I have written many blog posts over the last two years, sharing our journey with Kawasaki Disease, but it struck me this morning that I have never really been able to articulate how living with this disease day-to-day feels for a parent. It is a feeling I have become so accustomed to now, that it almost feels normal, and that is why I think I find it hard to describe. My goal today is to try, so that I might share with you a glimpse into how our world changed in June 2015.
In a nutshell, Kawasaki Disease is a form of vasculitis, causing inflammation in the medium to large blood vessels when it strikes. It is generally contained to children, mainly affecting those aged between 2 and 5 years old, though not exclusively (my daughter was 7 weeks old). It is characterised by a number of symptoms – persistent fever, red eyes, rash, swollen extremities, sore/cracked lips or strawberry-type tongue, and swollen lymph glands in the neck. With no known cause, there is no diagnostic test to differentiate Kawasaki Disease from other similar childhood diseases (Scarlet Fever looks very similar and is a common misdiagnosis), and therefore a diagnosis is reached based on presentation of the afore mentioned symptoms. Given that these symptoms don’t always show up at once, and sometimes not all of them are present, Kawasaki Disease can be a tricky illness to diagnose quickly. And the speed of diagnosis is important, as research has shown that treatment within 10 days of onset of symptoms can dramatically reduce the risk of heart damage in affected children. You see, 75% of children who get the disease will recover without long-term complications, whilst the remainder will sustain permanent damage to their heart if not treated (this reduces to around 5% with timely treatment). Sadly, this means that no matter how good the doctors are at diagnosing the disease, 5% of children who get Kawasaki Disease will suffer heart damage that will remain with them for life.
Whilst mortality rates for KD are considered low, at around 1% of cases, I’ve always felt that the statistic gives unreasonable hope to those of us with children whose hearts were damaged. I would be willing to bet that any deaths resulting from Kawasaki Disease are exclusively related to heart damage. So if there are 100 cases of Kawasaki Disease, the statistics say that 1 of those children will die. But when you consider that, with timely treatment, just 5 of those 100 children would suffer permanent heart damage, and you factor in the 1 child who will lose their fight, suddenly the numbers seem very different – especially if your child is one of the 5%. Suddenly that 1%, when factored into the heart population alone, becomes 20%. Now, whilst those numbers give the fear some perspective, I don’t want to cause unnecessary alarm for those of you living with a child with a broken Kawasaki heart – another bet I would place is that the majority, if not all, of the deaths resulting from Kawasaki Disease occur from misdiagnosis, or no diagnosis at all. Like the little girl who was diagnosed with rhinovirus and died 6 weeks later when her heart failed her.
So, I guess that sheds light on a couple of things:
- My daughter is one of the 5%. Unfortunately at just 7 weeks old when she became sick, she was in the high risk category for heart damage.
- It took 13 days to diagnose Freya, and therefore treat her (outside of the ‘magic’ window). Add that to the high risk factor, and she didn’t really stand a chance.
- Under the circumstances, it is pretty normal for me to feel afraid.
Thanks to Kawasaki Disease, my now 22-month old daughter Freya has a heart condition. She was born with a healthy heart, and after just 7 weeks in the world, and 13 days with a mystery illness, Kawasaki Disease broke it.
Looking back I don’t think it was the diagnosis that changed our lives. Hearing that the doctors had actually reached a diagnosis after two weeks of tests and various failing treatments, was a huge relief. Even when they told me that it was the damage to Freya’s heart that provided them with the conclusion, I didn’t realise they were talking about something that would stay with her forever. I presumed the damage to her heart was a symptom, one that would go away with the treatment. I was wrong about that. A week after celebrating Freya’s diagnosis I would be sitting in a room with a Cardiologist and a nurse as they told me that if my daughter’s coronary arteries (which had dilated to over 5 times the size of a normal baby) ruptured, she would die. They could not prevent it, and they would not be able to save her. That is what changed our lives. Until then I had never considered the possibility of losing a child. Facing that possibility head on, with no sugar coating, rocked the very foundations on which I had built my perfect, indestructible life. Of course, nothing is promised, there are no guarantees, life is fragile (and all those other clichés you see on Social Media memes), but I really didn’t think any of that applied to me. Stuff always happens to other people, doesn’t it…
20 months post-diagnosis, and I think I can dare to say that we are in a pretty good place (frantically touches wood). Freya’s coronary arteries showed significant improvement in the months following her diagnosis. Her heart function appears normal, her coronaries have remodelled to within ‘normal’ parameters and she shows no signs or symptoms of anything troubling going on in there. Good news, right? I guess that’s how we take it for now. The thing is though, that dealing with Freya’s heart is one thing, but add in the complications that come with ‘rare’ (KD affects just 8:100,000 children in the UK each year) and you find that ahead of you is a lot of uncertainty, confusion and contradiction.
