Case #03: Zach

your kidneys wind up failing. The risk of dying goes up by about one for every five minutes that passes. How terrifying would it be to fight an unknown enemy, one you didn't recognize and didn't see coming. What if that enemy was coming from within a disease even doctors couldn't identify. Nearly half of all Americans suffer from some chronic illness, and many struggle for an accurate diagnosis. These are their stories. I'm Lauren Bright, the checko, and this

is symptomatic. Zach Dobek was a self described relatively normal eleven year old kid. His favorite food was pizza, He loved sports, he loved being outside, but above everything, he loved Legos. Yeah, I was a big Lego kid. I would say I was never a huge video game guy, nothing like that. But we had a whole Lego set in our basement. He loved to fish and be in the water and just do all the things that kids

love to do. That was Zack's mother, Martie Doeback, who knew she had a rather exceptional kid on her hands from a young age. I literally can't help but like break into a huge smile because he is just a really unique kid who just sort of connects with everybody around him. And I think about how lucky we are

because he is such a special human being. So he was special before he got sick, and maybe he's even extra special now, a special kid that was forever shaped by a life threatening battle with a mystery medical condition. Marnie is a family physician who would be faced with an emergency even she didn't see coming. Was there anything that could have prepared you for the roller coaster you're about to go on? No? Simply no, there was nothing. You know, I think as a mom, probably all moms

worry about things that might happen to their children. You know, is my child going to have cancer? As my child is going to become a diabetic, as my child is going to get into a car accident, And these were the kinds of things that, like over the years, had you know, maybe run through my mind, but what ended up happening was so far from anything I could have even imagined. The first signs of something being wrong with Zach started to show up while she was cheering on

her son during a little league baseball doubleheader. I remember these these moments in exquisite detail. So I know that it was June four of two thousand fourteen, and that was a Wednesday, and my husband and I were at the game, and he had played, you know, particularly well, I think at those games, and so when the games ended, you know, I went over to him to congratulate him or whatever when they're eleven years old. I put my arm around him and I said good job, and he

started to cry. I told my mom and my dad was coaching me at the time. I told them that my knee was kind of hurting and I had like a really bad headache. And now, being the athletic kid that I was, I was busy all day and I had a double header baseball game, so two in a row so when I told them of that pain, they were kind of like, Okay, you just had a lot of physical activity. And being the fine parent that I am, my first thought was like, he's hungry, he didn't need

he played too long games, it's hot. So I really didn't think too much of it either, especially knowing my mom as a doctor, I kind of knew she would take care of everything. I knew I could always trust her, and the fact that she's like, all right, let's get get some dinner, let's drink some water, and see how you are tomorrow. Um, I really wasn't thinking too much of it at the time. The Dopebac family went home for dinner, but Zach didn't eat at all, which was strange.

Zach loved food and it was odd for Martie to see him pass up a meal. His curious nee pain lingered into the next day, so he woke up in the morning and he said that his knee was still hurting him. And you know, I guess those were the first glimmers where I was sort of like, mm hmm, that's a little bit weird. So I decided to keep him home from school, and I gave him some advil or something like that that you would give any kid for pain, and the advil kicked in after a little bit.

You know, he's a great kid, and he came up to me and he said, do you know what, Mom, I feel better. I think I'm okay to go to school. So I said okay. Zack didn't last long after she dropped him off. The pain was quickly catching up to him, causing him to start lumping. The school nurse was actually

the one to realize something wasn't quite right. She called me and she said that Zack had come to her complaining of knee pain, that he didn't have a fever, but he was limping, and then what she said, um, and I really remember, like she said these exact words. He just doesn't look right. And I remember saying to her, like, I know, you know, something seems really odd. And I said, okay,

I'll come pick him up. And I brought him home and I, you know, I got him set on the couch and I you know, I raised his leg up on something and I gave him some ice, and I gave him some more advil. And when I went back to check on him after some time, you know, I felt his head and he felt warm, and I took his temperature and he was running a fever. And I remember also thinking, that's weird lingering me pain and now

a fever. Marty thought it might just have been that getting some sort of virus, which would explain the pain and fever. But things started to get worse quickly. The next day, she was barely at work an hour before getting a phone call from their all pair, and she called me at work to tell me that she was downstairs in our kitchen and she could hear him crying up in his room. And again, you know, there are all these moments. That was another moment where I was like, okay,

