Angela Hadley should have spent her summer tubing the river, baby-sitting and writing in her journal.
Instead, the girl who was hit hardest in Spokane County's largest E. coli outbreak spent most of the past 27 days -- including her 16th birthday -- seriously ill in the hospital.
The Mead High School junior has endured seven sessions of dialysis, three blood transfusions and exactly 73 needle sticks. Her parents have watched her crumple to the floor, unable to walk back to her bed after a trip to the bathroom. They've heard her say, "I think I'm dying."
"This is how we spent our summer vacation," said Don Hadley, raising his eyebrows to indicate the hospital room, now decorated with helium balloons, flowers and stuffed animals.
"It's turned our world upside down," said Mary Hadley.
The infection began, public health investigators believe, when Angela ate part of a Caesar salad served at a drill-team camp she attended at Eastern Washington University.
maine lettuce from Spokane Produce. On Friday, produce company spokesman Dan Petek distributed copies of lab results from tests of lettuce collected by the U.S. Food and Drug Administration on July 29 and 30 at the plant. None of the tests found E. coli.
The tests don't necessarily clear the company or earlier lettuce batches, said FDA district director Charles Breen. "The illnesses were associated with lettuce that went through earlier," Breen said.
However it got there, once in Angela's system, the deadly bacterial strain E. coli O157:H7 produced toxins that triggered characteristic symptoms: diarrhea, weakness and vomiting.
She was sick when the Hadleys picked her up from camp on July 14. That night, her fever hit 103.8, and they took her to the Sacred Heart Medical Center emergency room. She was given Tylenol with codeine and sent home with advice to see a doctor if she wasn't better by Tuesday.
She saw her doctor that Tuesday and was back in the ER on Wednesday. While Angela was vomiting in the ER bathroom, she overheard another doctor talking with another patient about dance camp.
"Mom, listen," Angela said.
Another girl from the same camp was there for evaluation, after hearing from a coach about possible E. coli exposure. The Hadleys had missed a similar phone message.
When Don Hadley heard the words "E. coli," he recalled headlines from the 1993 Jack in the Box hamburger outbreak. He knew there had been some deaths. He pulled a nurse aside and said, "All I've ever heard about E. coli is bad news."
But Angela was at a good age to fight the infection, the ER staff said. E. coli's potentially deadly complication -- hemolytic uremic syndrome -- strikes only the very young and the very old.
During the next few weeks, Angela proved to be an exception to that rule. She developed HUS. Don Hadley looked it up on the Internet and found nothing good.
The E. coli toxins now were destroying his daughter's red blood cells and platelets. That explained her weakness and why her blood wouldn't clot when she had a bloody nose. Her kidneys were working harder, clogged by damaged red blood cells. She grew puffy because her kidneys weren't ridding her body of waste.
The Hadleys knew long-term prospects included abnormal kidney function, even eventual kidney failure. Death occurs in 5 to 15 percent of cases.
"She's my baby girl," Don Hadley said. "I would trade places with her in a heartbeat."
During the worst of it, Angela was so listless she couldn't look up to acknowledge her parents were in the room. She slept. She lay in bed and moaned.
Angela's doctors, family practitioner Melissa Sousley, kidney specialist Brendan Mielke and pediatric intensivist James Mellema, ordered a central line for IV feeding and dialysis to help Angela's kidneys filter blood.
Mary Hadley felt helpless. She took the night shift and watched over Angela in the dark. She saved her tears for home, believing Angela needed her to be strong.
Don took the day shift and got to know his daughter better during her four-hour dialysis sessions.
"She's as sweet as everybody says she is," he said.
Both parents' employers were generous with time off. Co-workers and friends made sure the family had enough food at home for their 19-year-old son, Aaron.
Earlier, Angela had asked her mother to take over writing in her journal for her and so Mary was chronicling hospital life. Three times she wrote that Angela had pronounced the day her "new worst day of my life."
It was a family joke. When Angela was 7 and had her tonsils removed, she had said, to her parents' amusement: "This is the worst day of my life."
Although the family kept a low profile, word got out. The Shadle High School drill team, who knew only that another dancer was in the hospital, brought gifts and balloons. Friends left phone messages and sent cards by the dozens.
"We have a lot of people praying for us," Mary Hadley said. "We can feel that strength."
Angela began to slowly get better.
The first meal she kept down was on her birthday last Sunday. A family friend cooked Angela's favorite, fettuccine, using Mary's recipe. On Wednesday, Angela took a walk to the meditation garden on the hospital campus. Angela's doctors believe she is out of danger, but the months to come will tell whether she has any long-term kidney problems.
None of the medical staff has been able to say why Angela, and none of the others stricken in the E. coli outbreak, developed hemolytic uremic syndrome.
They still don't know when she'll go home. Angela still vomits most of her food and doctors are trying to find out why.
Don Hadley said he is learning patience. He's grateful for a chance to slow the hectic pace of his life and for those hours spent talking with Angela while a machine cleaned her blood and pumped it back into her body.
Angela said she's learned how much her parents love her.
"But I knew that already."
Carla K. Johnson can be reached at (509) 459-5148, or by e-mail at carlaj@spokesman.com.