There are a number of long-term complications from Kawasaki Disease. We often hear the words ‘normal’ from Freya’s cardiologist, we are also told by world leading specialists in this disease that Freya’s heart will never be ‘normal’. We are told to celebrate remodelling, but warned of possible stenosis (narrowing of the previously dilated arteries). We are told stenosis will take decades to occur, but read stories of emergency heart bypass surgery within months of diagnosis. We are told to live a normal life, not to worry, but research shows that 80% of children who suffer significant damage to their hearts as a result of KD will require surgical intervention later in life. Our doctors talk about what they see and know, but do not give confidence that they are familiar with all of the ways in which KD alters the child’s heart. I won’t even pretend to fully comprehend all the possible risks associated with Freya’s heart. I read about fibroblasts, myocarditis, and damage to the heart muscle, but I can’t begin to understand what those things mean in relation to Freya’s heart. No matter how much I have learned and think I know about this disease, I didn’t spend years in school learning about human hearts.
When I allow myself to think positively about the prognosis for Freya, I believe she has a good chance of living a normal life. But then I worry that I am becoming complacent. Freya’s doctors have shared that they have a degree of anxiety over Freya’s condition, and need to take a closer look. They’ve postponed that closer look until later in the year, and I worry about what changes might be occurring inside her heart in the interim. Only a few days to wait for some reassurance on that score (Freya’s next cardiology follow-up is on Monday 13th March).
When I consider that there is a possibility (though perhaps not a probability) of Freya suffering a heart attack, for example, I find myself suffocated by the thought. It’s like there is no end to the suffocation because you never know when something like that will strike. And I know that can be said for anyone, but the worry is more tangible when you are faced with a known condition with associated risks. When I wake in the morning, I lay paralysed in my bed until I hear something through the baby monitor that will defy my worst fears – a rustle of a sheet, a snort or a murmur from my sleeping girl. Not until I hear a sound do I let out the breath that I’ve been holding since I opened my eyes. I’m sure every mother could say the same, we all worry about our children don’t we.
Aside from my concerns for Freya’s future, the uncertainty that came with our daughter’s heart condition has caused me to question my own mortality too. I was never afraid of death before, I don’t think I gave it any thought. Now I am terrified. Until just now I thought it was just because I love my family so much that I am afraid of leaving them behind and missing out on what is yet to come. But actually I have come to realise that I am not afraid of dying, per se, I am afraid of dying too young. I have had to work so tirelessly, stay so strong, fight so hard to keep on the front foot with our daughter’s condition, that I fear for her future if I am taken from her too soon on her journey with this disease. I am afraid that she will enter into adulthood not realising how important it is that she keeps her heart healthy, or how she may need to have a cardiologist on hand in labour if she ever has children of her own. I worry that others will forget about all of this, because they can forget. There are no visible reminders of what this disease did to Freya, so it wouldn’t be hard to put KD firmly in the past. Me; I’ll never forget. The last 2 years are etched in my memory so deep that I can play the entire journey in my mind as if I were watching a video recording. And my overactive imagination has managed to convert my fears into a DVD that plays for me over and over – I have ‘seen’ moments where life ended, clearly enough to feel the loss as if it were real. Perhaps the intense fear that I have about losing my daughter is one of the lasting gifts that KD gave me? Perhaps it has helped me to treasure what we have more than I may have done without it?
