Suffolk mother’s poison prevention lesson

Published 8:32 pm Saturday, March 4, 2017

A Suffolk wife and mother of four is preparing for her latest battle with a lifelong medical condition.

Frances Knaack-Day will have her second esophagectomy surgery this May. She said the more than 38 years of hospitalizations and invasive procedures she has endured are a warning of what can happen when a child ingests harmful substances. National Poison Prevention Week is March 19-25.

“This could have been prevented,” Knaack-Day said.

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When she was 18 months old, she swallowed a Clinitest tablet after she found it in a nurses’ breakroom at the hospital where her mother worked.

The tablet has been used in diabetic blood glucose testing and combusts when it gets wet. It caused massive damage to her esophagus when it combusted in her throat.

In the aftermath, Knaack-Day had to go to the doctors’ office almost weekly until she was 5 years old. She was given steroids and anesthesia when the scar tissue in her esophagus was expanded using a balloon dilator. She could only be fed through a feeding tube until preschool.

“My life has been in and out of the hospital,” Knaack-Day said.

Her countless doctor’s appointments had made her resistant to contra sedation — a light form of sedation doctors refer to as “twilight sleep” — by the time she was 22 years old. She had built a tolerance after more than 200 hours under sedation and required progressively stronger doses.

“It was a pain, so we were looking for a more permanent solution,” Knaack-Day said.

At age 22, she received a total esophagectomy to fix the problem surgically so she wouldn’t require monthly dilations. Half of her stomach was used to serve as a conduit for food to travel through her, and the other half was removed completely. Her entire esophagus had been removed and replaced.

She said that there is very little medical precedent for her case.

“Very few doctors are familiar this type of surgery and post-operative care over years,” she said.

In recent months, she experienced more pain than usual and needed to be hospitalized. She learned that her surgical modification more than a decade ago had created a pouch in her chest that collected bile. She experienced extreme pain when that bile interacted with her stomach acid.

“It’s very painful,” she said.

She and her husband visited North Carolina’s Duke University Medical Center and Maryland’s Johns Hopkins Hospital. Doctors agreed that the best course of action would be to surgically implant a new conduit using a portion of her small intestine.

“They said if it stays like it is, it will kill me eventually,” she said.

Four surgeons at Duke will perform more than 24 hours of surgery on her in May. Her family is preparing itself emotionally for what lies ahead. She said they receive constant support from their “phenomenal” friends and family, which brings its own mixed feelings.

“It’s very hard and humbling,” she said. “You want to contribute, but you’re relying on others.”

She said her house is “kid central,” with friends of her children often present. She loves being a parent.

“I did everything possible to be the best mom for my kids.”

She said she wants other parents to understand that what happened to her can happen to any child, and to be mindful and keep their children safe.

“Be aware of the environment your child is in,” she said. “Be aware that it can happen.”

Her 11-year-old son Sammy said it’s hard to put how much he loves his mom into words.

“I’m really glad she didn’t die,” he said.

Cards and well wishes for the family can be sent to Beech Grove United Methodist Church, 4251 Driver Lane, Suffolk, VA 23435.