Tuesday, November 18, 2008
In light of what has happened, Will and I really wanted to do something for Abby. We didn’t know what. I have researched many of the national and international organizations on meningitis. So many of them exist to get the word out about getting vaccinated. Well, that didn’t save our daughter because she was vaccinated, so while important, this isn’t the message that we felt that we needed to spread.
There are 91 strains of the s. pneumoniae bacteria and Prevnar, the vaccine, protects you against only 7 of these strains. My alternative was to support the development of a vaccine that covers all 91 strains. Dr. Richard Malley at Children’s Hospital of Boston is actually working on this endeavor. In my whole life, I will never raise enough money to make a dent in this research because when it comes to development of a new vaccine, that is pharmaceutical R&D money. That is billions of dollars (not just millions). So we figured we could do something else to help others in Abby’s memory.
Abby loved her books. We read to her just about everyday of her life. We still read to her, as we go to the cemetery daily and read stories. While she was in the Pediatric Intensive Care Unit (PICU), we wanted to read books to her, but there were none available. My sister-in-law, Bernice, had to go down to the gift shop and buy some books. This is a children’s hospital and it is unbelievable that there is no children’s library! So I made a few phone calls to Medical City, and they have agreed to let us host a book drive, Dec 1st-31st to collect new children’s books to supply the PICU. Any money raised in memory of Abby will go toward the Child Life Department at Medical City Children's Hospital.
We will mark each book donated in memory of Abigail Kearney. We also setup a wish list for Abigail Kearney on Amazon.com that will allow people to select a book from the registry to ship directly to us. Any monetary donations should be made directly to Medical City Children's Hospital in memory of Abigail Kearney. Alternatively, Will or I will collect checks made out to Medical City and ensure that the money is delivered. All donations are tax-deductible. Links to the official flier, the wish list, and the Medical City Foundation are available to the left.
Sunday, November 16, 2008
In the weeks and months that followed Abby's death, I devoted almost every moment of the day to researching Pneumococcal Meningitis. Here is a brief overview of the facts:
· What is meningitis?
o It is the inflammation of the membranes (called meninges) surrounding the brain and spinal cord. It can be caused by a number of viruses, bacteria, or fungi.
· What are the common types of bacteria that can cause meningitis and what vaccines are available?
o Haemophilus influenza type b- You don’t hear about this one too much anymore because children now receive an effective vaccine for Hib
o Neisseria meningitides – This is more commonly known as Meningococcal Meningitis. There are two vaccines that older children and adults can receive for some (but not all) of the strains: Memomune and MenactraT. If you have heard of meningitis outbreaks, this is the type that is usually involved. Anyone in contact with the infected person is usually given antibiotics as a precaution. There is an increased risk for college students living in dorms or military members living in barracks; essentially any group of people living in close quarters. Sub-Saharan Africa is sometimes referred to as the Meningitis Belt, as large epidemics usually occur during the dry season.
o Steptococcus pneumoniae- This is more commonly known as Pneumococcal Meningitis. There are presently 91 strains of this bacteria and Prevnar, a pneumococcal conjugate vaccine, has been available since the year 2000. It covers 7 strains: 4, 6B, 9V, 14, 18C, 19F, 23F. Wyeth, the maker of Prevnar is working on a new conjugate vaccine that will cover 6 additional strains: 1, 3, 5, 6A, 7F, 19A. There is also a pneumococcal polysaccharide vaccine, Pneumovax 23, which is not effective in infants, but given routinely to adults. It covers 23 strains: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, 33F. Abby died from a strain not covered by any of the vaccines. She received all 4 of her Prevnar vaccine shots; however, protection against one strain does not offer any protection against another.
· How do people get the bacteria that cause meningitis?
o I can only speak for s. pneumoniae. It is a common bacterium that lives in the nasopharynx of up to 25% of the population. That number can increase to 40% in children. The bacteria can spread through the exchange of respiratory or throat secretions. Having the bacteria doesn’t mean that one will get sick. Pneumococcal infections can invade the lungs and cause pneumonia, invade the bloodstream and cause bacteremia, invade the sinuses and cause sinusitis, invade the ears and cause otitis media (middle ear infection), or invade the covering the brain and cause meningitis.
