SIOUX FALLS (AP) — Earlier this month, Kelsey Mullenix had three questions for her family.
What, wondered the 19-year-old, was she doing in a hospital?
How much time had elapsed since her last clear memory when she visited an acute-care clinic?
And why on Earth was she relearning how to swallow applesauce?
"My first memory of being awake was a throat doctor (who) came in and was teaching me how to swallow water and eat soft foods," Kelsey says.
"I was like, why am I doing this? I didn't know I'd been asleep for nine days. I didn't know I had a breathing tube."
Kelsey is one of 258 South Dakotans who were diagnosed with H1N1 in the week that ended Sept. 26.
At that point, 471 state residents had been diagnosed with the disease. Since then, that total has risen to 2,141 diagnoses of H1N1, with two deaths.
Kelsey almost became a member of the latter group.
She went into the hospital Sept. 27 after she hadn't been feeling well for about 48 hours.
The next morning, her parents, Lori Schroeder of Brandon and Wayne Mullenix of Sioux Falls, heard a report that terrified them.
"Monday morning, the doctors said that there may be a chance that she could not pull through this," Schroeder says. "That's when they put her on life support and put her in a coma to let the machines do the work for her and give her body a rest."
It was touch-and-go the first two or three days, Schroeder says. She feared that her daughter, the middle of three siblings, would be lost to her.
Kelsey's illness was all the more shocking in its suddenness and because of H1N1's tendency to strike young, healthy adults.
It began, Kelsey says, with a fever, a "kind of sore throat," and feeling rundown.
"Kind of yucky, just like you'd expect from the flu," she says.
The 2009 Brandon Valley High School graduate had been attending classes at the University of South Dakota for only three weeks when she became ill.
Now, Kelsey won't be back on campus until second semester when she again will begin pursuit of a degree in dental hygiene.
She had gone home for the weekend, intending to do laundry. She made a trip back to Vermillion to tell her boss that she couldn't work, then returned to Sioux Falls when her parents knew that this was more than an ordinary flu.
In fact, Kelsey's body was facing an onslaught. In addition to H1N1, she also was diagnosed with influenza type A and type B; MRSA, a particularly nasty staph infection; and bacterial pneumonia.
Dr. Jen McKay, a hospitalist at Avera McKennan Hospital, is familiar with Kelsey's case, though she never treated her. Reports from her colleagues indicate that H1N1 is prevalent in South Dakota, she says.
"This is just blossoming like a wild weed in the community," she says. "I think the jury is still out on how people are going to react to it."
While Kelsey's case is extreme, McKay says, it sends out an important message to others.
"Pay attention to your body," McKay says. "Stay in contact with your physician, and if you feel something is not right, it is OK to make a phone call and say, 'Hey, I don't feel right about this.'"
McKay promotes "hand hygiene" – washing your hands with soap and warm water – as a good deterrent to H1N1.
She also says it is similar to the epidemic of 1918, when people often contracted bacterial pneumonia in addition to the flu, and to a virus prevalent in the 1950s.
"That's why we're saying that patients over the age of 65 are going to be the last to be immunized," she says. "These very young people who haven't had a chance to sort of develop their immune systems are having the most severe reactions to it."
As someone who fell into that category, Kelsey is looking at her world in a new light.
"It was awesome to be able to go home and see my family and my puppies and sleep in my own bed," she says.
Kelsey also will begin a new habit every fall: getting a flu shot.
"I got one before I left the hospital," she says.