Viagra Used to Treat Rare Meningitis Attack, Student Fights for Her Life
Rare complication ravages 20-year-old's circulation system, amputations expected
Feb. 5, 2009 -- College sophomore Jamie Schanbaum thought she was coming down with the flu when she started feeling nauseous last fall.
Within hours of first falling ill, Schanbaum, who was studying at her off-campus apartment at the University of Texas in Austin, realized she had something far worse than a simple stomach bug.
"She woke up and had blotches all over her body and felt a weight and coldness in her hands and feet," Patsy Schanbaum, Jamie's mother, told ABCNews.com.
Schanbaum says she is still shocked at how her otherwise "perfectly healthy" 20-year-old daughter, who was known for her skill on the volleyball court and her dream of becoming a pharmacist, has ended up where she is today: awaiting surgery on Friday that will amputate most of her fingers and the lower half of her legs.
Upon arriving at her Houston-area hospital on Nov. 17, Jamie was diagnosed with meningococcemia, the leading cause of bacterial meningitis, which, instead of infecting the brain, wreaks havoc on the bloodstream.
But within days of being admitted to the hospital, Jamie's condition worsened as doctors discovered she was also suffering one of the rarest complications of the disease.
The bacteria had spread throughout her body and had begun to prevent the blood flow to Jamie's extremities, causing gangrene and impaired circulation.
"This is a very rare complication," said Jamie's doctor, Dr. Peter Lin, who is treating her at St. Joseph's hospital outside of Houston, where she was transferred in December after doctors in Austin had told her the only treatment they could offer was bi-lateral leg and arm amputations.
"This is one of the most devastating complications of meningitis," he said.
But while Lin estimated that 40 percent of Jamie's skin surface had been eaten away by the bacteria when he first took over her care, he says she has made "remarkable" strides toward recovery ever since, thanks to aggressive treatment measures, including time in an oxygen chamber and doses of Viagra, the medication usually associated with treating erectile dysfunction.
Unusual Treatments Yield Promising Results for Meningitis Patient
The Centers for Disease Control and Prevention estimates that between 1,400 and 2,800 cases of meningococcal disease occur in the United States each year, with the fatality rate averaging somewhere between 10 and 14 percent.
Substantial morbidity -- neurological disabilities, hearing loss and limb loss like Jamie's -- occurs in 11 to 19 percent of cases.
With Jamie's case so severe, doctors wasted no time in starting her treatment. Lin said her skin was covered in scabs and had turned black as a result of the bacteria.
"Jamie was put into an oxygen tank for two hours a day and given high-concentrated oxygen," Lin said. "That increases the oxygen level in her blood, which is needed to accelerate wound healing."
Through the use of the oxygen chamber, known as hyperbaric treatment, Lin said Jamie's dying body tissues were able to regenerate new skin.
Lin also starting giving Jamie doses of Viagra in an effort to stimulate the blood flow to the damaged areas as soon as possible.
"The severity of this complication is almost near fatal in the first place," Lin said. "Now, she'll lose her fingers and her feet but she'll potentially save her thumb, which will allow her to drive a car and type and still have a way to adapt her lifestyle."
Lin said the nerve tissue in her feet and fingers had died before he was able to treat them, so amputation is unavoidable. Her surgery is scheduled for Friday and she will be eligible for prosthetics in the future, Lin said.
As for how Jamie is coping with her upcoming surgery, her mother said she's "accepting of it."
"It still hurts her and she still goes through the 'Why me's?'" she said. "But she's a strong girl and has a lot of loving family and friends supporting her."
Meningococcemia 101
According to Dr. William Schaffner, the chairman of preventive medicine at the Vanderbilt University School of Medicine in Nashville, Tenn., the theme of Jamie's story is all too familiar.
Schaffner says that it's not unusual to see otherwise healthy young adults think they're coming down with a seasonal cold or flu and just hours later find themselves in a far more serious situation.
"This is an infection that can begin and present itself to the individual and really just look and feel like the flu," Schaffner said. "But then it can rage on and become really ferocious in a matter of hours."
Schaffner says that vaccines are strongly recommended for people entering college because the activities they typically pursue raise their chances of contracting the disease.
"These sorts of bugs live in our throats and are transmitted from person to person through human contact or rather close contact," Schaffner said. "There are a number of activities students engage in that are shown to predispose them to this: smoking, going to bars or being places where they're all jammed in together, for example."
Bacteria that cause the different strains of meningitis, said Schaffner, often live in our throats for weeks and sometimes even months without developing into anything serious.
But a bad cold or even throat inflammation from smoking a cigarette can "provide an open door for the bacteria to get into the bloodstream," Schaffner said.
While a meningitis vaccine is available, it is not required for college students. Even so, Schaffner said he "strongly recommends" anyone about to enter college get the vaccine.
"There are no major side effects other than a little sore arm," said Schaffner, who added that many doctors are giving the vaccine to children as young as 11. "It's obviously worth it to get it."
And not making sure her daughter got the vaccine is something Schanbaum says she deeply regrets.
"My other two daughters got the vaccine," Schanbaum said, "but Jamie didn't; she opted out."
Now, Schanbaum said she has essentially moved into her suffering daughter's hospital room and spends every moment with her.
"It's horrible," Schanbaum said in a phone interview from her daughter's hospital room in Houston. "I have to be strong but it breaks my heart.
"Last night, Jamie told me that she's afraid of dying," she said. "It's just so hard to believe how this can happen to your child."