With mono, anguish is in stereo

THE BALTIMORE SUN

THEY CALL mononucleosis "the kissing disease," but I think that has less to do with how you contract it than it does with the fact that once you get it, you can kiss your social life goodbye.

At least that's how my teen-aged daughter reacted to the diagnosis.

A persistent sore throat sent us to the doctor Friday afternoon of Labor Day weekend, and when the mono test came back positive, I pulled the plug on Jessie's holiday plans.

For a child who had just been told she had a viral illness most often characterized by listlessness and extreme fatigue, she had plenty of energy to throw a fit.

Frankly, that's what I feared most after hearing the doctor's report.

God bless Jessie's little spleen, but I knew it was not in nearly as much danger of rupturing as was our relationship.

Try telling a high school senior that she has to quit the soccer team and be in bed by 8 p.m. on weekends and see what happens next.

The diagnosis swept through our family like a plague.

It was Jessie who was supposed to be sick, but it was I who took to my bed -- to avoid the fights. Nothing I said could convince the child she was ill.

Upon hearing that the symptoms were fatigue and achy joints, my husband declared that he now believes he has had the disease since 1989.

I had long ago made it clear that death was the only diagnosis that merited time off from parenting, so I ignored this complaint as I have ignored all his others, including, I must confess, gallstones.

My sister-in-law, who spent two weeks at the beach with us sharing community lip balms and random juice boxes, asked in a concerned tone of voice if I thought she should go for a blood test.

"What's the point?" I said. "You have three young kids. What are you going to do if it is positive? Sleep late?"

That's the only known cure for this virus: rest.

It is an irony of the disease that it most commonly afflicts the age group least likely to submit to its treatment.

Dr. Jim Campbell, assistant professor of pediatrics at the University of Maryland School of Medicine and a specialist in infectious diseases, says mono is caused by a pair of common viruses, and that children as young as 2 years old may contract it.

"But no one looks for mono in that age group," he said.

But a sore throat in a teen-ager or young adult is often a dead giveaway.

"The older you are, the less likely you are to have strep and the more likely you are to have mono," he said.

I remember high school classmates diagnosed with mono who were required to spend weeks, even months, in bed.

But Campbell says doctors today treat the disease according to the severity of the symptoms, telling teen-agers to listen to their bodies and do only what they have the energy to do.

"For some kids, mono is not much more than a sore throat. They feel bad for a few days or a week," said Campbell. "We don't know why."

Just about everybody carries around the viruses that cause mono. Periodically, the body sheds those viral cells, most often through saliva. So, it is possible to be infected by someone who does not have an acute case, Campbell says.

The only danger is damage to the spleen, which is part of the infected lymphatic system. It is enlarged and can more easily bleed as a result of physical exertion or a blow to the midsection.

I could add that acute fury can be symptom of mono.

By the end of the holiday weekend, Jessie was threatening to take hostages. It was increasingly difficult for me to believe that anybody that mad could be that sick.

When she demanded to see the blood work herself, I agreed to a return visit to the doctor.

As it turns out, Jessie was correct.

The full lab report showed that she had had mono sometime in the recent past, but did not have it now. All that was left was antibody fingerprints.

Triumphant, Jessie sashayed out of the doctor's office and out of my loving restraint to resume her life at full speed.

I was left to wonder: When had this child been sick, and how I had failed to notice? What kind of a mother was I, anyway?

Now I was feeling miserable -- listless and fatigued. My joints ached, my head hurt. My spleen felt like it was enlarged.

I decided the only thing that would cure my mood was a nice, long nap.

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