S.C. Medic Battles Necrotizing Fasciitis After Giving Birth
May 22--SHELBY -- Lynetta Swaffer sits at a table able at Chick-fil-A, her blue cellphone within reach.
The tall, slim 30-year-old doesn't know if the buzzing phone will bring good or bad news.
Over the past few days, it has provided a tenuous link between her and her sister, Lana Kuykendall, who's lying in a Greenville, S.C., hospital bed, heavily sedated and fighting off necrotizing fasciitis.
Four days after giving birth to twins on May 7, Kuykendall was diagnosed with a virulent form of the flesh-eating bacterial disease.
She hasn't woken up since.
Darren Kuykendall, Lana's husband, has been sending updates to Swaffer through text messages.
As of 4 p.m. Monday, Lana Kuykendall was in critical condition at Greenville Memorial Hospital, said Greenville Hospital System University Medical Center spokeswoman Sandy Dees.
'I knew there was something wrong'
The night Abigail Marie and Ian Gabriel Kuykendall were born, Swaffer went to visit the family in Greenville, S.C., taking some time off from her job as a manager at Chick-fil-A.
She was expecting to be back within a day or two.
"I got down there and I knew there was something wrong," Swaffer said.
Her sister, who had made it through nursing school while pregnant with twins and working as a paramedic, could barely get out of bed.
"She would try to hold the babies and she just couldn't," Swaffer said.
She described her sister as a strong woman, someone who had given birth to twins naturally with no medications.
"She started getting discouraged," Swaffer said. "She said to me, 'I must be a wimp.'"
Swaffer said doctors gave Lana Kuykendall bags of blood and said her blood pressure had been low.
By Thursday, Kuykendall was determined to leave the hospital and Swaffer had returned to her home in Lattimore.
The next morning, Kuykendall noticed a bruise on the back of her leg.
Both she and her husband, who is a firefighter, thought it was a blood clot and made the 10-minute drive back to Greenville Memorial Hospital.
"I got off work and I had a message to call Darren," Swaffer said. "I called him and he was crying."
She said she knew it was serious when she heard her brother-in-law in tears.
"They think she has necrotizing fasciitis," he told her.
Swaffer said her first thought following the news was "Oh, my word, she's going to die."
'I know it's the right thing to do'
Darren Kuykendall told Swaffer that within an hour of noticing the bruise, it had grown a quarter inch.
The bacteria moves quickly, destroying muscles, skin and tissue.
Getting immediate treatment was the key to saving her life, doctors told Swaffer.
Over the past week, Lana Kuykendall has had five debridement surgeries, is on antibiotics and has had hyperbaric oxygen therapy, Swaffer said.
Swaffer said during the surgeries, all the tissue has to be stripped away.
"Her thighs don't have fat or tissue on them, just muscle," she said.
Swaffer said doctors are still trying to kill all of the bacteria, which they recently identified as Strep A, but if they can't, amputation could be the next step.
Swaffer said she has been following the news stories of Aimee Copeland, the 24-year-old Georgia woman who is also battling necrotizing fasciitis.
On May 1, Copeland contracted the bacteria following an injury from a zipline that broke, causing a gash in her leg which was then infected with the bacteria when she fell into a river. Copeland has had her leg amputated, flesh removed from her abdomen and on Thursday, had her hands amputated. Her story has been reported by Reuters, ABC News and many other media outlets.
In a statement released to the media on Sunday, Dees wrote that a team of surgeons, critical-care physicians and infectious disease specialists are aggressively treating Lana Kuykendall.
"She has now undergone seven debridement surgeries to remove necrotic, or dead, tissue from her legs," Dees wrote. "Necrotizing fasciitis is typically managed by surgery, antibiotics and aggressive supportive care."
Dees wrote that according to Dr. Bill Kelly, hospital epidemiologist for Greenville Hospital System, in Lana Kuykendall's case, tests have confirmed that the bacteria was Group A Streptococcus.
"Everything has to heal from the inside out," Swaffer said.
