In A Medical Crisis, Knowing the Right Questions To Ask Is Key

My cousin Robyn is a beautiful young girl on the verge of womanhood, with a quirky sense of humor, a curious mind and a sweetness that I pray she never loses. Just 14, she’s the spitting image of her mother, my first cousin, Sheryn.  Robyn is loved by everyone in the family–especially her parents and Cameron, her cousin and closest friend. A little over a month ago, Robyn and her family’s world turned upside down. This young woman with so much clarity and focus became someone completely unrecognizable.

What could have happened to create such a change? Robyn had routine dental surgery to remove four wisdom teeth. Days after losing her teeth, she began losing contact with her world. After the surgery, Robyn went days without sleeping, but somehow she was still able to function. Though she was experiencing some confusion, she was clear-headed enough to go to the school nurse.

But that night, her condition advanced to a level that warranted an immediate trip to the ER. Robyn, her mother and her father, Dar’rell, spent the night in the emergency room, but went home Friday morning after a psychological evaluation cleared her for release.

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But over the weekend, the confusion and fuzziness continued and Robyn’s parents took her back to the hospital on Sunday. While there Robyn declined rapidly, losing control over her thoughts as well as other body functions. Though she talked non-stop—a steady stream of non-coherent words and quotes from books she’d read, songs, scriptures, etc. – she could not communicate with her family to tell them she had to use the bathroom.

Fortunately, Robyn’s Aunt Crystal and her sister, Robin’s mother Sheryn, were prepared to advocate on Robyn’s behalf. No strangers to hospitals, Crystal and Sheryn had years of experience advocating for their mother, who endured at least 6 back surgeries, post-stroke rehab and a kidney transplant until her transition a year and a half ago. Not only did they have a barrage of questions about what was being done for Robyn, they were trying to give her doctors answers, drawing a line from Robyn’s surgery to her deteriorating medical condition.

But the doctors weren’t listening, performing a battery of tests, including a spinal tap, to rule out meningitis, while insisting the tests ruled out any possible connection to the dental surgery. That same day, hospital personnel told Sheryn and Dar’rell that doctors had the right to institutionalize their daughter.

Her doctors believed a 72-hour hold in a psychiatric ward was remedied because they believed Robyn was a danger to herself and possibly to others. If her parents agreed, they would consider it a voluntary hold which meant that Robyn’ parents could visit. Because the admitting hospital didn’t have the appropriate facilities, it would mean transferring Robyn to BHC Alhambra Hospital which had a separate facility for adolescents.

Thank goodness her parents agreed to the transfer. It was the step that began to unravel the mystery.

“Thank God for the nurse and for Dr. Athena Lewis,” Sharyn told me. It was the charge nurse who looked at Robyn’s case and saw no family history of mental illness, a loving household and no drugs. She told Dr. Athena (as she likes everyone to call her), that this didn’t make any sense.” Dr. Athena promised to find an answer. For two days, Sheryn and Dar’rell visited their only child in a psychiatric facility. On the third day, Dr. Athena, the doctor who cared for Robyn like her own and vowed to find a treatment, called with that promised answer and told them “I know what it is.”

Dr. Athena discovered a case very similar to Robyn’s on the Internet that involved oral surgery. In both cases, patients were given the drug Dexamethasone, also known as “Decadron.” The article Dr. Athena discovered, “Postoperative Psychosis in an Adolescent Subsequent to Oral Surgical Outpatient Procedure” (published in The Oral Surgery Oral Medicine, Oral Pathology, Oral Radiology and Endodonogy, Vol. 107, No. 4 April, 2009) proved that side effects from the drug mimicked the symptoms Robyn was experiencing.

The antidote was administered and by Thursday, Robyn was coming back. Sheryn and Dar’rell took their daughter home the next day. When Robyn went in to have her wisdom teeth removed, her parents were informed Propofol was used to put her under. But they weren’t told that Robyn was also given Decadron, often used in dental surgeries to prevent swelling. But the drug has known side effects, like the psychosis experienced by Robyn and other adolescents. How were her parents to know what side effects to look for, if they were not told all the drugs their daughter was administered? When we don’t know, we have to ask. Ask, is X the only drug she was given? Will you go over her case notes with us to make sure there was nothing else like drug Y or drug Z?

I asked Crystal, what should be the take-away from Robyn’s experience. She said, “Be vigilant. Ask any questions you may have, no matter how inconsequential. WHAT are you giving my child/parent? WHAT are the side effects? WHY? HOW MUCH? HOW LONG should we be watching for any side effects? And REPEAT as needed.”

Today, Robyn is not only home, but back in school, working overtime to catch up. To add insult to injury, she was sidelined last week with a stomach flu, but thankfully, everyday she’s closer to a complete return to her wonderful self.

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