Seized With Fear

I went through something terrifying on Tuesday. One of my nineteen-month-old twins was roused from his nap by my wife. He had been well earlier in the day, playing in the children's water park at Kelowna's City Park. But J was upset and said that our son, G, wasn't looking right. I was in the middle of a haircut at home and told her to stop freaking out. She remained concerned and upset, and my hairdresser offered to release me from my chair.

I went to look at G and was instantly struck by how wrong he looked. His cheeks and ears were flushed, especially on the left side. He was grunting and moaning, his breathing laboured, and his half-open eyes were gazing fixedly up and to his left. His back was arched, his head lolled back, his jaw clenched, and he wouldn't respond to anything. "J, I think he's having a seizure." She nodded, her face openly showing her fear in her knotted brow, downturned mouth, and imploring eyes. "Let's go!" I said.

I grabbed G and ran barefoot to the van. I barked at J to get the keys and my shoes. I strapped myself in and held him in my lap while she drove the two blocks to the emergency department. He remained flushed, which was good, that meant he was still getting oxygen, but he had brief apneic spells prompting me to consider mouth-to-mouth resuscitation. Fear gripped me as I gazed into those eyes, eyes that did not look back, eyes that gave no hint of the bubbly toddler they belonged to. I rocked him back and forth and begged him to return to consciousness. I lied to J about how he was doing so she'd keep her eyes on the road and get us to the hospital intact.

I raced into the emergency department, went to the triage desk and said, "This baby is having a seizure." I was directed immediately to a nurse and said again, "This baby is having a seizure." In retrospect, I still don't know why I referred to G that way, as "this baby." Was it more clinical? Did I intuitively distance myself to seem more objective in my assessment, and gain credibility? I don't know.

We were quickly escorted to a vacant trauma room where--nothing happened. For a seeming eternity, nobody seemed to make much effort to match our concern. G continued to look into the void, we continued to fret, and aside from some vitals, nothing was being done. No anticonvulsants were administered, no doctor assessed him, no tests were ordered. This was unbelievably distressing to J and I, but we are both too reserved to press for attention.

At last, after about five minutes, a colleague and friend of ours arrived to quickly assess G, looking him over and listening to a retelling of the events leading up to this episode. G is a healthy nineteen-month-old identical twin. His brother had a febrile seizure three months ago (witnessed by my wife, and also prompting a trip to ER). He has recently been well, except for a low-grade fever that day before his nap. I gave him some acetaminophen before I put him down to sleep. His brother had been gamely suffering through a mild head cold, snotty nose, disrupted sleep, nothing serious.

G received more acetaminophen and some ibuprofen. It took a few more long drawn out minutes for G to finally recover consciousness, before his eyes brightened and he gathered in his surroundings, before he was able to give voice to his own distress with a good sustained cry. It had never sounded sweeter.

He remained irritable, jittery, and easily startled in his post-ictal state. Over the succeeding hour, his temperature remained over 40 degrees Celsius, and he threatened to seize again. But that terrifying vacant look never reappeared.

G was discharged within a couple more hours after blood and urine were collected.

Over the next day, I watched him carefully for signs of permanent or acute brain injury, my greatest fear given the duration and intensity of his seizure.

With my first son (the twins are my third and fourth), it took several years for it to dawn on me that he was not perfect. I aspired to his perfection as a parent. But when his lip was scarred by a fall to the pavement, when he needed his tonsils out to deal with his sleep disturbance, mouth-breathing, and venous stasis, when he ultimately needed glasses at six, I realized that he was not perfect. He was just a talented, affectionate, intelligent boy, and that's all I could wish for.

Now I was scared that G was beyond mere imperfection. I was concerned about a lasting impairment, cognitive or physical. He played with me later that day before bed, deftly repacking some wooden blocks into their box; listening to a favorite story, turning the pages; vocalizing some toddler conversation as I tucked him and his brother in. He was still febrile, still acted sick, but he seemed undamaged. I feel so goddamn f-ing fortunate that he is unscathed.

The next day, his fever rocketed to over 40 again (40.2). And again, shortly after I got him up from a nap, he seemed jittery, easily startled, and generally miserable. But he never had a repeat seizure. And it appears that he is now getting over whatever virus he was suffering from. We gave him antipyretics like clockwork, the ibuprofen every six hours and the acetaminophen every four, skipping an overnight dose when a hand to his forehead revealed a satisfyingly normal temperature.

