Singapore

Mother loses hair, fingernails in HFMD horror

Hand, foot and mouth disease (HFMD) numbers are at their highest in four years. One mother, Ms Glynisia Yeo, caught it from her son and spent 10 days in hospital. Her bout with HFMD saw her losing her fingernails, toenails and hair. She shared her harrowing experience with Young Parents, an SPH publication.

DAY 1 (MARCH 2):

I saw a red spot on my palm. I ignored it. My attention was on my two-year-old, Conran, who was recovering from HFMD and was cranky.

A few days ago, he had a few red spots on his feet and palms. He also had mouth ulcers. He lost his appetite for two to three days.

DAY 2:

More spots appeared.

A visit to the general practitioner confirmed that I had HFMD. By evening, blisters had spread to my fingers and wrist.

I was itching like crazy and only managed to sleep after applying calamine lotion.

DAY 3:

I woke up and discovered that my hands were covered with bulbous, freaky looking sores. I couldn't open and clench my fist without wincing in pain. There were red spots on my feet too.

Every spot was itchy and I couldn't stop scratching.

I cried as I changed Conran's diaper that afternoon. The diaper's coarse texture grazed my blistered hands - it was sheer torture.

When my husband, Adrian, arrived home from work, I showed him my hands and grumbled that I had been struggling the whole day, even in the toilet.

Perhaps I should go to the hospital, I said.

We arrived at Mount Elizabeth Novena Hospital at 8pm. I was sent to the isolation ward and put on a drip.

Dr Leong Hoe Nam, an infectious disease specialist, told me it is very rare for adults to get HFMD.

He warned that throat ulcers would appear the next day and to be prepared as I wouldn't be able to walk for a few days if I developed sores on my feet.

DAY 4:

My hands were so swollen; my skin was stretched taut.

I had fluids pumped into me regularly to prevent dehydration, and I needed to relieve myself every hour.

But my achy feet made it painful for me to walk to the bathroom (the doctor didn't want me to use a catheter).

I had no choice but to call the nurse for support every time nature beckoned.

For the first time in my life, I also needed a nurse to help bathe me as I couldn't hold the shower head or flip open the shampoo bottle cap, much less scrub my hair. I bathed with assistance for the next six days.

DAY 5:

Ulcers had developed at the back of my throat, making swallowing difficult.

Even eating cooled porridge was like stuffing a spiky ball down my throat. It hurt like crazy.

And, no, ice cream did not help at all because something in it made my ulcers sting.

Iced water was painful, cold jelly was bad... I stopped eating and drinking altogether.

Thank goodness for the drip.

DAY 6:

I still couldn't eat or drink - the pain from swallowing was just unbearable.

I distracted myself by watching TV. I couldn't carry Conran and I showed him my hands, explaining that Mummy was in pain.

He seemed to understand.

DAY 7:

My feet didn't develop blisters as initially thought; just painful red sores.

But my mouth, cheek and chin area broke out in a red rash.

I discovered a wonderful drink that I could down without wincing - iced chamomile tea.

I drank this like water. I couldn't hold the cup handle properly because of finger blisters.

My tongue developed ulcers today.

DAY 8:

Some blisters on my hands had ruptured, so the skin was peeling and very cracked.

As my skin had thickened during the outbreak, when it peeled, it was stiff and sharp at the edges.

A dermatologist gave me some solution to soak my hands in, plus creams to apply.

They didn't soothe the hands immediately.

My appetite was slowly coming back even though the ulcers persisted.

The medicated gargle caused such a stinging pain.

By now, I could walk without assistance.

DAY 9:

The skin on my hands peeled even more, with cracked skin hanging off my fingertips.

Some large blisters on my right hand remained intact.

I was ravenous at this point, having missed eating the past week.

I ate everything on the food tray.

The nurse finally took out my drip - hooray!

DAY 10:

I still couldn't do simple tasks with my hands, like opening a box or brushing my hair.

DAY 11:

The sores on my hands were drying up and I attempted to bathe by myself with gloves.

It went well although I took much longer than usual.

The mouth ulcers were disappearing and my food cravings returned. I asked my husband to buy me a curry puff. Another friend indulged my craving for iced milk tea.

