All hooked up and receiving antivenin.
Dear friends, at the request of one of you (you know who you are), I am writing about what I learned from Mikah being bitten by a rattlesnake. Please feel free to pass this along to anyone and/or add comments below. Maybe this will help avoid another bite.
To begin, here are some interesting facts about the snakes themselves. They are born with venom, ready to bite. Also, as many of you have noted to me, the babies are particularly frightening because they cannot control the amount of venom they inject into their victim. However, please don’t be misled by this tidbit. An adult can very well have MORE venom to give it’s victim, should it “choose” to do so! (Here’s a positive note: at the hospital a nurse told me an adult snake can give you a dry bite, aka, no venom. It’s unusual, but if I’m bitten I’m praying for the dry bite!)
Babies are born with one notch on their rattle. Each year they gain another notch, roughly speaking (and assuming nothing happens to the notches, like sometimes they can fall during a shedding). So, the older they get, generally speaking, the louder the sound of the rattle. You therefore won’t hear a baby rattle. Once again, don’t be misled by this info since an adult snake won’t always rattle in warning! I’ve heard countless first hand accounts of snakes who struck and then rattled, like the one who got Mikah. One lady told me about a snake that wasn’t rattling at all on her front lawn. When the fire department killed it, they told her the rattle had been damaged and that’s why she wasn’t hearing it. There any many more fascinating factoids, but I thought these were of utmost importance to understand.
What should you do as a parent or guardian with children in rattlesnake territory? Know that there is nothing to guarantee rattlesnake avoidance. You can get a snake fence (we need to repair ours, obviously). You can clear the brush and weeds on your property and keep random crap off the ground (like logs). Lollipop your bushes – cut the bottom leaves so you have a clear view of the ground. You can’t avoid the snake you can’t see.
Also keep in mind they can slither into your home! This is not a scare-tactic, I swear. A few people have told me how they found rattlesnakes in their homes. One was sitting coiled on the dryer. One was in a living room (my cousin’s house, thank you very much). Another was under the neighbor’s fridge in her kitchen! If doors are left opened, at least try not to leave them unattended. And don’t forget about the garage. I was dumb enough to look online and found a youtube video of a nest of rattlesnakes living in a garage . . . Lastly, if you have a porch with empty space underneath you may want to do something about that ideal hiding place. Two different nurses in the hospital told me about 2 separate cases where adults were bitten (one of them was repeatedly bitten by the same snake) when they simply walked out of their houses down their porch steps. In each of those cases, there was no way to see the snakes before they struck.
What about gardening? Reaching into dense foliage where you cannot see below the leaves is dangerous. Before diving in, warn the snake you are coming by striking the ground with a stick repeatedly. They feel the vibrations and will likely move away (fingers-crossed). (UPDATE: The snake wrangler informed me that you simply shouldn’t put your hand in greenery where you cannot see what’s lurking underneath. PERIOD. You can use a long stick to push aside the leaves giving you a better view underneath, and then proceed with caution.)
Someone told me that a rattlesnake must be coiled to strike. This is NOT true. A rattlesnake can bite from any position. Please keep this in mind.
It’s not like you can get a pet that will keep you safe either. Hawks and California King Snakes eat rattlesnakes. Everything else can easily be killed by the snake’s bite. I heard of a terrier that’s good at killing rattlesnakes, but it’s hit and miss depending on the dog’s particular character. In other words, even those special terriers aren’t foolproof. In fact, if you have a dog, I HIGHLY recommend rattlesnake avoidance training (see below). The snakes come looking for food and water (like rodents). So, keeping those to a minimum helps. At the end of the day, the most you can hope for is to be AWARE of a snake bite and respond quickly.
What should you do if you see a rattlesnake? BACK AWAY SLOWLY. When you have a safe distance between you and the snake (several feet), turn tail and RUN.
What are some symptoms to look for if you suspect your child was bitten?
- A noticeable bite on the skin that may appear as a discolored area with two (but occasionally only one) puncture marks
- Pain and swelling in the area of the bite (Swelling may take several hours to develop.)
