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Student overcomes meningitis
After almost dying from bacterial meningitis, an SCSU senior is on her way to graduating
 Media Credit: Ryan Henry SCSU senior Jessica Appelholm was hospitalized two years ago with meningococcal meningitis, a swelling of the brain that leads to death if untreated. After six months of rehab, she returned to SCSU last fall and now has three classes remaining until she graduates.
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Jessica Appelholm is all too familiar with the intimate details of meningitis.
But that was not always the case; two years ago, the SCSU senior knew little about the disease and was not worried about contracting it.
That all changed when she woke up Oct. 29, 2001.
Appelholm had spent the weekend in her apartment - in bed. She thought she was getting the flu - just another bug going around that she'd have to fight off while in class that week. But something was different that Monday morning.
"I knew something was wrong, because every time I got up I just kept feeling like I was going to puke," she recalled. "Every time I got up I was so weak and dizzy."
Appelholm did not just feel terrible - she looked it. Her skin was covered with purple spots. Unsure of what was wrong, Appelholm had her roommate drive her to SCSU Health Services.
Health Services tested her for strep throat; this is routine, said Dr. John Hann, the medical director of Health Services.
"Strep is not that common; probably one out of 100 people have it, but it's an easily done test," Hann said. The strep test helps Health Services narrow down what a patient may have, especially since a common cold, strep throat and meningitis all begin with similar symptoms.
If the strep test comes back negative but the patient has a high white blood cell count, Health Services knows the patient has something more serious than the usual upper respiratory infection, Hann said. This was true in Appelholm's case.
"By the time they seek health care, they're obviously ill, because we're talking a disease that progresses very rapidly," he said. "Basically, what you need to do is recognize this is a person who has an illness that is not your usual respiratory infection and send them to the hospital right away."
Health Services suggested that Appelholm go to St. Cloud Hospital, so her roommate came back to Health Services and drove her there.
At the hospital
She was so sick she could hardly move. Doctors at St. Cloud Hospital immediately performed a spinal tap on Appelholm. Her spinal fluid would tell them if she had meningitis.
"You don't even know how bad a spinal tap can hurt," she said, "when they stick a needle in your spine to try and drain the fluid out."
As if the spinal tap - which doctors had to do several times - wasn't bad enough, while they were drawing fluid from Appelholm's spine, she started throwing up and couldn't stop.
Then things started to get fuzzy. Appelholm remembers being hooked up to "some machine" and waiting for the test results to come back.
"At that point, I was just laying there and my roommate sat by me and kept talking to me," Appelholm said. "Then she saw my eyes roll back and I was gone."
Jessica Appelholm had slipped away into the blackness of a coma.
Her parents made the three-hour drive from their home in Coleraine, Minn. to St. Cloud Hospital that day to sit by their daughter.
"That was the worst day of my life," Appelholm's mom, Peggy Appelholm, said.
Test results came back the following day: she had meningococcal meningitis, an inflammation of the lining around the brain. While she was comatose, doctors gave her medicine to fight the disease.
She was lucky, they said. If she had not gone to the hospital early that morning, by noon she would have been dead.
Recovery, however, was up to the perseverance of her body.
"(Meningitis) makes its way up to your brain and from there on you get so sick your brain starts to swell," Appelholm said. "It's up to your brain whether you pull through."
They could do nothing but wait.
The coma snatched Appelholm from the conscious world for nine days. It would not release her until she had endured failing kidneys, temporary diabetes and seizures.
She doesn't remember waking up. She does remember her sister and grandparents being there, but she did not recognize her parents.
"She was very confused, didn't know anything or anyone, really," Peggy Appelholm said. "She had no idea what was happening, what had happened. She would just stare a lot, like so confused on where she was."
Rehabilitation
She stayed in the St. Cloud Hospital intensive care unit for 21 days, including the time she was in a coma and completed three days of rehabilitation in the hospital before being released the day before Thanksgiving.
