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Spokane, Washington  Est. May 19, 1883
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Steps to recovery

A life can change forever overnight.

Kaley Dugger knows that. And she’s just 8 years old.

Dugger was a first-grader at Spokane’s Jefferson Elementary School on Feb. 27, 2004. She remembers playing basketball that day. She remembers going to bed that evening. And she remembers waking up in the middle of the night with a fever and chills.

It’s a good thing she remembers just snippets of what happened in the days and weeks and long months that followed. But she’s certainly aware of the challenges she faces now.

Kaley’s illness came on lightning-fast. By the next afternoon, her temperature spiked to 104 degrees and red spots dotted her body. In a couple of hours, the rash blanketed her.

“We knew something was going on,” says Kaley’s mom, Debbie Dugger.

Kaley’s parents hurried her to an urgent-care clinic. The doctor there, knowing this was something serious, rushed her to the emergency room at Sacred Heart Medical Center.

Kaley’s dad, Mike, ran home for about 90 minutes to take care of Kaley’s now 12-year-old sister, Chloe. By the time he returned to the hospital, Kaley was sedated and on a respirator.

He remembers what the doctor told him then: “We have a life-threatening situation here.”

The culprit was meningococcal disease, a devastating and fast-moving bacterial infection. Kaley had developed the most serious form of the illness, which turned into septicemia or blood poisoning. The tidal wave of bacteria swarming the bloodstream forces vessels to burst. That’s what caused Kaley’s rash and what would cause the vast damage she’s still struggling with today.

“She was extremely, extremely ill in those very first few hours after coming to the hospital,” says Dr. Peter Graves, a pediatric intensive care doctor at Sacred Heart and one of the first physicians to treat Kaley. “This can strike anyone, particularly the young and the old. They can deteriorate from appearing normal to gravely ill in a matter of a very few hours. It’s just a scary disease.”

Says her mom: “She was slipping away pretty fast.”

Kaley’s illness, which spreads through airborne droplets from an infected person, made the front page of the newspaper a few days after she fell ill. Her family and her Jefferson classmates received preventive antibiotics; no one else contracted the disease.

Meanwhile, doctors gave Kaley just a 1 percent chance of survival.

“It’s an absolute testament to the fact that as good as we are at medicine and taking care of people and using our technological advances, there is still an absolutely critical role for hope and prayer and faith,” says Dr. Henry Mroch, Kaley’s nephrologist. “Because all of those things absolutely played a pivotal role. How else do you explain it?”

The bacteria shut down blood flow throughout her body. It killed off nearly half of her skin and underlying muscle. It was as if she had suffered third-degree burns everywhere. Nurses had to anesthetize her for a couple of hours each day during the painful and gruesome process of debriding, removing all of the dead tissue and deciding what could be saved.

Ultimately, surgeons were forced to amputate both of Kaley’s legs below the knees, along with many of her finger tips.

“This was devastating for us. Totally devastating,” says Kaley’s mom. “I guess what you realize is her life will be totally different from what we dreamed or imagined it would be.”

To make things worse, the infection also destroyed Kaley’s kidneys. She was particularly unlucky. In many cases, the kidneys bounce back from the illness. But, for Kaley, they did not.

Kaley has received dialysis three times a week ever since she got sick. And she’s finishing the final paperwork to get on the list for a donor kidney in Seattle. (Sacred Heart does not perform kidney transplants on children.)

But Kaley suffered another setback in May, when she fell out of her wheelchair, just as she was starting to learn how to walk on her prostheses. She broke her leg and needed to have metal rod inserted to fix the fracture. She can’t undergo a transplant until the rod is removed, but that should be soon.

The Duggers are hoping a live donor will step forward with a kidney for their daughter. Kaley has O-positive blood, but her parents are type A, so they cannot donate an organ.

The little brown-haired girl in the Strawberry Shortcake T-shirt and jean skirt has been through more in the past 18 months than any adult would want to go through in a lifetime. But what impresses those around her is her resilience.

“She a fighter,” says Rob Mildes, Kaley’s physical therapist at Spokane’s Shriners Hospital. “She’s got a great attitude. That’s what’s brought her this far.”

Kaley has worked several times a week with Mildes, building up her strength and learning how to walk on her new legs. He hopes Kaley will have the endurance to use her prostheses full time when she enters third grade this fall.

“I think that’s a realistic goal,” he says.

Even through everything, Kaley has remained a regular 8-year-old girl. There’s an extra mattress on the floor of her bedroom, at the ready for sleepovers with friends. There are stuffed animals in every corner. A pinup picture of the Olsen Twins. A sparkly pink “K” hanging from one wall.

“Sometimes we play house,” she says of her friends.

Kaley knows she faces a transplant and more struggles ahead.

But she has some more immediate concerns, too.

“I want to learn how to swim,” she says. “I want to learn how to run.”

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