Devastating Diagnosis 

Dr. Gelvez knew something more was going on due to the cloudiness of the spinal tap, so he prescribed multiple antibiotics for Adalyn. An MRI revealed she had experienced multiple seizures and a series of mini strokes. She was diagnosed with a rare strain of bacterial meningitis and transferred to the PICU. Most antibiotics were resistant to the strain Adalyn had so doctors put her on a wide variety. 

“She went down very fast,” Alexa said. “We are so thankful Dr. Gelvez ordered the spinal tap so we could get a quick diagnosis. Initially we were in shock and trying to comprehend it all. It felt like whammy after whammy with no good news. I was begging for her to live hour by hour and that turned into day by day.” 

Alexa said the doctors knew just how to talk with parents of a sick baby. Blake Nichols, M.D., pediatric specialist in the PICU, took the time to explain every detail of Adalyn’s treatment plan. 

“I remember they really wanted us to understand exactly what was going on with her and it felt like she was in the very best hands,” Alexa said. 

Audiology Emergency 

After a couple of days, they noticed that Adalyn was not responding to voices anymore. 

Bacterial meningitis comes with a high risk of varying degrees of hearing loss. Twelve days after being admitted, Adalyn underwent hearing tests. 

“Anytime we have a child with bacterial meningitis, we consider it an Audiology emergency and the child’s hearing is tested quickly,” said Lisa Vaughan, Audiology program manager at Cook Children’s. 

Patricia Purcell, M.D., MPH, pediatric otolaryngologist at Cook Children’s, said catching it in time is vital – a month after the diagnosis the cochlea hardens, and implants are not possible. 

Adalyn underwent her first hearing test and results were consistent with severe to profound hearing loss – the infant’s only option to be able to hear would be cochlear implants. 

Finding Funding for Cochlear Implants
Pediatric Otolaryngologists Dr. Purcell and Allison Chisholm, M.D., specialize in cochlear implants at Cook Children’s. In 2023, they performed 27 implants and since the program started 17 years ago, more than 600 implants have been inserted. 

The FDA has not approved cochlear implants for infants under 9 months old, so private insurance does not cover the procedure or devices. Vaughan quickly sprang into action, and within 72 hours, funding was secured. The cochlear implants, procedures and all related costs would be covered by generous donors through the Cook Children’s Health Foundation and the Cook Children’s Health Plan. Alexa’s three children have always used the Cook Children’s Health Plan, and Alexa said it has streamlined everything in the Cook Children’s network. They have also learned about resources to help Adalyn such as a deaf and hard of hearing teacher who now comes to their house. 

“Having it all under one umbrella has made a night and day difference,” Alexa said. “It has not only taken away the financial stress but has helped us with booking appointments through our healthcare manager. We are so thankful to have that stress taken off us.”
 
Dr. Purcell came up with a plan before Adalyn was discharged. She had another MRI to be sure she was a candidate for implants, and after a month in the hospital, Adalyn was on the way home.

“We really appreciated that they were on the ball and proactive in giving us information so we could prepare,” Alexa said. “We had come so far from where we started not knowing if she was going to make it. We were ready for the next challenge, and I was already looking up how to learn sign language.” 

Adalyn’s Chance to Hear Again 

A couple of weeks later, at 6 months old, Adalyn was wheeled to the operating room for her first implant. She would need two procedures – one for each ear – due to inflammation from an ear infection in her left ear. 

During the procedure, Dr. Purcell had to be careful not to damage adjacent structures to Adalyn’s brain, facial nerve and carotid artery. Dr. Purcell said technology like CT scans allowed for preoperative planning and a safe procedure. After three hours, the implant was complete. 

“Adalyn was a trooper the whole time,” Alexa said. “She wasn’t sick at all and healed quickly.” 

“We absolutely love Dr. Purcell. She went above and beyond and always returned our calls herself. She took time to clearly explain everything.” 

Home for Christmas

One week later, Dr. Purcell performed the procedure on Adalyn’s left ear, and she made it home just in time for her first Christmas. Alexa said she will never forget the holidays that year.
 
“We didn’t have much time to think about Christmas with Adalyn being in the hospital,” Alexa said. “Cook Children’s had gifts waiting for all of us, including our boys Brandon and Levi, and we were so grateful.” 

Alexa said that when they took Adalyn home, it was like having a newborn all over again. 

“Before Adalyn got sick, she could fully roll over and hold her head up,” Alexa said. “We were starting at ground zero again.” 

‘We had our Smiling Baby Back’ 

On January 12, less than a month after Adalyn’s procedures, Kristi Reed, Audiology program clinical coordinator at Cook Children’s, turned on the processor for the first time and initially activated the implants. She spent time with Alexa going over all the equipment.