- Tissue damage, skin color change, or tingling
- Rapid pulse and labored breathing
- Progressive general weakness or tiredness
- Vision problems or eyelid drooping
- Nausea and vomiting
- Seizures
- Drowsiness or unconsciousness
- Thirst
- Numbness
- Paralysis
- Shock
Note: Not all the above symptoms may appear and it may takes hours before any symptoms appear (especially swelling and bruising)!
Mikah wasn’t convinced he was bitten until I started freaking out (see below). He later told me he thought the snake licked him and hissed at him. He didn’t hear rattling at any point (the snake rattled after the bite, but I think Mikah was in shock and actually didn’t hear the non-stop rattling that proceeded after he was bitten, see below). You don’t see the fangs and it bites quickly. The telltale sign is the blood from the bite. It looks a little like a vampire’s kiss (has anyone seen Trueblood?).
Once the heat hits around late spring don’t leave your kids outside alone. This may sound extreme to some of you, who like me, would leave the kids playing outside while staying in the house to cook or clean. I don’t do that anymore. The kids can eat corn from a can for dinner – but I won’t let them play alone outside.
What should you do if, God forbid, someone is bitten?
1. Call 911 from a landline if possible (see below).
2. Try to limit the movement of the person who was bitten (e.g. don’t instruct them to get in the car, like I did).
3. Don’t ice the wound or suck on it (you will not get the venom out, and no I didn’t even try that).
4. Try to avoid anything that gets the blood pumping (like freaking out, I failed miserably on this count).
5. If there is anything constricting, like a ring or watch, near the location of the bite remove it. Swelling will cause those accessories to become tourniquets.
A couple additional freaky little facts about these creatures: 1) they can swim so don’t think that throwing one in the pool will drown it; and 2) they can bite (and inject venom) up to an hour after death! So if you are feeling brave with your shovel (and I DO NOT suggest this approach) you must behead the beast to make sure it won’t get you post-mortem.
Onto Mikah’s story. It was a typical weekend. We had just come home from playing at a neighbor’s house and were hanging out in the backyard. Nothing unusual. Suddenly, I hear something that sounds like a sprinkler turning on. A very loud sprinkler. I stopped immediately – call it mother’s instincts – and looked in the direction of the “spinkler”. It was coming from behind our green house, in the vegetable garden. This is the moment time stood still: I realized there was no spinkler in that area.
In that moment, that seemed to last forever, I knew there was a killer in my backyard with my kids. Mikah’s voice snapped me back to the present. He called for me calmly but firmly, his voice was coming from the vegetable garden. That’s when everything went from slow motion to hyperspeed. I sprinted up the stairs to the vegetable garden and saw Mikah standing straight in front of me. The green house was far to my right. Mikah looked at me and said one word, “jojo.” I looked at him confused. He pointed to the right and repeated, “jojo.” I turned my head and saw Jojo, who was not even 2 years old, heading toward the deadly rattling sound.
I didn’t know where the snake was exactly. I called for Jojo to come to me, but he wasn’t listening. The rattling was constant. For all I knew the snake had bitten Jojo and was coming for me. Without a choice, I walked carefully but swiftly toward the rattling sound to get Jojo. Looking at the ground I expected to see the snake at any moment, it wouldn’t stop rattling and it was incredibly loud. I scooped Jojo in my arms and made my way back to Mikah. I offered silent prayers that Jojo wasn’t already bitten. I looked at Mikah and asked if he was ok, fully expecting him to be perfectly fine. I was, in fact, eager to strip Jojo and make sure he wasn’t bitten.
Much to my horror, I saw Mikah’s leg had two dots of blood with some blood starting to drip down his leg. Mikah was already bitten by the time I got there, when all he told me was to get Jojo. Jojo was still in my arms and I was terrified to put him down. I was terrified, period. I yelled for everyone to get in the car. My only goal in life at that moment was to get Mikah to the hospital.
Side note (and something I didn’t know): antivenin must be mixed (or otherwise “prepared”) before injection, which takes some time (around 20 minutes or so). For this reason, it may be wiser to call for an ambulance and wait at home than rushing off like a crazy person to the hospital. When the ambulance arrives, it confirms the patient was bitten by a venomous snake and issues the request for antivenin while en route to the ER.
Back to the story . . .
