Meningitis is a disorder in which the linings that surround the brain and the spinal cord (the meninges) become inflamed. It can be caused by several different types of bacteria or viruses, and can occur at any age.

Meningitis is potentially a very serious illness, and the casualty may deteriorate very fast. Prompt treatment in hospital with antibiotic drugs is vital. Without immediate treatment, meningitis may cause permanent disability, such as deafness or brain damage, and it can even be fatal.

For this reason, it is important that you are able to recognize the symptoms of meningitis – these include high fever, severe headache, and a distinctive rash. With early diagnosis and treatment, most people make a full recovery.

Source : First Aid Manual Revised 8thEdition

Meningitis is not a common illness and it is rare for a person to be hit by it once in his/her lifetime, and it is very rare for a normal adult to be hit by it twice in a lifetime, so it was very, very unfortunate that my elder son was hit by meningitis not once, but TWICE in a year, in a space of a few months apart this year to be exact.

I quote the doctor’s own words. “Being hit by meningitis twice in a year is like being struck by lightning twice in a lifetime, which is very, very rare, and unfortunately, it had to happen to your son.”

There are two types of meningitis – viral and bacterial meningitis with bacterial meningitis being deemed as the more dangerous between the two.

I have been through the pain of seeing my elder son suffer from meningitis not once but twice this year and because it is such a dangerous illness, I decided to write this article to share my experience and to warn others of the dangers of this illness by talking about the symptoms, the test done to confirm meningitis as well as some of the complications that can arise after having had the test for meningitis done.

At the beginning of this year, barely a week into the new school term, my elder son complained of severe headache and was running an extremely high temperature and kept complaining that the lights were disturbing him. He also complained that there was pain just above both his eyelids.

He has a history of severe migraines, so I thought that was just one of those bad migraine attacks, so I quickly made an urgent appointment with the doctor who has been looking after him for his migraine and rushed down to his clinic.

At the clinic, thanks to the doctor’s experience and expertise, he told me that he suspected it could be a case of meningitis and said to admit him immediately.

I almost fainted when I heard the word “meningitis”. The first time I heard of the word “meningitis” was when I was in Secondary School when our Principal announced one morning during assembly that one of our schoolmates, had died of meningitis the day before. Said she had high fever, went into coma and never regain consciousness. From that day onwards, the word “meningitis” got stuck in my mind and I would equate “meningitis” with “high fever” and subsequently, “death”.

So when I heard the word “meningitis” from the doctor, my world crushed and I felt as it I was being served a death sentence. There was no time to loose, all I wanted then was for my son to be admitted and treated immediately. He was conscious, but was very, very weak and very, very hot to touch and the severe headache was driving him crazy and his words were incoherent. He could not walk by himself and had to be wheeled from the clinic to the hospital in a wheelchair. Luckily for us, the doctor’s clinic was in the medical centre of the hospital.

We quickly got my son admitted and upon admission, I was asked to sign a consent form for my son to undergo a procedure called “lumbar puncture”, also commonly known as a “spinal tap”.

A lumbar puncture takes samples of the fluid around the spine and brain, known as cerebral spinal fluid and it involves inserting a needle into the middle of the lower back collecting some drops of fluid. The procedure was done under local anesthetic under sterile conditions in the hospital room itself.

A few hours after the tests, the results came back and it was positive for viral meningitis, the lesser of the two devils, but the results for bacterial meningitis would take one or two days. That was enough to have me worrying for the next two days till the results came back. Meanwhile, he was treated accordingly for the viral meningitis. 

The doctor warned that should he be tested positive for bacterial meningitis, all classmates, teachers, family, friends or relatives or whoever who had come into contact with him a few days before his admission would have to be put on a course of antibiotics, as a safety precaution. I quickly informed his form teacher about it so that he can be prepared.

Fortunately for us, the results came back negative for the bacterial meningitis and the school was informed accordingly. 

My son stayed in hospital for a week and was given another one week of medical leave before he returned to school, but unfortunately, our worries did not end there.

