Heart of a Fighter

Heart of a Fighter

Pictured above from left: Dr. Thomas Horsman, pediatric pulmonologist; Katherine Manzella, cardiologist NP; Dr. Meredith Hitch, pediatric gastroenterologist; Dr. Patrice Tyson, pediatric gastronenterologist; Denean Hilbert, RN and transport team member; Dr. Brad Culotta, pediatric orthopedic surgeon; Joy Sutton; Dr. Lauren Haddad, pediatric cardiologist; Dr. Aadora Uzodi, pediatric infectious disease; Mark Hall, RN and transport team member; Dr. Michael Brummund, pediatric cardiologist; Dr. Les Hixon, pediatric cardiologist; and Dr. C. Swayze Rigby, thoracic surgeon. Not pictured: Dr. Faith Hansbrough, Dr. Michael Bolton, Dr. Firdous Laique, Dr. Scott Williams, Dr. Michael Crapanzano.

An infection nearly took one teen girl’s life. Here's how an extraordinary team saved it.

An active student at Zachary High School in Zachary, La., Joy looks forward to competing on Junior ROTC rifle team, playing piano and just being in class with her fellow sophomores. A busy schedule will be a welcome challenge after what she’s been through this year.

A routine emergency room visit in January 2016 for fever and other mild symptoms would develop into a life- threatening infection that swept through Joy’s body. She would require multiple surgeries, weeks in pediatric intensive care and an emergency, life-saving heart procedure.

Joy is now recovering thanks to an extraordinary collaboration. Teams at both Our Lady of the Lake Children’s Hospital and Our Lady of the Lake Heart & Vascular Institute—which almost exclusively treats adults—worked together to save Joy’s life. Led by pediatric cardiologists Les Hixon, MD, and Michael Brumund, MD, more than 17 physician specialists worked together for months to restore Joy to health.

The culprit that nearly took Joy’s life was sepsis.

It’s a life-threatening infection that can result from a bacteria, virus or fungal infection. Unchecked, sepsis can overwhelm organs and even cause death.

As a regional pediatric intensive care unit that accepts patients from all over the state of Louisiana, sepsis is one of the top three diagnoses that we see at Our Lady of the Lake Children’s Hospital.

Still, Joy’s case was exceedingly rare and complex.

Joy’s ordeal started unremarkably around New Year’s Eve. She spent a busy day with her family going to the movies and then visiting a trampoline jumping center. On the car ride home, she could hardly move. Her foot was in severe pain, her neck was stiff and she was running fever. At their local emergency room, Joy’s blood pressure started dropping rapidly, a sign of a serious condition. The staff there contacted Our Lady of the Lake Children’s Hospital, which dispatched its 24/7 pediatric transport team.

Joy was having difficulty breathing and her organs were starting to fail. She was placed on a ventilator and administered intravenous antibiotics.

Her rapidly worsening condition would frighten any parent, but Joy's parents, Shirl and Glen Sutton, were no strangers to fear. After meeting in college, they enrolled at the U.S. Army Airborne School and served in the 18th Airborne Corps. They are now Junior ROTC teachers at local high schools.

With Joy’s illness, they would embark on a crash-course in sepsis. Shirl learned it can lead to toxic shock syndrome, and that it may start with a wound, but not necessarily.

“With Group A strep (the type Joy had), she may be a carrier but show no evidence of infection,” Shirl says. “They don’t know the source.”

After three weeks in the hospital, including 14 days in the pediatric intensive care unit, Joy was well enough to go home.

The plan was for Shirl to tutor Joy at home to catch up with her studies until she was healthy enough to return to school. But those plans were soon scuttled. Shirl grew alarmed as Joy’s minor cough worsened over the next two days.

“She was reading a book, and she said, ‘Mom, I’m having trouble breathing,’ ” Shirl recalls. The Suttons raced Joy to the ER at Our Lady of the Lake Children's Hospital.

There, doctors diagnosed her with a persistent fever, a kidney infection and suspected she was suffering from pneumonia. Worse, Joy was having increasing difficulty breathing. Cardiac tests revealed a loud heart murmur, and cardiologists suspected that her heart valve was leaking blood with every beat.

Bacteria had migrated from the original infection, lodged in the heart valve and started to destroy tissue around it. Not only was the valve damaged, but the muscle around it that opens and shuts the valve had ruptured.

Joy’s condition? Utter cardiorespiratory collapse.

Once again, she was in a fight for her life. Joy would require emergency heart valve replacement, an uncommon procedure among children and teens, and one not usually performed on patients as young as Joy at the children’s hospital.

While receiving treatment, Joy gives her brother, Jordan, a high-five.

Cardiovascular surgeon C. Swayze Rigby, MD had been out of town but hastily returned to Baton Rouge to operate on Joy. The surgery took about three hours, Shirl recalls. “We felt confident, we had to feel confident.”

In fact, the operation was one of several Joy required during her stay.

Pediatric orthopedist Brad Cullota, MD, operated on her infection- damaged foot. Pediatric surgeon Faith Hansbrough, MD, operated to remove Joy’s gallbladder. Ultimately, more than 17 specialists took part in Joy’s care, including a kidney specialist, infectious disease specialist and a hematology specialist, to name a few.

Joy’s recovery was slow, but the Sutton family rallied around her. Having been intubated for so long, Joy was unable to speak. So her uncle, Laroy Peyton, a colonel in the U.S. Army who drove in from his base in Georgia, fashioned a communication system using a dry erase board and colorful sticky notes.

“There were little phrases like ‘hands, hot, cold, etc,” Shirl says. “Eventually, it got to the point where she could write on it.”

Just as the Sutton family rallied around Joy, so did the unusually large array of physician and nurse specialists in the children’s hospital and the Heart & Vascular Institute.

“Joy went to the new Heart and Vascular tower after the heart surgery and was cared for by a joint team of pediatric intensive care nurses, cardiac intensive care unit nurses, the pediatric intensivists, pediatric cardiologists, the infectious disease specialists and the adult cardiac surgeon,” Dr. Hixon says. “Her recovery was uneventful and she did very well postoperatively given the critical nature of her presentation.”

For now, Joy continues to get healthier. She must avoid contact sports for six months, and she’ll have to be more careful because she bruises more easily from the blood thinning medication she’ll take for life.

She’s also eager to work on getting stronger.

“The other night Joy wanted to do sit ups, she did 25 in a minute,” Shirl recalls. “I said, ‘Tomorrow let’s just leave your goal at 25,’ and she said, ‘Thirty! I can do 30!” ?