I wanted to write about this awful experience to let you know what happened to us and also to reach out to other parents trying to make some sense of this condition. As physicians, both J and I have counseled parents going through what we just did. That didn't really make it easier to handle it though. We were scared.

For more, check out this fantastic parent-oriented page from the Mayo Clinic. Here's another from the NIH. An excellent review article appearing in the Archives of Disease in Childhood can be found here. In the scholarly literature, there is evidence of a familial association of febrile seizures, and thus, unsurprisingly, genetic susceptibility loci associated with the condition. Consequently, concordance rates in monozygotic twins are higher than in dizygotic twins.

I hope your child never suffers such an alarming episode. But if they do, I hope knowledge of our experience with this condition gives you some comfort.

Technorati tags: febrile seizure, identical twins, monozygotic twins

(In)Security

I flew yesterday, after more stringent security measures were applied in response to the plot to detonate explosive devices aboard ten transatlantic flights bound for the US from Heathrow. I flew from Kelowna to Cranbrook via Vancouver, not exactly hubs of terrorist activity.

Nevertheless, I had to check my overnight bag, containing shaving cream, toothpaste, hair gel, and other potentially compromising materials. I also didn't dare venture outside the security checkpoints in Vancouver to avoid having to line-up again. However, I was allowed to carry through my cell phone, iPod, laptop, books, pens, and key fob. I couldn't if I was flying from Heathrow.

British passengers were advised the following:
"Passengers may take through the airport security search point, in a single (ideally transparent) plastic carrier bag, only the following items. Nothing may be carried in pockets:
• Pocket-size wallets and pocket-size purses plus contents (for example money, credit cards, identity cards etc (not handbags)
• Travel documents essential for the journey (for example passports and travel tickets)
• Prescription medicines and medical items sufficient and essential for the flight (eg, diabetic kit), except in liquid form unless verified as authentic
• Spectacles and sunglasses, without cases
• Contact lens holders, without bottles of solution
• For those travelling with an infant: baby food, milk (the contents of each bottle must be tasted by the accompanying passenger) and sanitary items sufficient and essential for the flight (nappies, wipes, creams and nappy disposal bags)
• Female sanitary items sufficient and essential for the flight, if unboxed (eg tampons, pads, towels and wipes)
• Tissues (unboxed) and/or handkerchiefs
• Keys (but no electrical key fobs).
All passengers must be hand searched, and their footwear and all the items they are carrying must be X-ray screened. "

At least you don't have to taste the female sanitary items. Just the breast milk.

The main problem for experienced travellers is the noobs who gum the whole procedure up. It may take me less than 45 seconds to pass through the security checkpoint, because I know which shoes and belt to avoid; to take off all my metal anything including watch, pager, pens, foil wrapped gum; to have my boarding pass ready for presentation, my passport close at hand; to remove all banned items from my carry-on in advance; to remove my laptop from the bag; etc.

But the noob traveller does not do any of these things. And the rest of us have to stand around while he walks through the detector wearing his jacket, then he withdraws, takes it off, puts it on the conveyor and walks through again. *beeeeep* Oh, I've got these steel-toed boots on. *beeeeep* I'm supposed to put my keys on the thing? Whoops. *beeeeep* Then the wanding. Open the belt, close it up. Turn around. Now on to the bags. "Sir, is this your bag? You're going to have to remove the scissors, the nail file, and the pocket knife. You'll also need to remove the lighter, contact lens cleaner, after shave, conditioner, shampoo, pomade, hair gel, and mousse. If you like, sir, you can return to your airline gate to check these items in your bag. Otherwise they'll have to be confiscated. Please don't use that language with me, Sir. These regulations are intended for your safety."

How safe does this make us, anyway? I have no doubt that these regulations have prevented many more incidents from occurring. Security works. Nobody's hijacked an El Al airplane in over 35 years.


I think what needs to happen, though, is a way to accommodate air travellers better. If I can't bring food and drink through security, the airlines or airport better provide it and in copious amounts. If I can't bring my toiletries on board and the airlines lose my checked luggage, they should provide a his or hers two-day toiletries supply. I shouldn't have to spend the first few hours at my destination shopping for them. And give us good stuff to read on board. And video and audio on demand. And a way to do work on board. In short, they should replace all the amenities we passengers ourselves are prevented from providing.

