Talavou
ALAILIMA
In the early hours of April 19, 2012, the doctors of the Lady
Ridgeway Hospital (LRH) Medical Intensive care (MICU) were fighting to
save the life of my five month baby son Jason, after having been
diagnosed with a severe attack of dengue. It was the first time LRH-MICU
had dealt with such a badly managed dengue case of a baby in its
history, and the job of not only dealing with this severe dengue attack,
but also undoing the damage done due to the bad management of Jason's
dengue, fell into the hands of a brilliant young paediatrician Dr. Daham
de silva who was a Senior Registrar at the hospital. If not for his out
of the box, bold and aggressive treatment of Jason, with the support of
Dr. Srilal de Silva and Dr. Nalin Kithulwaththa the Head consultants of
the MICU, and God's direct intervention of making the impossible,
possible, Jason my son would have been lost.
Such a disaster deserves reflection on where I failed as a father and
what I could have done better as a parent to have protected my five
month baby from this dreadful disease. This write up is about sharing
with you the lessons I learnt and what all of us should know and
understand about what can and must be done, to beat dengue!
* If your child is under the age of one year and gets fever, show the
child to a board certified paediatrician immediately. Ideally, one who
is also linked to a government hospital. Board certified means that
their credentials are in order. The fact that they are also linked with
a government hospital further confirms their qualification and also, if
the situation goes terribly wrong, the government's emergency setup is
the best way to deal with life and death situations.
* If your child has fever and you are concerned that it could be
dengue, get a blood test called 'Dengue Antigen', as it tells you
whether you have dengue or not even after one day of fever, unlike the
standard 'Dengue Antibody' blood test that needs several days of having
fever before you can get a positive test for dengue.
This delay in time of knowing whether your child has dengue or not,
gives the virus more time to succeed in weakening your child's ability
to fight it.
* Beating dengue is about knowing as early as possible whether you or
your child has it, because at such an early stage you or your child's
platelet count may even be within the normal range and you can win the
fight with ease from that position of strength.
This was the case with my three year old second son Jonathan who got
fever just a day after my five month baby Jason, and was warded in the
hospital for dengue as well. The Dengue Antigen blood test showed he was
positive for dengue but the platelet count was at 160,000 just above the
lower end of the normal range. Because we were able to react early with
this information, the lowest the platelet count was able to go was
80,000 before it turned around.
* Even though it is said that there is no treatment for dengue, the
indirect treatment for dengue does save lives. Balancing the intake and
outflow of fluids is critical and at the heart of the solution. Roughly
50 percent of deaths are due to the mismanagement of dengue and 50
percent is due to a delay in providing treatment for dengue. Many
hospitals and doctors are getting this balancing act wrong, more times
than we are willing to believe. So, please don't take your eyes off the
ball, believing that the doctor or hospital will not get it wrong and
everything will be fine.
* The dengue virus' goal is to create a deficiency of vital nutrients
to other life sustaining cells while it attacks important organs. The
virus however, has only a maximum of a six day window to do this, from
the day that the fever first appears. If it fails to overcome us within
that window of time, we win! The proper management of dengue is to keep
supplying the vital nutrients etc., to the body to support its ability
to fight.
The Full Blood Count test and a few others taken every 6 to 12 hours
help us to know the direction of the attack, so that we can counter
attack it by knowing how to support the body. This kind of support and
management of dengue is the only way to beat it. Therefore, who the
doctor is and where this support is provided is absolutely critical and
central to the battle.
* When you have fever, only take Panadol as a principle! Do not take
any other fever reducing medicine such as Dolor, Brufen etc. If you do,
and you or your child has dengue, and the fight goes down to the wire,
this will tip the balance against you. The simple reason being that most
other fever reducing medication has the ability to increase the leaking
of blood from vessels and organs which begins to take place in dengue
patients when the platelet counts go below 100,000.
* What drove me to cycle in a fever medication, in between the six
hourly Panadol dose when my second son Jonathan of three got fever, was
the fear of him getting a fit if the fever rose too high which, I feared
could lead to brain damage.
I believe I am not alone in this line of thinking and that is why I
am addressing this issue as well.
I am told that such fear is misplaced and that brain damage does not
take place if your child gets a fit as a result of high fever. If a fit
does take place, turn the child on to his/her left and within five
minutes the fit will end.
However, if the fit extends beyond 10 minutes, show the child to a
doctor to confirm that all is fine. If the fever rises between Panadol
doses, tepid sponge the child to bring comfort. Tepid sponging also does
not guarantee that a fit will not take place in a child that may have a
history of having fits because of fever or has a family history of such
fits taking place. If we follow the above instructions diligently,
beating the dengue virus will be a walk in the park! |