When Swaffer first saw Kuykendall following the first surgery, she was unconscious.
"She didn't look like herself," Swaffer said. "She was all swollen. Her mouth was taped shut, she had all these tubes in her."
She said the new mother is on a ventilator.
Once Kuykendall reaches the point where she no longer needs to be sedated, Swaffer said, it will be months before she can leave the hospital.
Family and friends have been caring for the newborn twins, but Swaffer is in the middle of packing up her belongings, leaving her job and house behind and becoming a surrogate mother to her sister's children.
She said she can't replace the twins' mother, but she knows her sister wants her babies to be loved and to have a consistent caregiver.
Swaffer plans to stay as long as she is needed.
"I know it's the right thing to do," Swaffer said. "She's always been there for me."
She said she and her sister have always been close.
"It kills me to know she's going through this," Swaffer said.
Recording milestones
Darren Kuykendall has been staying close to his wife's side every day.
Married for four years, the two met on the job in Greenville, S.C.
"They met at the scene of an accident," Swaffer said. "She was a paramedic and he was a firefighter. He chased her for a long time."
Swaffer said when her sister and her husband found out she was pregnant, the parents-to-be bought a picture frame with monkeys on it.
"I can't wait to meet you in May of 2012, Baby Kuykendall," the frame read.
Swaffer plans to keep a journal and shoot video of the twins so that once their mother recovers, she can still witness all their milestones.
"She was so excited," Swaffer said of her sister becoming a mother. "She would have made a great mother."
Swaffer, who came to Cleveland County to attend Ambassador Bible College, has been living in the county for seven years.
People have brought her sister's family meals and have held fundraisers.
Mothers who donate milk to the neonatal intensive care unit have specifically asked that the milk go to Lana Kuykendall's babies.
"We're trying to do things as much as how she wanted things done," Swaffer said.
She asked for prayers for her older sister.
"When doctors saw us Friday and gave us the first report, they said it's only by the prayers she's made it this far," Swaffer said.
Reach reporter Rebecca Clark at 704-669-3344.
What is necrotizing fasciitis?
Dr. Andrew Taylor, wound center medical director and general surgeon at Cleveland Regional Medical Center, said there are thousands of cases of necrotizing fasciitis that occur in the United States each year and there are usually one or two cases at Cleveland Regional annually. He said the severity can vary widely from case to case.
Taylor said necrotizing fasciitis is caused by bacteria that can enter into a cut, injury or even an ingrown hair and typically is found in people with comprised immune systems, including mothers after giving birth.
Healthy people can also contract the bacteria.
Taylor said the same type of bacteria that causes necrotizing fasciitis can be found on our skin, but the type that becomes dangerous is a particularly virulent strain that is resistant to treatment.
Taylor said as the bacteria grows and spreads, it releases toxins which cause the tissue to die.
He said the most common kind of necrotizing fasciitis bacteria is Strep A.
Taylor said people are just as likely to pick the bacteria up from a grocery store, fast-food restaurant or even "Uncle Joe who came over for dinner."
"It's out there," he said.
Taylor said the bacteria can spread very quickly and is treated with antibiotics as well as surgery. During surgery, dying tissue is cut away as well as a portion of surrounding tissue.
"They can be very small to large operations," he said. "It's different in every patient."
Some patients might require one operation and a week or two of antibiotics while others might need multiple surgeries and months of antibiotics.
"What you hope is if you have a true necrotizing fasciitis, if it's not getting worse, it means it's getting better," he said.
Taylor said length of recovery could depend on whether the bacteria has gotten in the bloodstream and started spreading through the body, affecting kidneys and other organs.
Taylor said most likely, in the case of Lana Kuykendall, by the time she noticed the bruise, "things were really starting to fire up."
Although there is no way to prevent contracting the bacteria, hand washing, general hygiene and overall healthy habits are all important, Taylor said.
He recommended that people seek immediate treatment for infections or wounds.
Copyright 2012 - The Star, Shelby, N.C.
