Second opinion brings relief to teen suffering with GI issues

Gabe had always been a strong, healthy kid who rarely even caught a cold. At 5’10”, 240 lbs., he was a dedicated athlete who was excited to start his sophomore year playing offensive lineman for his high school football team. Between morning workouts in the weight room, afternoon football practice, and games for both the varsity and junior varsity teams, Gabe was exercising multiple times a day.

But as the fall of 2016 rolled on, the 16-year-old noticed that his bowel habits had changed. At first, things were just less solid. Then he started to go to the bathroom a few times a day, often urgently. When the problems persisted, Gabe and his parents assumed it might be the byproduct of his diet and rigorous workout routine. A family practitioner suggested more fiber, but it didn’t help.

By January 2017, Gabe was having 12-15 bowel movements a day and was passing blood. Desperate for answers, his mother took him to see a gastroenterologist who specialized in treating adults.

“Honestly, I never even thought of Children’s Wisconsin,” said Gabe’s mom, Jane. “Gabe was going to turn 17 that summer, and I figured, why start with a pediatric provider if in a year we were going to have to start somewhere else?”

A colonoscopy revealed that Gabe had ulcerative colitis, a condition in which the lining of the large intestine and rectum become inflamed and develop ulcers, causing abdominal pain and cramping, frequent and urgent need to use the bathroom, weight loss and fatigue. His case wasn’t easy to treat: Gabe cycled through medication after medication. Each brought a month or so of relief, but his symptoms always came back.

“His doctor kept telling us to be patient and to wait it out and the medicine would start to work,” said Jane, who had started calling the doctor’s office nearly daily. “In the back of my head I kind of knew better, but I was hopeful, I guess.”

A second opinion

Meanwhile, Gabe’s condition deteriorated. He was up to 20 bowel movements a day and started vomiting, too. He lost more than 30 pounds and struggled to keep up with school and activities.

“It got to the point where I was so sick that I had to go the bathroom at least once or twice during every class, and I was taking breaks all the time to go during football practice,” Gabe said. “I was trying really, really hard to get through everything, but I had to miss my final exams because I was so sick. It was horrible.”

By the time summer started, Gabe could hardly leave home. During Gabe’s annual physical, Jane shared her frustrations with the pediatrician, who made some calls and then recommended they seek a second opinion from the Gastroenterology, Liver and Nutrition Program at Children’s Wisconsin. Gabe was reluctant to start from scratch with another gastroenterologist. But after thinking it over and discussing it with family and his football coach, he decided to give Children’s Wisconsin a try. Because of the severity of Gabe’s case, he was able to get a same-day appointment.

The family knew they’d made the right call as soon as they met Jose Cabrera, MD, a pediatric gastroenterologist at Children’s Wisconsin.

“You can tell he’s very intelligent and he knows what he’s doing, but it’s not like he overpowers you,” Gabe said. “He listens to you and takes into account all of the things that are important to you.”

Gabe was relieved that Dr. Cabrera not only listened, but was ready to take action.

“Once I got to Children’s Wisconsin, I could tell they were trying to make a change to help me instead of just sitting around and waiting to see if I would get better,” he said. “I felt like I was finally in the right hands.”

Not just for babies

Gabe’s story isn’t unusual, noted David Gourlay, MD, a pediatric surgeon who also treated Gabe.

“Many families think of Children’s Wisconsin as a place for babies and children, not older adolescents,” said Dr. Gourlay. “But they soon see the difference between Children’s Wisconsin and the care provided by other providers. Our pediatric GI group manages one of the largest patient cohorts in the Midwest. The experience they bring to bear is unparalleled in the state.”

Gabe’s first visit to Children’s Wisconsin in June 2017 turned into a three-day hospital stay as the medical team worked to get his symptoms under control with IV steroids. That initially worked, but by late July, Gabe was sick again. Dr. Cabrera then prescribed regular infusion treatments.

His symptoms finally under control, Gabe resumed playing football that fall. But by January of 2018, his condition flared up again and Gabe was back in the hospital. More testing showed that Gabe’s disease had spread to his entire large intestine. Over the next few months, Gabe underwent three surgeries to remove his large intestine and adapt his anatomy so he could resume normal bowel elimination. While he encountered a number of complications after surgery, he has since recovered and is now doing well.

Dr. Gourlay performed the surgeries. “Although Gabe had complications, the complications would have been much worse if it were not for some of Dr. Gourlay’s choices in the operating room,” Jane said. “Dr. Gourlay and the entire surgical team deserve a lot of credit for Gabe being in the place he is now.”

After spending a total of seven weeks in the hospital, 18-year-old Gabe was eager to get back to football and back to normal life as a high school senior. Eventually, he will need to switch to an adult provider to monitor his condition, and when that time comes Children’s Wisconsin will help him transition.

“I’m very grateful that we ended up at Children’s Wisconsin instead of with another adult doctor,” Jane said. “I honestly don’t know what we would’ve done without them.”