Just over six months after her last day in the pediatric intensive care unit at Sinai Hospital, Riley Brager is savoring a clean bill of health heading into summer.
The Reisterstown resident and soon-to-be senior at Roland Park Country School is not being overly dramatic when she says that "I'm glad I could live to tell the story," about her battle with hemolytic uremic syndrome, a complication from contracting the sometimes deadly E. coli bacteria that invaded her body beginning in late October.
That was the start of a nightmarish couple of weeks for the Brager family, a time fraught with fear, uncertainty and plenty of pain for Riley, a goalie on the Reds' varsity lacrosse team.
On Oct. 18, Riley was a happy and healthy junior at the private girls school in north Baltimore when she complained of not feeling well.
Two days later, her abdominal pain was so severe that her mother, Jacquie, called her doctor. The next morning, a dehydrated Riley was taken to the Greater Baltimore Medical Center emergency room to be pumped full of fluids.
After a two-day stay at the Towson hospital, Riley was released, until symptoms returned.
Jacquie said that, after rushing back from a trip to visit another daughter, Erica, at Jacksonville University, she noticed that Riley's coloring was bad and that her daughter was vomiting.
"She couldn't even stand at that point," Jacquie said. "I dragged her back to GBMC."
Fortunately for Riley, the physician who treated her on the return visit, Kristen Britton, recognized the symptoms of E. coli infection.
"She knew exactly what it was," Jacquie said. "We were frantic. Riley's hemoglobin levels were low (half of the normal amount), and we were worried about kidney failure."
Those fears eventually motivated the Bragers to move Riley to Sinai, where nephrologist Ira Mandell recommended that she be immediately admitted to the PICU (pediatric intensive care unit) in order to receive blood transfusions.
During that time, Riley's kidney failure prompted bloating throughout her body, causing her to retain 35 pounds of fluids.
"She was almost unrecognizable," Jacquie said. "She looked like a completely different person."
Hemolytic uremic syndrome, described by the website http://www.about-hus.com as a "a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli, is now recognized as the most common cause of acute kidney failure in infants and young children. Adolescents and adults are also susceptible, as are the elderly, who often die as a result of the disease."
To get an idea of how virulent Riley's episode was, consider that "DNA from bacterium-producing toxins, known as Shigella dysenteriae type 1, can produce one of the most potent toxins known to man — so potent that the Department of Homeland Security lists Shiga toxin as a potential bioterrorist agent," according to the website.
With the bacteria rampaging through her body, Riley's condition worsened.
"I collapsed," said Riley, who was given morphine for the pain. "I don't remember a lot of things."
Still, her recovery was not brought about by any miracle drug or antidote, considering that HUS is not directly treatable. HUS can, and in her case did, run its course because of supportive care at Sinai that included making sure that her fluids and electrolytes were in proper balance.
Slowly, but surely, Riley's health returned.
Her recovery was buoyed by cards, letters and visits from friends and family..
Within five days, Riley was released from the hospital and her doctor said she could even participate in her club lacrosse team's tournament if she felt well enough.
And, as luck would have it, when one of the TLC goalies did not show up, Riley played in a game.
"I was holding my breath the whole time," said Jacquie, who gave Riley her reluctant blessing to participate. "But from that day on, her recovery has been amazing."
By the following weekend, Riley played well enough in the goal to catch the eye of recruiters from Monmouth University, where she has committed to play lacrosse.
This spring, Riley had a banner year as a first-time starter, helping the Reds to advance to the Interscholastic Athletic Association of Maryland A Conference championship game against McDonogh. Despite losing to the Owings Mills-based juggernaut in the title game, 15-12, Roland Park finished with a 16-5 record and rose to No. 3 in the Baltimore Sun end-of-season poll after a lackluster 5-10 the previous season.
"It was a huge accomplishment for her to come back like that," Roland Park varsity lacrosse coach Kristin Nicolini said. "She was really sick."
Even so, Riley was not handed the starting job.
"It was an open tryout," Nicolini said. "We were looking for someone to step up and fill that role, and Riley did."
And while things have gone well for Riley on and off the field, it wasn't easy for her.
"I didn't know if I was even going to remember how to stop a shot," she said. "But eventually, things kind of fell into place."
Yet her elation over returning to school and lacrosse is tempered by anxiety that remains over her recent health scare.
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"I never thought anything bad could happen to me," Riley said. "I know it sounds cliché, but now I try to live every day like it's my last. I saw the worst of the worst [at Sinai]. A lot of kids weren't as lucky as I was."