DAY 12:

My toes were a little swollen from the stretched skin, but walking was no longer painful. The red spots on my hands were lightening.

Good sign. I made sure I was able to function without assistance before being discharged.

DAY 13:

I said goodbye to the nurses at ward 1132 and I was given a three-week medical certificate by the doctor.

I had to be quarantined at home as the blisters on my hands were still contagious and not fully healed.

BACK AT HOME:

I thought the worst was over - it wasn't. The skin on the soles of my feet started peeling.

Standing and walking became a challenge again. My soles felt extremely sensitive because of the raw and exposed skin. I was frustrated that I couldn't do anything to accelerate the healing process.

Then, HFMD unleashed its ugliest symptoms: I was losing my nails and hair!

I observed that the nails on my right thumb and index finger were turning whiter and separating from the nail bed. I waited two more days before contacting Dr Leong when I realised it was not getting any better.

"Doctor! My nails seem to be falling off! Is that normal?"

"Yes. That happens sometimes," was all he said.

The worst was yet to happen

I figure he omitted mentioning this somewhat disturbing phenomenon to not cause premature panic attacks.

Over time, my toenails and fingernails dislodged. I freaked out.

The discomfort was more pronounced on the fingers, probably because they are more visible.

Without my fingernails, I found any prying action, such as opening a canned drink, was no longer an easy task. Even peeling stickers from my son's sticker book took time.

The most painful part of the nail-dropping wasn't the exposed nail bed; it was when the nail was peeling off, but still attached to the skin.

Things such as hair and tissue paper got trapped in between and caused pain. I wrapped surgical tape around all my fingernails and it made my life so much better.

Then, there was my hair, which fell out in clumps. When I realised nothing could be done to prevent it, my heart dropped. I cried for a few days because my hair is thin by nature.

I braced myself for the worst and my kind doctor reminded me it would all pass.

As I write this in late May, my nails are growing back. I am definitely looking forward to a well-deserved manicure and pedicure - hopefully by September.

I'm discovering, albeit slowly, that time does heal all wounds.

Over time, my toenails and fingernails dislodged. I freaked out.
The discomfort was more pronounced on the fingers, probably because they are more visible.
Without my fingernails, I found any prying action, such as opening a canned drink, was no longer an easy task. Even peeling stickers from my son's sticker book took time.

- Ms Glynisia Yeo


This story, which has been edited for length, first appeared in the July 2016 edition of Young Parents. Published by SPH Magazines, it is available in both digital and print formats. Go to www. youngparents.com.sg/subscription to subscribe and for more parenting stories

 

Expert: Adult HFMD cases rare

An infectious disease expert, Dr Leong Hoe Nam from Mount Elizabeth Novena Hospital, answers our questions about HFMD and Ms Glynisia Yeo's case:

How unusual is Ms Yeo's reaction to HFMD?

It is unusual. Most adults would have had previous exposures and hence protection.

It is important to understand that repeated exposure (to the infection translates to) higher infectivity and thus harsher effects of the disease.

When you acquire HFMD from the public, it would have been a one-off exposure, giving you one dose of the virus. However when you acquire HFMD from a family member, it would be repeated exposure, and multiple doses, resulting in (harsher effects of the) disease.

Ms Yeo acquired the infection from her child, who she looked after, thus (receiving) multiple doses.

Why did she lose her hair, fingernails and toenails?

"She lost her nails because the HFMD affects the nail beds, and destroys the nails.

Eventually, the nails fall off once the (nail beds) die, however, they will (eventually) recover.

Her hair loss is due to stress, causing the hair to be accelerated into the next stage of the hair growth cycle. The hair falls out thereafter. It is the same rationale as hair loss after pregnancy.  

How rare is it for an adult to contract HFMD?

I estimate the rate of adult contraction to be about one per cent.

- Catherine Robert

HOW TO PREVENT HFMD

  • Maintain good hygiene.
  • Put on a face mask when feeling unwell.
  • Discourage sharing of drinks, eating utensils, toothbrushes or towels.
  • Parents should keep their sick children at home and away from other children until they are fully recovered.
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