Sutton Strong

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“How did this happen?”

It’s the question Cali Smith gets most, and not coincidentally, the question she most dreads. In fact, it probably isn’t the most sensitive question one could ask of a mother who nearly lost her son to infectious disease.

But Smith, a 5th-grade teacher at Bailey Station Elementary in Collierville, doesn’t let it offend her. She knows it’s a question born of fear — every parent’s worst nightmare.

In fact, Smith spent weeks asking herself the same question. The answer isn’t easy, bringing back a flood of emotions — joy and gratitude over her son’s recovery from a life-threatening illness, the trauma of having to watch her 7-year-old son, Sutton, fight for his life, and finally, the shock of learning that nothing, absolutely nothing, could have prevented his illness.

Last fall, what began as a moderate football injury resulted in a series of surgeries, medical procedures, and physical therapy for the usually happy, fun-loving first-grader. Today, Sutton is doing great, back at school in Collierville where his teachers and friends had been praying for him every day, yet he and his family still struggle with more than the usual amount of anxiety that comes along with any diagnosis of strep.

What parents usually think of as group A streptococcus (GAS), or strep as it is commonly called, is the characteristic sore throat that usually clears up quickly with easily available and affordable antibiotics. Most of us have had, or know someone who has had, this version of strep, which is probably why so many people ask Cali, “How did this happen?” 

For Sutton, strep meant something far more serious, and, according to Dr. Sandra Arnold, division chief of pediatric infectious diseases with Le Bonheur Children’s Hospital, what happened to Sutton is more common than most people realize. 

Sutton developed multifocal musculoskeletal infection due to GAS, a kind of infection that can also be caused by a staphylococcal bacteria or staph. Complicating matters further, Sutton also developed toxic shock syndrome, or sepsis, which made him even sicker.

It all started on a Friday at football practice. Sutton felt the soreness, pain, and weakness that is typical after a sports injury. But when his pain didn’t improve, and in fact, seemed to worsen, his parents took him to the doctor the following Monday. Their orthopedist thought it might be Sever’s Disease (calcaneal apophysitis), a swelling of the growth plate in the heel. They were told to “keep an eye on him” and notify the doctor if he didn’t improve. He was given crutches and went back to school the next day. But, before the end of the day, he was running a fever and the pain had worsened. Back to the doctor again, this time to the pediatrician, who said Sutton probably had a “fever virus.” They were told to continue monitoring him and let the doctor know if he didn’t improve. 

In the midst of all this, Cali Smith was scheduled to go out of town with friends for a long-awaited girls’ trip. She had misgivings about leaving, but with her husband’s encouragement and assurance, she reluctantly joined her friends. “But, I was never truly at peace with going,” she says. “Something just didn’t feel right.”

By midday Thursday, Sutton was in a boot with instructions to continue monitoring the pain. When his father called the doctor Friday morning to describe Sutton’s pain, the doctor said, “This kind of pain is not normal.” Sutton’s mother rushed home as fast as she could to meet them in the ER at Le Bonheur. “That was the longest plane ride of my life,” she says. When she arrived at Le Bonheur, the doctors told the Smiths their son was very sick and would need surgery right away.

The infection in Sutton’s body had been spreading and multiplying, and if not stopped quickly, threatened to take his limbs and possibly his life. According to Dr. Arnold, “Children are uniquely predisposed to infection because of the growth plates in their body and the fact that their bones have rich, but sluggish, blood flow.” These conditions provide an opportunity for infection to fester and multiply. “We see this type of infection more often than people might expect,” says Arnold. In short, infection loves bones, and children’s bones especially.

“I knew that we had to get people praying,” says Smith. And pray they did — throughout multiple surgeries, procedures, and physical therapy. “I saw pictures and video of my fellow teachers, administrators, friends, and school staff at Bailey Station Elementary… all praying for my child,” she says. 

In addition, the school raised money for Sutton’s medical expenses by selling “Sutton Strong” T-shirts. There were frequent visits and gift baskets to encourage and support the Smith family. “That meant so much to us; we can never express the full measure of our gratitude,” Smith says. “When I think of my Bailey Station family, the word ‘compassionate’ comes to my mind and probably always will.” 

Still, mixed with relief and gratitude, Smith acknowledgesthat there was a time when she also felt doubt and guilt as to whether or not they could have done anything to prevent Sutton’s illness. Dr. Arnold says emphatically, “There is absolutely nothing that could have prevented what happened to Sutton.” The most important thing parents can do, she says, is to be aware of the possibility of infection. Surprisingly, most parents don’t realize how quickly infection can occur and spread, or how to recognize the signs.

According to the Centers for Disease Control and Prevention, infection can result from bacteria entering the body through a break in the skin. However, parents may be surprised to learn that an infection can also follow blunt trauma. Signs of infection include fever, redness, swelling, a rash or severe pain. 

“Sometimes parents are reluctant to continue asking their doctor about an injury once they’ve been sent home,” says Arnold. “Don’t be! If your child isn’t getting better, keep asking, keep calling, and keep going until your child begins to improve. There’s a very good reason why doctors tell patients to let them know if it doesn’t get better or gets worse. Sometimes it does get worse.” When that happens, it’s important to be a persistent advocate for your child’s health. 

Today, as a result of the infection, Sutton still has trouble with his left hip, which requires ongoing monitoring by an orthopedic specialist. But for the most part, Sutton is a happy, healthy boy who enjoys each day thanks to some persistent, diligent parents and an amazing team of medical professionals at Le Bonheur.

Katherine Perry is a freelance writer, as well as an educator,wife, and mother of three adult daughters.She lives with her husband and two dogs in Collierville.