Osteomyelitis: Shlomo’s Story

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In the summer of 2021, thirteen-year-old Shlomo was at sleepaway camp when he started to feel pain in his ankle. That pain, and his eventual diagnosis with a rare infection called osteomyelitis, would change the course of the next 15 months for Shlomo and his family.  

When Shlomo’s parents, Sharon and Yosef, spoke to the camp nursing staff one day in early July, they were told it looked like an ankle sprain that should heal within 10 days, and that the pain should subside soon. Shlomo wanted to wait it out in camp. Two days and two tearful phone calls from Shlomo later, his pain had not subsided, it had become excruciating. His parents knew they needed to bring him home.Shlomo with friends & family Shlomo was surrounded by family and friends throughout his entire osteomyelitis treatment and recovery.

Back at home in New Jersey, Shlomo’s parents took him to the local emergency room, where he was admitted. Doctors there ran a variety of tests to determine what could be causing Shlomo’s pain, including one for inflammatory markers. Those test results showed extremely concerning numbers that could indicate anything from an infection to cancer. Sharon recalls, “I couldn't breathe. I literally thought the world was just collapsing around me.”

A diagnosis of osteomyelitis

After additional testing and treatment, including two MRIs, and three surgeries to try and clear out infection, they finally had an answer: Shlomo was diagnosed with osteomyelitis, a rare infection in the bone, and septic arthritis because the infection had also spread to his blood, and could have spread to his organs.

The most common way to treat acute osteomyelitis is through surgery to clean out infected tissue, combined with antibiotics administered through an IV. Doctors were confident they had removed all the infected areas, and that Shlomo would recover quickly.

After the hospital’s intervention, Shlomo’s pain levels decreased, which seemed like a good sign. He was sent home, where his pain lessened, but never completely went away.

Consulting with specialists at CHOP

By August, Shlomo had not fully recovered. Sharon thought it was time to seek out a second opinion. “I said, just to cross our T’s and dot our I’s, let's go to CHOP. It’s an hour away from my house. It didn’t make sense not to go to the top orthopaedic center in the country.”

Sharon asked friends and family for recommendations and kept hearing the same name, Dr. Alexandre Arkader, MD, pediatric orthopaedic surgeon and orthopaedic oncologist at CHOP. “We went to see him (Dr. Arkader), and we immediately felt very connected to him. His knowledge and level of empathy and care were extremely impressive. He was just incredible,” Sharon said.

Dr. Arkader answered all the family’s questions and reassured them that their local hospital had been doing all the right things to treat Shlomo’s infection. Armed with Dr. Arkader’s feedback, they decided to stick with their local hospital, where Shlomo’s case was well known, for the time being.

A turning point and further diagnosis 

After two more surgeries at the family’s local hospital, Shlomo was feeling virtually pain free. But that didn’t last long. In November, he tried to walk for the first time since his pain had begun the previous summer, leaving him mostly confined to the family couch and relying on crutches or a wheelchair to move around.

During his treatment, doctors had found the source of infection was in Shlomo’s tibia (shinbone), even though it affected his ankle too. Through surgeries, doctors removed pieces of dead bone from Shlomo’s leg. They anticipated the bone would regenerate once the infection was gone. But the bone had become so weakened from infection and his previous surgeries that it broke from the pressure of Shlomo’s attempts to walk. He was again in unbearable amounts of pain.

Treatment and recovery at CHOP 

The family knew it was time to transition Shlomo’s treatment to Dr. Arkader and the team at CHOP. Dr. Arkader and his colleagues confirmed that Shlomo’s case was in the rare 1% of the most severe cases of osteomyelitis and that there were no other diseases present.Shlomo and family in Knicks jerseys During his treatment, Shlomo enjoyed watching basketball with his family and dreamt of one day playing on his high school team.

Shlomo underwent two additional wash-out surgeries at CHOP and was monitored for several months to confirm the infection was completely gone. Then, Dr. Arkader began preparing him for reconstructive surgery to fix his bone defect. A large segment of Shlomo’s bone was missing and needed to be reconstructed.

In April 2022, after confirming Shlomo’s body was completely cleared from infection, Dr. Arkader presented the family with several options to consider to facilitate healing, with the most severe being amputation of Shlomo’s leg.

The family made the difficult decision to try bone graft surgery, the least invasive option – and the least likely to work. In this procedure, bone was taken from Shlomo’s pelvis and used to fill in the areas in his leg. An external fixator – a device that connects to the bone using pins and wires – was then attached to his leg to keep it stabilized while it healed. Within six weeks, Shlomo’s leg was showing considerable progress. In August of that year, he slowly began bearing weight again, and in October he started walking unsupported.

What Sharon remembers most about that time was how well-cared for her family felt at CHOP, from detailed appointments where all their questions were answered and almost immediate response times when the family had questions outside of their appointments, to the warmth of the staff when checking on Shlomo while he was inpatient at the hospital.

Fulfilling a dream

Shlomo is now a healthy 16-year-old who is walking, running, and jumping normally, after a total of eight surgeries, and close to a year and a half without walking. Shlomo recalls, “I spent a lot of time on the couch. Over a year of not being able to get up to do the simplest things. I am so grateful to be able to walk, run and play ball again – gifts I don’t take for granted.” 

He has gone from attending his entire first year of high school virtually and beginning his sophomore year on crutches, to playing on his high school basketball team by his junior year, something that just two years prior had seemed impossible.

Sharon says, “We all have big, lofty dreams in life, but when Shlomo was couchbound for 15 months, all he dreamt about was living a normal life. Something as simple as getting back on the court is fulfilling a dream for him. Dr. Arkader and Amy Rapino, his nurse practitioner, were amazing. I just can’t say enough about them and CHOP, in general. I’m so grateful.”

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