On March 20, Joshua Kerner, 15, of the North Hills, headed out to ride his bike — without a helmet. It was the worst decision of his life. Swerving to avoid an oncoming car, he jumped a curb, clipped the pole of a stop sign, and landed head first on the concrete. A neighbor, who is a nurse, immediately called an ambulance. Josh went into a seizure. He was rushed to Children’s Hospital of Pittsburgh of UPMC and diagnosed with a severe concussion.

Josh returned home after a short hospital stay, but his life is no longer the same. He has headaches, dizziness, stiffness, and difficulty sleeping. Comprehension and concentration also are challenging, and Josh is currently home-schooled. “At first, he tried going to school for a half-day, but the lights and noise were too much for him to handle,” says Josh’s mom, Gwenn.

Josh is expected to recover, but now, the time he spends reading, watching TV, and playing video games is limited. Prior to his crash, Josh played football and baseball. He doesn’t any more, due to the risk of suffering a second concussion.

“Our lives have pretty much changed,” says Ken, his father. “We all have gained a new outlook on life. Considering how bad it could have been, Josh was lucky.” When asked what he’d like to say about his experience, Josh simply said, “I should have worn a helmet.”

Children’s Hospital has one of busiest trauma programs in the entire country and receives patients from throughout the tri-state region. Zachary’s story is a good example of why families should be reassured they’re in good hands.

Zachary Weight, Age 16

In September 2009, Zachary Weight was riding his dirt bike at his home in Belle Vernon, Pa., when the family’s dog ran out in front of him. To avoid a collision, Zach slammed on the brakes, falling directly onto the handlebars as he was thrown from the vehicle.

Having witnessed the crash, Zach’s father, Dan, rushed to his side. Moments later his mother, Christy, called for an ambulance. Zach was taken directly to the Pediatric Trauma Center at Children’s Hospital of Pittsburgh of UPMC, where pediatric radiologists determined he severely lacerated his liver, fractured a rib, and lacerated his spleen.

Due to the severity of his injuries and his strained breathing, doctors feared Zach’s body would be unable to handle major surgery. He was sent instead to the Pediatric Intensive Care Unit for recovery, where he endured abdominal drains to remove the large amount of fluids overwhelming his body. “From the trauma team to the housekeeping staff, everyone was so kind, they truly cared,” says Christy.

For 45 days, Zach underwent continuous testing and treatment including physical and respiratory therapy before he was sent home after a full recovery. Zach has since returned to playing soccer, football, and wrestling for his high school teams.

Zach with his dog Taz

A lightbulb went off for Jeff Goff, pharmacy director at Children’s Hospital of Pittsburgh of UPMC. When pharmacists pull medications from the 2,000 or so dispensers at the hospital, they visually inspect each medication they pick to make sure it’s the right medication, the right preparation, etc. By adding another sense into the equation – in this case, sound – he could improve patient safety and reduce the risk of medication errors.

Twenty-five dollars later, he and systems analyst Fred Roberts had a prototype. Now they have a patent application, and a safer pharmacy.

Ryder McDermitt’s mom, Karrie, sensed something was wrong with her son from the time he was an infant. She became increasingly concerned when, at 16 months of age, Ryder seemed to be getting sick a lot but not recovering.

He seemed to do well when he was taking antibiotics but when he finished a course of medication, he would become sick again.
“It was as though he didn’t have an immune system to fight it off,” Karrie explains.

Two months later, Karrie noticed that Ryder he had begun to bruise easily, and as she became more concerned, she insisted that Ryder undergo blood testing to determine if there was an underlying cause for the bruising and his seemingly weakened immune system.
Worst Fears Confirmed

Karrie’s worst fears were confirmed when she received the devastating diagnosis. Ryder had Acute Myeloid Leukemia, a blood cancer that is more commonly diagnosed in adults and more challenging to treat in children.

It was June 2007, a time of year when Ryder should be playing outdoors. Instead, he was at Children’s Hospital where he underwent five rounds of intensive chemotherapy treatments.

A round of chemotherapy for Ryder involved being hospitalized for four to six weeks. During the first week, he would receive chemotherapy daily, and over the next three to five weeks, Ryder would recover. His length of stay in the hospital following each round of chemotherapy was dependent upon how sick he got from the treatment. After each round of chemotherapy, Ryder would go home for two weeks before starting all over again.
Following all five treatments, Ryder’s leukemia was in remission.

