Coxsackie and me

sounds like a movie just waiting to be made, huh?  well, ever since our fam got hit with Coxsackievirus (aka: hand, foot, and mouth disease), i have been on the hunt for answers to my ever growing list of questions about contagiousness, reinfection, and what in the world, if anything, it could do to the little one growing in my womb.  after my recent visit with the high risk doctor, many if not most of my questions have been answered (though of course, i now have more!)  but for those of you in our family or circle of friends who have children who have gotten this, you have gotten this, or you're dreading every play date for the summer because you're afraid of getting it...i thought it may be helpful to share what i've learned on this not-so-well-known-but-oh-so-common virus.

for basic info on the virus itself, what it can do, general duration, etc., check out the Center for Disease Control's web site.  their general info page is very informative and thorough.  that's your best starting point.  from there, here's what else i've learned:

How long am I really contagious?  Really?  
until the blisters/sores/pimples/spots/rash goes away.  it's not just when the fever is gone. (bummer!)

Can I get it again?
yes.  sorry but it's true.  there is Coxsackie A and Coxsackie B...and there are multiple strains within each.  so will you may have been exposed/infected by one strain, you can be infected by another at another time.

Random fun facts:
*first known case was in Coxsackie, NY...hence the name (that poor town)
*it can be spread through water...hence the breakouts that can occur in beach towns, lakes, etc. and why it's so common in the summer months

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PREGNANCY AND COXSACKIE


How cautious do I have to be to not get it again?
more than likely the strain that went around our circle of friends, was probably the same strain.  so all of us (aka: the gazillion kids and three adults that i know of) who have gotten it have our immunities and won't get that strain again.  just keep praying no other strains come our way :)

What risk does this virus pose to my baby?
most doctors and web sites say no risk at all.  HOWEVER, there are known cases (incredibly few though) where the baby was infected.  it poses no risk of congenital defects (birth defects like cleft pallette, paralysis, etc.) but it can cause an infection around the baby's heart, which would then lead to hydrops (which is when fluid builds up around the heart, lungs, and stomach...the skin thickens) and the baby would likely die.  however, with coxsackie, the chances of this happening are SO slim...the doctors i've talked to have said without wavering, "we don't expect any problems with your baby."  the doc i talked with yesterday added that she's never seen a case of it and doubts anyone in her office has either.  she added that in all her medical books and physicians' web sites...there are three sentences if that on this topic.  information is very limited.

however, they are quick to say that the most risk is posed to the baby when you are late in your pregnancy and get the virus.  they are concerned that you will have the virus when you deliver and then pass it on to your newborn baby, which can be dangerous for the baby.

What can be done?
if you have coxsackie while pregnant (not just if you were exposed to it...they are very different) they will have you go in for an ultrasound where they will check to see if there is fluid build up anywhere.  in addition, they will probably do an Echo cardiogram to check the baby's heart function.  while it is most likely that the baby would get this virus sooner than later, there is no conclusive evidence to prove how long exactly the baby is at risk.  so to cover all grounds, they will monitor every 2 weeks or so through the rest of the pregnancy.

if they find fluid or an indication of infection...there is nothing they can do.  it's a virus.  if they found it after 24 weeks, they could deliver the baby prematurely, try their best to stabalize him, and hope for the best...and if it happens before 24 weeks, the ultimate outcome is no different.  you just have the benefit of tracking it via ultrasound.  (not sure if that's a blessing or a curse, honestly)

My remaining questions:
*Can all these ultrasounds be harmful to the baby?  I've been told no, but something inside me is not content with that answer...
*If nothing can be done to help the baby, why is so much surveillance necessary?  (data collection, possibly?  for liability purposes?)  Should we even do all this????

Our current status:
my blood work in June showed that i had antibodies for three of the six coxsackie B strains, meaning i have been exposed to/infected by them at some point.  however, there's no way to gauge the time frame. so i will have blood drawn in a few weeks.  by comparing levels of antibodies they can tell if it was recent or not.  i have another ultrasound and an echo of the baby's heart scheduled for next week.  two weeks later, another ultrasound and blood work.  assuming the blood work indicates a recent infection, they want to monitor me every two weeks for the rest of the pregnancy.

more importantly, our heart status:

we are trusting the Lord.  what other option is there?  He has been kind in not allowing it to be a struggle to trust Him thus far though.  i was standing in front of the elevator waiting for it to come whisk me away from the hospital yesterday, and all that kept running through my mind was, "this baby is in Your hands, Lord.  he's in Your hands.  he has been all along and he will be all of his days."  praise God for not allowing fear and anxiety to consume my heart and mind.  thank you to all who have prayed to that end!  our only prayer requests at this time are these: that we would have wisdom as to whether to proceed with all this surveillance or not...and that God would protect our little one, to the glory of His Name.

i hope this is helpful...even to just one person.