Mikah was calm up until that moment, when he saw his mother frantic. Prior to my urgent behavior, he wasn’t even crying. From the vegetable garden he somehow made his way to my car, which was maybe 30 feet away. I put Jojo in the car and buckled him in. Leah, my 5 year old daughter, was suddenly at my side from where I don’t know. I yelled at her to get in the car NOW. She started crying. At that point everyone was crying but me.
I would’ve been flying down my driveway but my car was blocked by my cousin’s car, who was visiting with Ori (my husband). They were walking around the house somewhere. I was TRAPPED. I would’ve driven over my front lawn but I was secured by 3 walls of concrete and a Lexus. I tried to call Ori but my fingers were shaking too much and my phone DIED on me. It just crashed, battery perfectly charged. I started screaming Ori’s name.
I learned that when you scream as hard as possible, you need to bend over a bit so your lungs can hold more air, or maybe so you don’t pass out from hyperventilating. Also, if you try to scream words, like “Ori,” they just sound like ahhhh. Still, I figured he would hear me within a 5 mile radius and would come running. I screamed and screamed, it seemed endless. My throat was raw.
Finally, after what was probably only 3 minutes, Ori appeared with my cousin. I looked at him and flatly stated, Mikah was bitten by a rattlesnake, I’m taking him to the hospital. He told me to put Mikah in his car (to spare the little ones the journey). I carried Mikah over to Ori’s car. Already he was going into shock. He cried that his leg was cold and he didn’t want to die. Ori was gone in a flash, taking with him my firstborn son and half my heart.
They went to West Hills Hospital since it was the closest. Meanwhile, I called 911. Luna, our husky malamute mix (who was just under a year old), was in the vegetable garden antagonizing the snake, still. From the moment the rattling began it hadn’t stopped. I stood there for a moment, frozen, with the little ones still in the car. I told them to stay in the car and not move. I wanted to keep them safe. That was my new goal in life since Mikah was on his way to the hospital. Then I realized I could probably keep them safe in the house. I felt like a defenseless animal that needed to run from a predator. With the rattlesnake still rattling, my mind was on overdrive. “Everyone in the house,” I yelled. Leah was afraid to cross the 2-foot threshold from the car to the side door of the house. I carried her.
A 911 operator answered my call. I explained what was going on, while sporadically screaming at Luna to “come here!” The operator had so many questions for me, where was I, was someone bitten, what’s my address, where’s the snake? Please note: always call from a landline when at all possible! The operator will know if you are at a residence and where. This would’ve saved time (which could be vital if you want to have the ambulance take you to the hospital). She patched me over to the fire department, where I had to repeat my answers to the same questions. Frustration rising. Luna, COME HERE!
I went into the house and shut the door. In the kitchen, I paused for a moment. I remember thinking, this cannot be happening, the room seemed to be spinning. Leah was crying with Jojo on the couch in the living room. I put the TV on and may have cried with them for a moment. Leah asked, through her sobs, if Mikah’s heart was going to stop beating. I resolutely assured her it was NOT going to stop beating. And then I cried for sure.
The fire department arrived within minutes. A huge fire truck (or two) parked in front of my house as men swathed in protective gear headed up my driveway, like the snake-killing infantry. Some had long metal poles with claws on the bottom. I felt like ET was in my backyard, but he wasn’t eating M&Ms hiding in dolls, he was trying to kill my family. Perhaps a dozen men started combing the vegetable garden. I pulled one of them inside and demanded he inspect Jojo to make sure he wasn’t bitten. Jojo was already naked on the sofa, since I naturally stripped him for inspection at some point earlier. The fireman actually laughed. “Oh miss, if he was bitten he would be crying right now.” Jojo was sitting calmly drinking out of his bottle watching TV. Oblivious to danger, and perhaps mildly confused by his mom and sister sporadically breaking into sobs.
Luna helped the men distract the snake and they killed it (beheaded). Apparently, it had been stuck in the fence. They held up it’s headless body for my assessment. It was probably 3 inches thick and 5 feet long. Like identifying a criminal, I wanted to say, “Yes sir, that was the one that got him.” But all I was thinking was COULD THERE HAVE BEEN ANOTHER? I pictured the snake with a dozen babies lurking behind every rock. I asked if there was any other snake out there. “Yeah, I heard something up the hill a bit in the brush on the other side of the fence maybe 5 feet up.” Said one dressed in yellow. Oh my God. “Can you get it? That’s still my property.” I asked, trying to seem reasonable. “No.” he answered. I pocketed that thought for later. “Can you cut off the rattle for my son?” I asked. I don’t know what possessed me. I wanted Mikah to have something from this snake, other than nightmares. They kindly obliged.