He was fine after he was discharged from hospital, but about one or two days after returning home, he kept complaining of a disturbing headache each time he stood up or sat up and the pain would go away the moment he laid down to rest. I decided to take him back to the doctor earlier that his pre-scheduled follow-up date. 

The doctor said what my son was suffering from was what is commonly called a “low-pressure headache”, a common complication of the lumbar puncture that was done at the hospital a week ago. Said it’s a very common complication though it does not affect everyone and if it does, it affects different people in different ways and one of the cures for “low-pressure headache” is by drinking plenty of fluids and increasing caffeine intake.

Increasing caffeine intake? I thought I was hearing things but the doctor assured me that yes, increasing caffeine intake is one method of dealing with the complication of a lumbar puncture. He prescribed some medicine for him as well while advising us to let him drink as much caffeinated drinks as possible in order to cure the low pressure headache. We had a good laugh when the doctor rattled off words like Coke, Pepsi, Mountain Dew and Coffee as “his prescription!”

I was shocked when I heard that as that was the first time I heard of such a thing as using caffeine as a cure for something. I never knew caffeine can be a “good thing”. I did a search on the internet and found that true to what the doctor advised, caffeine is indeed a cure for “low-pressure headache”. Here are some links for those who are interested in reading more.

http://www.hopkinsmedicine.org/neurology_neurosurgery/conditions_main/low_csf_headache.html 

http://www.merck.com/mmpe/sec16/ch216/ch216e.html

http://www.emedicinehealth.com/spinal_tap/page2_em.htm

I was convinced after reading the articles on the Internet, so over the next few days, we literally ‘drowned’ our son with all kinds of caffeinated drinks and true to the doctor’s prediction, my son recovered and eventually went back to school two weeks from the onset of the meningitis.

We thought we had seen the end of the meningitis episode in our lives and never in our wildest dreams did we expect the meningitis to return again a few months later down the road.

On the eve of Hari Raya Puasa this year, the same son complained of severe headache in the evening and again, we thought he was simply having a bad migraine attack. He took the standby medicine which we have at home for the migraine and hoped for the best. The pain subsided after about an hour or so and my son went to sleep.

However, at about 3plus in the middle of the night, he woke up with yet another severe headache and was running a very high fever and he also complained of nausea. He was extremely hot to touch and began to show signs of disorientation, so I rushed him down to the A&E at 4.00am. Call it motherly instinct or whatever, but I suspected that it was meningitis that we were dealing with again.

The resident doctor at the A&E deemed his condition serious enough to be admitted immediately and to make a long story short, yes, a lumbar puncture was done again. Incidentally, the lumbar puncture test was not done by our regular doctor as he was on leave at the time of my son’s admission, but yes, it was confirmed he was infected with meningitis the second time in a space of a few months and even the doctor himself was puzzled.

However, this time round, probably due to our experience a few months back, we were not as worried and also because we had complete faith in the doctor and knew that he was in control.

He stayed for about one week in the hospital and was discharged the following Sunday. He was well when he left the hospital, but the moment he reached home, he started vomiting and kept complaining about a mild headache each time he stood up, the exact complaints that he complained about the last time.

Thinking that it could be the due to the complications of the lumbar puncture again, I called the doctor for advice and was told to continue with the medicine that was given the last time for the complication and to increase his caffeine intake again like the last time but to see him at his clinic the next day if the symptoms persisted.

Since we increased his caffeine intake, we thought he would respond to it like he did the last time, but unfortunately, this time round, by the following day, he was still complaining of low-pressure headache and continued to vomit.

I then decided to take him back to the clinic as advised by the doctor. 

At the clinic, he kept complaining of giddiness and the nurse ushered us to a spare room and my son was allowed to rest while we waited for the doctor to attend to him. Seeing that my son was in great discomfort, another patient gave up his place in the queue and allowed the doctor to attend to my son first since his situation was not as serious as my son’s. We were really lucky to have met such a kind man like him.