like bring him to my office. So I'm a family doctor, and I had asked one of my associates if she would take a look at him for me. So she came into the room and by that point he was really uncomfortable, like he couldn't sit still because of the pain. But when you looked at his knee where he was complaining of pain, it wasn't read, it wasn't swollen. She was able to move it, and so she sort of examined him and looked at me and like almost like shrugged at me like, I don't know, it's weird. She

ordered him some pain medicine. She thought maybe it was a weird case of lime disease. So he got some blood work and she prescribed an appropriate antibiotic for lime disease that maybe we could just get started on. In the meantime, the pain, the fevers, both of these are adding up to look a lot like I'm disease. That was until the blood work came back with some alarming results, results that made Martie start to get really nervous. Within a couple of hours, we got a call from the

lab with a critical result. And one of the tests that had been run is called a c reactive protein or a c RP, So a c RP is it's a very non specific test, but it's a test that sort of measures like a level of inflammation in the body, so it doesn't tell you what's causing the inflammation. But his came back extraordinarily high, to a point where I knew something Everyone knew, not just me, but I knew something was really not right. So I started to panic.

That was the moment I was gonna say, take me to that moment, because you're wearing your mother hat and you're wearing your doctor hat. And usually when as a parent you are told of a result like this, you have to educate yourself. But you instantly that must have been like ice cold feared on your back. Yeah, I mean it was. I knew something was very wrong, but you kind of start spiraling into like that half doctor, half mom, like you don't want to overreact, you don't

want to underreact, you know. I always say like I didn't want to be that patient that was like difficult or an over worrior, and you know, trying to balance all of it was not easy, but but I was. I was nervous at that point. It's becoming apparent there's a lot more going on here than just lyme disease. But what Martie is starting to fear the worst because she knows how telling those test results, maybe being a

doctor herself. Looking to where it all started with his knee, Martie takes him to an orthopedis to see if they can source any answers. And Zach was laying there on the table and he looked ill, like he did not look well. But he had also already taken like Thailand all with codine at that point, so it was a little bit hard to tell what was what if he was drowsy from that, but he did not look well. So the doctor pulled the fluid out of the joint and he said, to me, the fluid doesn't look normal,

but it doesn't look like a bacterial infection either. He thought it was what we call like a viral synovitis, like what I had kind of originally thought that he had some kind of virus that was causing the lining of his joint to be inflamed, and the abnormal fluid was because of all the inflammation in there. The fluid was going to all go out to the lab and you know, so that was it. So I sort of like stood there. I remember feeling like almost dumbfound like okay,

but my mother, doctor censors were going off tremendously. I knew that that wasn't it. But what do you do? What stopped you in that moment? That must have been so difficult for you to navigate because I felt like I had done everything, you know, I I took him to a primary care doctor. He was examined, he had blood work, he had an X ray, he saw an orthopedies, He took the fluid out of the knee, like I

I didn't know what else to do. Like I felt like even if I took him to the hospital, they were just going to send him home because everything had been done. But I just I knew something was not right. She went to her younger son's baseball game the next day, but Marnie was buzzing with nervous energy. Having left Zack with his older brother, the family came home to find Zack's leg had ballooned while they were away. And I remember I just had to go pee and I literally

couldnot get up to walk to the bathroom. So my older brother I got in his back. He gave me a piggyback ride to the bathroom. I could like barely even stand up at that point. The fact that I couldn't even walk to the bathroom is like mind boggling. And by the time we got home, we noticed that like his thigh looked swollen and um. As that date progressed, he just, I mean it got it started to get ridiculous. He started to have extreme pain everywhere, like all over

his body. I even had to ask my parents, like to move my limbs for me. I would ask them like, oh, can you move my arm. I'm not comfortable. Can you move my leg? My husband had to pick him up, carry him up the stairs to put him in bed. And my husband tried to put him in his bed, and Zach said to him, can I go in your bed?

It's more comfortable, So my husband put him in our bed, which you know, in retrospect, thank god, three days have passed since the onset of symptoms fever, body aches, swelling, and so much pain that Zack couldn't move on his own. The antibiotics and medicine so far hadn't helped things change course. All the specialists and even Marnie were stumped as to what was really happening to him. Things kept spiraling in the wrong direction, and Marnie slept in the bed with

