Two-year-old Chett Sailer is a happy little boy. He loves to play with trucks and tractors, and hang out with his sisters. But not too long ago, when Chett was just nine months old, things weren’t so happy.
“He woke up in the middle of the night completely inconsolable, thrashing, throwing his head back. Just not like the typical sickness. You knew something was off,” said Chett’s father, Luke Sailer.
The Sailers brought Chett into the ER. He was admitted to the hospital overnight after tests showed fever, as well as inflammation throughout his body. He was treated for his symptoms, discharged and the family was told to monitor him closely.
“We went home for two days, and fevers and rash became pretty consistent,” said Chett’s mother, Ciarrin Sailer. “Once we were back in the hospital, they ran several more diagnostics that showed his inflammatory markers were through the roof at that point. We thought we were losing our son.”
Getting to a diagnosis
That prompted calls to specialists at Sanford Fargo, including Clifford Mauriello, M.D., who specializes in pediatric infectious disease, and Christopher Failing, M.D., a pediatric rheumatologist. Failing and his colleague Grant Syverson, M.D., are the only two pediatric rheumatologists in the entire state of North Dakota. They treat patients like Chett all across the Sanford Health footprint of North Dakota, South Dakota, Minnesota and beyond.
“It’s really important to have a good team, especially early on when the diagnosis is unclear,” said Dr. Failing. “You really need a teamwork effort to make sure you’re not missing something else.”
In Chett’s case, different diseases had to be ruled out before finding a clear diagnosis. It would take nine days from his first trip to the ER to determine what was wrong.
“It’s like a puzzle,” said Dr. Failing. “There’s no single diagnostic test for any of the diseases that we treat. So when we come into these fever cases, we really look at the fever pattern. That gives us a really big clue to what could be going on for the patient.”
With Chett, not only would his fever come on strong around the same time each day, but it was accompanied by a rash as well, which would also fade away as his temperature went down. That was the clue Dr. Failing needed to diagnose Chett with systemic juvenile idiopathic arthritis or sJIA, which affects about one in every 10,000 kids.
“In Chett’s case, he had arthritis of an elbow and of his cervical spine. But with early treatment we can get everything controlled pretty quickly and prevent any long-term deformities or issues,” said Dr. Failing.
Road to recovery
Within days of starting his treatment for JIA, Chett was recovering nicely and feeling like himself. It was sheer relief for his parents.
“We got our son back,” said Ciarrin.
Photo courtesy of the Sailer family
“You go from your son not moving. Anytime you would move with him, he would just be crying. So just to get him to like, reach for a toy or start to reach for a snack … it just brings you pure happiness,” Luke said.
Chett is still being monitored, but for now his symptoms and arthritis are under control. Around 30% of children with sJIA have a monophasic disease course, meaning the disease burns itself out in three to four months before going into permanent remission. Others have a polyphasic course where the disease flares up occasionally followed by periods of remission which last months or even years. For Chett, only time will tell which form he has.
“We treated him for six months and we were able to stop therapy in May, and he’s been in remission since then,” Dr. Failing said.
Now it’s just the occasional checkup with Dr. Failing, who has quite a bond with the Sailers.
“Dr. Failing is a wonderful man. Very smart, intelligent and very caring,” said Luke. “Almost feels like a family member at that point. He truly, truly cares for his patients.”
For the Sailer family, those nine terrifying days are a memory now. And on this trip to the doctor’s office, Chett is not just a happy little boy. He’s a healthy one too.
Learn more
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- Podcast: Caring for joint pain in the pediatric patient
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Posted In Children's, Fargo, Specialty Care
