Starting Off the New Year with Heart and Hope

Carden FamilyThere's a reason Rosie and Craig Carden have such a good feeling about the New Year. All they have to do is look at their tenacious infant son, Sammy, who fought so hard to survive the old one.

"He's a tough little guy," says Rosie. "Tough as nails."
In fact, Nails is his nickname. And when you hear his story, you understand why.
On Jan. 3, Sammy will usher in 2013 with his this third heart surgery at All Children's Hospital since coming into the world nearly eight months ago. He was born with an extremely rare, life-threatening condition marked by criss-crossed ventricles. "Only one in a million children with heart defects has it," says Rosie.
But Sammy, a baby with a mega-watt smile and shock of wavy brown hair, has proven himself to be a one-in-a-million kind of kid.
He underwent his first surgery at just a week of age, after All Children's cardiologist Dr. Kathryn Nardell gave his parents hope by correctly diagnosing his complex heart problem prior to his birth. And then came his second operation on June 29 - a harrowing, 10-hour ordeal in which Sammy suddenly seemed to be slipping away.
Yet the team of talented All Children's cardiovascular physicians and nurses - led by surgeon, Dr. Jeffrey Jacobs - refused to give up on him. And Sammy wouldn't quit, either.
"There was a point where we actually talked with the Sammy's family and Mom, especially, and explained to them that we thought it was not likely that the baby was going to make it," Dr. Jacobs says. "We sat down with them and said, 'We're going to continue trying and do our best to make it through this, but things don't look promising.'
"But the whole team just kept working and working. And we were able to get him to pull through."
Rosie and Craig will never forget the gut-wrenching swing of emotions with their first child.  One day earlier, Sammy had actually coded during a heart catheterization procedure but came around after 35 minutes of CPR. The next morning, however, their hearts sank after learning of the dire turn their 8-week-old son had taken two hours into emergency surgery. By late in the day, Sammy's prospects still appeared bleak and Rosie and Craig braced for the worst.
"The nurse had called me to say they were taking him off of the bypass machine, and that would probably be it," Rosie recalls. "They literally clamped the machine and said, 'Come on, take a breath, buddy!' "
And something amazing happened. Sammy showed everyone what a fighter he was.
He inhaled - a big, deep breath, all on his own.
"When they told me that, I fell to the ground," Rosie says. "I couldn't believe it."
For Dr. Jacobs, saving Sammy represented a true team effort in the face of a most challenging set of circumstances.
"Sammy was born with a problem in which his heart had one functional ventricle, and he didn't have a good connection between his heart and his lung," he explains. "So we had a plastic tube called a shunt that was placed from his heart to his lungs, to allow blood to flow to his lungs. It's not unusual that those tubes can narrow.
"It narrowed, and that led to a whole series of emergencies which were all quite stressful.  But ultimately Sammy pulled through and did great. And I think the fact that Sammy's still alive and getting ready to have another operation - and ultimately should do very well - is first of all reflective that he's obviously a very strong kid. But it's also reflective of the fact that we have such a great level of depth in our cardiac program at All Children's Hospital.
"What really saved Sammy is that there is so much depth in that program at all levels: the combination of cardiology, cardiac surgery, anesthesia, critical care and nursing. To get Sammy to live required excellence in at least those five areas. That combination of excellence is what really pulled this kid through this life-threatening emergency. A weakness in any one of those areas - and Sammy would not be here today."

* * *
He almost didn't wind up at All Children's in the first place.
Rosie and her sister, Suzy Mendelson, help run a Tampa-based family business that provides employee benefit solutions to companies. All Children's wasn't on the Carden's radar. But it soon would be.
Early in her pregnancy, Rosie remembers receiving a grave prognosis from doctors not affiliated with All Children's. "They said that I should terminate my pregnancy," she says. She and Craig were shaken but determined to seek a second opinion, assuming that would mean a trip to a children's hospital out of state - specifically, Boston Children's Hospital. But their research led to All Children's - only two miles from their St. Petersburg home - and the visit with Dr. Nardell that changed everything.
"Dr. Nardell spent four hours with us looking over hundreds and hundreds of pictures," Rosie recollects. "I said, 'Just give it to me straight. We're going to be prepared and if his quality of life is such that he can't be here, then he can't be here. But I need you to tell me.' And she said, 'We can fix it.' "   