Once they all left, I arranged for Leah to go to our dear friends, who would take the best possible care of her. I called my aunt to come watch Jojo. Within the hour, I was rushing to the hospital. When I got to the ER, Mikah was already receiving antivenin. He was hooked up to several machines. He was being monitored. The doctors had explained to Ori that they had to give the antivenin very slowly at first to make sure that Mikah wasn’t allergic to it (apparently, as an added bonus, some people are allergic to the actual venom and/or the antivenin, which causes further complications when getting bitten). So, we had to wait and see.
His leg was bent, elevated and marked with a sharpie. He had 2 IV machines, one in each arm. One was for anti-venin, the other for saline to flush out the poison. He was having difficulty speaking, since he was experiencing little spasms constantly (they were all over his body, including his face). His leg was in extreme pain so despite painkillers, he couldn’t rest. As the clock ticked, his foot seemed to expand. It eventually lost all contours and started looking more like an oblong ball with toes.
It didn’t take long for the hospital to arrange a transfer to Tarzana Hospital, where they have a pediatric department. Someone came to Mikah’s bedside. A doctor I think. He said that Mikah was doing well, he didn’t appear to have a reaction to the antivenin, and if he were an adult they would send him home. Everyone was so impressed that he wasn’t swelling so much. But since he was a child, they were being extra cautious sending him to Tarzana for further observation. That sounded hopeful. He was still fully conscious.
Side note: I mentioned Mikah’s leg was elevated in the hospital. At that point the doctors wanted to manage the swelling in his leg. He was already receiving antivenin, which they were expecting to counter the effects of the venom. If, however, you need to respond to a rattlesnake bite (awaiting medical treatment) you do not want to elevate the wound site above the heart (as noted above)! Elevating the wound site would encourage blood flow to the heart. That would be bad.
Back to the story . . .
I rode in the ambulance with Mikah to Tarzana Hospital. We were quickly received and located in the Pediatric Intensive Care Unit (PICU). They continued giving him antivenin and saline. They took his blood every few hours to see if the antivenin was having an impact. The swelling continued. They kept drawing more sharpie lines up his thigh as the swelling increased. Every hour a nurse measured all the different sharpie points with a measuring tape. This was a very painful procedure for Mikah, even on morphine. This lasted through the next day. The first night he got no rest. He was on morphine every 2 hours. After an hour and 45 minutes he would start to cry out in pain and I would know 2 hours were almost up. In the hospital, time was just a number. The day before, Time told me when to feed the kids or put them to bed. In the hospital, it was just an arbitrary number, an indication for when to give meds or give blood or measure swelling.
Over the next 6 days, the doctors kept in close contact with poison control. They would convey Mikah’s status and poison control would suggest how much antivenin to give. The process of fighting a rattlesnake bite is nerve -racking because nobody can ever tell how much venom the snake used (even babies). Doctors have to guess when to reduce the antivenin, and then wait and see if they reduced it too early. The routine went like this: the hospital can only give someone a few vials of antivenin for a certain period of time (I think it was 4 vials in 6 hours), then the hospital draws a blood sample (several vials) and checks for various indicators of recovery or further damage (for example, they checked for coagulants since the venom causes the blood to thin). Side note: each vial of antivenin costs well over $1,000.00. Mikah had a total of 25 vials pumped into him.
A couple times the doctors reduced the amount of antivenin and Mikah’s swelling increased. I was fuming. The swelling rose to his hips and I was nearing panic mode. Luckily, it never rose above his hips. The highest sharpie point was around his hip bone, which under normal circumstances pokes out from under his skin. In the hospital, I watched as his hip bone descended into puffy flesh.
