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Mr. Ballin
Hey, prime members, you can binge episodes 65 through 72 right now and ad free on Amazon Music. Download the app today. On a fall morning in 2021, a pediatric specialist stood in an examination room at a hospital in Boston, Massachusetts. He stared down at his two month old patient, being careful to avoid eye contact with the baby's parents. He knew how worried they were, and he felt guilty for what he was about to do. The little boy had spent the past two days crying nonstop until he was so exhausted from the screaming and whatever trauma was causing him such discomfort that he had finally passed out. But now the specialist knew he had to wake the child up, but in the most painful way possible. A nurse stepped up to the examination table and and the specialist asked her to turn the sleeping boy onto his side and ball him up into a fetal position. Then the specialist rubbed a bit of numbing cream on the baby's back and gave it a minute for the cream to activate. He finally looked up at the baby's parents, assuring them that the procedure would only take a few moments. When the mother nodded, the specialist removed a thin hollow needle from its sanitary wrapping and attached it to a clean syringe. And then, slowly and carefully, he used that syringe and he pierced the baby's back right into the skin between the little boy's vertebrae. Then immediately, the child yelled out in pain and began crying all over again. The specialist knew he had to act quickly, and so, as carefully as he could, he began to withdraw yellow fluid from the baby's spine, pulling it back into the syringe. He wished there had been another way to figure out what was wrong with this infant. But he'd run every test in the book and they had all come back normal. So this was the last resort. And so, as the infant continued to scream, the specialist just hoped that the lab results from this test would be worth the pain he'd just caused. 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Get up to 60% off your Babbel subscription, but only for our listeners@babbel.com mrballin get up to 60% off@babbel.com Mrballen spelled B A B-B-E-L.com Mrballin rules and restrictions may apply. Thumbtack presents the ins and outs of caring for your home Out Uncertainty Self doubt stressing about not knowing where to start in plans and guides that make it easy to get home projects done Out Word art Sorry Live Laugh lovers in knowing what to do, when to do it and who to hire. Start caring for your home with confidence. Download thumbtack today Foreign Studios and wondery I'm Mr. Ballin and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape our own bodies. So if you like today's story, when you and the follow button are at the beach, tell them to bury themself and promise you'll dig them up, but then just leave. This episode is called the Endless Cry. On a chilly fall afternoon in 2021, a woman named Ruth Jones pushed her grandson stroller through the Boston Common, a beautiful city park in Boston, Massachusetts. Ruth beamed with pride as people leaned in to get a look at eight week old Tommy, who was cooing and gurgling in his stroller. This was one of Tommy's very first excursions outside of the house and he was bundled up so much that he almost looked like a little burrito with big brown eyes. Fascinated by the treetops overhead and all the new faces waving hello, Ruth walked them around the pond, marveling at all the autumn foliage in the park, then sat down on a bench across from her favorite people watching spot the vintage carousel with hand painted wooden horses and zebras. She turned Tommy's stroller so he could see the flashing lights and hear the lively organ music. But after a moment, Tommy started to cry and so Ruth turned Tommy around and tried to calm him down, but it was like nothing she could do could get the boy to stop crying. Ruth's daughter Emily had warned her that Tommy had been very irritable lately. So she picked Tommy up out of the stroller and cradled him to her chest, thinking that might calm him down. But he just continued to wail in her arms, almost like he was actually in pain. Ruth then tried to give Tommy a pacifier, something he normally liked, but he wouldn't take it. And if anything, it just seemed to make him even more upset. Ruth wondered if maybe he was hungry, but she didn't have a bottle with her, so she decided it was time to take Tommy home. Tommy cried the entire way back. By the time Ruth got him to her daughter's house, his voice was hoarse. Now, at this point, Ruth did feel very sorry for Tommy. She didn't know what was going on, and obviously he was very upset. But if she was being honest, all this persistent crying was actually now giving Ruth a bit of a headache. And so she carefully brought Tommy into the kitchen and she put the kettle on the stove for tea and then put Tommy's bottle in a warmer. And while the milk was warming, she set out a teacup, put a tea bag in, and also got some honey out. All the while, Tommy just continued to wail and cry on her shoulder. Once Tommy's bottle was warm, Ruth tried to give it to him, but he was so upset he wouldn't take it. And so now Ruth was sort of out of ideas and really didn't know how to calm