Day at the Emergency Room

I was right to take Spane to the ER. He's been diagnosed with Dandy Walker Syndrome. This is the final report I got from the ER. We were at the ER from 12 noon to 9:30 at night. They finally did a CT scan, and this is what they came up with.

The psychiatrist at the ER said that Spane needs to see a pediatric psychiatrist to determine if it is an organic psychosis (his words).

Emergency Room Discharge Instructions:

Neurology: HEADACHE = hx of Mega Cisterna Magna (Dandy Walker Syndrome) (unspecified) The cause of your headache is probably due to a congenital formation in your head.

FINAL REPORT:

Reason for Exam:

Headache

Report:

History:

7-year-old male with headache

Technique:

CT of head is performed utilizing serial 5-mm axial images obtained from skull vertex down through foramen magnum without the use of intravenous contrast administration.

Findings:

No acute intracranial hemorrage or cortical ischemia. Ventricular size is normal. Gray white matter differentiation is well-maintained. No midline shift or mass effect. No extra-axial fluid collection. Posterior fossa structures are intact. Incidental Mega cisterna magna is seen. Visualized paranasal sinuses and mastoid air cells well aerated. Osseous structures are unremarkable.

Impression:

• No acute intracranial disease.
• Incidental Mega cisterna magna.

There are 42 People in My Head

At the Therapist

Next morning, June 28, 2011, I made a frantic call to Spane's therapist. She said to come by at two thirty that day.

The interesting thing about this is that just that past Tuesday, had been the last day of therapy for Spane. He was sent away with a clean bill of health, a good child, no problems. I guess not, huh?

So, we get to the therapist's office, and she sits him down and starts asking about the voices. I sat in a chair and tried to keep calm.

Therapist

So, Spane can you tell me about the voices?

Spane

There are 42 of them.

Therapist

42?

Spane

I just counted them. There are 42 voices all yelling at me.

Therapist

Can you see them, too?

Spane

Yes

Therapist

What do they look like?

Spane

Well, they look like The Three Stooges

Therapist

Are they all boys?

Spane

Yes

Therapist

How old are they? Are they young like you?

Spane

No, they are adults, like you know, 35, 40 years old

Therapist

Do you see them standing in the room?

Spane

No, they are like on a white piece of paper, in my head. I don't see them in the room, just my head. They are all wearing white tee shirts with the word Bully written on it

Therapist

So what do they say?

Spane

Well, they tell me to do bad things. They tell me not to pay attention to my mother, to hit my mother. They tell me to be disrespectful, they just tell me not to be good boy.

Mom Remembers

Spane went to another room to play while the therapist and I discussed his case. She said it was definitely not Schizophrenia, but that we would need to see a the psychiatrist to find out what has really going on.

Then I remembered that Spane had hit his head at school about two years ago, in the same spot where he was complaining of the headaches hurting. I told the therapist I was going to take Spane to the ER and get a CT scan to find out if there was anything physical affecting this.

Mommy, I'm Hearing Voices

Monday night, June 27, 2011, Spane was beginning to act up a little.  He seemed like he was angry, although he had had a nice day playing with the friends next door.

Me:

"Spane, it's time to go to bed.  Can you put on your pajamas, please?"

Spane:

"No!"

Me:

"Spane, are you mad at me?"

Spane:

"No, Mommy"

Me:

"Are you mad because your other friends weren't able to come over and play today?"

Spane:

"No, Mommy"

Me:

"Spane, what's really going on?"

Spane:

"Mommy, I have a head ache!"

Me:

"We have Tylenol for that.  Do you want me to get you some?"

Spane:

"No, Mommy. It doesn't work."

Me:

"Well, honey, I don't know what to do then."

Spane (agitated and frustrated):

"Mommy, I'm tired of the headaches telling me what to do!"

Me (really calmly):

"Spane, are you hearing voices?"

Spane:

"Yes, Mommy, I am"

Me (trying to stay calm):

"What do they say, honey?"

Spane:

"Well, they tell me to do bad things.  They always tell me to do bad things, and I can't get rid of them, or make them go away!"

That was the first night. That was the beginning.