On the fourth night he developed a fever and I almost had a fight with the doctor, who was trying to tell me it wasn’t a real fever. It turns out that body temperature can rise when responding to severe swelling and tissue/muscle damage. When we think of fever, under normal circumstances, we think virus and antibiotics. The doctors kept a close watch on Mikah’s temperature to make sure it didn’t exceed a low-grade fever, which it didn’t.
There was an incredible outpouring of love that truly helped us survive those 6 days. Family and friends visited the hospital, bringing games, cookies, dinners, drinks (Mikah drank 2 cases of Capri-sun), and get-well cards. Mikah was immensely uplifted by everyone’s attention. His teacher texted me a video of his entire class wishing him well. CBS Channel 2 News even came and did a story on the kid who rescued his brother but got bit by the rattlesnake (link below). A neighbor I never met before brought our family a home cooked dinner. My daughter’s friends picked her up from school and tried to cheer her up with playdates (she wasn’t allowed into the PICU and still wasn’t convinced Mikah was ok). I will forever be grateful for everyone’s support.
When we were released, the hospital told me to order a wheel chair for Mikah and gave me the contact information for the physical therapy company that would be working to rehabilitate Mikah’s leg. The venom destroyed much of the muscle and tissue in his left leg. In fact, his leg was black and blue up to his rear end. From being bent and elevated for so long, he couldn’t straighten his leg. He also couldn’t put any pressure on it. He couldn’t walk, but he was alive.
We set up a station for him at home and I watched him constantly. He had physical therapy three times a week and we had to practice various exercises every hour. It was difficult for him to deal with physical limitation but he refused to take any pain meds. He fought very hard to straighten his leg. Once I saw his level of determination, I hesitantly canceled the order for the wheel chair. I figured a wheel chair wouldn’t progress the healing. I got him a walker instead. He used the walker for about 3 days. By the 5th day, he was fully mobile and antsy. He was ready to go back to school.
I am pleased to report he has made a full recovery and it appears nothing was permanently damaged. Mikah was incredibly lucky, given the circumstances. Had the swelling been more sever they would’ve made an incision to release the pressure (which could lead to infection). I don’t remember the medical details precisely, but the doctors were monitoring his blood work and urine to ensure his kidneys were not impaired (apparently they were concerned that the kidneys, and other organs, could’ve been permanently damaged). Some people have allergic responses to the venom, and/or the antivenin. Mikah had neither. Like I said, he was so lucky!
The next weekend I took Luna to a rattlesnake avoidance training (which, incidentally, was scheduled MONTHS ago). Mikah joined me. At the avoidance training there were several rattlesnakes slithering on the ground, rattling. Even with their heads in weird plastics covers, I was terrified. Mikah appeared fascinated, not in the least bit scared. The trainer placed an electric collar on Luna and brought her to the first rattlesnake. Once Luna noticed the snake, she got zapped. Next, she went to a snake whose rattle was dysfunctional (wrapped in tape I think). She had to rely on her sense of smell to spot the snake. Again, when she saw the snake, she got zapped. By the third snake, she was trying to lead the trainer away from the snake! She took a short break and the trainer walked her through the snake stations again. Each time she detected the snake, she responded with fear and tried to avoid it. It took less than 10 minutes.
Although this training is for dogs, if you bring your child they will get to see what a rattlesnake looks like in the wild, not behind a plexiglass enclosure at a zoo. They blend with the leaves and are difficult to see. I wish we would’ve gone 2 weeks earlier.
In the hospital, one of Mikah’s visitors (someone we love very much) told him that if he was ever bitten again, he was now immune to the venom. I nearly choked on the spot. I had to immediately and unfortunately inform Mikah this was so NOT true. Apparently, this may be true for horses. But not humans. A couple weeks after we got back home (and Mikah was already back to his regular daily life) he asked me if I thought he was going to be bitten again, and if so, if he was going to die. I wanted so badly to tell him this nightmare would never happen again, but how could I make such assertions? In fact, I need him to understand that he must always be on the lookout for snakes while playing outside. I told him he may very well be bitten again, but as long as we got to the hospital quickly, he would survive.
Here’s the link to the news report about Mikah that aired while we were in the hospital:
Thank you for reading this posting. If you live in Calabasas, CA, or anywhere else where there are rattlesnakes, please keep them in mind and stay safe. Tell friends and loved ones to do the same!