I think I would have been able to handle the effects of Kawasaki Disease better had it been more commonly known. The rarity of the disease means that we don’t really know what the future holds. We can guess, we can use the limited amount of information that is available from adult KD studies, we can trust that Freya’s doctors understand what they are dealing with. We can have faith that it will all work out, that Freya is a little fighter, a tough cookie, a miracle.
People tell me I should stop worrying. They tell me that no amount of worrying will change the future. Some tell me that the future is out of my hands, that ‘someone’ already has a plan for us and we should put our faith in ‘Him’. Some say that any one of us could get run over by a bus tomorrow or struck by illness. They are all right of course. Except accepting that something could happen, and knowing that something might happen, are two completely different things. The fact is that the most important organ in my child’s body is faulty, and she only has one of them. I am finding it easier to deal with that with each day that passes. I find it easier to be optimistic about the future, even if only cautiously so. But I won’t ever be completely free of the overwhelming sadness that this disease brought to my doorstep, and I will never stop being afraid of what this disease might yet have in store for Freya .
Kawasaki Disease didn’t just break Freya’s heart. It broke mine too.
The other night, I had a dream that I had not retained until I saw a patch of ‘beach’ by the side of the Albert Dock in Liverpool where I was visiting with family. I had not given the dream a second thought until I saw the dark brown, muddy stretch below me, and then the memory of the dream hit me like a punch in the gut.
In the dream I was driving my car, a Volkswagen Tiguan 4×4, along a country lane, parallel to an expanse of water. On the other side of the water I remember seeing some people that I know. One was my best friend; she was waiting for me to arrive. The car was full, although I cannot remember who all of the passengers were. As I passed round a corner at the foot of a hill, I spotted my friend and also saw there was patch of beach by the side of the road. It was almost like a lay-by, and seemed like a pretty good place to stop and park up. I drove the car onto the patch of what had looked like sand, but as soon as the four wheels of my car touched down the ground gave way beneath us and the car began to sink rapidly.
I don’t remember exactly what happened over the next few minutes, but I do remember rushing into action to get the passengers out of the car before it was too late. One by one I pulled them from the car and got them to the side of the road. I freed the last person, and lay back on the roadside, wet and exhausted, but filled with relief that I had managed to get us all out. I watched the car disappear beneath the surface of the water, and then a wave of sickness came over me. Freya was still strapped into her car seat…
And that is all I can remember. That, and the total feeling of wretchedness as the realisation hit me that I had let my little girl slip away from me. Even as I recount the dream here on these pages, I cannot stop the tears. The knots in my stomach, and the heat of bile rising to my throat return to me, almost as real as the dream itself. What does it mean?
Having shown a particular interest in dreams over the years, I reckon I could hazard a pretty good guess at the meaning of this one. Or meanings; I think there are a few things going on, that I can interpret even just from this snippet that remains with me.
I am scared of losing Freya. That’s an obvious one if you’ve followed Freya’s Story. Not just the kind of fear we all have for our children and our futures though. A nail-biting, sleep-stealing, catastrophic-thinking kind of fear. It’s a kind of fear that I reserve just for Freya, because I know that she stared down Death and beat him, a defeat that has left me looking over my shoulder ever since. Have you ever seen the movie, Final Destination (and 2, and 3, and…..)? The idea that you can’t cheat Death is one that occupies my thoughts a lot. Booking our first holiday abroad with Freya should have filled me with excitement, but I have developed anxiety about the flight. 11 hours. Plenty of time for something to go terribly wrong. My husband says that the length of the flight is irrelevant, that most problems occur on take-off or landing, but whilst that might be true of an incident, that logic doesn’t hold up for all scenarios. Like a child becoming sick on the plane, for example. I just have to keep trying to focus on the holiday, and the wonderful time that we will have before I return to work after a 2-year career break. And that brings me to my next theory.