Within a few hours of adjusting to hearing again, they had their babbling and smiling baby back. 
“It was like a switch went on, and we saw her personality again,” Alexa said. “We felt relieved and joyful to have overcome that first big hurdle.”
 
Adalyn was back to giggling and playing peek-a-boo – her favorite. 

During the first six months after surgery, Adalyn visited Audiology frequently as they increased the range of the implants. Adalyn mapped soft and loud noises and quickly made progress. She also saw an Audiology verbal therapist who specializes in working with children who have experienced hearing loss. Alexa learned how to facilitate language and listening at home.
 
“I’m amazed at how far she has come,” Alexa said. “Before the implants, a jet plane could take off and she wouldn’t hear it. Now, she even hears the shaking of a bell and can tell where it’s coming from.” 

A Thriving Toddler

Seven months ago, Adalyn graduated from feeding therapy and started baby food. Now 17 months old, Adalyn continues weekly auditory and verbal therapy and physical and occupational therapy as well as in-home physical therapy and sign language lessons.
 
“From the beginning I said she was our little warrior, and she is showing us every day how strong she is and continues to work toward and achieve her milestones,” said John, Adalyn’s dad. 

Alexa said they look forward to their visits with Physical Therapy at Cook Children’s in Mansfield where they come up with new ideas to try at home. Adalyn has made significant progress the last couple of months and now rolls all over the place and is working toward crawling. Her joyful personality continues to inspire those around her. Alexa said she babbles all the time and as soon as they put on her “ears” in the morning she lights up and smiles.
 
“It’s a miracle to sit back and see it all unfold,” Vaughan said. “This changes the trajectory of these kids’ lives forever.” 
 

The Dallas Morning News reports that person from another state who had mumps traveled to Dallas for the National Cheerleaders Association All-Star National Championship, which took place Feb. 23-25 at the Kay Bailey Hutchison Convention Center. 

At this point no Texas residents have developed mumps in connection with the case, but people are urged to watch for symptoms. 

This is another reminder about the value of vaccination in preventing what can be serious illness. Mumps cases decreased 99 percent after the introduction of a successful strategy for vaccination.

Here's a quick look at mumps cases over the years according to the CDC:

*Case count is preliminary and subject to change

** Cases as of Jan. 27, 2018 Case count is preliminary and subject to change

Meningococcal disease refers to any disease caused by the Neisseria meningitides bacteria. This is one of the most serious and devastating bacterial infections a person can get. Its most feared complication is meningitis, an infection and inflammation of the fluid and lining around the brain and spinal cord, which can have devastating consequences.

This sneaky bacteria is spread person to person via saliva, and young people are notorious for “swapping spit” (i.e. sharing water bottles/cups/utensils/food, inhaling droplets from someone coughing nearby, or kissing). It is recommended that ALL adolescents, ideally age 11 or 12, get the vaccine with a booster at age 16, before the peak of increased risk. (The incidence is highest among freshmen living in dormitories. Do you remember your tiny dorm room in college? Just picture those germs circulating in that closet-sized room. This and the "swapping spit" scenario are why meningitis outbreaks are particularly devastating and far-reaching on college campuses.)

Younger children and some adults who are high risk may also need the vaccine. Your doctor may recommend more than 1 type of meningitis vaccine to ensure complete coverage against meningococcal meningitis.

Meningococcal meningitis can strike quickly, possibly killing someone within a few hours. Here are some signs and symptoms of bacterial meningitis:

• High fever with cold hands/feet
• Drowsy/difficult to wake
• Severe muscle pain or headache
• Confusion/irritability
• Diffuse rash of tiny red "pin pricks" that doesn't blanch with pressure, evolving to look like fresh bruises
• Neck pain/stiff neck
• Sensitivity to light

Even when meningococcal meningitis is caught early and treated correctly, there can be severe long-term side effects such as:

• Hearing loss or deafness
• Visual impairment or blindness
• Loss of digits or limbs
• Damage to major organs
• Death (in about 7 percent of cases)

Let me tell you about my friend Kyle. In 1995, Kyle was a healthy 16-year-old high school student who woke one morning with a severe headache and high fever. His mom noticed he was acting a little "off" but assumed it to be just the fever.

About eight hours later she noticed a rash and that Kyle was having trouble standing on his own. She took him to the ER where doctors quickly recognized the signs and symptoms of bacterial meningitis and immediately administered antibiotics before even getting confirmatory lab work, because with bacterial meningitis, immediate treatment is essential. Kyle was admitted to the ICU for a week, and his parents were told his prognosis was bleak.

