Beyond ECMO: Cadence’s Story

Cash is not your average 9-year-old. When it comes to athletics, he’s an absolute star. He regularly beats his dad, a former basketball player, in three-point shootouts. He sleeps with a football. College scouts are already taking notice.

“Not many kids can play a full game of football, then go straight to play a full game of basketball,” says Cash’s dad, Jeff. “Then when he gets home, he wants to go training.”

But sometimes, without any clear reason, a common illness can affect a child more severely than others — even if they’re in peak physical shape. When Cash started having trouble breathing, his parents rushed him to Connecticut Children’s Emergency Department. To their shock, they learned that his everyday illness had turned life-threatening.

“He was a normal healthy kid who had the flu — and got really sick, really fast,” says Hayley Wolfgruber, MD, a hospitalist on Cash’s care team.
 

What is ECMO?

The infection had severely damaged Cash’s lungs, leaving his body with dangerously low oxygen levels. The critical care team tried to support him with multiple different ventilators, but nothing worked. Cash needed drastic measures: Extracorporeal Membrane Oxygenation (ECMO), a life support system reserved for the most critically ill patients.

“Just like you can’t heal a rolled ankle if you keep walking on it, sometimes your lungs, heart or kidneys need time off to recover. ECMO makes that possible,” says Dr. Campbell, who is the surgical director of Connecticut Children’s ECMO program.

ECMO requires a huge, highly specialized team — from the surgical team that initially attaches the machine to a patient’s veins, to nurses and ECMO specialists who monitor the system around the clock. While the machine supports the lungs, other specialists manage every other aspect of the patient’s care. Patients remain sedated for the entire time, whether the healing takes days, weeks, or months.

The process can look intense and scary — but at Connecticut Children’s, families know their child is in expert, compassionate hands.

“We don't take this job lightly. We understand that your kids are your world, and we treat them as such,” says Dr. Campbell.
 

For the next two weeks and three days, respiratory specialists sat by Cash’s bedside in 24/7 shifts, adjusting the ECMO pump and fine-tuning his medications.

Meanwhile, critical care experts like Jessica Winters, MD, checked in — not just on Cash, but on his family.

“Taking care of Cash and supporting his family during their time in the PICU was such a privilege,” says Dr. Winters. “Families in our unit are going through an unimaginably difficult time. I know it’s impossible to even think straight. So, I try to check in frequently, in case they have any new thoughts or questions I can address.”

“Whatever control we can give back to the parents and the child — it’s so important,” adds Dr. Wolfgruber.

Connecticut Children’s social workers and Child Life specialists are also vital for families, offering mental, emotional and even logistical support for the unique stresses of caring for a child who is seriously ill. In Dr. Campbell’s words, they’re the ones “walking with the family through this process.”

Finally, after 17 long days, Cash’s lungs began to heal. The surgical team disconnected the ECMO technology, and the intensive care team gently brought him back to consciousness.

Cash woke up to the faces of his parents in a room decorated with adoring notes from his big sister and photos of him in his football uniform.

It was time for a new kind of athletic challenge.
 

Recovery from a serious illness isn’t just a physical test — it’s a mental one, too. Cash’s comeback took extraordinary determination, both from him and from the people around him.

“I will never forget the warmth Cash’s parents and sister brought to that room every day,” says Marie Nader, MD, another critical care physician on Cash’s team. “They were all so selfless. His sister was a ray of sunshine. I remember thanking them for showing us what family truly means. I’m convinced that Cash's recovery was fueled by their support and love.”

“His family was so committed to his future,” agrees Dr. Wolfgruber. “Their mindset was: Cash is going to work hard and live a beautiful, long life and we’re going to get him there.”

When he was in the hospital, Cash threw himself into rehab, tackling the physical therapy gym before any of his doctors thought would be possible. (Cash’s parents, used to their boy’s athletic excellence, were not surprised.) Once he was home and back in school, he attended every one of his football team’s games, and cheered his teammates on from the bench. Soon, he was strong enough to start training beside them. Within six weeks, he was once again leading the pack in workouts.

At his first follow-up appointment with Connecticut Children’s pulmonology team, his lungs were more than 80% recovered. The team was astonished. And delighted.

“Taking care of Cash definitely left an impact on me,” says Dr. Winters. “Knowing we were able to help get him home with his sister and parents and back to doing the things he loves — that’s what makes this job so special.”

Eight months after his illness, Cash was cleared for full-contact sports. Football season had ended, but he was already thinking ahead.

“Watch, Dad,” Cash said. “Next year, I’m gonna do the best I’ve ever done.”
 

“Some of the most caring people in the world”

Reliving the past year brings up difficult memories for Cash and his family. But among the traumas are memories of comfort and hope — the nurses who never left Cash’s side, the kindness of cleaning crews and security staff, and the encouragement from other parents facing their own battles.

“Before this, I didn’t even know about Connecticut Children’s,” says Jeff. “You drive by it and you don’t even think. Now, we know how many families are going through these difficult situations — and that some of the most caring people in the world are pulling them through it.”