I am losing Freya. Not completely, I know. But when I return to work I will be losing one of my favourite pastimes – spending time with my lovely little girl. She’s the best company! She makes me smile and laugh, and she makes my heart feel full to bursting. I can almost hear the sanctimommies telling me that I should be grateful that I have my daughter, that I shouldn’t be so insensitive to others who are less fortunate. But you know what? I am grateful. I am and will be grateful for Freya, for all three of my children, every day of my life. I don’t take anything for granted anymore, nothing. That doesn’t mean I am some kind of perfect parent. Trust me, I still lose my shit from time to time. Making sure I appreciate what I have doesn’t mean that I have to live a flawless life, it means I have to live a normal one. That said, I cannot help but feel the impending sadness and the sense that I am losing something very precious. Indeed, I am losing the most precious thing of all; time.
Maybe that is why I had the dream now? Because time, in terms of my time with Freya, it is running out. Again, not completely, and yes I know that I will still have the time when I am not working. But we all know that when you work around children, you are most likely grabbing stolen moments between them sleeping and eating, and the quality time has to wait for the weekends. Although I am sure that returning to work will bring some benefits to family life (not least the money!), it’s still hard for me to imagine dropping Freya off anywhere and just walking away. We’ve not really done that at all in the last 2 years. Time to get some practice in I think, or the pair of us are going to be a nightmare! I know I’ll find a way to make it work, just like I did working full time around the other two children. In the meantime I will keep my fingers crossed that I am able to get a balance, and perhaps not be required to work a full 5 days every week. Until April though, I just need to make sure that I don’t let any of the time go to waste. I don’t want to be sat at work thinking about all the things I should have done. Time to start working down that list.
According to dreambible.com, dreams involving a car sinking in water “represents feelings of uncertainty as you attempt to take control of a situation. Decision making abilities that are being overpowered by negative emotions or problems that are too big to control.” Being actively involved in raising awareness of Kawasaki Disease is something that gives me a lot of hope, pride, and purpose. It has added meaning to Freya’s diagnosis, knowing that she didn’t go through what she did in vain. But it comes with a price, albeit a tab that I am more than willing to pick up. It comes with a great deal of sadness, frustration, fear and despondency. I expose myself to information and personal stories, sometimes good, often not so good. Whilst many of those stories spur me on to continue doing whatever I can to ensure that none of our children suffered at the hands of KD for nothing, they do affect me deeply. Some recent stories, as well as things that are on the horizon for Freya, have made me thoughtful about the future. I am apprehensive about many things, in fact I shared a blog post about those worries just recently. I worry a lot about time. About how much of it we have, about how much of it Freya has. Thankfully, I have this voice in my head that tells me to stop being so damned melancholy, and reminds me that I cannot live the rest of my life waiting for something bad to happen. That would be the most tragic waste of whatever time we have, for anyone, not just us.
I have often dreamed of water during periods of great emotional stress in my life. When I suffered with post-natal depression after the birth of my first child, over 12 years ago, I had many vivid dreams. I remembered them all, or else I woke in a panic and wrote them down in a book I kept by the side of my bed. Those dreams involved me drowning, or my daughter drowning, sometimes able to prevent a tragedy, but often not. At times when I was under considerable pressure at work, I would often dream about natural disasters involving water; huge Tsunami’s that swept away everything and everyone that was special to me. Generally speaking those dreams have occurred when I have felt overwhelmed, either by physical pressure or emotional stresses. Or at times when I have felt like I am unable to keep my head above water but nobody is there to help keep me afloat. I think that is the case here – I have so many things that I would like to achieve, but very little time left in which to achieve it. On top of that I have no idea what position I will be taking when I return to work, or what hours or days I will be working, so maybe as April draws nearer there is some anxious anticipation building.
Edreaminterpretation.org tells me that dreaming of an object sinking “may suggest that we are about to lose something we value”, and boy are they right on the money with that one.
It seems like such a long time ago that I ever really felt afraid for you, but today I find myself reunited with feelings I hoped would never feature in my life again. Looking at you, no-one would understand what there could be to worry about – you are a ‘picture of health’ as they say. Those rosy cheeks and that sparkle in your blue, blue eyes betray what lies beneath.