"I would not be here if it wasn't for all of the wonderful doctors and nurses at St. Cloud Hospital that cured me," Appelholm said.
Being "cured" did not mean things returned to normal, however.
Appelholm did not realize she was home for several days - she went to Thanksgiving with her family, but does not remember it.
It took six months of therapy at the hospital in Grand Rapids, Minn. to bring Appelholm's life back to some semblance of normalcy.
At first, she couldn't cook. She couldn't get herself ready for the day. She couldn't even tie her shoes. She needed her parents' help through every part of each day.
In therapy, she would throw and catch a ball help strengthen her muscles. But speech was the main focus; therapists would ask her to tell them the date and year every day. They would ask her what the opposite of something was, to help her concentrate and stimulate her brain.
"I felt like I didn't need to be there," Appelholm admitted. "You're thinking, 'Why are they sending me here? I'm fine.' But when they ask you to do things like a game on the computer, when you have to turn around and ask that therapist - or your mom - 'How do you do this?' you realize you do need help."
Going back to SCSU
Living at home and working at her job in a Grand Rapids gift shop also helped Appelholm down her road to recovery. The next fall, she believed she was ready to return to school.
That meant she had to take a five-hour neuropsychological test at St. Cloud Hospital. The results stated she was at a seventh-grade reading level. She was determined to go back to school, however, so her doctor suggested she take two classes, one easy and one harder. Give it a try, he said, and see how it goes.
"I don't know if I was ready but to me, I was," Appelholm said. "To me, I'm like, 'I'm not quitting; I'm so close.'
"It was hard ... I had to go through disability services now, because I need help. I need note-takers."
Still, the neurological bruises that the meningitis left on her brain did not deter Appelholm. She did well with two classes and decided it was a good strategy. Things kept getting better.
Today, 23-year-old Appelholm has three classes remaining before she graduates with a degree in public relations. Continuing her two-classes-per-semester formula, she expects to graduate next fall.
"You look back and it's like, 'Why me? Why did this happen to me?'" she said. "But you also look back; you can't help that it happened and you have to thank God that you are here and there's a purpose that you are here. You are back in school and you have a goal that you're going to reach."
Peggy Appelholm is proud of her daughter's return to school.
"I love it," she said. "It's wonderful."
Common bacteria
Of the several different types of meningitis, meningococcal meningitis, caused by a specific strain of bacteria, is quite rare - and more serious than other types. If left untreated, those infected will die with almost 100 percent certainty, Hann said; between two and four people out of 100,000 will become ill with this form of meningitis.
The bacteria that causes meningococcal meningitis, however, is not uncommon.
"If we were to go on campus and do nasal pharyngeal swabs on students, we'd find 10 percent will culture positive for it," Hann said. "The carrier state of the infection is very, very common; the actual illness is very, very uncommon."
He explained that most people at SCSU are exposed to the bacteria every day. The reason that more people do not get sick from the bacteria, he said, is that "we have an immune system that works well."
"What can you do to avoid exposure to that strain, to that exposure of bacteria? Probably nothing, unless you want to live in a bubble," Hann said.
Appelholm wants students to be aware of the dangers of meningitis. Students need to heed the warnings issued by campus clinics, she said, know symptoms and get vaccinated.
"You don't understand how my life is now," she said. "This is something that you don't have to go through if you get the vaccination. It can be prevented up to three years once you get the shot. The biggest risk is college students living in dorms, because that's where germs are."
The vaccine lasts for three years, Hann said, and prevents about 80 percent of meningococcal infections. He suggested that only people who are asplenetic - people who do not have a functioning spleen - need the vaccine. The best thing people can do, Hann said, is wash their hands before eating or touching their faces.
Appelholm said meningitis and her brush with death have brought her a broader outlook on life.
"You're so happy to be here," she said. "Day by day, you wake up and realize, thank heaven you're still alive and doing better every day."
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