Tommy down. And so she just began walking around the kitchen, you know, patting her grandson on the back and, you know, doing everything she could to be motherly. But Tommy just kept on wailing and wailing. And then Ruth remembered that her daughter and son in law had said something about giving Tommy something sweet when he had been really upset these past couple of weeks. But Ruth looked around the kitchen and couldn't find anything that fit the description and didn't feel comfortable just giving him something random. And so ultimately, Ruth just sort of walked around the kitchen as Tommy screamed for the next few hours, until finally, Ruth's daughter Emily came home and took Tommy from her. Six days later, Ruth was at Tommy's pediatrician's office holding the crying baby to her chest while trying to fill out a clipboard of check in forms. Over the past week, Tommy's meltdowns had gotten longer, louder, and more frequent. Ruth and Emily were both worried that something was genuinely wrong with him. And so Emily had scheduled this doctor's appointment for Tommy. But today Emily had to work, and so Ruth had taken the baby. When they finally got called back to the examination room, Tommy's Crying only seemed to get worse. And so the pediatrician, upon seeing Tommy, sort of furrowed her brow as she began conducting a routine physical exam. And as she did, Ruth explained that these crying fits had been going on like this for a full week. The pediatrician nodded as she touched the right side of Tommy's abdomen. And as she did, Tommy wailed harder and louder than Ruth had ever heard. She jumped to her feet out of instinct, genuinely horrified by the noise coming from her grandson. But the pediatrician just shook her head and said not to worry. She now knew what the problem was. There was gas stuck in his tiny stomach. The pediatrician then showed Ruth some exercises to do on Tommy, and she literally began pedaling Tommy's legs and folding them up and down and rubbing his stomach to help him pass the gas. And as she did that in demonstration for Ruth. Ruth. It did seem like Tommy was calming down just a little bit. However, by the time Ruth and Tommy were back home again, Tommy was wailing all over again. And so Ruth carried him up to the nursery and ran him through all those exercises she had been shown on his changing table. And he did pass some gas, and he did start to quiet down. And for a second, Ruth felt relieved, like they were onto something, that they had really figured out what was wrong here, and they were slowly making it better. But the second she picked Tommy up again, he started to cry again. Ruth was at a loss. She just couldn't seem to keep him calm. She paced the hallway with him, and she also just stopped and rocked him back and forth. She carried him up and down the stairs. She sang lullabies, but nothing worked. A few hours later, when Emily got home from work, Ruth almost cried with relief. She handed Tommy off to Emily the moment her daughter stepped through the door. Ruth was obviously still very concerned for Tommy, but she also desperately needed a break from the constant crying. It had just gotten worse. All afternoon. I mean, his screaming was relentless. And now, as she walked outside down towards her car, she could still hear him crying in the house. And as Ruth drove back to her home, all she could think about is, what's going on with Tommy. Half an hour later, back at Emily's house, Emily sat in the nursery with Tommy, trying to feed him. Downstairs, she could hear her husband Dave in the kitchen making dinner. And even though Emily was hungry, she knew she had to give Tommy his own dinner before she could eat. And that was proving much more difficult than usual. Now, Tommy had always been a fussy baby, but nothing like the last week. The only time Emily noticed Her son seemed even remotely calmed down and happy was when he was nursing or when they dabbed a trace of honey on his pacifier and actually got him to use it. And so Emily rocked Tommy, and finally he did latch on, and he began breastfeeding. And at that point, he did sort of quiet down, except as he was eating, Emily noticed that he was not latching onto her breast as firmly as he usually did. As the minutes went by, she noticed that he seemed to be drinking less and less milk, too. She wondered if maybe it was just because he was so tired from all the crying. A minute later, he'd stopped drinking completely and was fast asleep. Emily thought that maybe he wasn't all that hungry, so she put him in his crib and joined Dave downstairs for dinner. The next morning, just before dawn, Emily was back in Tommy's nursery, back in the armchair she used for nursing. But Tommy was not latching. No matter what she did, she could not get him to begin to breastfeed, not even in the weak way he'd done the night before. It was just like he wasn't doing it. She knew Tommy had to be hungry, but she had no idea how to get him to actually eat. At this point, Emily felt like Tommy's behavior was more than just typical baby fussiness. And so when her husband appeared in the doorway a moment later, she told him they had to go to the emergency room. A few hours later, Dr. Ann Brogden walked down the hallway of her Boston area pediatric hospital. She