For the last year, we have taken the news from every cardiology follow-up as fantastic steps towards you being a miracle in the making. Each appointment showed further reduction in the aneurysms in your heart, and we celebrated every little move towards what we thought was your recovery from this awful disease. And then, little by little, the reality dawned that the likelihood that your heart was magically repairing itself from the damage that had been done was slim, if near impossible. My mind is filled with a constant echo of statements and warnings; babies diagnosed under 6-months are at increased risk of coronary stenosis, 75% of children with giant aneurysms will require intervention later in life, an angiogram will show us if there is any sign of stenosis, look out for signs of angina… the list goes on.
Something shifted this weekend following the receipt of the letter from your last Cardiology appointment. At that appointment the Cardiologist measured your coronaries with an echocardiogram. I noticed the figures 0.18 at the bottom of the screen – that is 1.8mm. The cardiologist said “About the same [as last time]” and I remember thinking, “No, that’s smaller still…” That said, the outcome was still the same, and your Cardiologist continued to urge us to proceed with the advised angiogram. In the time since that appointment I had some e-mail exchange with a reputable Cardiologist in the Kawasaki world which gave me some comfort, and I have also spoken with the Cardiac Nurses who have agreed to make an appointment for me to meet with the consultant who will perform the angiogram to ensure I am completely comfortable with what you will go through when the time comes. And then at the end of last week the letter came. Encouragingly, your Doctor has discussed your case with a Paediatric Cardiologist in London, whose name I immediately recognised as one of the speakers at the KD Symposium in London earlier this year. I was pleased that your doctor had taken this step, and it restored my faith a little. Well a lot, really. The letter also gave a better explanation than I received verbally at your appointment, and I now understand that an angiogram is really the only solution because of your size. Although I still feel some degree of trepidation about the procedure, I have reconciled myself to the idea that this really is necessary for us to understand how this disease will continue to affect you in your future.
It was niggling me that the measurement was described as ‘the same’ at your appointment, but my memory was telling me something different. So I fished out your medical file (yes, I have a very organised file that is getting pretty thick now!) to have a look through the previous letters. I was right – the previous appointment recorded a measurement for your left coronary artery (LCA) as 2.7mm. So rather than being ‘the same’, the artery has actually remodelled by almost another millimetre, which is a reduction of a third of the size that it was just three months prior! I don’t know if you can work out where my thoughts are going with this, but let me tell you, it has got me really concerned.
My initial concern is obviously the speed of remodelling. OK, so we don’t know what is causing that – could it be layers of blood clot (thrombus) that is causing a narrowing of the arteries, or scar tissue forming on the artery wall as the aneurysms repair? Since your KD journey began, I have plotted the measurements on a graph since the beginning (this will come as no surprise to those that know me personally!). It’s been a bit hit and miss, because not all the measurements are documented in the letters (sometimes we get all three – left, right, and left anterior descending) sometimes only some, sometimes none. And I haven’t always managed to jot the numbers down from the bottom of the screen during the appointments. But one measurement that I have been able to capture consistently is that of your LCA, which was the most severely affected by Kawasaki Disease.
What the graph shows me is that your LCA is now 65% more narrow than it was at it’s worst, and the pattern of remodelling has been as follows:-June (diagnosis) to July 2015 15% reduction
July to August 2015 32% reduction
August to September 2015 10% increase (anomaly?)
September to November 2015 6% reduction
November ’15 to May 2016 13% reduction
May to September 2016 33% reduction
Now I’m not statistician, but these numbers have got me worrying about the rate of remodelling. How long it could be before that 1.8mm results in 100% stenosis? And if your arteries become completely occluded, preventing the blood from flowing through your heart, there is no other outcome but a heart attack. Is that even possible?! I can’t even…
So now I’m thinking all sorts – why didn’t the Cardiologist mention this difference at the last appointment? Is she not as worried as me? She said the measurements were the same, but they clearly are not. And if you are now on a waiting list for months before the investigation can be carried out, I am worried that you could suffer a heart attack before we get the chance to understand what is going on. I mean, can that happen? What is the likelihood? It’s possible, but is it probable?
