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The Honolulu Advertiser

Posted on: Monday, July 12, 2004

Former Iolani athlete survives toxic strep

By Leila Wai
Advertiser Staff Writer

He no longer feels the constant drumbeat of pain in his legs. The scars, more than a foot long and as thick as an electrical cord, are still purple and new. They are painful to look at.

Lilly Jackson greets her son DJ at Honolulu International Airport upon his return from Utah. During his college finals, DJ fell ill and was diagnosed with toxic strep syndrome, also known as "flesh-eating bacteria."

Photos by Rebecca Breyer • The Honolulu Advertiser

His khaki shorts and compression socks hide the scars, so none of the other passengers from United Flight 63 notice as they wait for their luggage at Honolulu International Airport.

He shifts his weight from one foot to the other, seemingly impatient. But he is really trying to keep his legs — which were nearly amputated — from swelling as he waits for his mother, Lilly, to pick him up.

Finally she rushes up and gives him a hug and a kiss. She places around his neck three graduation lei that came almost three months late. He hugs her back, the inside of his left arm divided by another scar that goes from his armpit to the middle of his forearm. She doesn't notice, concentrating on two things: her baby is home, and he is alive.

Wednesday marked the homecoming of Doug Jackson, an Iolani and Brigham Young University baseball player, after a tense two months that started with a sore throat and ended with seven surgeries and six days on life support.

"She thought I was going to die," Jackson said, pointing to his mother.

"We did!" Lily Jackson exclaimed, with a little chuckle.

'Flesh-eating Bacteria'

Doug Jackson was diagnosed with toxic strep syndrome, commonly referred to as the "flesh-eating bacteria." The syndrome:

• Destroys muscles, fat and skin tissue.

• Is caused by a strain of the bacteria group A Streptococcus (pyogenes), the same strep that causes rheumatic fever.

• Almost never follows strep throat, unless left untreated.

• Afflicts 1 in every 489,000 people.

• • •

Doug Jackson's ordeal

• Seven surgeries in eight days.

• In a coma for one week after his second surgery.

• On life support for six days.

• In critical care for 11 days.

• Has scars on his left arm and both legs that are about a foot long and half an inch wide.

They can laugh about it now, but Doug Jackson recalls overhearing his father, Bill, talking on the phone with Doug's brother Michael, telling him not to leave his home on the Big Island, but instead to wait and purchase a ticket to O'ahu — for Doug's memorial service.

It all started April 14 in Utah, when the college student came down with a sore throat and fever, which eventually reached 104 degrees. He was too preoccupied with studying for finals to see a doctor.

But he was feeling so sick that he eventually went to the emergency room April 20, learned he had strep throat, and was given fluids intravenously to help with his dehydration. Then he left, promising to return the next day, after his last final.

"I just thought it would pass, I thought I would get better in a little bit, I thought it would go away," he said. "Every day I was talking to my parents, telling them how I felt, and they told me to go to the doctor. After my last final, it was unbearable."

During that last final April 21, DJ, as he is called, noticed that his arms and legs were slightly swollen. He saw light-red discolorations that looked like birthmarks growing in patches on his limbs.

Keeping his promise, he returned to the hospital for a check-up for his strep throat, accompanied by a fellow Iolani alum, Ianeta Le'i.

"He was saying his calf and his arm were sore, and they were really swollen." Le'i said. "He just wanted to get it over with and go home."

When he got to the hospital he couldn't even walk. He was rushed to the emergency room in a wheelchair.

DJ waited for three hours, watching as the swelling in his limbs grew an inch each hour. Le'i finally flagged down a nurse.

DJ was diagnosed with toxic strep syndrome, more commonly referred to as the "flesh-eating bacteria," which destroys muscles, fat and skin tissue.

Toxic strep syndrome is caused by a strain of the bacteria group A Streptococcus (pyogenes), the same strep that causes rheumatic fever. It rarely follows strep throat — unless the ailment is not treated.

In 1999, the Centers for Disease Control reported 600 cases of toxic strep syndrome in the United States. It strikes about one in every 489,000 people.

The Utah Valley Regional Medical Center was prepared to handle DJ's case because they had just treated a patient with a similar disease, according to DJ's father.

"Seeing his limbs all swollen, you knew it wasn't going to be good, but we never expected it to take the turn it did," said DJ's older sister Angie.

DJ underwent surgery the day before he was supposed to graduate, enduring a 5›-hour surgery to his left arm and left leg to clean out the infectious matter attacking his body. The next day, it was six hours in surgery for the right leg. Then he fell into a coma for seven days, during which he underwent five more surgeries.

For six days, he was on life support. While his wounds were being cleaned, doctors had to take care of the fluid accumulating in his lungs and his liver, which was beginning to jaundice.

"He was a battleground," his father said. "It looked like he was attacked by a shark."

DJ, who is 5 feet 6 and averages 155 to 160 pounds, dropped to 125 pounds.

"I'm still fuzzy on the details, because it was such a frightening time for us," his sister said. "You hear the stories, and you see the worry in the faces of the nurses and doctors."

His mother, a licensed practical nurse who has treated many patients, knew he was gravely ill.

"I've never seen anybody that sick in my life like that," she said. "I thought he was a goner; when I first saw him I thought he wasn't going to make it."

DJ was in critical care for 11 days. His older brother Tony later told him the doctors were given permission to amputate his legs if they needed to.

"I was pretty shocked, but when they showed me the pictures, I couldn't even recognize my own limb," DJ said. "I was like, 'That's my arm? It looks like my leg.' "

It would be about 10 days before DJ was able to move on his own again. He still couldn't bend his left arm at all, and he could barely move his legs. The constant morphine, for the pain, also made him numb.

"Just seeing him fight and try to reassure us even when he couldn't speak, whether it was squeezing our hands or nodding his head," Angie said. "He couldn't even open his eyes."

Eventually, DJ healed enough to begin walking. He started with a stroller, using the nurses as crutches.

"I could move my legs after a while, but I couldn't put any weight on them," said DJ, BYU's two-time all-Mountain West Conference centerfielder. "It was frustrating because I'm used to being in control of my body."

Angie added: "I've never seen him like that, I only see him as that strong, vibrant athlete."

After the barrage of surgeries on his limbs, DJ had to start from scratch.

"It was like seeing an old man learn to walk and feed himself again," Angie said.

On May 22, a month after DJ entered the hospital, the doctors declared him healthy enough to leave. But his treatment was far from over.

DJ began his monthlong outpatient therapy in Provo, going to physical therapy two to three times a week and having weekly visits with a specialist in infectious diseases. He still had an IV needle in his arm the entire time, pumping him with antibiotics. He had to carry a fanny pack with him at all times, filled with his medicine.

At his physical therapy, DJ began walking on a treadmill for about 20 minutes and lifting light weights. Every session, he increased the time and weight, even if it was just a minute or pound at a time.

Eventually, he grew strong enough that his therapists released him, a couple of days earlier than planned.

"I was so happy, I was just tired of being at the hospital," he said. "I have a phobia of hospitals now. I hate the way they smell."

On June 22, almost two months after his graduation date, DJ was finally cleared to leave Utah. But he left with the one thing that drove him to go through all of it in the first place: his diploma.

"I'd better have passed," he said. "I paid a big price for it."

Reach Leila Wai at 535-2457 or lwai@honoluluadvertiser.com.