A Set Back
In August 2008, Karrie noticed that Ryder’s eye seemed to be swollen. She immediately called Children’s Hospital to have Ryder seen. His leukemia was back.
“He underwent a hard round of chemotherapy, and then we were able to go home for two weeks,” Karrie remembers. “When we came back to the hospital, he had five days of full-body radiation, and then three days of chemotherapy.”

Many children don’t survive the intensive radiation and chemotherapy because it severely weakens their immune system.

A Risky Procedure
In order to boost his immune system, Ryder had to under a risky cord blood stem cell transplant. The odds of finding a perfect match – which is ideal for a successful transplant – was nearly impossible but Children’s Hospital doctors found a perfect match through the National Cord Blood Stem Cell Bank.

Physicians informed Ryder’s parents of the risks associated with the procedure transplant, and they knew that his chance of survival was slim but he underwent the cord blood stem cell transplant on October 17, 2008.

It would be a long recovery for him, but the transplant provided his family with hope.

The Journey Home
Over the next several weeks, Ryder made rapid progress and while he had to remain in Pittsburgh for a few more months, he was discharged from the hospital in late November.

He continued to make trips back to the hospital three days a week to undergo blood work and check-ups to ensure that he was still cancer free, and he was able to spend his first Thanksgiving outside of the hospital. His extended family traveled over two hours from their home in Duncansville, Pennsylvania, to Pittsburgh to celebrate the holiday with him and his mom.

Looking at Ryder, the family had much for which to be thankful.
At Christmas, and Ryder and his mom were permitted to go home to Duncansville for two days and, although the visit was brief, it was joyous and invigorating for both Karrie and Ryder.

Also during that month, Ryder received an injection of chemotherapy in his spine to further ward off the leukemia that nearly took his life. On March 20, 2009, Ryder and his mom moved back home but continued to make the monthly drive to Children’s Hospital to receive his chemotherapy injections until June 2009.
A Healthy, Happy Child

While his chemotherapy ended in June, its effects did not. That same month, while running and playing, Ryder fell and broke his arm that was left brittle from all of the chemotherapy he received. After surgery and two pins in his arm, Ryder is now good as new.

Now as a healthy, active four-year-old, Ryder continues to be monitored regularly and is thriving among family and friends.

Read more about how Ryder was selected for Children’s Miracle Network’s Champions Across America.

Genre Baker, 9, of Irwin, was diagnosed with leukemia at Children’s Hospital of Pittsburgh of UPMC on Memorial Day of 2009. He quickly realized during his lengthy hospitalizations that video games and other distractions helped pass the time in the hospital. So he started Genre’s Kids with Cancer Fund to raise money for hand-held video game systems like Nintendo DS. Since then, he’s been working with the Child Life Department at the hospital to provide systems to all the cancer patients that pass through our doors. The gaming systems are provided to individual patients (not to the hospital) so patients can actually take the systems with them.

If you’re interested in reading more about Genre and his program, visit Genre’s Kids with Cancer Fund.

At 20 months and 30 pounds, Austin Ball is tall for his age and bursting with energy. It’s hard to believe he’s the same child who, at 5 months, arrived at Children’s Hospital of Pittsburgh of UPMC on life support, his future uncertain.

Before his birth, Austin had been diagnosed with a large tumor in his left ventricle that prevented his heart from working normally. Within hours of his birth at Georgetown University Medical Center in Washington, D.C., Austin was whisked off to the cardiac intensive care unit (CICU) at Children’s National Medical Center in Washington.

“I didn’t even get to hold him,” remembers his mother, Cher. “They were worried that he might immediately go into cardiac arrest.” Two weeks later, when Ms. Ball took Austin home to Waldorf, Md., he was on 12 heart medications. Austin ate and slept well, but his heart often beat much faster than normal.

Surgery to remove Austin’s tumor would be risky. So at 4 months old, Ms. Ball took Austin to Johns Hopkins Medical Center in Baltimore to begin the evaluations necessary to place him on its heart-transplant waiting list.

At Children’s National in September, Austin had a procedure to measure the pressure in his heart, one of the last steps before being added to the transplant waiting list. Austin’s tumor made the procedure especially delicate. Two days later, in the CICU, he had a cardiac arrest.

Doctors worked feverishly to revive Austin. “Finally, our cardiologist said ‘There’s one more thing we can try. I’m not sure it will work. They don’t use it often — it’s called ECMO,’” Ms. Ball says.