I’ve left a message with the Cardiac Nurses – I really need to speak to them to air my concerns and get some answers. I feel, whether logical or not, that we are just waiting for your heart to fail. And what just dawned on me last night as I was over-thinking this whole situation is that we have never considered when the worst could happen. We were told to look out for signs of angina – the only sign we were made aware of was if you were to suddenly stop playing for example. But last night as I marvelled at this amazing little girl who sleeps through the night, always has, the thought entered my head; what if it happens when you are asleep…? I mean, if I were a statistician I would be able to calculate the probability of a heart attack happening at a certain point. You sleep between 14 and 17 hours per day! That means that you are asleep for up to 70% of any given day…
So now I have a new fear, and I cannot shake it. It kept me awake last night and brought tears silently streaming as I lay there struggling to get to sleep. It caused me to jump out of bed on more than one occasion to check the monitor was switched on, and it meant that I woke this morning with that old feeling of dread until I heard the first murmur from your room. When you were diagnosed with KD and we were told that your heart was significantly damaged by the disease, I feared every day that I would wake to find you taken from us. I was so afraid of finding you gone that I was frozen to the bed until I heard even just the slightest movement from the baby monitor. Every bit of me wanted to get out of bed and check you were breathing, but I just couldn’t physically move because the fear kept me pinned down. How would I know? I mean are there any signs? You often cry out in your sleep, maybe just once, and then you drift back off to sleep. Is that what it would be like? If you were sleeping, and me and Daddy were fast asleep, would there be anything to hear?
I have read that the signs of heart failure in a child could include the following:-
- excessive sweating
- extreme tiredness and fatigue
- poor feeding
- rapid heartbeat
- rapid breathing
- shortness of breath
- chest pain
- a blue tinge to the skin
Would you let us know about any of those if you were sleeping? Would we hear? Would we know you were in trouble? You think about emergency procedures in the event of a heart attack – call 999, get an ambulance, perform CPR… But if it happened in your sleep and we didn’t know, you could be left for hours before we realised, and by then it would be too late.
I wish I didn’t have such a vivid imagination. My mind plays out these scenes like a movie in my head, and I can’t shake it. I have ‘seen’ it – the moment I find you gone. I have ‘felt’ how I didn’t want to live anymore in a world without you in it. I am angry at the world, angry at this insidious disease that crept up on you and broke your heart. And I am afraid beyond words of what might be around the corner. All parents worry about the fate of their children. Hopefully most see the death of their child as an unlikely threat, and it features just for a nanosecond of each day. To know that there is a possibility (regardless of the probability) of losing your child is a feeling I cannot describe adequately to anyone who hasn’t experienced something similar. It’s like standing on the edge of a cliff, a dark and indeterminate cavern beneath, knowing that just one breath of wind could change the course of your life forever. Sometimes I can barely breathe for fear that the slightest movement could unbalance me.
You have many people rooting for you – hoping, wishing, praying. Some believe you are going to change the KD history books. Others say you are a fighter, an inspiration and a miracle. I’m too superstitious to believe in any of that for fear of jinxing your progress. There are some that have so much faith in God that they ‘know’ you will be ok. I worry that if there is a God his plan could be for the world to learn from a tragedy – your tragedy. I just don’t know anymore, Peanut. All I know is that right now I find myself out of control yet again at the hands of this disease. I am still in utter disbelief when I consider the events of the last year, and often think about bundling you in the car and running far, far away from all this. Pretend it never happened. But there isn’t just you to think about, and I have responsibilities and relationships to consider. And sometimes, no matter how hard it is, I just have to accept that I am indeed a grown up.
I don’t want to be a grown up anymore 😦
When the phone rang at around 9:30pm last night and my mother-in-law was on the end of the line telling me to tune into ITV because an episode of Doc Martin was showing a case of Kawasaki Disease, my stomach did a little somersault. A prime-time TV programme mentioning KD? I could hardly believe it. I switched over a little too late so set the programme to record on ITV+1. As more and more comments and messages came into the various Kawasaki support group pages on Social Media sites, including Freya’s Story, the adrenalin was pumping. You could almost feel a collective buzz as parents of children who have suffered at the hands of Kawasaki’s from all over the UK tuned in to witness KD getting a voice.