Zach to keep a close eye on him. You can ask my mom. We didn't sleep that much to that night, especially her. She was worried sick. It was just hours of him like tossing and turning. He kept asking for water over and over, and you know, he would doze for a few minutes and and finally like somewhere in the middle of the night, maybe it was three o'clock in the morning. He asked for the water and I said sure, sure, I'll get it for you. And then he looked me straight in the face and he said,

is someone going to fly it to our house? And I looked at him and I said what. And I kind of remember being like in a dream stay almost tired, So I said it and I told her and I was like no, no, no, I'm just tired. I'm just dreaming like it's okay. Uh. And then I asked again, like five seconds later, are they going to fly it over to me? And he again said is someone going to fly it to our house? So he was like starting to like hallucinate. I don't know, but I started

to cry and she was like, that's it. We're going to the hospital. And I actually sat there and I was like no, I'm so tired, Like can we please go in the morning. Can we please go in the morning? And she was like Nope, absolutely not, We're going right now. And I think about that and like if we had said yes, Like the honest to god truth is that I think he would have died in that bed that night. We'll be right back with Symptomatic, a medical Mystery podcast.

Now back to Symptomatic a medical mystery podcast, Zach Dobec was fighting for his life against a mysterious illness that now had him heading to the e R. He still had an extremely high fever, was in so much pain that he couldn't move on his own, and now he was starting to become delusional. He wasn't himself, and that terrified his mother, Marny, And we got him into the emergency room and into like the triage nurse, and the triage nurse took one look at him and she said,

he doesn't look good. And I thought, no kidding, lady. I mean we were. We were deliriously tired, so I think I was dozing on and off. But they did a chest X ray and blood work and he was on oxygen, and you know, we were there for a few hours, and you know, sometime early in the morning the results started to come in and he was in multi system failure, you know, liver failure, kidney failure, He had fluid in his lungs. I mean, he was a wreck.

Just four days after first showing symptoms, Zach is now experiencing multi system failure, with him being transferred to the i c U. Every passing hours critical defining the cause of his symptoms and most importantly, the right treatment. It is literally to the point of life or death, as the doctor's race defined an answer, but that doesn't stop Martie from trying to find a way to comfort her son,

as his mother, in these moments, he looked. I mean, in medicine, like when you see a really sick person, a lot of times you say that they looked toxic. He looked toxic. I actually took pictures of him in the ambulance. I can't remember why. I think I was like talking, I don't even know. I think we were trying to like make him laugh or cheer him up, you know, I don't remember why, but I took some pictures of him. And when you look at the pictures, I mean, he looks gray. He looks horrible and gray

and very ill. He was kind of just laying there still. Yeah, I haven't seen it in a while, but I mean, with the fever as high as it was, um, I was pretty much just like a blank slate. My body was literally just like a sack of potatoes, just almost lifeless, and even in my eyes you could kind of see that I wasn't there that's so frightening because it's is like your body had lost all feeling except for pain. Yeah, and it's not the pain you would think of, like

ow I stubbed my toe. It was like pain, like shut down, like something really bad was going to happen. Placed in the care of the pediatric I see you, Zach and Marney were repeatedly given the same conclusions as before, some sort of tickborn illness in the family of lyme disease. Zach was already on oxygen and using an ivy for hydration. He was then put on full spectrum antibiotics and hopes that any of them would help combat the illness that was causing his body to start to shut down. But

it wasn't enough. The doctors needed to take more drastic measures to try to save his life. And so the I c U doctor came in and he said, let's go have a meeting in my office. And he basically said, like, we think he needs to go on a ventilator or a respirator. And I mean, what are we going to argue? You know, of course, of course if that's what he needs, and so you know, we we obviously said okay, and we um they asked us to step out, and we were out of out of the I c U. I

don't know if it was twenty minutes or what. We were waiting, and you know, they call you back in. Trying to control my tears, but they call you back in, and your kid, who was playing baseball, you know what, three or five days earlier, was laying there on a ventilator with like tubes and like and you know they're un they put them out, so he's, you know, unconscious, un a ventilator and I just remember thinking, like, what is happening here? Can I ask a question? So? Was

it technically? Did they put him in a medically induced comma? Yeah, that's exactly what they did. Zach was now in a medically induced comma to protect his brain from swelling and to keep him alive. While the doctors scrambled to figure out the root of his symptoms, nothing seemed to be working, and his fever just kept persisting through all the attempts to bring it down to the point where they were

putting him on like cooling blankets. You know. I just kept thinking, like, oh my god, even if he survives, his brain is going to be fried. His lung collapsed at one point, so he needed a chess tube to re expand his lung. There was just complication after complication. When I was in the coma. Again this is second hand, but they said I could hear, and my dad would um. He would tell me every day when I was in the coma. He would say, wake up, Zack. We got

