As a physician who specializes in emergency medicine, Dr. Josh Brueggemann has lost count of the number of times that he has ordered blood transfusions for patients at his southeast Kansas hospital.
“Often people need transfusions emergently,” Dr. Brueggemann said. “There’s no time to waste. It’s one of those situations where the blood needs to be there and available in the moment where it’s needed.”
Dr. Brueggemann also has an intimate knowledge of what happens when that blood is not available.
“When we start dealing with shortages, sometimes – in the more rural areas – blood has to be driven in or flown in from other areas,” he said. “That obviously can take quite a bit of time and time is something we don’t have when there’s active bleeding and you’re facing shock or organ damage for lack of blood.”
While Dr. Brueggemann has met dozens of people whose lives have been positively impacted by a timely blood transfusion, the one that perhaps best illustrates that point wasn’t any of his patients.
It was his own son.
‘THEY NEEDED TO HURRY’
Shortly after celebrating his third birthday, Nolan Brueggemann woke up with a fever – but no other symptoms that might hint at the cause. He developed a headache and became more and more irritable over the next four days, but he wasn’t coughing, vomiting, or showing any signs of a severe illness.
With no improvement in his condition, Dr. Brueggemann and his wife, Sammy, had Nolan admitted to the local hospital where the family was living at the time. Nolan underwent a series of tests designed to identify the source of the illness, and finally received a diagnosis three days later.
Blood cultures came back positive for MRSA, a bacterium that is resistant to many antibiotics. But the hospital’s MRI machine was not available, so there was no immediate way to determine the site of an abscess.
“I would probably say it was the scariest parenting timeframe ever,” said Nolan’s mother, Sammy Brueggemann.
Doctors got a clue a short time later, when Nolan began to display obvious swelling and pain in his thigh. But, more importantly, the development indicated that the infection could be life-threatening.
“We made the decision he must be septic from some process happening in the joint or bone of his leg,” Dr. Brueggemann recalled.
Sepsis is when an existing infection causes a chain reaction throughout the body, which can quickly lead to tissue damage, organ failure or death if left untreated. The Centers for Disease Control and Prevention estimates about 270,000 adults die because of sepsis every year in the United States.
Nolan was in danger of severe complications.
“His kidneys were shutting down,” Sammy said. “He was doing poorly enough that they needed to hurry to get him to a more specialized facility.”
‘HE NEEDED A TRANSFUSION’
Nolan was airlifted to Children’s Mercy in Kansas City, where an MRI determined that the MRSA abscess was in his left femur. Surgery was scheduled for the following morning, so doctors could clean out the bacteria.
Despite a successful procedure and more aggressive antibiotic treatments, Nolan continued to run a fever. Follow-up blood tests continued to show MRSA in his body, and doctors wound up having to perform two additional surgeries over the next week to re-open the incision and re-clean the abscess.
“We were worried that he was maybe going to lose his leg because we just could not figure out getting the infection under control,” Sammy said.
Doctors ultimately determined Nolan would be able to keep his leg, but additional complications arose during his stay in the intensive care unit.
Because of the effects of the infection, Nolan spent about 10 days without really eating or drinking anything. He received some nutrients through a nasogastric tube, but he’d been given so many strong antibiotics that they weren’t being absorbed properly. He was severely anemic from the malnutrition and repeated blood draws, and was also going into respiratory and kidney failure.
But there was something that could immediately help with all of those issues.
“For his breathing, for his energy, for his healing, to help combat swelling – all of those things – he needed a transfusion,” Dr. Brueggemann said.
‘AN IMPORTANT PART OF HIS TURNING POINT’
Thankfully, the hospital had blood on the shelf that could be transfused to Nolan.
“The knowledge that that blood was immediately available is something that alleviates one more serious concern as a parent,” Dr. Brueggemann said. “When that discussion takes place with the doctors, I mentioned to them ‘He’s so anemic. Do you think he’d benefit from a blood transfusion?’ And they said ‘Yes, actually we do. I think we should do that.’ Knowing that that blood is immediately available and can be started within the hour, that is not a luxury that people in healthcare have with every decision.”
The decision had an immediate impact on Nolan’s health, reducing some of the swelling and fluid buildup around his lungs. It also helped with his anemia.
“That really helped him turn the corner and restore some of those vital functions of breathing and circulation and healing,” Dr. Brueggemann said. “He only required one transfusion, but that was an important part of his turning point in his illness.”
