Friday, July 27, 2012
Young Salem swimmer winning battle with infection
Twelve-year-old Garren Snow of Salem has fought a serious MRSA infection since last July.
Photos by Rebecca Barnett | The Roanoke Times
Garren Snow, 12, of Salem waits for his heat to start during a swim meet at Hidden Valley Country Club on July 16. Last July, days after the annual city/county championship meet, Garren showed symptoms of a MRSA infection. Garren is finally able to get back in the water after a long battle with the infection.
Garren Snow, 12, of Salem starts his heat by pushing off of the wall, unlike the other swimmers who dive, at a swim meet this month at Hidden Valley Country Club.
Garren Snow does the breast stroke during a swim meet. He is finally able to get back in the water after a long battle with a MRSA infection, and still is recovering from the illness. He is a student at Andrew Lewis Middle School in Salem.
He should have been having a good time.
Instead of celebrating the Stonegate swim team's first championship in 40 years at the annual team sleepover last July, Garren Snow was limping and listless. At the height of festivities, his mother, Kristi Snow, found her 11-year-old son curled up asleep in his tent and took him home.
That limp would prove to be the first clear sign of what has become a more than yearlong ordeal: a methicillin-resistant Staphylococcus aureus, or MRSA, infection in his left shin that was at one point hours from being potentially fatal, resulted in multiple surgeries and the threat of more, starting middle school in a wheelchair, finishing the year in a leg brace.
Today, Garren, now 12, still depends on that brace, but he'll be back at the Duane Whitenack City/County Championships at the Salem YMCA, helping his team try to win again.
That he is swimming again is a testament to his will and the support of friends and community, his parents say.
His recovery, while agonizingly slow, has shown the Snows that prayers are answered, though not always when you'd like, they say.
And while you're waiting and navigating the medical system, it's up to you to take up your child's cause yourself.
'A million miles from home'
Doctors examined Garren's knee and tested for infection but found none. The best guess was it was a sprain.
So the family left for their annual Myrtle Beach vacation, figuring it would be better in a couple of days. It wasn't.
Garren was ordinarily a quiet but active and witty kid, and a healthy one. He hadn't missed a day of school in four years. But at the beach, he remained lethargic and rarely left their hotel room.
By a fluke, Mike and Kristi Snow met a pediatric nurse from Northern Virginia in the hotel. She examined Garren and quickly urged them to get the boy to an emergency room.
"We thought we were getting some antibiotics and going back to the hotel," Kristi Snow said. Instead, Garren was admitted and scheduled for surgery.
Doctors there identified the MRSA infection in his shin area and wanted to operate to remove it. According to the Snows, if they had gone to the hospital a day earlier, diagnosis would have been difficult. A day later and it could have bloomed, infected his entire blood system and turned fatal.
They never learned the last name of the nurse at the hotel. They know her only as Linda.
What Linda apparently recognized was a less common and potentially more serious form of MRSA infection. Most such community-acquired infections are on the skin, said Ronald Turner, a professor of pediatrics at the University of Virginia Medical Center. While an internal infection such as Garren's isn't unusual, it is more rare, and more likely to turn serious.
Community-based MRSA infections in general, though, are less common than they were five or six years ago, Turner said.
A day later, the family's hotel reservation expired, and Kristi's parents moved with Garren's three younger siblings to another hotel.
Kristi and Mike Snow stayed at the hospital.
"It's like we weren't even at the beach," Kristi Snow said. "I felt a million miles from home."
'Fight like a warrior'
As the Snows waited for Garren to recover, Kristi was texting with a friend back in Salem.
Cathy Shenal's son, Jonathan, 7, had come down with similar symptoms as Garren. Both women were sitting in hospitals with their sick boys.
Though Jonathan would recover much sooner, the mothers formed a bond over their shared worries.
It was Shenal who gave Kristi Snow a notebook to document Garren's treatment. "You've got to go in and fight like a warrior" for your child, said Shenal, an intensive care nursing assistant at LewisGale Medical Center.
Other acts of friendship helped the Snows through, too.
Their twin son and daughter turned 9 with little celebration while Garren recovered. But the family returned to their Salem home to find not only "Welcome Home" decorations for Garren, but also birthday balloons, cupcakes and gifts for the twins.
Meals arrived daily for weeks. People turned up in the Snows' yard from out of nowhere, mowing and raking.
Friends voluntarily picked up the other Snow children for outside activities.
Garren's recovery, meanwhile, was troubled and painful.
His first week home, his wound had to be unpacked and repacked twice a day.
It's "the hardest thing I probably have had to do in my life," said Mike Snow, a financial adviser. "It's prayer, it's looking within, it's visualizing the process."
Garren has always craved information, the kid on the football team who memorized the playbook. So his father described each step in the process for him. Still, Garren screamed throughout it.
As the summer wore on, Garren's recovery wore on him. Will I be better by my birthday, he asked? Or before school starts? Both days came and went.