could hear her new patient screaming from inside the small examination room. And when she walked inside, she saw the patient's parents, Emily and Dave, who told Dr. Brogden that their son Tommy had basically been crying non stop for days. Dr. Brogden went straight to work. She knew that Emily and Dave were new parents, and so she really wanted to put them at ease because Dr. Brogden assumed this was just, you know, child fussiness. So she gave Tommy a routine physical examination, checking his reflexes and taking his vitals. And as she gently poked and prodded him, she asked Emily about his medical history. And everything Emily said sounded typical and healthy. She told the doctor that she'd had a routine vaginal delivery after an equally normal pregnancy. Tommy had no known allergies, and he wasn't on any medications except for vitamin D supplements. He was also still wetting his diapers regularly, though his last bowel movement had been two days earlier. Tommy didn't have all of his immunizations just yet, so he was susceptible to pneumonia, influenza type B and whooping cough. But Tommy's symptoms seemed more like a gastrointestinal problem than any of those diseases. And unfortunately, Dr. Brogden's physical examination wasn't giving her any real clues either. And so she told Tommy's parents that she would just have to conduct a little bit more testing. An hour or so later, Dr. Brogden looked at Tommy's test results on her tablet. Tommy had tested negative for a whole bunch of diseases. Rsv, influenza types A and B, and even Covid. So his distress probably was not caused by a viral infection. Tommy's blood levels were also all normal, which ruled out other things like appendicitis, pancreatitis, liver disease, or some kind of obstruction in his digestive system. Dr. Brogden's physical exam had also already ruled out the possibility of child abuse. And it was unlikely that a breastfeeding infant could have ingested poison. So what was going on here? Dr. Brogdon decided to ramp up her efforts. Something was obviously wrong with Tommy, and it couldn't just be a case of bad gas. So she ordered a urinalysis, an ultrasound of his abdomen, and an X ray of his chest. She hoped one of those more advanced tests might finally solve the mystery around what was going on with Tommy. When Dr. Brogden opened the door to Tommy's room an hour later, the sound of his wailing immediately filled the hallway. And inside the room, Emily was pacing back and forth with Tommy in her arms as his screams echoed off the walls. Emily and Dave looked utterly miserable, totally sleep deprived and confused and nervous. And unfortunately, Dr. Brogden didn't have anything really positive to say, which only made it that much harder to deliver the news. She still didn't know what was wrong with their son. His chest X ray came back normal. His ultrasound and urinalysis were also normal. And yet he was still crying. Emily and Dave were heartbroken. They couldn't believe that nobody knew what to do here. But Dr. Brogden promised them she was doing everything she could to help. And then she told Emily and Dave that she was going to admit Tommy to the hospital. Creating really great retail experiences is tough, especially with multiple stores, teams of staff, fulfillment centers, separate workflows. It's a lot, but with Shopify Point of Sale, you can do it all without complexity. Shopify's Point of Sale system is a unified command center for your retail business. 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One purchased equals one donated. Now go to bombas.com wondery and use code wondery for 20% off your first purchase. That's B O-M-B-A-S.com wondery and use code WONDERY at checkout Four hours later, one of the hospital's pediatricians, Dr. Christopher Reynolds, entered Tommy's hospital room. He'd read in the clinical notes that Tommy had been crying for days, so he was surprised to find that the room was actually silent when he walked in. Emily and Dave were inside the room, sitting on the bed. Dave was holding Tommy, who was nearly asleep. After more than six hours of uninterrupted crying, it seemed like the little boy had finally tired himself out. Dr. Reynolds hoped that was a good sign. The doctor introduced himself and reached for the baby to do a physical exam. He'd already scanned Tommy's case file and knew that despite crying for days, Tommy was mentally alert. But when Dr. Reynolds took Tommy and fully woke him up and tried to get his attention, he noticed that Tommy did not seem to focus on him. At first, he wondered if maybe it was because the boy was just so sleepy. But the more he examined the child, the more he began to realize that Tommy seemed to have no energy at all and his reflexes were quite slow. It was like his reactions were on a time delay. Dr. Reynolds knew Tommy had to be tired, but this was something else. Dr. Reynolds immediately ordered an MRI to see if there was something wrong with the child's internal organs, and fortunately, that scan showed no abnormalities. But it meant Dr. Reynolds had to order more testing to figure out what was actually going on here. He told Emily and Dave that he wanted to test Tommy's next stool sample and in the meantime, he also wanted to perform a lumbar puncture or