The boiling point was in March. It was after one of my blood tests to look at my electrolyte levels. I had to have these frequently to assess if it was time to put me in the hospital.
“Your levels are “circling the drain” my pediatrician had told me… I was ten years old and for the last couple of months, I felt full-to-bursting all the time. Any food I did eat, I immediately threw up. My body had now been running on absolutely no food for a couple of months. Everyone was threatening to put me in the hospital. I was so used to their threats; I didn’t take them seriously anymore. Besides, part of me wondered if I’d be better off in the hospital where they could run some tests and actually figure out what was wrong with me.
I had been living off sips of Gatorade, but the last couple of days, I had started vomiting back up the Gatorade as well. Being ten and hating throwing up and the pain that went with it, I stopped drinking the Gatorade completely. Everyone once again blamed that non-existent eating disorder and continued to threaten that I would end up in the hospital.
“Take a couple of sips of Gatorade every ten minutes,” my pediatrician told me two days earlier. When we got home, my mom poured me little medicine cups with 30 ml of Gatorade in it.
“Drink half of one or one every ten minutes, just like the doctor said so that we don’t have to take you to the hospital.” My mom set me up on the couch, with the little medicine cups of Gatorade, a blanket, my teddy bear, and my laptop.
Well, after about three hours of a few sips every ten minutes, I would projectile vomit back up, all of the Gatorade I had been sipping at for the last few hours.
After a few days of sipping then projectile vomiting Gatorade, I’d had enough. My throat was sore with a froggy voice. I gave up and just completely stopped putting any food or drink in my body. There was no point. It would just cause pain, bloating, nausea, and then I would vomit it back up. Sometimes I would vomit up stuff that I had drank the week before. My parents and my doctors had immediately jumped to blaming that non-existent eating disorder for all of this, saying I must be forcing myself to vomit.
“If you’re not careful you’re going to end up in the hospital with a feeding tube jammed up your nose,” both my parents kept warning me. “You might as well eat something now by mouth so that you can stay home and we can help you instead of some clueless fresh-out of medical school resident”:
I heard what they were saying, and it terrified me to no end, but I just physically couldn’t hold anything down.
When I woke up on the floor of the elevator, I felt like I was waking up from a long sleep. I heard my dad calling my name.
“Five more minutes,” I mumbled. Without even opening my eyes all the way. My head throbbed. It had hit the railing on the edge of the elevator on my way down.
“Becca…Becca…Becca!!!!” When I heard the panic in my dad’s voice, I forced my eyes open. I was confused at first. Where was I? What was I doing in an elevator? Why was I on the floor?
Slowly my memory filtered back into me with every painful throb of my head.
I’d had a blood test. The lady put a gauze pad on me and then snapped a piece of tape over it.
“Here’s a unicorn sticker for being such a good girl,” she had told me, handing me over a really awesome unicorn-jumping-over-a-rainbow-doing-a-fist-pump-sticker.
Then I got off the special blood draw chair. When I first stood up, the room moved around on me. It was like it was trying to pin me down. Somehow, I made it into the elevator. As soon as I got in the elevator I grabbed onto the railing. Then I remember feeling like I was falling through the darkness on a bumpy roller coaster. That was right before I woke up on the floor like this.
“Dad,” I croaked, my voice coming out all gravelly. Then I felt myself getting very foggy and sleepy again, blackness was swirling in around the edges, and then swallowed me whole again, and then spit me back out, back into the elevator where my dad was scooping me up in his gentle, but strong arms and carrying me to the car. I didn’t wake up again until I was halfway to the hospital. He informed me, in as steady a tone as he could manage, that he was taking me to the ER.
I didn’t argue.
The world tilted and spun around me so much that I felt like I was in a kaleidoscope. My legs and arms and face were tingling badly. This is a symptom that I now immediately recognize as a sign of low potassium. My entire body felt like it was partially-set Jell-O.
I was hoping that the hospital would have a fresh perspective and would run some tests and figure out what was causing my symptoms of nausea, vomiting, pain, feeling full to bursting after taking a few sips of Gatorade, and not being able to hold down anything. They would be able to tell that this was more than just an eating disorder.
My mouth was so dry that when I moved my lips to speak, they were cracking and bleeding. My heart was beating so fast that I could feel it pulsating through my entire body. It felt like the car was moving upside down, sideways, and popping wheelies. At some points, it felt like it was trying to pin me on my side. When I shut my eyes. The feeling was so scary, I felt like I was freefalling. My vision was starting to get really blurry. My skin was hot to the touch and my cheeks were white as a ghost according to my dad, but with two flushed spots.