Technorati tags: carry on baggage, security, Heathrow, airlines, El Al

Galloway Excoriates SkyTV Interviewer

British MP George Galloway blasted a SkyTV interviewer, the media in general, and everyone in the world with a memory no longer than 4 weeks for the obfuscating rhetoric and perspective employed in reports about the recent conflict in Lebanon. This interview is not to be missed.

"The Hezbollah are a part of the Lebanese national resistance who are trying to drive—having successfully driven most Israelis from their land in 2000—Israel from the rest of their land, and are trying to get back those thousands of Lebanese prisoners who were kidnapped by Israel under the terms of their illegal occupation of Lebanon. [...]

"[Israel] has killed thirty times more Lebanese civilians than have died in Israel. So it's you who should be justifying the evident bias which is written on every line on your face, and is in every nuance of your voice, and is loaded in every question that you ask. [...]

"America has given Israel missiles that can target not just every city in Lebanon, but every city in the Arab and Moslem world including Iran. Why should America be allowed to give long-range missiles to Israel—including hundreds of nuclear missiles—but Iran is not allowed to give—"
"Because Hezbollah is a terrorist organization—"
"But they're not a terrorist organization. [...] It's Israel that is a terrorist state!"

Technorati tags: Israel, Lebanon, propaganda, media, George Galloway

Japanese Tongue Twisters

I can't resist sharing this with you. A Japanese tongue twister game show.



Hurts so good.

Technorati tags: Japanese game show, tongue twister, Japan, vids, clips

Peace, Propaganda, and the Promised Land

A friend forwarded me a link to a provocative documentary titled Peace, Propaganda, and the Promised Land: Media & the Israel-Palestine Conflict (link to the movie, the imdb entry, or the Media Education Foundation page). In footage from the occupied territories and interviews with media analysts like Noam Chomsky, this 2004 documentary explores the calculated public relations campaign by Israel to obscure the truth.

Take a listen to a perspective that is too rarely heard, the perspective from the West Bank. An illegal military occupation. Harrassment, detention, and torture. Illegal and strategically deployed Jewish settlements throughout the West Bank. Bad faith offers at peace. The documentary makes the point that American media reports on the area are filtered and skewed; sometimes they are even authored by the Israeli Press Office, filed from their facilities, and constrained by their accepted lexicon.

While not directly related to the current conflict, the film is a worthwhile way to further refine your own perspective on the region by hearing a perspective that—I concede—is also filtered, but not by the Israeli Press Office. By The Independent, Rabbis for Human Rights, Fairness and Accuracy in Reporting, The Village Voice, Tikkun Magazine, The Palestinian Initiative for the Promotion of Global Dialogue and Democracy, The Institute for Public Accuracy...

Where is your opinion coming from?

Technorati tags: Israel, Palestine, propaganda, media, Noam Chomsky

Nasrallah Defiant

Reuters reports casualties incurred in the 23 days of violence triggered by Hezbollah's incursion into Northern Lebanon:

"Lebanese Prime Minister Fouad Siniora said the war had killed 900 people in Lebanon and wounded 3,000, with a third of the casualties children under 12.
"He said a million Lebanese, a quarter of the population, had been displaced and infrastructure devastated. The Reuters tally of Lebanon deaths is at least 683.
"Sixty-six Israelis have been killed in the war including 40 soldiers. Israel lowered the number of people killed in rocket strikes to seven after earlier reporting eight."

A little lopsided.

And yet, Hezbollah's Nasrallah remains defiant and continues to invite Israel to wreak devastation on Lebanon:

"If you strike Beirut, the Islamic Resistance will strike Tel Aviv and it is able to do so."

Neither side wants to back down first. The death toll continues to mount.

Meanwhile, the UN Security Council continues to deabte the form any stabilizing force would take, and the details of a ceasefire. A French proposal calls for the creation of a buffer zone in south Lebanon which can be occupied only by UN Forces or Lebanese security forces. Other stipulations of the plan are likely to prevent its adoption, such as provisions for the release of the abducted Israeli soldiers and Lebanese prisoners detained in Israel, and the disarmament of "all militias in Lebanon". You will recall a resolution containing this final provision was already passed by the UN and ignored (UNSC Resolution 1559).

Plus ca change, plus c'est la same goddamn thing.

Technorati tags: Israel, Lebanon, Hezbollah, UN, Nasrallah