The doctor came in and checked on my son and told me that it’s not normal for the complication of the lumbar puncture to last so long, and he said he had no choice but to resort to a simple procedure called “Blood Patch” to rectify the leak in his spine since that leak was what’s causing the headache and vomiting. He told me he would revert after he has made the necessary arrangement for the procedure.

I asked him what the procedure entailed and sensing the worried look on my face and voice, he simply said the procedure was as simple as drawing some blood from another part of my son’s body and then injecting the blood into the exact hole in the spine where the lumbar puncture was done, to “seal the leak”, his exact words, so to speak.

Okay, simple enough, right?  So can you imagine my shock when the nurse came to me and asked what sort of hospital room I wanted for my son?

“What room?” I asked. “You mean my son has to be admitted for the simple procedure? Thought it is just a simple procedure that can be done here?”

The nurse replied in a very reassuring voice, “Yes, a simple procedure, but unfortunately, this simple procedure must be done in the sterile conditions of Operating Theatre, not here.”

Goodness me, I was shocked beyond words!

Okay, I suppose the doctor knew better, right? So off we went to get the admission procedure done and the nurse told me that the procedure was scheduled for 3.30pm in the afternoon.

At about 3.00pm, my son was wheeled into the Operating Theatre and the doctor told me that at most, the procedure would only take 15 to 20 minutes. 5 minutes turned to 10, to 15, to 20 and then 30 and more and it seemed like eternity while I waited outside the Operating Theatre so can you imagine my worry when my son did not appear till about 5.00pm in the evening?

Thought the doctor said it was a simple procedure that would only take 15 to 20 minutes at most? But yet there was nothing I could do about it apart from waiting outside the Operating Theatre and the sight of a first-time father pacing up and down the corridor did not help to make things more comfortable either. His wife was also in the Operating Theatre, having a Caesarian Section to deliver their first child.

I asked the doctor when he finally appeared from the Operating Theatre and he said first of all, another doctor who was asked to assist in the procedure came a bit late since it was a last minute urgent arrangement and he had other prior appointments to take care of. But on top of that, he explained that the procedure took a bit longer than usual because they had difficulty finding my son’s veins. Because he was on intravenous drips throughout his earlier hospital stay, his veins were swollen and therefore finding suitable veins to draw blood proved a bit difficult, hence the delay, but well, whatever it was, important thing was that the procedure went well and the effect was almost immediate. By evening time, my son was feeling much better and was no longer complaining of giddiness nor feeling nauseous.

To play safe, the doctor kept my son there for 2 days after the procedure just to be sure that he was absolutely alright when he was discharged.

While I was at the hospital the second time round, I checked out on the “Blood Patch” procedure and realised that it was not as simple as the doctor had made it to sound. He probably knew I was up to my neck with worries, so didn’t want to frighten me further. My son was wide awake throughout the procedure and from his description, the procedure was definitely no walk in the park.

Here are some links on the “Blood Patch Procedure” and it is also called “Epidural Blood Patch”. 

http://www.associatedcontent.com/article/2702479/epidural_blood_patch_purpose_and_procedure.html?cat=5

http://my.clevelandclinic.org/disorders/headaches/hic_spinal_headache.aspx

Glad to say that everything ended very well under the care of our very experienced doctor and it’s been a few weeks since the meningitis attack the second time round and I am really glad to put that episode behind us. My son has since gone back to school as per normal.

To sum it up, once again, I want to warn that meningitis is a very dangerous illness and must be treated as soon as the symptoms appear. For my son’s case, he had extremely high fever, very severe headache, sensitivity to lights and also pain in the eyelids, but there was no rash at all on his body even though that is one symptom of meningitis and my final advice to all is to trust your motherly instinct and get medical attention right away the moment you suspect your child or any of your loved ones to be suffering from a meningitis infection. Do not delay medical treatment as your loved ones’ life is at stake.

©25hourmaid
October 2010