The nausea was getting worse too, I tasted the vomit as it rose up and threatened to make a projectile-style exit out my body. I kept swallowing it back down because I hated vomiting so much. I could barely move because my body felt so weak and exhausted. As much as I tried, my hands and feet refuse to move. The fingers on my hands were halfway in fists and halfway relaxed and they also refused to move.
Years later I learned that this was from hypokalemic paralysis. Hypokalemic paralysis is a paralysis caused by dramatically low potassium levels.
My dad carried me into the ER in his arms, like I was a baby again.
“This is my daughter Rebecca Pava, she hasn’t been eating for two months and hasn’t really been drinking anything the last few days. She has an eating disorder and she just passed out after getting a blood test”. My dad’s voice was shaky. I had never heard my dad’s voice get shaky like that before. He was rubbing my back like he was afraid I was going to disappear if he didn’t.
“How old is she?” asked the lady behind the desk at the entrance of the ER.
“She’s ten,” my dad answered and proceeded to answer a bunch more questions.
“What’s her date of birth?” the lady asked.
My dad gave her all the info she needed. She also asked what my address was, what insurance I had, my parents’ names, and my pediatrician’s name.
“Do you want a wheelchair for her?” The lady asked.
“No that’s all right, I’ll just hold her,” my dad told the lady, and I swear his grip on me tightened. I just hugged him back as much as I could, which wasn’t much, because of hypokalemic paralysis. At least I was at the hospital now where they could help me and explain to my parents whatever was wrong with me.
“You’ll need to go to the waiting room for a few minutes until the triage nurse calls you to take vital signs and do an assessment. The pediatric waiting room is to the left.” the lady told us.
My dad carried me into the pediatric waiting room. It had a video game system, coloring pages, and some dolls and teddy bears to play with. We were only in there five minutes tops. My dad just kept a hold of me on his lap the whole time. He didn’t say much, but his forehead was all pinched up and tense. I was nervous too, but my dad’s anxiety was pouring off him like sweat. I had hope, I thought maybe I was going to find out what was wrong with me and get treatment at this hospital
“Rebecca Pava,” the triage nurse called my name. My dad stood up with me still in his arms and we followed the triage nurse to a little cubicle where she had my dad put me down on the chair. My dad seemed hesitant to put me down. He hung onto me a long time before letting go of me completely once I was sitting in the chair.
The triage nurse wrapped an infant size blood pressure cuff around my arm, My blood pressure was 82/46 and my heart rate was 148. At that point, I didn’t know what those numbers meant, but normal blood pressure for a ten-year-old is anything from 114-127 for the top number and anything from 77 to 83 for the bottom number. A normal heart rate for a ten-year-old is 60 to 100. The triage nurse’s eyes widened when she saw my readings.
“Tell me a little bit about what’s been going on, dad,” she said.
My dad proceeded to explain all about my “eating disorder” and how I passed out.
“I don’t have an eating disorder,” I tried to explain, “the reason I haven’t been eating is that my stomach hurts too bad and it makes me throw up.”
“We’ll look into that,” the triage nurse told me.
“Her pediatrician has been following her closely. There is absolutely nothing physically wrong with her. All of the sudden she developed an eating disorder and stopped eating.” my dad cut in.
“Well we will have to do our own testing as well,” the triage nurse explained.
My dad just sighed and shook his head in disgust.
The triage nurse had my dad put me in a wheelchair and wheel me down to the doors that said “Treatment Area” then she used her badge to buzz us all through. I noticed that this time my dad didn’t insist on carrying me. In the treatment area, there were tons of people wearing scrubs with stethoscopes swung around their necks rushing around. There were lots of little rooms with curtains in front of them. We stopped at one of the rooms and went inside, my dad put me on the stretcher.
After the triage nurse left, a patient care tech came in right away and put stickers all over my chest and tummy, then she hooked the stickers up to wires. The patient care tech connected the wires and stickers to a plug in a screen above my bed. It made big spiky lines that she told me was a picture of my heart. She also put another infant blood pressure cuff on my arm, my arm was too skinny even for the toddler one. Then she showed me a special sticker.
“I’m going to wrap this around your finger,” she told me, “Pick a finger.”
I held out my pointer finger on my right hand
“That will tell us how much oxygen you have in your blood,” she explained as she wrapped it around and stuck it on. Both the oxygen sticker and the blood pressure cuff had wires that hooked up to the TV screen with the picture of my heart. I could watch the screen and see what my body was doing. My finger with the sticker on it glowed red. I called it my ET finger. It was kind of neat.
