For one girl, treatment and success

USA Today Series
12-06-1995

For one girl, treatment and success

Valerie seemed like a happy, well-adjusted 8-year-old when she went to summer camp for a week in 1993.

She was popular at school. She got excellent grades. She worked hard to please people.

But when Valerie came home from camp, she was withdrawn. She cried. She was hard on herself, always worrying that she was being bad. She kept saying, “I don’t feel like myself.”

Her parents – who asked that the family’s last name not be used because they feared Valerie’s name would later turn up in a computer database, possibly stigmatizing her – took her to a psychiatrist at the University of Iowa College of Medicine. The doctor put Valerie on 20 milligrams a day of Paxil, a newly released anti-depressant.

A week later, Valerie was worse. She began hitting herself with her fists. She ate less. She spoke in whispers and became so overly compliant that she asked permission to do the simplest tasks.

Valerie was hospitalized in a psychiatric ward. Her daily dose of Paxil was increased to 30 milligrams, then 40 milligrams. Still, she got worse.

She became bedridden and rigid. She had to be fed through a tube.

After a month, she was taken off Paxil and put on Haldol, then nortriptyline, bethanechol and Ativan – all anti-psychotic drugs.

Yet she remained largely silent and emotionless.

“No medicines seemed to work,” said her mother, Deb, who, like Valerie’s father, is a dentist in Iowa City, Iowa. “She went downhill faster and faster.”

The psychiatrists suggested electroconvulsive therapy, commonly called shock therapy or ECT.

“By the time we got to ECT as an option, I begged to have it done,” Deb says.

Valerie was shocked 19 times, once every Monday, Wednesday and Friday morning for about six weeks. She got a two-second electrical jolt each time. Her brain seizures averaged 52 seconds.

Doctors first noticed improvement after the eighth shock. But Valerie’s parents didn’t see it.

“After eight treatments, I said, ‘What are we doing to this little girl?’ ” Deb recalls. “But we had no good options left.”

After the 11th shock, Valerie’s parents noticed a change. Their daughter seemed more alert.

After the 12th treatment, Valerie’s dog was smuggled in against hospital rules. Bugsy, a Boston terrier, jumped onto Valerie’s lap and lovingly licked the girl’s face.

Valerie smiled.

Sitting in a wheelchair, she hugged and petted her dog.

“To this day, she credits the dog with curing her,” says her mother.

After her 13th shock, Valerie had a party and ate three slices of pizza.

“It was a miracle,” Deb says.

The last four shocks were done to the right side of her head – not the front, where they cause more disorientation – because Valerie was acting confused and uninhibited, telling toilet jokes.

“She probably would’ve gotten better on her own at some point,” says Valerie’s psychiatrist, Beth Cizaldo. “But that could have meant losing a year of life in the middle of elementary school. That was an unacceptable trade-off.”

“I credit ECT with saving my daughter’s life,” Deb says.

Deb thinks it can help other children, too, and she’s telling that to other parents.

“Last night, I spent an hour on the phone with someone who’s 12-year-old boy is undergoing ECT. He’s only had three. I said, ‘Don’t blame yourself. This will work.’ ”

It’s still unclear what caused Valerie’s decline in the first place.

The adults couldn’t find evidence of anything traumatic, such as molestation, at summer camp.

Paxil’s safety and effectiveness in children hasn’t been established. But the doctor doesn’t think Paxil caused her decline: Catatonia hadn’t been a reported side effect. However, stupor and lack of emotion have been infrequently reported side effects.

Also, Valerie was having hormonal changes at the time, which foreshadowed early puberty.

Her parents wondered if they were to blame.

They admit to being hard-driving perfectionists who expect a lot of themselves, Valerie and her younger brother. Deb talks rapid-fire, bustling with energy and vibrancy. She successfully defended her doctoral dissertation recently.

“I’ve asked, ‘Did we put the stress on our young girl? ” Deb says. Some mental illness runs in Deb’s family: a sibling spent seven months in a psychiatric hospital at age 10 but recovered and is now a successful physician.

Students welcomed Valerie back at school. Her parents and doctors lectured the children at school about her illness and the shock treatment.

Valerie, now 10, says she’s doing OK: “I get mad at my brother and those kind of things, but I feel pretty good.” She likes school, gymnastics, roller blades and “hard-down dirty soccer.”

She loves the doctors and nurses who treated her, but says she remembers only three things about the hospital: her dog and two other patients.

“This kid, Jarvis, always made me laugh,” Valerie says. “Anything he did, even the way he took a step, was funny. And this kid, Andrew, who was deaf, we did sign language together.”

She has no memory at all of summer camp in 1993.

Valerie caught up with her school work in two weeks: “I work hard.” She still gets A’s.

But she scored slightly lower on the standardized Iowa aptitude test, her mother says. She concentrates a little less well than before.

And Valerie sometimes laughs at odd things or doesn’t seem fully engaged. She takes 20 milligrams of Prozac a day. “She’s still a sensitive little girl,” her mother says.

By Dennis Cauchon, USA TODAY

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