Garren, who confessed to already being nervous about the typical adjustments of life in middle school, including finding friends and fitting in, began school in a wheelchair with a wound vacuum attached to his leg.
Shenal and others drove him to school daily. Garren's friends rallied around him, volunteering to carry his backpack, push his wheelchair, ride the elevator with him, and sit with him at lunch.
'Sometimes prayers are answered'
A few weeks into the school year, Garren felt ill again.
The MRSA had not only returned, but it also was in his shinbone, or tibia. Osteomyelitis — a bone infection — they knew, raised the specter of amputation.
"I literally fell to my knees and sobbed," Kristi Snow said.
A surgery to cut out the infected part of the bone was scheduled for about a week later.
The day before the surgery, the Snows' fellow members at First United Methodist Church all agreed to pause at 7 p.m. no matter what they were doing and pray for Garren.
At that moment, many noticed a rainbow over Salem and it seemed to end at the Stonegate area, where the Snows live. From then on, rainbows became a symbol of hope for the Snows.
Garren spent months in a full leg cast before graduating to the brace and crutches. He had not been in a pool since the championship meet. And he'd had to abandon karate, though he was just shy of earning a black belt. Soccer would have to wait, too.
His parents tried to get him back into anything that felt normal. Attending Sunday school three weeks in a row was a victory.
As medical appointments piled up, Kristi Snow's notebook of Garren's records graduated to a red, three-ring binder. Kristi Snow had come up with a name for the mother she had to become to advocate for her son: "Mama Snow Bear."
Garren, meanwhile, never asked why such a fate had befallen him, his parents said. Likewise, they never pondered where the infection came from. To speculate would do no good, they said.
They simply prayed. "Sometimes," Garren said, "prayers are answered."
But the Snows learned that they aren't always answered right away. Garren's healing was slow.
The prospect of a bone-salvaging surgery they dreaded was growing more likely, and they were running out of time. Doctors said that if the healing didn't accelerate soon, Garren would need surgery in June.
A scan in April showed the same miniscule healing. Kristi Snow, leaving the doctor's office, said she nearly wrecked her van in the parking lot. She called Shenal. Could she feed the kids and help them with their homework? Could she, in effect, be their mother for a few hours?
Shenal understood. "You don't want ... the children to see you losing it."
When the Snows gathered themselves, they learned of a specialist in pediatric bone issues like Garren's at Sinai Hospital in Baltimore.
Kristi Snow sent a pleading letter. They were given an appointment, but it was weeks off. Mama Snow Bear begged some more and got an appointment just a week or so away.
When the family arrived in Baltimore, there was a snag. Half of Garren's records, sent ahead by mail, were suddenly missing.
Kristi Snow said she let the staff fret for a little while before handing them her red binder, now 4 inches thick — Garren's complete medical record right down to his scans.
The appointment went ahead, and at last the scans brought what they had sought: miraculous healing.
For days afterward, Kristi Snow would pull up the latest scan on her computer and stare at it, like an expectant mother going over and over a sonogram.
Garren went from facing another surgery to being released for physical therapy.
Not far into it, Kristi Snow walked into the therapist's office and saw something she could hardly believe. Garren was in the water swimming freestyle against a current.
"It's like the moment you see your kid walk for the first time," she said.
And then it dawned on her what it could mean. Maybe Garren could rejoin the swim team this summer.
'G-Man is back!'
Kristi Snow lived her family's crisis out loud, posting thank-yous and updates on Garren's progress frequently on Facebook. At least once a month, as far back as fall, she reiterated her dream of seeing him swim again.
Given that the whole ordeal had begun during the championship meet, his return to the pool had become a symbol of his recovery.
The Snows went to work learning if Garren could start races in the water, since his bone wouldn't bear the push required for a dive. The Roanoke Valley Aquatic Association said he could.
So on June 11, at the first meet of the summer, Garren slipped off his brace and slid into lane 1 at Stonegate for a heat of 50-meter backstroke.
Mama Snow Bear had made up index cards explaining the situation and given them to every race official so there would be no hiccups to his competing. Still, she worried that Garren wouldn't follow through.
Garren said it was never in question. In 55 seconds it was over, and he had actually cut seven seconds from his previous best time.
Mike Snow wept.
"G-Man is back!" Kristi Snow posted on Facebook. "Osteomyelitis, he beat you!"
'Far from over'
This afternoon, Garren will bring his journey full circle when he takes to the water to help the Stonegate Gators seek a repeat championship.
Much of his personal victory is already in hand, but there are other milestones ahead.
Ditching his leg brace for good, going to Andrew Lewis Middle School able to use steps and not the elevator. Though Garren was anxious about it, the family returned to the beach for a few days this summer.
His parents said they believe that greater things will come from Garren's suffering, and the empathy for others he's learned.
"The journey's far from over," Kristi Snow said. "He's going to touch the lives of so many people."
If you go
>> What: 2012 Duane Whitenack City/County Championship Meet
>> When: 8 a.m.-4:30 p.m. Friday and Saturday
>> Where: Salem YMCA