spinal tap, just to make sure that Tommy was not suffering from an infection in his brain or spinal cord. The spinal tap procedure did not take very long, but Dr. Reynolds knew it was very difficult for Emily and Dave to watch. The doctor had placed Tommy in the fetal position on his side and then inserted a long needle into his spine to draw out the spinal fluid. And even though he had placed numbing cream on the injection site, Tommy's cries were still ear splitting the instant the needle broke the skin. Thankfully, it was all over in just a few minutes. Once Dr. Reynolds had the spinal fluid sample, he sent it for testing right away. And this time, Dr. Reynolds did get a useful clue. The spinal fluid analysis showed an elevated protein count, which could mean Tommy's body was working overtime to fight off some kind of infection. But since they had already ruled out a lot of the more common infections, Dr. Reynolds was now worried that Tommy might have meningitis or inflammation in the brain. Bacterial meningitis, especially in children, is extremely dangerous. It can cause long term problems with seizures, brain damage. It can even be fatal. And so, even though the doctor didn't know specifically what kind of infection the baby was fighting, what he did right away was just put Tommy on antibiotics to try to kill whatever bacteria was causing the infection. About an hour later, Dr. Reynolds checked in on Tommy to see if the antibiotics were kicking in. But as soon as he examined the little boy, he could see there was a big problem. Tommy was really struggling to breathe. And whenever he breathed in, it almost sounded like he was grunting. In fact, Tommy was fighting so hard for oxygen that Dr. Reynolds could see his ribcage straining against his skin with every breath. And there was a faint blue tint growing around Tommy's lips, which truly scared Dr. Reynolds because that meant the baby was not getting enough oxygen. And so he immediately put Tommy on supplemental oxygen and instructed the nurses to rush him to the intensive care unit. Moments later, the hospital's pediatric critical care specialist, Dr. Cassandra Pierce, examined Tommy in the pediatric ICU while his parents, Emily and Dave, stood by at the foot of his hospital crib. Dr. Pierce thought Tommy's cry was more weak and pained, and in fact, it sounded more like a snore than a wail, like it was taking everything out of him just to make a sound. To Dr. Pierce, that was a sign of an airway obstruction. So she turned Tommy onto his back, and when she did, she noticed his eyelids were drooping and his head sort of bobbed strangely up and down on his neck. Dr. Pierce knew she had to act quickly, and so she called for an intubation kit, and right away, a nurse came back with one. Then Dr. Pierce took the hollow tube and slid it down tommy's throat, past his vocal cords. All the while, tommy was jerking in discomfort, Trying to pull away. But once the tube was all the way in and Tommy stopped thrashing, Dr. Pierce hooked it up to a ventilator, A machine that would now breathe for tommy so his body could rest and get the oxygen it desperately needed. But even as the child's chest began to rise and fall in a steadier pattern, Dr. Pierce knew Tommy's lungs were still at risk to collapse. But just then, the heart rate monitor by tommy's bedside began beeping. Tommy's heart began beating much faster than normal. Then another monitor began going off, Signaling that tommy's blood pressure was rising, too. It was like his entire body was panicking, Even though he was lying there quietly thinking fast. Dr. Pierce turned to the nurse and asked her to start tommy on continuous infusions of opioids and drugs called benzodiazepines, which would hopefully get his body to relax and relieve his pain until she could figure out what was going on. Also, Dr. Reynolds administered Tommy a sedative and lower dose painkiller. An hour later, Dr. Reynolds was leaning over tommy, Testing his reflexes, and they remained very weak. In fact, overall, tommy was just growing weaker by the minute. Further analysis had been conducted on tommy's spinal fluid, and it had come back negative for meningitis. On the one hand, Dr. Reynolds and the rest of the medical team Were relieved that the boy did not have meningitis. But on the other hand, at this point, they still just didn't have a diagnosis for tommy, which was making caring for him nearly impossible. It's like, in some ways, just having a diagnosis, Even a bad one, Would sort of be an improvement. They'd at least have the ability to try to treat something, but without a diagnosis, they were just sort of left scratching their heads. Dr. Reynolds went back to tommy's medical history and looked for anything that somebody might have missed, but there was nothing that stood out. The child had no neurological deficits. He had no swelling in his heart or lungs. There were no gastrointestinal issues or urinary issues. On paper, tommy should be fine, and yet he continued to get sicker. In fact, he was now developing something called hypotonia, or severe muscle weakness. Something was clearly slowly paralyzing Tommy, but when Dr. Reynolds reviewed Tommy's brain scan, it showed nothing abnormal, which meant that whatever was weakening his