I couldn’t help but feel a sense of pride in being part of this campaign for raised awareness. I cannot claim credit for the inclusion in this TV programme, or the coverage in The Daily Mirror last week, but I would like to think that somewhere along the way there will be a link with Freya’s Story and the small bit I have done to help raise Kawasaki’s profile. I can claim credit of over 300 signatures on the Kawasaki Support Group UK petition (change.org/kawasaki), and I know that a lot of the 500+ people who now follow Freya’s Story on Facebook and Twitter will not have heard about Kawasaki Disease before;
“This evenings episode of Doc Martin includes a case of Kawasaki disease, wouldn’t have known what it was without this page and good coverage to help raise awareness.” (Posted by Facebook user on http://www.facebook.co/freyasstory)
“I saw the Mirror, I have read nearly all of Freya’s story, I have cried for you and smiled at the lovely pictures. It’s amazing though what you have done, I knew you were strong and raising the awareness is fantastic.” (Friend, and follower of Freya’s Story on Facebook)
But I’m not doing this for praise or thanks. I’m doing it because I don’t want another parent to have to go through what we did, what so many parents have, because of a lack of knowledge and understanding of this disease.
So, what did I really think of last night’s episode of ITV’s Doc Martin? Initially, I was excited and amazed that Kawasaki Disease had even managed to make in into the public eye in such a dramatic way. One of the nation’s most prolific TV channels mentioning something much of the country has never even heard about! Fantastic! And then I watched it.
What were the positives? Well, you get to understand the symptoms of the disease. The little girl has a temperature, a red tongue and a rash on her body. They allude to the fact that she may have peeling skin on her hands when a little boy remonstrates about having to hold the sick child’s hand on a school outing. The child eventually collapses, and the show’s ‘hero’ appears. After one look at the child, he makes a rather pompous statement, which went something like “this child hasn’t been eating sweets, she has Kawasaki Disease”. And just like that, after seconds of seeing the child, he makes his diagnosis and drives the child at high-speed (she may die within 30 minutes apparently) to get her the treatment she needs to avoid the risks of a coronary artery aneurysm. Amazingly the medication is waiting for them on arrival at the hospital and the child receives the treatment. In terms of the programme, this whole thing took 3 minutes. Remarkable.
So why the long face? It didn’t take long for the celebratory feelings to wear off once I let what I had just watched sink in. Part of me still wants to believe that no matter how the issue was covered, any coverage is good for raising awareness of a disease that most haven’t heard about. But (you could see that but coming couldn’t you!) it was scripted in such a glib and blasé manner that I wouldn’t be surprised if the message was lost on most viewers. I suspect many won’t even remember the name of it today, let alone the symptoms. And if they did remember it, I do not believe that anyone who hasn’t experienced KD first hand will have one iota of an idea about how serious, or how scary this disease is.
I know that the ITV would argue that Doc Martin is a medical comedy drama series; it does not profess to deliver messages in a serious manner (that can be left for the likes of Panorama and Casualty who gave KD some airtime about 20 years ago, in the mid-90’s). We can be grateful that such a rare disease has even made it on the ITV radar, I guess. But when you’ve watched your child battle with this disease, you can’t help but be left with a sour taste in your mouth after watching the episode. In fairness to the programme, however, I am not a regular viewer so am unfamiliar with the usual format and scripting, and I know that they are likely to come under attack from victims of all manner of illnesses that they cover; they’re never going to please everyone.
If you watched the programme, and you think that Kawasaki Disease is a funny sounding illness, maybe even fictitious, then please know that it is very real, and is the leading cause of acquired heart disease in children. If you think that it is easy to diagnose on first look at a few symptoms, please know that is not the case and often the symptoms come and go, disappearing just when you needed them to be seen. In fact in many cases, not all the symptoms are present. If you agree with Doc Martin’s assessment of the child’s parent being negligent by not noticing the signs, then please know that most medical professionals in our country have never heard of Kawasaki Disease, and many mis-diagnose the illness, sometimes with catastrophic results. If you think that the treatment is readily available, please know that intravenous immunoglobulin is in short supply, and it is expensive. It’s a product derived from human blood; we’ve probably all seen the marketing campaigns from various blood donation schemes recently – there is not a bottomless pit full of blood that we can all tap into at any time. And if you think that all cases of Kawasaki Disease have a happy ending, you’ve just got to be a part of the support groups on social media sites to know that isn’t the case. There are children currently fighting for their lives, and many that have lost their fight altogether.
