On a perfect spring day, Andy Walerius was crouched behind home plate hand signaling his pitcher and waiting for the next delivery. No one on the field that day could have imagined what was about to happen. Pale and not himself, Andy stood up to tell his dad that he wasn’t feeling well.
Suddenly, he collapsed. In an instant, Andy went from being just another kid on the baseball field to a boy in crisis. Whether there would be another game behind the plate in Andy’s future was less than clear.
Andy, 15, was taken by ambulance that night – May 2 – to Children’s Hospital in Minneapolis, where emergency room doctors ran a series of tests to determine what was wrong.
The next 24 hours would prove harrowing. More than 25 members of Children’s touched this boy’s life. Andy had a new team. They were doctors and technicians, nurses and therapists. They were in the pharmacy and at the phones. They screened his visitors and washed his linens. They embraced and informed his parents.
Andy’s care extended to Abbott Northwestern Hospital, our neighboring adult hospital, and ultimately he required the immediate deployment of our ECMO (extracorporeal membrane oxygenation) team to save his life.
“You’re almost better off having a heart attack than what he had,” said Dr. Stephen Kurachek, an intensivist at Children’s.
Shortly after Andy’s arrival, preliminary tests suggested he might have a blood clot in the lung. Typically, this diagnosis would have been confirmed with a CT angiogram, but Andy’s renal function was so poor that the dye required for the study would have injured his kidneys.
Other studies were performed. Dr. Chris Hills, cardiologist, alerted Dr. Kurachek of a “potentially lethal” looking echocardiogram. Children’s nuclear medicine and venous doppler staff quickly ran tests. Andy had a large blood clot in his right leg that created a “shower” of blood clots to both lungs as described by Dr. Sonya Wright, a radiologist at Children’s.
Cases like Andy’s are rare in kids. Limited clots to the lung occur in vulnerable children, but clots to both lungs in a healthy boy that critically impair heart function occur only once every few years, Dr. Kurachek said.
Immediately following the tests, Andy was taken to Abbott via an underground tunnel that connects the two hospitals.
At Abbott, a filter was placed to prevent additional clots from entering the lung circulation and medicine was injected directly into the lungs to dissolve the clots that were obstructing blood flow. During the procedure, Andy’s heart slowed and then stopped — cardiac arrest. Children’s intensive care team and the Abbott resuscitation team performed full CPR on Andy for 10 minutes before his heart started beating again.
Andy was returned to Children’s PICU (pediatric intensive care unit), where the ECMO team had assembled. He was placed on bypass until his heart function recovered. Dr. Kurachek credits the care coordination among staff throughout Children’s and Abbott with saving Andy’s life.
“In retrospect, there was a cadence to all this. A rhythm. It was like poetry. On this particular day for this particular boy, it happened well,” Dr. Kurachek said.
Andy’s mom, Joan Walerius, agrees.
“I felt like they were two steps ahead of Andy,” she said. “This was a well-oiled machine.”
She’s grateful for the medical care her son received and how Children’s helped her family remain normal during an “abnormal” situation.
Andy’s family was able to stay at the Ronald McDonald House during his 21-day hospitalization. Joan and her husband, Ken, could go to the Family Resource Center to escape the beeps of Andy’s machines, write notes and use the computers to send emails – all while listening to soothing music. During recovery, the Geek Squad even helped Andy Skype with his friends.
“That was a gift,” she said, of the services.
It’s still unclear why blood clots formed in Andy. Months before he collapsed, he recalls having trouble breathing and he tired quickly during baseball. He has asthma and control during exercise was a concern, but he was being treated.
Blood clots can develop for several reasons. Sometimes people are born with a “clotting problem.” Sometimes a simple virus can stimulate the body to make proteins that promote clotting. Our hematologists will monitor Andy very carefully during the next few months to make sure the clots don’t form again.
“He really escaped this,” Dr. Kurachek remarked. “In retrospect, had he died on the ball field that day, no one would have been surprised.”
Instead, Andy is back on the field with the team he should be with, and he’s healthy. He returned to baseball practice last week, and he played in his first game Monday night.
“Everything is pretty much the same except for the running,” Andy said. “I don’t run as fast.”
“As parents and as guardians of children, there are reasons why we pray,” reflected Dr. Kurachek. “This is one of them.”
To learn more about Andy and his story, visit his CaringBridge journal.