This story originally appeared in Duke Children's magazine.
By Burgetta Eplin Wheeler
THAT COLBY HEATH SLEPT A LOT HARDLY
CONCERNED HIS MOTHER. He was a growing
teenage boy after all. And though Colby’s occasional
nosebleeds were a nuisance, they weren’t in any way
worrisome.
Yet, as Colby’s family now knows, those were two clues
that something was horribly wrong.
“He went from being a seemingly healthy kid who plays
hockey to all of a sudden a kid who needs a liver transplant
in a very short span of time,” says Megan Butler, MD, a
hepatologist who has treated Colby at Duke Children’s.
In fact, it was playing hockey that likely saved Colby’s life.
During a game early in 2015, a body check sent Colby to
the ice, where he alarmingly remained. He couldn’t feel
his legs, he said. Taken to an emergency department, he
eventually regained sensation and walked out of the
hospital that night.
At his hockey evaluations that fall, however, he reported
that he was still having occasional numbness in his legs.
His parents, Naomi and Brian Askew of Apex, North
Carolina, are both emergency department nurses, and
they immediately had him evaluated at a Wake County
hospital.
Tests showed that Colby had a rare congenital liver
abnormality. His portal vein was missing, and his body
had responded by creating new pathways for blood that
resulted in a dangerous increase in pressure in his blood
vessels. That pressure caused his spleen to enlarge and the
veins in his esophagus and elsewhere to swell in ways that
were potentially life-threatening.
“Colby was at risk of a ruptured spleen and possible
death with any abdominal injuries,” Butler says. “Playing
hockey was obviously a risk factor.”
Because of the seriousness of the condition, Colby was
referred to Duke Children’s, where the team determined
that only a new liver would save Colby’s life. His scarred
liver was failing to remove toxins from his blood, causing
ammonia to build up periodically in his brain, a condition
called hepatic encephalopathy. Fogginess, confusion, and
sleepiness often result.
In February 2016, Colby was placed on the United Network
for Organ Sharing list, added to the names of 86 other
North Carolina children under the age of 18 waiting for
an organ donation. Duke performs 16 to 18 pediatric liver
transplants each year.
Much to Colby’s unhappiness, the enlarged spleen meant
that he couldn’t play hockey while he waited. At the rink, he
started working as a scorekeeper instead.
“He has a huge,
strong work ethic like no other,” says Naomi Askew, mother
also to Kristyn Heath, 20, and Carter Askew, 3.
The day the family got the call that a liver might be available
is hard for Colby to remember. About 10 days before, he had
to make a trip to the ER, where his ammonia level was found
to be 161 micrograms per deciliter. The high end of the
normal range is about 50.
His mother, however, remembers May 22, 2016, vividly.
Colby was asleep at the family’s home in Apex. Naomi was
at a hair appointment 20 miles away and didn’t feel her
phone vibrate.
When she returned the call to David Cousino, the pediatric
transplant coordinator whom the family uniformly adores,
he joked about her missing the call.
“Then he said, ‘Is today
a good day to get a liver?’” Naomi recalls. “I just stopped. I’m
screaming in the middle of the salon, saying, ‘Yes! Yes! Yes!’”
Colby’s surgery would not be a straightforward transplant.
Because of the teenager’s extremely rare blood vessel
issues, even more exacting precautions and skills would be
needed.
Twelve long hours later, surgeon Stuart Johnston
Knechtle, MD, let the family know that they were finished
and that Colby was doing well.
“I can’t thank Duke enough,” Naomi says. “We love them.”
Her gratefulness also extends to the family who reached
through their grief to donate a loved one’s organs. “How do
you thank somebody for a gift you can’t put a price tag on?”
Naomi asks.
Since the transplant, Colby, now 15, has donated the hair
he started growing at the beginning of his odyssey to the
Children With Hair Loss nonpro fit. At Christmas, he bought
toys with the money earned at the rink and gave them
to patients at Duke Children’s.
One day soon, he hopes to
return to the ice as a player.
Having a new liver should not keep Colby from his sport,
Butler says, and she is eager to see how he progresses.
“That’s one of the great things is we get to see patients in
the clinic years down the line, hear how they’re doing in
school, about boyfriends and girlfriends, where they’re
going to college. All the things kids are supposed to be
doing.”