fish to catch. And that was his way of saying, like, you gotta get up. You're not done yet. We got stuff to do. We got fish to catch. And Zack's dad was right. The doctors had taken a blood sample that held the key to finding out what was really going on here, a seemingly simple course of action that would give the Dopbec family the answers They were desperate for. The blood culture that they had taken that night. Eight

in the emergency room was growing MERCA. I don't know if everyone knows MERCA, but it stands from methicillin resistance staff aureous. It's a staff bacteria that is um resistant to the majority of antibiotics that we have, and it tends to be very aggressive and cause very serious infections sometimes. And so they knew he was in septic shock from merca. They had finally gotten to the bottom of what was slowly draining the life from Zach mersa that had developed

into sepsis. Here's Dr Jem O'Brien, the vice president of Operations for Population Health and Ohio Health and a board member of the Sepsis Alliance. For those not familiar with sepsis, could you give me a layman's definition. Yeah, So, your body has an army that's designed to fight infections. And if you think about if you get a local infection of boil or ingrown, tony al or something, it gets read head, it gets inflamed, it hurts, it might even

have some pasts, and then it gets better. What sepsis is is when those body defense systems actually go haywire, and so instead of having a focused response to the infection, you wind up with widespread response to infection throughout the body, and so your body functionally suffers friendly fire from your immune system trying to battle the infection. If you experience septic shock, the risk of dying goes up by about one percent for every five minutes that passes without appropriate antibiotics.

Zach had gone into septic shock because of how rapidly the mercer had spread throughout his body. They knew what disease they were up against, but every minute was now critical to finding a treatment that could save his life. An orthopedis came to see me and my husband to tell me that he had a massive infection. It's called osteomyelitis. It's a bone infection in his femur bone or his

thigh bone, and he needed urgent surgery. So the orthopedist shout out Dr Minkowitz, who saved his life, took him from the m r I directly to the emergency room. So I ended up having six surgeries on my femur and they basically just scooped out the bone that was infected. Sounds pretty gross. It is pretty gross. I have a really cool scar now, which I love my scar, so that's pretty cool. I had basically no femur, so they

had to just let that bone regrow. After the surgeries on his femur, Zach was seeing small improvements, but the doctors were still struggling to break his fever, and we're concerned about it causing long term brain damage. Here's Dr O'Brien again. One of the things we're just beginning to understand is there's also something called post sepsis syndrome that is present maybe as many as fifty of all survivors of sepsis, and could present in a wide range of ways.

One of the ways that's been most well studied is actually the presence of something called cognitive dysfunction. Think about people having problems with memory or doing calculations, kind of the higher order functions of our brain. People can have significant limitations as a result of that. But all that changed when the nurses made a routine swamp of Zack's

IVY line. A lot of times when patients are in an I c U, they have what's called like a central line, you know, so instead of having just an ivy in your arm, it's in a bigger blood vessel. So he had what's called the central line entering in his neck, and you know, it kind of goes in deeper. And that central line had gotten like colonized with the bacteria. And so once they pulled that out and put a new one in, that's finally when the fever's like stopped.

I think it kept like circulating the bacteria. When they finally got rid of that, that's when things finally started to take a turn for the better. Finally, a light at the end of the tunnel changing out that central line led to a pretty rapid recovery for Zach. Just a couple of days later, the doctors were able to take him off oxygen. He was breathing on his own again for the first time. I'm in weeks. I remember

when he finally woke up. He was like desperately trying to say something, and he had like oxygen, you know, like a mask on and we were trying to figure out, you know what does he want to say what? And we pulled his mask away, and you know what he said. He said, I just want to say thank you very much, And like the nurses all started to cry, and I remember saying, like, see, see, he's so special. That's like

one of my mom's favorite stories. They told her, like, oh, when he wakes up, like you might hear some some things you've never heard before, and she's like, not my son, he would never I just said wanted to say thank you. I guess that's pretty impressive. So you were in a medically induced coma for twelve days, you know, nearly two weeks. That is surreal on so many levels. Do you remember

anything about coming out of it? I actually did have one really crazy, crazy, like very distinct memory, like a coma dream basically, which is pretty wild. Um. I was in a target parking lot and I was actually in a wheelchair, and my mom pushed me in a target, and all of a sudden, the target started to burn down, and I actually got separated from my mom. Uh, And I was in a wheelchair, I couldn't really move on

my own. And eventually, as the target was burning down, some person found me and rolled me outside the building and I was eventually reunited with my mom. And I know it's crazy, but like the symbolism in that is ridiculous. Zach had gone from playing Little League baseball on Wednesday to being on the verge of death on Sunday. That's how rapidly mercer and stepsis took hold of his body.