muscles was probably wasn't affecting his brain or spinal cord. Now, Dr. Reynolds knew he could diagnose Tommy with something called spinal muscular atrophy, a degenerative motor neuron disease that weakens the muscles closest to the center of the body. That would explain Tommy's overall weakness, his drooping eyelids, and his inability to latch when his mother tried to breastfeed him. It was also one of the more common genetic disorders in young kids. But deep down, Dr. Reynolds knew that diagnosis did not explain all of Tommy's symptoms, including the high protein levels in Tommy's spinal cord fluid. Then he thought Tommy's high protein levels and growing muscle weakness could be a sign of Guillain Barre syndrome, a condition caused when the immune system attacks the nervous system and weakens the muscles. But Dr. Reynolds knew that that syndrome was very rare in babies. Dr. Reynolds paced the hallway outside of Tommy's room, trying to think if there was anything he hadn't thought of or some question he hadn't asked. And then he realized there actually was one question he had not personally asked the parents yet. And so he dashed back down the hallway to Tommy's room. He went inside, and he asked Emily and Dave, who were at their son's bedside, what had they fed their son in the past few weeks. Now, keep in mind, Tommy was breastfed, and so the assumption was he only got milk. But Dr. Reynolds was wondering if maybe this child had eaten something other than milk. But Emily looked up at Dr. Reynolds and just told the doctor that, yeah, Tommy is breastfed, and he's only had her milk. Dr. Reynolds felt defeated for a second. He felt like maybe he had just solved what Tommy's issues were. Maybe it was coming from eating something that was not his mother's milk. However, just then, Tommy's father, Dave, added that on occasion, when Tommy would not take his pacifier, they would sweeten it with a drop of honey. Suddenly, it all made sense, and Dr. Reynolds knew what was wrong with Tommy. But it was a terrible diagnosis, and there was no time to waste. Tommy needed emergency treatment right away. Even before the diagnosis was confirmed. The second Dave had said they fed their baby honey, on occasion, Dr. Reynolds realized that Tommy had something called botulism. Botulism is a rare but serious illness caused by a bacterial toxin that attacks the nervous system. As the disease progresses, it causes difficulty breathing, muscle paralysis, and sometimes even death. Adults can typically fight off botulism, but babies like Tommy are not capable of overcoming the bacteria that spreads it. About 90% of untreated infant botulism cases are fatal. While botulism is rare, the bacteria that causes it is not. In fact, it's found in many kitchens, often hiding in an unlikely place. Honey Honey is a natural sweetener, but it should never be given to babies under the age of one for this reason. Unfortunately, Dave and Emily didn't know this, and when they dipped Tommy's pacifier in honey to sweeten it, they had unknowingly made their baby very sick. Dr. Reynolds sent Tommy's stool sample out for testing, knowing that it would take six days for the results to come back. But he was so sure about the botulism diagnosis that he just started Tommy on a special antitoxin treatment right away. Over the next 10 days, Tommy slowly regained movement in his arms and legs and his botulism diagnosis was confirmed. It would still take another 20 days or so before he was well enough to be discharged from the hospital, and then once he was discharged, he had to spend eight more days at a rehab facility. However, at the end of it all, he would make a full recovery and he is doing well today hey prime members, you can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad free on Amazon Music. Download the app today and also Wondry subscribers can listen to Mr. Ballin's medical mysteries ad free. Join Wondry Today before you go, tell us about yourself by completing a short survey@listenersurvey.com from Ballin Studios and Wondry. This is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin, a quick note about our stories. They are all inspired by true events, but we do sometimes use pseudonyms to protect the people involved and also some details are fictionalized for dramatic purposes. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis or treatment. This episode was written by Aaron Lan. Our editor is Heather Dundas. Sound design is by Matthew Cielelli. Our senior managing producer is Nick Ryan and our coordinating producer is Taylor Sniffen. Our senior producer is Alex Benedon. Our associate producers and researchers are Sarah Bytak and Teja Pelikonda. Fact checking was done by Sheila Patterson for Ballin Studios. Our head of production is Zach Levitt. Script editing by Scott Allen and Evan Allen. Our coordinating producer is Samantha Collins. Production support by Avery Siegel. Executive producers are myself, Mr. Ballin, and also Nick Witters for Wondry. Our head of Sound is Marcelino Villapando. Senior producers are Loredana Palavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louie. For Wondry packages by Expedia, you were made to be rechargeable. We were made to package flights, hotels and hammocks for less. Expedia made to travel.