Amundsen House of Chaos

Let's face it, when you have a kid who survived a stroke, life is always going to be a little chaotic.

Thursday, March 11, 2010

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E. coli 0157 and a Medical Awareness Bloghop

Just in case you haven't read the reason behind Colby's stroke it was due to E.coli 0157 poisoning. It was right around the time when there was all the Moran ground beef recalls. We all got sick from E.coli but not from ground beef. Ours came from a mountain river that cows had been grazing nearby. His illness was one of those luck of the draw type deals. There was no way to prevent him getting the E.coli it was in the water. Someday I'll take a trip back up the river and take a picture of the spot where we had that fateful picnic. Just not today. I figured that I started this blog to keep people away of Colby's recovery but also to talk about E.coli posioning. I haven't done a good job on the last part.

Before I go any farther I need to tell you that in no way am I giving medical advice. You should always consult with a doctor if you think you have any type of problem. I'm just a jaded parent of a child whose E.coli posioning was misdiagnosed.

So what is E.coli?

It's a bacteria. It is usually found in the intestines of people and animals. There are lots of strains of E.coli. Most are non-pathogenic so they don't cause disease in the intestines. The trick is that if they get outside of the intestine than they can cause disease. If it gets into your urine it can cause a kidney or bladder infection. If it gets into your blood it can cause sepsis.

Some strains CAN cause disease in the small intestine. They start by causing diarrhea and they release toxins that inflame the lining of the small intestine and the colon. There is a third strain and this is the one I hate (only because it's the one Colby had), it's called E.coli 0157:H7. It causes inflamed intestines, colon and bloody diarrhea.

Now when I called the doctor's office to ask about the bloody diarrhea they thought I meant a small streak of blood. Something like you might see if a kid has a bad bad diaper rash. Small streaks of blood. This kind of bloody diarrhea is like straight blood. You can't tell the difference between fecal matter and the blood because it's all blood. I'm talking open the diaper and let out a string of words you wouldn't normally say because there's so much blood. I told the doctor office this. They apparently thought I was over reacting and told me to call back in two or three days if it got worse.

A half an hour later I took him to the emergency room. There they took a sample from his diaper and sent it off to the lab. 7 days later it came back negative. Seriously by this point he was on a ventilator and had already had his stroke so I have no idea how it came back negative. That's crazy in my opinion but I'm not a doctor so what do I know right?

Anyway the bloody diarrhea is technically produced by a toxin called the Shiga toxin and that is the toxin that damages the intestines. This nasty little toxin infects more than 70,000 people a year in the United States. That's crazy! That's a whole lot of people every year. You'd think Colby's doctor would have picked up on the major indicator of something like that but again that's just the jaded parent talking.

The incubation period between exposure to E. Coli beginning of symptoms is usually three to four days. Symptoms include severe abdominal pain and abdominal tenderness which often is associated with bloody diarrhea. There is little or no fever with this little bug. The diarrhea typically lasts for six to eight days. When I took Colby in he had started showing symptoms three days before. He was only two and he was starting to become dehydrated from all the diarrhea. His stomach was not tender though. I could push on it and he never said anything about it. Funny that his ER doctor said he had tenderness and wincing. Nope he didn't. Sorry I'll try to keep that jaded thing away for now.

That doctor insisted he had appendicitis. His appendix was slightly enlarged but his colon and small intestine were very enlarged. Do you remember the symptom list? Enlarged colon, bloody diarrhea. These all should have been red flags. Just wait till the next part it gets even better.

Hemolytic-uremic syndrome or HUS is the worst complication of the E.coli infection because it is a serious and potentially fatal illness. Hemolytic means that the red blood cells are breaking up which causes the patient to become anemic. The platelets in the blood are literally destroying themselves which leads to low blood levels of platelets or thrombocytopenia. Thrombocytopenia causes abnormal bleeding. The Uremic part of HUS means the failure of the kidneys. Once the kidneys fail you can have problems with seizures, stroke and coma may occur.

HMMM sounds familiar. Probably because his lab work said he had Thrombocytopenia right on it and that his platelet levels were already low at that point. Two days later when they life flighted him to the childrens hospital his platelet level had decreased by half.

HUS is most common in kids under the age of 10. It is the most common cause of acute renal failure in infants and young children. It occurs in 6%-9% of hemorrhagic colitis caused by E.coli and usually occurs 7 to 10 days after the onset of the diarrhea.

Another complication of this is called Thrombotic thrombocytopenic purpura or (TTP). TTP causes clotting of blood within small blood vessels, anemia due to fragmentation of red blood cells, and shortage of platelets (thrombocytopenia) that results in easy bruising, neurologic abnormalities, impaired kidney function, and fever. The difference is that TTP usually has a fever where HUS does not.

Next week I'll continue this post with ways E.coli posioning is treated and then I'll go on to ways to keep from getting E.coli posioning. I do this so that others are aware that if you have a young child with severe bloody diarrhea it is a big deal. Overreact. Demand tests and don't take no for an answer. Now I don't advocate overreacting for a small amount of blood but if you have a diaper full of bright red blood it's something you probably need to be concerned about. Just the humble opinion of a mother whose been there.

If you'd like to you have a medical issue you'd like awareness brought to please link up. I thought it might be kind of different to do a medical awareness type of blog hop. I only ask a couple of things. You state that your not a doctor somewhere in your post unless of course you are a doctor. Then I don't care what you do! Two if you'd be so kind as to link back to me that would be awesome. I think if this goes well this week I'll do it again next Thursday. Any thoughts or feedback would be appreciated. If it goes well I'll try to have a button for next week also. And third I dont' really care if it's a rant, a rave or just informational. I know that when your dealing with a medical issue (and I use that term lightly because I think we all have some type of issue or another) sometimes you need to do all three to get the word out.

Here is a link to the newest donation button for Colby's fundraising account. This ebook is for fondue recipes.
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