· Who is at risk for pneumococcal infection?
o Alaskan natives, American Indians, persons aged 65 and older, individuals with a weakened immune system, individuals without a functioning spleen, alcoholics, and children in large day-care centers. I have also read studies indicating that it is more common in males, children who were never breastfed, smokers, and more common during the winter months. For reference though, my daughter did not meet a single one of these increased risk factors.
· What are the symptoms of meningitis?
o Again, only speaking for pneumococcal meningitis. In persons over age 2, common symptoms are high fever, severe headache, stiff neck, vomiting, sensitivity to light, and in some cases, bruising and seizures.
o In infants, common symptoms are fever, vomiting, poor feeding, lethargy, and in some cases bruising and seizures.
· How is meningitis diagnosed and what is the treatment?
o A spinal tap (lumbar puncture) will be performed to take a collection of spinal fluid and grow bacteria from a sample.
o Treatment includes a number of antibiotics administered intravenously. A lengthy hospital stay is usually required for those that survive this disease. Due to the speed with which the bacteria multiply once in the bloodstream, a person can go from asymptomatic to critically ill within hours.
· What are some of the complications from meningitis?
o Death, brain damage, coma, hearing loss, mental retardation, paralysis, and seizures.
· How common are pneumococcal infections?
o Annually in the US, there are about 175,000 cases of pneumonia; 50,000 cases for bacteremia; and 3,000-6,000 cases of meningitis. According to the CDC, there are around 6,000 deaths annually from invasive pneumococcal infection (source: National Foundation for Infectious Diseases)
· What is the future development of vaccination?
o Wyeth is making progress on a pneumococcal conjugate 13-valent vaccine. It will cover 6 additional strains of the vaccine that the existing Prevnar (PCV-7 valent) vaccine does not cover. The original 7 strains (serotypes) were selected because they were the most common cause of invasive pneumococcal disease. The next 6 strains to be included are now becoming more common (This is called The Replacement Effect – e.g. now that the 7 most common have been taken out of the population due to the vaccine) and some have been found to be antibiotic-resistant. Additionally, work is being done to develop a vaccine that will cover all 91 strains. This work effort is being led by Dr. Richard Malley of Children’s Hospital of Boston. My opinion: bacteria have been around for millions of years. As smart as we think we are, bacteria continue to evolve and sadly, will never be eliminated.
Saturday, November 15, 2008
This will be difficult to keep brief. Who doesn’t want to brag about their children? Will and I never realized how much joy a child could bring us. I would always selfishly say that my 20’s are for me; I couldn’t fathom carseats, midnight feedings, anything baby-related. Maybe it was once we were in our thirties, or maybe it was we became more mature…I like to tease Will it was because I was bored with just him…but we knew that we wanted a family. My pregnancy went smoothly; no problems at all. I went into labor on Easter Sunday and Abby was born the next morning. I was so amazed by this little girl and so overcome with every emotion possible. I felt like we had finally found our purpose and it was the most important job of our lives.
Abby made us laugh and smile. She was the happiest baby I had ever met. She smiled at everything. We couldn’t go out without strangers stopping us to tell us how beautiful she was and how happy she was. We used to joke that Abby had more friends than Will and I. She had her own social life and never wanted to miss out on anything. She would get mad when she would fall asleep and wake up only to realize that there were a group of people around and she was missing out on being social.
Will and I spent every possible moment with her. During the weekdays, we had a woman watch Abby in her home. She only had one other baby and a handful of older girls that she watched during the day. Abby had so much fun at Lydia’s house. The girls would sing, read, dance, and play all day. It was so hard to be away from her, but I knew how much fun she was having and it made me feel better. In the evenings, we enjoyed our routine of dinner, bathtime, playtime, storytime and then bed.
Something else unique about Abby was that she loved to play with her feet. All babies find and grab their feet, but Abby took it a step further. She would grab wipes with her toes, she could grab her sippy cup with her feet and even bring it up to her mouth. We were even at the doctor’s office once and she grabbed the doctor’s stethoscope with her toes! She was a riot to watch. She also loved her books. We would read so many books each day. Her favorite book was one called “Counting Colors” as well as “Goodnight Moon”. We read our books so often I had them memorized. We would also sing songs and play games like patty cake. I know that she must have practiced patty cake at Lydia’s because everytime we played she would grab my hands in hers and clap along. She even knew the motions for “roll it, pat it, mark it with a B”…I didn’t even know that! It was so cute to hear her say “Pat Cake”.
