RICHLAND — Krystal Tiscareno thought her husband had fared the worst with their family’s August bout of COVID-19 as he shook with chills and endured a fever and headache.
Her youngest daughter, Rozay, a Richland second-grader with dark eyes and a sweet smile, did not even have symptoms — only a positive test.
She is so healthy she rarely gets colds and doesn’t have allergies, Tiscareno said.
But a few weeks later she was airlifted to Sacred Heart Medical Center & Children’s Hospital in Spokane.
She was in heart failure, her lungs were filling up with fluid and her kidneys were not working, Tiscareno said.
Rozay was the third child in the Tri-Cities area to be diagnosed with multisystem inflammatory syndrome in children, a little-understood condition sometimes diagnosed after children are infected with COVID-19.
The other two children were residents of Franklin County, and at least one of them also was younger than 10.
Multisystem inflammatory syndrome in children, or MIS-C, is a rare but condition associated with COVID in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, according to the Centers for Disease Control and Prevention
“As parents we do everything in our power to make sure our babies are healthy, happy and safe,” Tiscareno posted to her Facebook page.
She just didn’t think COVID was something that a healthy young family needed to worry about.
Rozay’s parents had no risk factors for a severe case and had not been vaccinated when Jonathan Saldaña was apparently exposed to the virus as a Columbia Basin Youth Football Coach.
When he got sick, the whole family was tested, including daughters Rozay and Lyric, 8. All had positive results and the family went into quarantine for two weeks.
Everyone had tested negative by the time they planned a day at the Benton Franklin Fair the last week of the month.
They started with the animal barns — Rozay particularly likes horses — and sampled the fair food.
That’s when the Saldaña Tiscareno family’s ordeal started.
2 Tri-Cities ER visits
Rozay complained that she didn’t feel good, and when her mother felt her, she was hot.
Tiscareno thought it was just a matter of being out in the hot sun, and Tiscareno’s mother offered to take her home.
Rozay was “burning up” when Tiscareno picked her up from the girls’ grandmother’s house later that day.
Tiscareno stayed up all night with her daughter, trying to get the fever to drop. But the next day, Sunday, it spiked to 105 degrees, and Tiscareno took her to the Trios Southridge emergency department in Kennewick.
At that point Rozay seemed to have a stomach bug or flu, Tiscareno said. They were sent home with a prescription for anti-nausea medicine and told to take Rozay to see a pediatrician within 48 hours.
The pediatrician prescribed an antibiotic, thinking she might have a bacterial infection.
But the fever persisted and she also developed a rash.
After four nights of Tiscareno staying up to watch over Rozay, one of Tiscareno’s sisters came over to help out so Tiscareno could take a nap.
But the nap was short. The sister woke Tiscareno up when Rozay complained that her throat was closing up and she could not breathe.
Tiscareno took her daughter to the Kadlec Regional Medical Center emergency department, thinking she was having an allergic reaction to the antibiotic.
There she was lethargic and fell asleep in an emergency room bed as they waited for care, only to wake up and scream out in pain, saying that she was hurting.
Then she screamed out that she thought her heart was going to come out of her chest.
When a nurse hooked up a monitor, her heart was racing at 160 beats per minute and her blood pressure had dropped to 60 over 35, her mother remembered.
The doctor said the problem might be extreme hydration and ordered fluids to see if that would bring her blood pressure up. But that didn’t seem to help.
Tiscareno said she knew something was seriously wrong when the room became crowded with three doctors and six nurses.
Doctors said Rozay was going into acute kidney failure.
Flown to Spokane
Kadlec stabilized her and sent her to Sacred Heart by helicopter, with Tiscareno accompanying her and Saldaña staying home long enough to arrange care for Lyric and their dogs.
At the intensive care unit in the Spokane hospital, seven nurses and two or three doctors got to work.
Tiscareno was told Rozay needed a catheter line to the large veins near her heart and she needed it immediately or she would die.
Tiscareno agreed, after a call to Saldaña who arrived that night.
The second day after arriving at the hospital, Rozay “started to swell up really, really bad,” her mother said.
Her skin was so sensitive that she screamed in pain when her face was touched.
Doctors needed an ultasound of her heart and the medical staff cut off her shirt rather than subjecting her to the pain of removing it for the test.
The next day doctors told Rozay’s parents that she was in heart failure and her lungs were filling up with fluid. Her heart was working at about 40% of normal, her mother said.
Doctors gave her platelets intravenously and heart medication.
They also put her on a high-flow oxygen mask and warned that if that didn’t work she would have to be intubated.
“Thank god that high flow helped and she was getting the oxygen she needed so we didn’t have to go that route,” Tiscareno said.
Rozay would spend two weeks in the ICU and then another week in the pediatrics unit.
At first she was so weak she could not stand and then had to almost learn how to use her legs again, Tiscareno said.
Rozay’s aunts and uncles in the Tri-Cities wanted to see her and help support her parents, but only Tiscareno and Saldaña were allowed in the hospital due to COVID-19 restrictions.
It was particularly hard for Rozay and Lyric not to be able to see each other, Tiscareno said.
Home in the Tri-Cities
Rozay’s back in the Tri-Cities now and has been able to stop taking steroids and blood thinners.
“Thankfully, her heart is back to where it needs to be,” Tiscareno said.
She’ll need to continue to see a cardiologist annually and is restricted from playing competitive sports until January.
As soon as Tiscareno and Saldaña got home from Spokane, both were vaccinated against COVID-19.
They had thought COVID-19 was “kind of like the flu. You are sick for a couple of days and you are fine,” Tiscareno said.
“(Rozay) had a massive infection that caused her entire organs to become inflamed, which then caused her to go into acute renal failure, which caused so much damage to her heart because it was trying to overcompensate for her failing kidneys,” she posted on her Facebook page. “A flu doesn’t do this.”
Each family needs to make the decision about vaccination that is best for them, Tiscareno said.
“All I ask is to stay safe, keep your distance and protect your babies from this scary virus,” she posted on Facebook.
77 MIS-C cases
To date 77 children in Washington have been diagnosed with MIS-C since the syndrome was first identified internationally early in the COVID-19 pandemic.
Patients are younger than 21 and have a fever and laboratory evidence of severe illness involving more than two organs that require hospitalization.
Affected organs can include the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, according to the CDC.
To be diagnosed with MIS-C children must have tested positive for COVID-19 or been exposed to a confirmed case in the four weeks before the symptoms began and also have no other plausible diagnosis for symptoms.
Symptoms include an ongoing fever and one or more of the following: stomach pain, bloodshot eyes, diarrhea, dizziness or lightheadedness caused by low blood pressure, skin rash or vomiting.
“While MIS-C is very rare, parents should be aware it can happen and contact their health care provider if their children develop new or unusual symptoms,” said Dr. Kathy Lofy, health officer for the state Department of Health, not long after the initial cases in the state were identified.