I am disappointed in the programme, not only for its flippant handling of the illness, and think they could have done more to make it clear that this is a sinister disease that needs some real focus. Many programmes include messages in the credits to support people who may have been a victim to the contents of an episode. I think the ITV could have at the very least put up a public message about Kawasaki Disease, making it clear that this is very real, and even just supplying a link to NHS Choices for further information.
In order to reach a diagnosis, I had to watch a 7-week old Freya battle constant temperatures above 39 degrees for over 2 weeks. Her heart rate was dangerously high. She was resuscitated in a high dependency unit after her body started to shut down. She had cannulae in every site possible in her tiny body, delivering a cocktail of various potent antibiotics, ibuprofen and paracetamol, and she was being fed through a tube. She had blood taken every day for a period of 6 weeks, sometimes twice a day. She had an MRI scan, ultrasounds, x-rays, ECG’s and echocardiograms. She had 2 lumbar punctures, one under general anaesthetic which they performed at the same time as performing a bone marrow aspiration to test for Leukaemia. She received a blood transfusion when her haemoglobin levels dropped dangerously low. And she has received intravenous immunoglobulin – a product that is derived from thousands of blood donors – as well as a drug that shuts off the protein that is instrumental in the body’s fight against cancerous cells. She is not even 6 months old yet.
Sounds shocking to read it all like that, doesn’t it? See all the tests that she underwent, just to try and work out what this illness was. Kawasaki Disease threatened to take her life. If the Rheumatology Consultant that came so see her on Day 12 of her illness had not suggested performing another echo “just as a precaution” the damage to her heart would have remained undetected, and her coronary arteries would have continued to dilate further and further until perhaps they wouldn’t have been able to stretch any more. That means rupture. Rupture means sudden, unavoidable, unpreventable death.
Now think about what you just read about Freya, and imagine now that her case is not the worst by far. Yes she had a severe presentation of the disease, and her life was in very grave danger. But as I type there are parents fighting against doctors won’t entertain a KD diagnosis, parents whose precious children have been in hospital for weeks struggling to fight off the disease, parents who still co-sleep with their children for fear of losing them, and worst of all there are parents sitting at home wondering how they will ever recover from the death of their child.
I cry every day. I cry when I hold Freya in my arms and am overwhelmed with how much I love her. I cry because I can’t shake the images in my head of how close we came to losing her. I cry when I see other people happy, without a care in the world and no appreciation of just how lucky they are. I cry because I am still heartbroken that this happened to my baby girl, before we had even had a chance to get to know her properly as Freya, just Freya. I cry because I am so scared about the future. I cry because I daren’t take Freya to baby groups for fear of her contracting chicken pox or the flu (as they can develop into another rare and potentially fatal disease, Reyes’ Syndrome) and I cry from guilt that she is missing out on a massive part of her development as a result. When I visit the children’s ward at the local hospital where this all started, I have panic attacks. Even this week, when I thought I’d be ok and felt no anxiety approaching the hospital, I was suddenly struck by uncontrollable sobs, and I couldn’t breathe. I cry because I am grieving for the loss of my child’s health – she was perfect when she was born; Kawasaki stole that from me far too soon. I cry because I feel the pain of every parent who is going through this, or something similar. And I cry with frustration that more isn’t being done to improve the advice and support that is currently being offered by the medical profession. Chances are I cry a lot because I sleep for less than 4 hours a night; not because I have a young baby – she sleeps through the night – but because I am permanently researching the illness or related issues, or communicating with parents and doctors on the other side of the world. I cry because I am devastated, because I am sad, because I am frightened, because I am exhausted, because I am frustrated. I cry because I cannot forget the journey we have been on, and am haunted by the playback of the last few months, which is constantly on repeat.