During a three-week hospital stay, Kyle went into acute kidney failure, respiratory failure, and had to have multiple fingers amputated. Thankfully, he survived. Once home, he had 4 more major reconstructive surgeries and skin grafts requiring almost a year of wound care and dressing changes. Today Kyle is an advocate for the meningococcal vaccine. He only wishes he had the vaccine available to him as a teen (The meningococcal meningitis vaccine Menactra was licensed for use in adolescents in the U.S. in 2005; since then the annual incidence of meningococcal disease has decreased 64 percent.)

So the next time your adolescent moans and groans when the pediatrician says he needs a meningitis shot, tell him, “It could save your life.”

The

I understand the fear. Ebola is a terrifying disease. Symptoms start off similar to flu and progress to liver and kidney failure, followed by internal and external bleeding and then often times by death (about 60 percent of the cases).

So, I get it, it’s scary. The way people die from Ebola is very unpleasant which makes it even scarier. But it shouldn’t be the scariest infectious disease to us. Here are three reasons why:

Reason No. 1 – It’s actually not that contagious.

Ebola is transmitted via blood and body fluids. Contrast that with measles and flu, which are spread via droplets. Obviously, doctors are using extreme caution when treating patients with Ebola and I agree with that. However, the likelihood of catching Ebola from being in the same room with a person with it is not that high. If someone with measles or flu coughs or sneezes near you, it’s very possible that you will contract the disease.

Hepatitis A is another virus that can spread quickly because it is spread via a pathway called the fecal-oral route (yes, it’s as gross as it sounds). It causes vomiting and in severe cases, liver failure. Outbreaks of Hepatitis A often occur when a food worker unknowingly spreads the disease by handling the food with contaminated hands.

Meningococcal meningitis is another illness that commonly spreads quickly and anyone who has been in the room with an infected person is at risk. Outbreaks used to occur commonly on college campuses prior to the introduction of universal vaccination. Health care workers who are exposed to a patient with meningitis have to undergo treatment to try to prevent contracting the disease. So remember that when the person next to you in a room looks sick; it’s probably not Ebola, but it could be any of these other scary things.

Reason No. 2 - People with Ebola are not contagious until the affected person is sick.

Because patients with Ebola are very sick, they are unlikely to be walking around infecting everyone in their path. There will not be people walking around looking fine, unknowingly spreading the disease to everyone they meet. This is not the case for many other infections. See my example for Hepatitis A above.

Pertussis, or whooping cough, is another disease where many infected people (usually adults) can walk around contagious for weeks at a time coughing the bacteria on everyone they meet. Pertussis is not that serious in adults (aside from an occasional broken rib here and there), but it can be deadly in small babies. Despite being sick, many people with flu suck it up and trudge into work or school because they think flu isn’t that big of a deal. The problem is that while one person may not have trouble with flu, they may have contact with small infants, pregnant women or older adults who can have significant complications from it.

Another disease that affects 1/3 of sexually active teenagers and adults is human papilloma virus (HPV). Most often boys and girls who carry HPV do not know they are infected and thus spread it to their sexual partners. HPV by itself is a troubling problem, but even more troubling is the fact that HPV is the leading cause of cervical cancer (about 99.7 percent of cases).

Reason No. 3 - Ebola is not that common and has not been transmitted in the United States.

The world-wide, all-time death total from Ebola sits in the thousands … the world-wide death toll from measles was 122,000 in 2012 alone. Ebola has a very high rate of death and severe illness, much more so than measles, but because measles is much more common it affects many, many more people. There has never been a case of Ebola transmitted from person to person in the United States. There have been over 600 cases of measles in the United States thus far in 2014. What about deaths? Fortunately, there were no deaths from measles, but in 2012 there were 52 deaths from the flu just in pediatric patients. It’s a simple reminder that we sometimes forget how dangerous things are when we have not heard about them for a while.

Now what?

If you aren’t convinced that many of these other infectious diseases are a more immediate concern for you than Ebola, I understand. When things are new and sound scary they tend to take over your mind. But after reading all the points I’ve made above, know there is something you can do to protect your child from the other diseases I’ve mentioned …

Every single bolded disease has a vaccine! While vaccines are not perfect and getting a vaccine in some cases does not protect you 100 percent, they significantly decrease your chances of contracting any of these diseases. In many cases, if vaccines don’t completely prevent the disease, they make the case milder and less serious. If you agree with my concerns about these other diseases, give your child the best chance by having them vaccinated.

I hope I’ve addressed all of your questions or concerns. Maybe, you still have questions about the diseases mentioned here or the vaccines to fight them? If so, please talk to your pediatrician.