Will and I were always trying to come up with songs or phrases to go with her name. We would sing our Abby C’s (instead of ABC’s), would call something that would seem abnormal to some but normal for our family, Abby-normal. We also had nicknames for her: Abigoogle, Absters, and sometimes call her the Sesame Street character, Abby Cadabby. We would sing lots of songs too, usually ones that I made up as we went along. Ironically, we even had a bath-time song about germs and another one to sing while we brushed our teeth. I always wanted to make sure her hands were clean, which is a difficult task for a baby that crawls on the floor. If we were out and she dropped her sippy cup on the floor, we would wash it off completely; we never wanted to take the chance that she would pickup any nasty germs. Babies are going to encounter germs of course, so I’m not going to say that we kept her in a sterile environment; that would have been bad actually, but we did our best to prevent the spread of germs. That is one of the things that just baffles me that she died from a common bacteria. You see plenty of children in the grocery store or at restaurants touching the ground or shopping carts; things that are loaded with germs, but our daughter succumbed to a bacteria.
In the dozens of meetings and phone calls with doctors following Abby’s death, as well as the hours upon hours spent researching Meningitis, there is consensus on what happened, but the “why” will never be known. Abby died from a common bacterium that entered her bloodstream. Time from onset to death was under 24 hours. It was a non-vaccine strain of s. pneumoniae. When people ask me where she got this, I want to scream at them, “What do you think, I took her to Pneumococcal R US?!!” Where does anyone get exposure to bacteria? Bacteria and viruses are everywhere. You touch something with germs and then rub your eyes, or cough and then shake someone’s hand. Bacteria can also live a very long time in your nasopharynx. Abby could have encountered this bacterium 6 months prior to getting sick, two weeks before getting sick, or even the day she got sick. We will never know.
We also don’t know where or how the bacteria entered her bloodstream. Her doctors hypothesize that when she vomited she tore a tiny blood vessel and the bacteria happened to be at that exact spot. The odds of this are hard to comprehend. An immunologist validated that her immune system was functioning properly and that essentially no one, especially a 13 month old child, can overcome an attack like this. Others have told me how they or a family member survived meningitis. There are so many different strains, each replicating at different speeds and each body reacting differently. A difficult thing to comprehend and something that several doctors have confirmed, is that it was a domino effect. Once it entered her bloodstream, no amount of antibiotics in the world could have stopped it. Even if we were at the hospital insisting on a spinal tap within minutes of her first sign of fever, it wouldn’t have been enough. I find that hard to swallow. You think we live in 2008 in Dallas, Texas, not the 1400’s or in a third world nation. We have access to excellent health-care, our children get vaccines for scary things like polio, measles, and hepatitis, but that nothing could have stopped this?
We are touched by the outpouring of support from friends, family, and colleagues. I see so much good in people and the lengths they have gone to console us. There really are no comforting words anyone can say, other than “I care”. Even though I should, I find it incredibly hard to dismiss the well-intentioned comments that sting and are so hurtful. The accusations that we didn’t vaccinate her and that is why she died, the one that makes all bereaved parents cringe, “It was God’s will so don’t question it”, the people that tell me to just have another child and I’ll get “over it”. I’ve even had people tell me they know how they feel because they have lost their dog. I just have to walk away. Will and I would have given our life for our child. She deserved to grow up, have sleep-overs, go to the movies with her friends, go to school, have a boyfriend, get married, and just live. Abby was the greatest joy of our lives and in her short 13 months, she taught us more than we were ever able to teach her.
Friday, November 14, 2008
Hello and welcome to the Kearney Family Blog. We have created this blog so we can keep you up to date on what we are doing. The initial impetus for creating this blog is to talk about our daughter Abigail Ann Kearney. Pictured here to the right, Abby always liked to smile and also show off her curly hair on top of her pretty head. She was born on April 9, 2007, weighing 6 lbs., 3 oz. Abby is the absolute joy of our life. She always brings happiness to those around her.
On May 12, 2008, the most devastating thing imaginable occurred. Abby died after a brief illness with a non-vaccine strain of pneumococcal meningitis.
We will write on this blog to keep everyone up to date on pneumococcal meningitis research. We invite people to read and even suggest topics to write about pertaining to pneumococcal meningitis. We will even write about topics interesting to our family.