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by Dawn Slade
Last October, 15-month-old Sarah Strohmayer slept in her parents room because she had been vomiting. In the middle of the night, she threw up again and her dad got up to clean up the mess. When he turned on the light, John and his wife Mary found their daughter covered in blood. Her face and one hand were swollen like a balloon.
Little Sarah never cried out that she was in pain. Instead, she silently chewed on her tongue and her lower lip. She chewed so much that her mother said Sarah’s tongue was like hamburger.
They rushed their daughter to Fairview Northland Medical Center in Princeton where the Strohmayers and doctors first thought she had the stomach flu. But, when a doctor felt Sarah’s abdomen, he found an abnormal lump.
Still not fearing anything bad, Mary said, “I think what really sent her to the U [of M] was what she had done to her tongue.
“Doctors had never seen that before. She never cried out.”
The toddler was immediately taken to the Children’s Hospital at the University of Minnesota where doctors discovered Sarah’s large intestine had swallowed up her small intestine.
“It was like a big sausage,” Mary said of how she described the colon turning inside out.
X-rays showed Sarah had intussusception, which is the telescoping (prolapse) of a portion of the intestine within another immediately adjacent portion of intestine. It decreases the supply of blood to the affected part of the intestine, and frequently leads to intestinal obstruction.
If not treated expediently, it can result in death within days.
Happily, today Sarah is a two-year-old little girl who likes to play with her brother and sisters, feed apples to their old mare and chase chickens in the yard.
But the road to recovery was long and risk for dehydration is great. In fact, just last week Sarah caught some type of bug and became quickly dehydrated from fever and vomiting. Luckily, she was able to stay out of the hospital and is doing better.
Sarah’s intussusception
Most cases of intussusception occur in children between five months and one year of age. Boys are affected three times more often than girls. The cause of intussusception is not known, but Mary said one theory is simply growth. Because so much growth is happening in such a short period of time.
Two barium enemas were administered, but the forced liquids in the little girl caused her body to swell and she had trouble breathing, causing her to have respiratory distress. Sarah ended up in the ICU.
She kept getting fevers, but doctors didn’t see any leaks in her intestines.
Sarah was intubated and sedated as they waited for her bowels to start functioning again.
In the process she developed pancreatitis, which causes a lot of pain.
Mary said the surgeon at the time seemed positive that things were going well. However, as they began to take her off the narcotics, Sarah was screaming out in pain.
At the same time, a resident saw something in Sarah’s blood work that warranted a CT scan.
“At that point I felt there was something going on,” Mary said.
A week after first entering the hospital, Sarah was having emergency surgery at midnight, performed by a different surgeon than they originally had.
That surgeon found pockets in Sarah’s abdomen that were filled with infection.
Because of two massive lacerations in the large intestine and a small hole in the small intestine, Sarah was filled with excrement.
“She’s lucky she survived,” Mary said of her daughter.
After the surgeon removed two-thirds of Sarah’s colon.
The ascending and transcending colon were removed and in order to help the descending colon recover, the toddler had a colectomy.
A few days later, Sarah was still battling a fever and signs of infection. A dressing change at her stitches indicated the infection was there, so they opened her abdominal incision, with the exception of her belly button. It remained opened until it healed (from the inside out).
The weekend after Thanksgiving, Sarah finally left ICU and was in a room where she could receive visitors (one of which included the actor Will Smith).
Mary’s mother, Mary Bohn, a former emergency room nurse in Princeton, came from Florida for two months to help.
Back home
Amid the sounds of Christmas carols, the family was finally able to go home.
Mary, who was a para-educator at Princeton schools, sterilized their house.
“I became a clean freak,” she admitted. Making visitors wear masks. “But I kept her healthy.”
Not only did the family scrub and wash, they learned a lot more about the medical world than they ever anticipated.
Sarah had a TPN (Total Parenteral Nutrition) line and a nasogastric tube. Both of which she pulled out.
For a couple of months, Sarah was fitted with a colostomy bag to collect waste.
Changing the bag hurt Sarah. Mary described the difficulty in getting a new one put on, which was often a half hour process. And at times, it wouldn’t stay on.
“How do you explain that to a child?” Mary asked.
In February she was readmitted for a process Mary referred to as “take down.” Doctors connected the healed descending colon to the small intestine.
“It went like a dream,” Mary said. And a week later, Sarah was back home.
On the mend
Before the age of two, Sarah had undergone surgery, serious infection, physical therapy, occupational therapy, and speech therapy.
Today, Sarah is on the growth chart once again and is no longer considered underweight.
She still deals with some eating issues and she’ll need to learn what foods are sensitive for her.
“One thing she’s developed...she’s become a chipmunk, storing food in her cheeks, afraid to swallow,” Mary noted.
But when tragedy strikes, the small town community is there. And Mary couldn’t say enough about all the support they received.
The Strohmayer’s are relatively new to the Milaca area, both John and Mary having been raised in Princeton.
“Cards and prayers came from all the churches,” Mary said. “I didn’t even know these people. It was amazing.”
Neighbors came over and did farm chores, taking care of the horses, chickens and pets.
“I didn’t even know them,” Mary said of the neighbors.
While the family was concentrating on Sarah, life continues on.
John, who is in the Army National Guard, had to return to his regular job the first week after Sarah entered the hospital. He had a high-stress, high-demand job at the time, Mary said.
“It was hard for him,” she said. “It was hard on our marriage. He wanted to be there.”
The Strohmayer’s 14-year-old daughter Jessica, who has Down Syndrome, needed close attention so she stayed at Mary’s sister’s home.
And 11-year-old Dan, who also stayed with his aunt, told his parents, “I really wish Sarah would come home. I miss her crying.”
“He took it real hard,” Mary said of their sixth grader.
Their daughter Mary, who is three, basically potty-trained herself during their time at the hospital and the Ronald McDonald House.
Needless to say, the Strohmayer’s weren’t out Christmas shopping as they prepared to bring Sarah home, so surprise gifts from the Ronald McDonald House were greatly appreciated.
Sarah doesn’t remember much of her months of medical mayhem, but there are things that still bother her, like Band-Aids and people with ID badges.
But, the next time she hears a mandolin, she may recall how a visit from the mandolin-playing volunteer at the hospital could get her to calm down after a hard day. She would fall asleep to the sound, but quickly wake up when he stopped playing. Ironically, her last night in the hospital, he was able to get her to sleep.
“Things happen in your life for a reason,” Mary said. “We learned so much. It’s not something we want to repeat, but you can be thankful for the opportunity to gain strength and what you can from the experiences.”
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