Dr. Nardell laid out the course of action involving a series of three common surgeries Sammy would undergo. From that first visit, the Cardens were sold on a hospital about which they had known precious little.
"We couldn't believe that this kind of facility was literally two miles from home!" Rosie says.
The team that cared for Sammy also included Dr. James Quintessenza, who performed the first shunt surgery on Sammy. And ultimately, it even grew to include All Children's chaplain David Pitt, who spent countless hours offering support to Rosie and Craig - especially during the tortuous second surgery when things looked so bad.
As Sammy recovered in the days and weeks that followed, Rosie and Suzy became determined to show their gratitude in a special way. They felt indebted to the Child Life Department, which worked tirelessly with their baby to provide stimulation and keep his development on track with various toys and games. So they decided to organize a Christmas toy drop sponsored by their business, donating the kind of items to the Cardiovascular Intensive Care Unit that had helped Sammy so much.
They never imagined the turn their mission would take ¬- complete with a helping hand from an entity that knows something about special operations, U.S. Central Command.

* * *
As fate would have it, Suzy's young son has a classmate whose father works in Special Operations for CENTCOM, based at MacDill Air Force Base in Tampa.
When the child's dad got wind of the  toy drop, he sent Suzy an e-mail that CENTCOM had some toys left over from its own charity drive and offered to donate them to her project on behalf of Sammy. "He said, 'I've got to get them out of here today, can I bring them by?" Suzy says. "I told him yes, by all means, and was picturing a few boxes."
Instead, he showed up with a truck filled with several thousand toys - making Sammy's toy drop for All Children's one to remember. The military involvement seemed particularly fitting, given that the older sister of Rosie and Suzy is a Lieutenant Commander in the U.S. Navy who works as a congressional liaison at the Pentagon.
After receiving CENTCOM's massive contribution, Rosie and Suzy, along with a handful of their employees, diligently divided up the haul for girls and boys by age appropriateness. And they delivered the impressive load the week before Christmas, with some toys going to the CVICU and most  to the hospital as a whole.
Even amid the mountain of toys, Sammy was still the star of the show.
Smiling in his mom's arms, he was greeted by various nurses who'd fallen in love with him during the four months he'd spent at All Children's. Child Life's Loren Mirsky-Piatkin, who had worked so often with Sammy to help spur his mental process, was there to coordinate the event and hug the baby and family she's gotten to know so well.  And Dr. Nardell even made a special trip to the lobby to see her exemplary patient.
"He's doing well," she says. "We're looking ahead to his next surgery and hoping that goes well for him. He looks wonderful. And he has a special family. They've been involved from the beginning and he has parents who've always wanted to be involved - and know as much as they can. They've been great. It actually doesn't surprise me that they've pulled this off.  If there's anyone who can do it - it's them."
For Rosie, the trip back to All Children's that day held special meaning.
"This place is not a hospital to me - it is home," she says. "And these people are my family. It's not just the doctors. It's every single nurse that's in the CVICU, all the nurse techs. It's speech therapy. It's physical therapy. My child has not had any developmental delays. He's been in the hospital four months out of the seven months of his life and he doesn't have any physical or mental delays. And he was given CPR for 35 minutes here. He's a miracle. And he's a miracle because of these people."
"I just think of how strong he is to have made it through such hardships, as young as he is," Craig adds. "It's really amazing. It's totally unexpected for anyone to have to go through what Sammy's been though. But just knowing that it's not outside the norm for All Children's makes me feel so much more at ease. Everyone there just blew me away."
The family experienced its share of adversity in 2012. The sisters' father had a stroke the day after Sammy's first surgery, though he's doing well now. Their grandfather and grandmother passed away. And out of the blue, the Carden's beloved dog died, too. And of course, there was the rollercoaster of emotions tied to newborn Sammy.
"Considering how 2012 went, I'm pretty sure 2013 is going to be awesome," says Rosie with a smile. "We're going to hit it out of the park this year."
And judging by how he's done so far, tough baby Sammy is going to nail it.

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