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meningitis & septicaemia can kill in hours!

People who are faced with meningitis and septicaemia have to act fast to help save a life.

Max McKendrick

Meningococcal disease at 9

Meningococcal disease

Max was nine when he became sick with meningococcal septicaemia, at Christmas time 1998.

About a week earlier, Max had woken with a large 'mump-like' swelling in his neck, that went down within the day. My doctor told me not to worry, that it was a virus. On 17 December, Max developed flu-like symptoms at around 6pm (fever, shivering, lethargic), so I did the usual thing and gave him Calpol. By 8pm he was fine, watching Top Gear with my husband Bruce. In the early hours of the morning of 18 December, I was awoken by a faint voice calling "Mum". I found Max lying on the bathroom floor after suffering vomiting and diarrhoea. I bathed him, and he moaned that his body was aching. I put him back in bed and watched him. His breathing was rapid and shallow. I still thought it was a bad case of flu, and did not want to bother the doctor in the middle of the night (why is it, that we are reluctant to 'bother' doctors, to whom we pay large amounts of money through our taxes?).

At 7.30am the following morning, Bruce called in on Max before leaving for work. Max was delirious, asking for water. Bruce fetched him a glass, but Max had no recollection of asking for it, and could not see it. I called the doctor immediately but was told he couldn't come until late morning, after his surgery. Although we did not know it at the time, had we waited for the doctor Max would have been dead long before the doctor arrived.

Being a mother, I am aware of the symptoms of meningitis . I checked closely for signs of a rash - no rash. I did notice however that his feet were very cold. By now it was about 8am and our other two children (Joe and Louis) were ready for school. It was then I noticed a small 'freckle' below Max's left eye, which I had not seen before. Bruce carried him to the car and we drove him to the surgery immediately. Why that rather than call an ambulance I don't know. Perhaps we are programmed to go first to our own doctor rather than to casualty, which, even then, all seemed a bit too dramatic and unnecessary.

On arriving at the surgery, we were told bluntly to sit down and wait our turn. Bruce ignored this and pushed his way through the swing doors to find a doctor. The doctor told Bruce to put him on a bed and said "let's have his pyjamas off". It was now about 8.25am and Max's body was covered in bruise-like blotches about the size of ten-pence coins (the 'rash'). It was then the seriousness of the situation really kicked in. The doctor, thankfully, injected penicillin, and Max fell unconscious. An ambulance took Max to St Peter's Hospital, Chertsey.

The team at St Peter's were wonderful. All hands on deck, fighting to keep Max alive. Huge syringes were used to pump fluid into his body, to try to stop his vital organs failing, but not so much as to crush his brain. A team was scrambled from St Mary's Hospital, London - one of the leading centres in this field - and during their journey along the M4, St Peter's reported Max's vital signs, so the St Mary's team could assess the situation and give instructions. We were told later that the doctor told the driver to slow down, as Max's situation was so advanced that he would be dead before they made it. Nonetheless, make it they did, and Max was still hanging on, barely. The medical teams spent the next five hours fighting to save his life, whilst we were sat down and prepared for the worst. Bizarrely, I remember at one calmer point in the proceedings, having tea and toast within the team from St Mary's, discussing Scotland, work and where we went to University, but we were gathered round the bed of a blood-soaked, bloated child in a coma, with tubes going into orifices on his body, natural and those created by the medics. It was like living someone else's nightmare, these rare things "always happen to someone else".....but it was OUR nightmare.

By 3pm, Max was stable enough to be strapped to a special stretcher and moved to St Mary's to their Paediatric Intensive Care Unit (PICU). We were told if he made it through the next 24 hours, there was hope, if he made it through 48 hours, there was real hope. He did both, and after five days on life support they began to wean him off the machines and see if his vital organs were functioning. Although they didn't let on, the PICU nurses were worried that his brain had been damaged, as he had not been responding well to various tests and was taking longer than normal to 'wake up'. Eventually, after many hours, he was able to breathe on his own, and slowly, slowly opened his eyes. He stared at the clock (3pm) and mouthed (he couldn't speak having been intubated for five days) "Where are Joe and Louis?" Those five simple words told us his brain was still in working order.

We were not prepared for the next two awful weeks in a high-dependency unit, where Max had to remain to build up his strength. He had shed all his muscle and a third of his body weight in five days, he could not stand or walk, and understandably was rather depressed. We eventually took him home nearly three weeks after he became sick. Christmas and New Year has passed. He refused to use a wheelchair and returned to his schoolmates after the February mid-term.

Bruce and I spent the next year in turmoil, talking about little else, wondering what might have been, and why this awful thing had happened to us. Eventually, we realised what had happened to us was a miracle, it was an absolute miracle that one of the worst cases St Mary's had seen, had resulted in survival with no loss of limbs, as can so often be the case. For whatever reason, I guess Someone decided it just wasn't his time.

Lessons:

1. The hospital trauma side of the NHS was absolutely first rate in dealing with this emergency. We owe them Max's life. The GP side however, was a barrier to be overcome. Had we been meeker, and waited for the doctor to arrive, or sat in line at the surgery, we would today be visiting Max's grave rather than his university in Oxford with washing and money.

2. The signs are sometimes hard to see, can come quickly and in any order. Learn them and look out for them. And don't think of a 'rash' in the conventional sense.

3. Speed is critical. When that manipulative bacteria kicks in, you are in a race against time. Do not hesitate. Act quickly. Kick down any barriers that are put in your way and don't take no for an answer. I will never ever regret wasting a doctor's time. I would always regret wasting my time in getting to a doctor.

VANESSA MCKENDRICK
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