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Recovery from serotonin syndrome gives 10-year-old her life back

Sep 7, 2023News

Delta, CO (August 23, 2023) – At just 10 years old, Hannah Winget started developing headaches. When normal over-the-counter medicine stopped working, she was switched to stronger medicine. But even those medications weren’t helping.

Hannah’s Mom, Laura, reached out to Children’s Hospital in Denver and in Utah, but the wait time was months out before she could be seen. Less than six months later, Hannah went to her mom expressing she had the worst headache of her life. She was weak in both of her arms, couldn’t see straight, and her pupils were dilated – that’s when they knew it was something serious.

Once in the Delta Health Emergency Department, a CT scan detected an abnormality on the right side of Hannah’s brain. This is the area that affects fine motor skills and balance. Not even 24 hours after getting home from St. Mary’s where they confirmed the abnormality with an MRI, Laura was contacted by Children’s Hospital in Denver asking if Hannah could come the next day for an appointment.

“Once at Children’s Hospital in Denver Hannah went through more than 20 different medications but nothing worked or helped to completely fix the problem,” said Laura. “Finally, they put her on nortriptyline which is an antidepressant that also helps with migraines and things were going awesome.”

But Hannah also suffers from severe anxiety, so it was decided to also put her on anti-anxiety medication to help with those symptoms too. What they didn’t know was that the anti-anxiety medication actually cancels out nortriptyline so that the body can no longer metabolize it out of the system.

“After 5 days of putting Hannah on the anti-anxiety medication, Hannah was in full-blown serotonin syndrome, anticholinergic syndrome and norepinephrine syndrome,” said Laura. “We took Hannah to the Emergency Department (ED) right before Mother’s Day and she was pale, shaky and vomiting.”

Serotonin syndrome is a potentially life-threatening drug-induced condition cause by too much serotonin in the brain. In most cases it in involves two drugs that increase serotonin in different ways or an overdose or one serotonin-elevating drug.

Once in the ED, Dr. Lebsack, physician at the Delta Health West Elk Hotchkiss Clinic and on-call pediatric provider, took over Hannah’s care.

“Dr. Lebsack literally saved Hannah’s life,” said Laura. “He was actually the one that figured out Hannah was experiencing serotonin syndrome. It was the best experience a parent could ask for because he was there every night and every morning.”

Hannah had a total of 16 EKGs during her stay. Because Hannah was starting to have changes on her EKG, orders were placed to complete an EKG every hour until her healthcare team knew she wasn’t going into Torsades, which is an electrical problem with the heart that can be fatal.

Dr. Lebsack and Hannah’s parents were in close contact with Children’s Hospital in Denver and with poison control for guidance on what the parameters were in case things shifted quickly and they needed to fly Hannah to Children’s Hospital in Denver. At one point, Hannah’s EKG started to change and they almost had to fly her out. Another time Hannah’s heart rate and blood pressure were very high and if Hannah’s condition had turned too critical, then the hospital would have had to transfer her to Children’s Hospital as well. Luckily, Hannah was able to stay at Delta Health for her treatment.

Hannah’s ultimate diagnosis is atypical migraines but the medications caused the serotonin syndrome that almost took her life.

“To be fair, I don’t even remember the whole experience,” said Hannah. “Most of the time I was just laying down playing games on my phone [to stay distracted].”

Laura said she remembered Hannah telling her a couple of times that she felt like she was going to die and that she was afraid she wasn’t going to leave the hospital in Delta because of how severe it was.

“Hannah just wanted to go home and to be a kid again instead of being tied down with IVs and getting EKGs every hour – it’s a stressful situation,” said Laura.

After the experience Hannah’s mom said she remembers writing a post on Facebook saying that for Mother’s Day she didn’t get presents, but instead her present was the gift of life – her daughter’s life. “Because Dr. Lebsack let me keep her,” she said.

Hannah’s parents both work at Delta Health and this helped them to navigate the stressful situation and to lean on the trust they had built between themselves and the healthcare team. The entire healthcare team stepped up to provide compassionate, quality care that Hannah and her family trusted.

“Knowing that my mom was there all along and knowing that I wasn’t going to be all alone in the hospital, plus the fact that they put me in a room with my mom so that she could stay with me made me feel better,” said Hannah. “I knew I was in good care.”

“Dr. Lebsack also went above and beyond with all of the testing he did for Hannah,” Laura said.

“Anna on Med/Surg deserves everything in the world because of how seriously she took it. She was there when Hannah had anxiety attacks, and instead of suggesting more medicine, she would sit down with them and say ‘OK what are 5 blue things in the room’ or ‘What can you hear?’ Even Sherry Heinel, Hannah’s Case Manager, provided us with coloring books and ways for Hannah to divert her attention from everything going on. There was a lot of support.”

Hannah finished physical therapy with Kasi Snook, PT, at Delta Health Outpatient Therapies and Sports Performance, and has been working with Dr. Lovette from Delta Health Pediatrics for her follow-up care.

“I absolutely love Dr. Lovette,” said Hannah. “She’s so nice and very understanding.”

Dr. Lovette is helping Hannah to monitor the enzymes in her liver that break down medications to make sure that she doesn’t go back into serotonin syndrome because it can happen so easily.

“[As a parent] if you’re ever in this situation, remember to trust your gut, and when you know something is wrong be your child’s advocate,” said Laura. “Just know that you’re going to get through it. It was probably the scariest time for all of us when Hannah was going through this, but you have people to back you up and support you. It’s rare for a 10-year-old to have serotonin syndrome but the fact that we handled it at Delta Health and didn’t have to fly over to Denver was so nice.”

Fast forward to today, and Hannah and her family are feeling hopeful and optimistic about the future. Hannah will be starting charter school in the fall and is excited to be learning again since she missed a lot of school in the previous year due to her health issues.

Hannah enjoys drawing, reading and going on hikes. Her favorite book series in Nancy Drew and she also loves autumn time.

For children afraid of being at the hospital, Hannah offered this advice: “Try to focus your attention away from it and try to think of the good things that could happen from it.”

To learn more about pediatric and family medicine care available at Delta Health, visit deltahealthco.org.

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