Fever Pitch

On Thursday afternoon, Kristine called me at work. She was not feeling well, complaining of a fever and stomach ache. When I got home she was pretty worked up. She normally has trouble getting comfortable - we all take for granted the small adjustments we make to our body's position while remaining stationary for any length of time -- but for Kristine any additional malaise can be a tipping point to emotional distress. I think just my presence helped to calm her down. I got her to bed where she was able to doze off for small intervals as I lay at her side.

She periodically awoke shivering with chills despite several layers covering her. All evening I monitored Kristine's temperature. At seven o'clock it had reached 102.7degrees Fahrenheit, but by eight it was down to 101.5. The reduction in temperature helped us both to relax enough that we were able fall asleep.

Then, at around 9 o'clock, Kristine's body jolted and she let out a horrid, muffled wail. I jumped up from my sleep to see Kristine's left arm and the left side of her face and neck in a quick, rhythmic and violent spasm. Her entire body moved in unison with her convulsing left side. I ran around to her side of the bed lifting her torso upright in order to sit behind her and press her back against my chest. I grabbed hold of her body grasping her left shoulder with my right hand and the side of her face and neck with my left in a vain attempt to slow or halt her contracting muscles. Kristine was aware but groggy from her sudden awakening from a deep medicated sleep. Her attempts to cry out were suppressed by her inability to control her mouth -- her efforts to speak yielded only a dull, muted bellow and a stream of involuntary saliva from the corner of her lips.

The episode passed in less than a minute but it seemed like several. Kristine was fully conscious during and after the event. We were both shaken by what had happened, but I can only imagine how scared Kristine had to have been. As a result of what we presumed to be a seizure the left side of Kristine's face remained drooped and the movement she had previously established in her left hand was no longer evident.

My first reaction was to call the doctor's office. Kristine at first opposed the idea, fearful of yet another trip to the ER, but she quickly came around convinced that it couldn't hurt to call. The on call resident in the Department of Neurosurgery responded promptly to his page. After reading through Kristine's file and hearing the details of the night's story he was less alarmed than we expected. He said that the incident was isolated (the spasms had not reached her leg) and was likely an "uncomplicated" seizure (classified as such based on Kristine's alert mental state). He said that a trip to the ER was not necessary, but to watch for additional deterioration and instructed us to pay a visit to the office first thing in the morning to exam Kristine more closely.

Kristine was quite composed after the call. An hour had passed since the seizure and Kristine calmly picked up her left hand, wiggled her fingers and said that her movement had returned. Glancing at her face I noticed, to my delight, that her facial muscles had also rebounded as she flashed a soft smile.

The entire moment was surreal. But just after the seizure and before the doctor's call Kristine said something that was all too real. She instructed me soberly and with little emotion that should anything happen I was not to, "do anything drastic." Implying that should we face another decision to extend her life with any consequence of additional physical impairment, the alternative was not just preferred but mandated. We have talked about this several times especially after her brain surgery, however, it never gets any easier to face. Although I know that I have to be prepared I remain optimistic that I will not have to encounter such a decision anytime in the near future.

Kristine is doing well now, though still slightly shaken. Her MRI did not return any urgent issues. In fact there is a strong possibility that Kristine's fever triggered the seizure as an isolated occurrence verses a more serious clot or hemorrhage. Our neurosurgeon has suggested at a conservative approach forward. We will be meeting with him on February 2nd to discuss potentially treating the original site of the resected brain tumor with Gamma Knife radiation. Kristine and I are apprehensive about this since it could set Kristine's physical rehabilitation back further or even permanently. We will cross that bridge when we come to it.