After she had me all hooked up to the monitor, the patient care tech took out a tray of blood testing supplies. She used a butterfly needle to draw a whole bunch of tubes of blood. She called it “drawing a rainbow”. Then she turned on the TV that was an actual TV, not a monitor, found SpongeBob SquarePants, and told me to try to rest until the nurse comes in.
The nurse came in about fifteen minutes later and asked a bunch of the same questions that everyone had been asking. When you go to the ER of any hospital, they ask you to tell your story about a million times. My dad answered most of the questions, and I again attempted to explain that I did not have an eating disorder. I don’t know who listened to me and who listened to my dad, but that’s about how the situation kept playing out.
The doctor came in about an hour later. He used his stethoscope to listen to my chest, back, sides, and tummy. Then he explained that I had low potassium, low magnesium, low phosphate, low albumin, low iron, low hemoglobin, and hematocrit, and decreased kidney function. He said that I had protein and ketones in my urine
Which meant my body was eating my muscles for energy. In addition, I had severe dehydration, and hypoactive bowel sounds to the point where he could hear pretty much nothing.
“Your labs that show us how inflamed or irritated your body is, are off the charts high. There is more going on with you than just simple starvation. When I saw that result, I also added on a blood test called an ANA titer, which also came back super high. That means your body’s immune system that fights off infection might be fighting off your own body as well. I will have to have a few specialists look at you as well…”
After he finished explaining all this he pressed on my belly in a few places asking me if it hurt. I tried not to scream, it hurt like a stabbing burning hard-pressure pain.
“I’m going to have my nurse start an IV so that we can replace some of your electrolytes and rehydrate you to wake your kidneys back up. We’re also going to run some tests on your belly to check out what’s going on in there and make sure there’s no serious reason why your tummy’s not moving the way it should. It’s important to figure that out because you should have at least some bowel sounds. Also, I’m concerned about the amount of pain you feel when I press on your belly. We’re also going to give you some medicine so that you don’t feel sick to your stomach. It can go right into the IV line that your nurse is going to put in.”
Then the doctor turned to my dad.
“She also has some other odd blood test results as well, Dad,” he said to him. “Her C-reactive protein, which is a marker of inflammation is 149 which is extremely elevated. This can be caused by autoimmune diseases, inflammatory bowel disease, Lupus, Juvenile arthritis, or infection, so we will have to look into things more closely.”
“Can stress and anxiety increase C-reactive protein?” my dad asked.
I wanted to scream.
“It can, but never usually to that extreme. A normal C-reactive protein level is less than 10 mg/L, and hers is 149 mg/L. ” the doctor tried to explain to my dad.
I watched my dad carefully to see if he would listen to the doctor, but I knew my dad, once he made up his mind about something there was no changing it. He was determined to say that all my problems were in my head because that was the theory my parents had been going with for the last two years and now it was too late to change it.
“Her level of something called Erythrocyte sedimentation rate or sed rate as we refer to it is also extremely elevated, it’s 234. This is another marker of severe inflammation.” the doctor continued.
“What’s the normal range?” my dad asked.
“The normal range is anything under 20 mm/hr.” explained the doctor.
I just lay back in the bed looking at my unicorn sticker feeling so relieved that finally, people were seeing proof that I really wasn’t making this stuff up. My insides were finally telling my story for me. Dr. Monroe just hadn’t had the right tools to get them to talk.
“What’s that mean?” asked my dad skeptically.
“It could mean a whole bunch of things, mainly it means that Becca has some sort of inflammatory or infectious process going on that we need to look further into.”
My dad just nodded and didn’t make eye contact with anyone.
The doctor immediately decided to admit me to the hospital. After a long wait for a bed to become available, A man in gray scrubs brought me up to my room on the pediatric floor for further treatment.
With the doctor listing all this proof that stuff was wrong with me, I felt like I was seeing bright lights appearing in the distance. My tummy wasn’t moving the way it should. There really was something wrong with my stomach and my blood inside of me, and this hospital was going to try and figure out what it was so that they could fix me. This doctor was even going to give me some medicine right away to try and help me feel better. I should have passed out in an elevator months ago.
For once people seemed to be focusing on the right area. Doctors were giving me medicine for nausea and they were encouraging rest. Most importantly for the first time ever they were validating that, yes, my body was not working correctly, and they weren’t blaming it on an eating disorder.
I was in a battle for my life. Although I had left childhood innocence on the floor in tatters at age ten, for once I felt vindicated.