Searing pain, fevers, confusion, delusion and multi system failure, countless antibiotics and treatments, a medically induced coma, six surgeries, months of rehabilitation. Zack pulled through all of that with the support of his family. So they wouldn't let me leave the impatient rehab hospital for a while until they thought I was stable enough to get in the car. So

I guess what we did. As soon as they told me I could leave the hospital, my dad was like talking to all the doctors making sure we could go. He took me to some fishing pier about thirty minutes away. I was in a wheelchair. He pushed me out on the dock and uh, you know, we caught little blue fish that were no more than like five inches long.

But I know it sounds a little cheesy, but that's when I knew like it would be okay, Like the sun setting over the water, I'm catching fish with my dad and that was like I was like, I'm gonna be okay. They were a little blue fish, but they might as well have been swordfish right for me. It's like it was like a magical experience. It really was. That's beautiful. Zach went on to make a strong recovery,

but nerve damage to his leg remained. He was no longer able to play competitive sports, no longer able to go on long walks or hikes, and sustain some mobility issues. It was hard being like the athletic kid that wanted to play all the sports and coming out of it being barely able to even walk. It was definitely physically and mentally challenging. And that's where that phishing passion comes

into play. I needed something that I could call my own, something that makes me happy, something where I could be outside, and you know, that became fishing, but more than just the fishing part, it was a new me. And remember that huge scar Zach had from all those surgeries on his femur. You said that you love your scar. Can you describe it and what is it that you love

about it? So it's probably seven or eight inches long down my entire femur, pretty much like the lower half of my femur into my knee, and it's a pretty big scar. But it's kind of like my battle wound, you know, like I can say that I beat that and I have something to show for it. I remember my surgeon actually said to me that she could kind of make it look a little better, um, and I was like, no, you you don't get to touch that.

That's my battle wound from winning the battle. So I have a really cool tattoo idea that I really want to get, like a fish head on one end of the scar and a fish tail on the other and kind of like a fish carcass, almost the crossbones going through the scar and the scar being the backbone. So

I want to get that soon. And my parents are surprisingly in full support because they know that's like super meaningful and like I said, it's my battle wound, a badge of honor to remind him of the fight of his life against a mysterious illness that turned out to be sepsis, A mysterious illness that took him from healthy to the e R in three days, A mysterious illness that is actually much more prevalent than people may realize.

How common is sepsis exceedingly common. So in the US alone, there are approximately one point six million cases a year, results in nearly three d thousand deaths just in this country alone. So it's the most expensive reason for hospitalization, it's the most likely reason for readmissions. So it's an exceedingly common diagnosis. We do a national poll of Americans

have never heard the word sepsis. And that's one of the reasons that Sepsis Alliance is dedicated so highly to awareness is to try and make it easier for people to communicate about this actual disease. I think the things that I like come back to our raising consciousness about sepsis, that it is a possibility and at least considering it, trusting your instincts, and don't be afraid. Don't be afraid

to bring it up. You know, say it out loud, you know, go to your doctor and say, like, I listened to an heart radio podcast about sepsis, could this be sepsis? Like, don't be afraid to say it, because sometimes doctors are not thinking of it. People sometimes say like, oh, is it hard to talk about? And I told you,

I don't really look back on as a negative. And I like to share my story and make people more aware and how mentally and physically I've been through challenges and struggles and I'm still Zach, but I keep saying it shaped me, like it made me who I am. To find out more information, visit the Sepsis Alliance at sepsis dot org. My name is Zake Dobec and when I was eleven years old, I suffered from immerse infection

in my right femur. I went into septic shock and was placed into a medically induced coma for twelve days. On the next episode, of Symptomatic. Shelby Morrison faces a life threatening health crisis that spirals as her first pregnant see progresses. Everything started to flare back up again when I got pregnant, and um my body freaked out. I just remember praying in the room, you know, to let me meet my daughter, to let me get through this with my wife. I didn't want it to all in

before it even it all started. Symptomatic a Medical Mystery podcast is an original podcast from I Heart Radio. Are shows hosted by me Lauren Bright Pacheco. Executive producers are Matt Romano and myself. Our EP of post production is James Foster. Our producers are cra Kaiser and John Irwin.