper service - they were nice because they had snaps on the side, so I did not have to slip them down his leg). And still the poo leaked out.
So I took him to the doctor. He told me that it happened, and since he was being smiley and happy it was a “minor” case of diarrhea. I also had to make sure he stayed hydrated with the electrolyte products for children sold at the drug store.
But he refused the drink the recommended stuff. So I took the advice of my “Natural Baby Care” book and gave him diluted apple juice.
Then I got it! Obviously dealing with that many dirty messy diapers I passed the infection to myself. I actually put the large toddler cloth diapers on before my undies so I didn’t make a mess on the way to the toilet.
So sometime within a week I took him to the doctor again. Again he was happy smiley toddler, it looked like he was on the mend. Hooray!
Uh, not quite.
The next evening he was being his sweet happy self, and then he collapsed on the floor in convulsions. The next moments seemed to drag on in a type of time warp. I know I screamed to my husband that BigBoy was having a seizure, and I leapt to the phone to dial 911… and got a busy signal. Aaah!
I dialed again and got a person. And in a few minutes three large firefighters were in our tiny house hovering over our tiny boy who was now unconscious. An ambulance was called, and I went into it carrying my little boy. I laid on the gurney with my son on my lap as we were driven to the children’s hospital.
At their emergency department it was determined he was severely dehydrated. This is not trivial. Dehydration can cause heat injury, cerebral endema, seizures, hypovolemic shock, kidney failure, coma and death. He was given IV fluids, and did get better. He did not have to be admitted to the hospital.
I was also told that the worst thing to give a kid with diarrhea is diluted apple juice. Apples and apple sauce are included in the BRAT diet (bananas, rice, apples, toast) because they have pectin; the juice lacks the fiber and makes things worse. When we got home later that night, I took the “Natural Baby Care” book and put it into the fireplace, where it was burned the next day.
The funny thing was that my symptoms completely disappeared starting with his seizure.
We also got a phone call home from his doctor asking about what happened. He had received a notice about BigBoy from the hospital. Yes, doctors are human and do react when they misjudge conditions. But how could you call it? BigBoy was dancing to music just a couple of hours before the seizure.
We will never know what caused over a week of diarrhea. A likely culprit is the rotavirus. According to the CDC Pink Book chapter on rotavirus, it happens to almost every kid, and “the most common cause of severe diarrheal disease and account for a higher proportion of severe episodes leading to clinic or hospital visits.”
It continues with:
In the prevaccine era, rotavirus infection was responsible for more than 400,000 physician visits, more than 200,000 emergency department (ED) visits, 55,000 to 70,000 hospitalizations each year, and 20 to 60 deaths. Annual direct and indirect costs were estimated at approximately $1 billion, primarily due to the cost of time lost from work to care for an ill child.
In 1989 we accounted for two physician visits and one ED visit of the above statistics.
Fortunately, there are two effective and safe vaccines for rotavirus.
There is often discussion about the original vaccine, RotaShield, causing intussusception. For some reason it is assumed that because there was an issue for this vaccine, it also occurs in the others, which is false. Plus intussusception happened to only fifteen infants, and they all survived.
Think about it: a vaccine was removed from the market when it caused problems in fifteen infants due to normal post-license surveillance. This is for a condition that caused over fifty thousand hospitalizations and several dozen deaths per year.
For other more recent issues with the vaccine, please read this virology blog and listen to the podcast.