‘I’M VERY THANKFUL THAT OUR STORY WASN’T DIFFERENT’
Nolan was eventually released from the hospital, though he had several follow-up appointments over the next 18 months due to a complication that affected his immune system. Doctors also monitored the bones within his leg, as there was a concern the location of the abscess might affect the way they grew.
But other than a scar on his leg, he now displays no lingering effects from the ordeal that could have killed him – or significantly altered his life. He is now a gifted student and three-sport athlete who is preparing to enter sixth grade in Joplin, Missouri, where the Brueggemann family has since relocated.
“Because he was in septic shock and so malnourished, we weren’t sure if he was going to have cognitive problems because of that – especially at such an important developmental age,” Dr. Brueggemann said. “And actually, the kid is extremely smart. Like, painfully so.”
“On all his stuff, he scores in like the 99th percentile on his achievement tests – and always has,” Sammy added. “He didn’t have any of those delays, which we’re really thankful for, both physically and mentally because we did worry that there were going to be repercussions of what happened.”
The Brueggemanns believe the timely blood transfusion likely helped Nolan avoid those repercussions.
“By definition, septic shock is when sepsis starts to affect the end organs,” Dr. Brueggemann said. “That includes the brain. The fact that he got a transfusion to help treat the septic shock means that transfusion may have helped preserve some of that cognitive function, so we’re very grateful for that.”
“If we wouldn’t have had that, the kind of life he has might not have been the same,” Sammy added. “The opportunities he’s going to have – and the opportunities he has had already by just being able to be healthy, to recover the way he was able to recover because of that transfusion – has just given him a really wonderful life. I’m very thankful that our story wasn’t different.”
‘EVERY COMMUNITY NEEDS BLOOD ON HAND’
Blood is something that cannot be manufactured. It has to come from volunteer blood donors, like the one who helped Nolan. And when the demand outweighs the supply, it can have devastating impacts.
“Every community needs blood,” Dr. Brueggemann said. “You never know when that’s going to be needed. It’s usually not a scheduled occurrence that happens when blood is needed. Every community needs blood on hand and so every community needs to contribute to that. It’s sort of a pay-it-forward to your friends or family, or even to yourself because you never know the day when you have a surprise event.”
He thought back to Nolan’s surprising and unscheduled hospital visit, and what life would be like if a donor hadn’t given.
“How would my experience be different if the blood wasn’t immediately available – and what worries would that create?” the doctor said. “How would that have delayed his recovery or his treatment?”
‘HE MAY NOT HAVE SURVIVED WITHOUT IT’
Thankfully, the Brueggemann family does not have to answer that question.
“There are dozens of people who did a hundred little things that saved his life,” Dr. Brueggemann said.
There was the nurse who finally started an IV after seven different attempts. The helicopter who flew them to Children’s Mercy. The radiologist who read the MRI. And the person who donated blood.
“It was truly a team effort,” Dr. Brueggemann said. “Every single one of those little things saved his life. Any one of those components – if they were missing – may have resulted in catastrophic outcomes. We don’t know the full extent of what that transfusion may have done. The transfusion may have made all the difference in the world. That transfusion may have been the thing that really did save his life. He may not have survived without it. And so, you’re talking about somebody who is three years old who now may have another 90 years of life because somebody gave that blood or somebody who has 90 years of more quality life because they didn’t suffer permanent consequences from the septic shock.”
‘DECADES OF IMPACT’
The Brueggemann family had known about the importance of blood donations long before Nolan’s life-threatening illness. In addition to Dr. Brueggemann’s work, multiple other Brueggemann family members had required transfusions. Both Dr. Brueggemann and Sammy donate with the CBCO whenever possible.
But Nolan’s story gave them yet another reason to advocate for a cause that is near and dear to their hearts. They routinely posted updates about his treatment and recovery on Facebook, receiving prayers and well-wishes from people all over the country. But the story also inspired countless new blood donors.
“I always think about that ripple effect,” Sammy said. “Other people maybe think of (giving blood) now because they love Nolan and they love our family and so they give blood as well.”
Most importantly, each of those new donations has the potential to help another family’s Nolan.
“What seems like a very small task to show up at a blood center for 30 or 45 minutes and give some blood has decades of impact on someone else’s life – and every life that that person touches,” Dr. Brueggemann said. “It’s a seemingly small thing, but it saves lives.”
Donating blood with the Community Blood Center of the Ozarks allows more than 40 local hospitals to continue to provide lifesaving treatment to friends, neighbors and loved ones here in our communities. There is no other organization that supplies blood and blood products to these hospitals, who rely exclusively on CBCO donors to help patients like Nolan. What kind of stories will your donation inspire? Click here to find a drive near you.