ECMO — extracorporeal membrane oxygenation — is an advanced form of life support where a machine adds oxygen to blood and pumps it through the body. ECMO allows time for a patient’s own heart and lungs to heal or for a donor heart to be found. A patient can remain on ECMO for only about two weeks without a risk of serious complications.

Children’s National did not (in the fall of 2008) have an active heart transplant program, so Austin would have to be moved, on ECMO, to another hospital for a transplant. Children’s Hospital of Pittsburgh of UPMC is one of few children’s hospitals in the United States that will transport children on ECMO.

THE TRIP
On a stormy autumn day in Pittsburgh, Kent Kelly, director of Children’s ECMO service, got a call saying that a child on ECMO needed to be transported from Washington, D.C.

“We couldn’t leave for about 18 hours because visibility was bad — we had to wait for clearance for the helicopter to fly,” says Kelly.

The four-member ECMO transport team arrived at Children’s National the next afternoon. Very carefully, Austin was disconnected from the hospital’s ECMO system and connected to the one on which he would be transported to Pittsburgh.

With the ECMO equipment, the transport team, and the flight crew on board the helicopter, there was no room for Austin’s mother. So Ms. Ball kissed her son goodbye and set off to drive to Pittsburgh.

IN PITTSBURGH
When the medical team at Children’s Hospital of Pittsburgh of UPMC met to work out a treatment plan for Austin, a heart transplant wasn’t at the top of the list.

A year earlier, Children’s Heart Center had treated another child with a large tumor in his left ventricle. “We removed the tumor, and the child has done extremely well,” says Steven A. Webber, MBChB, chief of Pediatric Cardiology. The team thought this procedure might work for Austin.

Austin also would be fitted with a special infant-sized heart pump known as a ventricular assist device. This pump is not on the market in the United States, but Austin could have one because Children’s surgeons are taking part in trials testing the device.

Austin remained sedated on ECMO for a week while the pump was shipped from Germany. Then, in a nine-hour operation, Victor Morell, MD, chief of Cardiothoracic Surgery, and his team removed Austin’s tumor and attached him to the pump. Three days later, they performed a second operation to try to shrink Austin’s left ventricle, which the tumor had stretched.

Meanwhile, Austin’s own heart began beating more strongly on its own. The surgeons removed the pump a week later. The next day, they took out the breathing tube — his lungs were working without assistance.

Austin underwent two more open heart surgeries in November and December — one to remove an aneurysm that had formed in his aorta, and another to insert a mechanical heart valve.

As spring approached, Austin no longer needed around-the-clock nursing care. Ms. Ball took him home, where he was reunited with his 7-year-old sister, who had been staying with her grandmother. The
family celebrated Austin’s first birthday on April 29, 2009.

Despite around-the-clock heart medications, Austin’s heart sometimes still beat too fast. He wasn’t eating well. Any exertion made him sweat. In mid-May he was admitted to Children’s National with coughing and vomiting — signs that his heart was failing.

A heart transplant was now Austin’s only option.

BACK TO PITTSBURGH
A five-hour ambulance ride brought Austin and his mother to the new Children’s Hospital in Lawrenceville just three weeks after it opened. Austin was placed at the top of the waiting list for a donor heart.

In a six-hour operation on June 5, 2009, Peter Wearden, MD, PhD, performed Austin’s heart transplant, the first at the new hospital.

When he woke up, Austin started to eat, says his mother. And eat. And eat. By Christmas, Austin had gained eight pounds. “He has so much energy, I feel like I have triplets,” says Ms. Ball. “I’ve traded my
hospital shoes for track shoes.”

Ms. Ball brings Austin back to Children’s every few months for a checkup, and he sees a pediatric cardiologist in Washington, D.C. “He’s on what they call a holiday right now — doing well, no rejection, progressing like a normal kid,” says Ms. Ball. “But I know he might have another bump in the road.”

In the meantime, she’s savoring watching him thrive. “Every day it’s a joy to see how far he’s come.”

Read more in Promises.

We’re excited to introduce this new blog from Children’s Hospital of Pittsburgh of UPMC. Here you can read more about the cutting-edge clinical care and science happening at Children’s Hospital. We’ll introduce you to some of our amazing physicians, nurses and other staff. And you’ll also get to meet some of our patients and families, who have remarkable stories to tell.

We’re counting on you to let us know how we’re doing by commenting on our posts and sending us suggestions on the types of posts you find most interesting and useful.