Some children love reading, others enjoy drawing or coloring and some delight in dressing up as superheroes or princesses. For Carlos – known as Carlitos to his family and friends – nothing compared to the joy of riding his bike.
On a warm, sunny day in May 2023, 6-year-old Carlitos was riding his bike in his backyard in Modesto, California. It was an activity he loved doing with his family. Suddenly, Carlitos fell off his bike and hurt his ankle. At the time, his parents didn’t imagine it was anything too serious as he continued to play. As a precaution, they took him to a nearby clinic the next day for an X-ray, and after receiving reassurance from the doctors that he was fine, they momentarily felt better. Little did they know that day marked the beginning of a challenging journey.
Ana Lilia, Carlitos’ mom, sensed something was wrong when she noticed his usual bubbly and joyful demeanor had dimmed over the past few days, as Carlitos complained of pain in his feet and had difficulty walking. During his kindergarten graduation ceremony, he could no longer endure the pain, prompting his parents to rush him to the hospital again. This time, the visit was different: They took him to the ER, and after some checkups, the doctor informed them that a medical helicopter was waiting to transfer Carlitos to a larger hospital in Madera, California.
“As a family, it was one of the most challenging times we have endured,” said Ana Lilia. “I felt lost and afraid of how quickly everything escalated, and didn’t know what to do to make Carlitos feel better.”
Doctors discovered that a streptococcus bacteria had infected Carlitos’ ankle. According to the Centers for Disease Control and Prevention, streptococcus is a bacterium that can cause a variety of infections. Most of the streptococcus infections are mild, but some cases are serious or even life-threatening. Carlitos’ case was one of them: He had internal bleeding from the fall, and the absence of antibiotics had made him ill, causing renal failure and low blood pressure. He was placed in an induced coma for a few days, and since he had a compromised immune system due to asthma, they needed to wait for the antibiotics to take effect.
“It was heartbreaking to see Carlitos in that position,” said Roberto, Carlitos’ dad. “I couldn’t help but imagine what we had done wrong, and the feeling was terrifying.”
This is my hospital, I love playing with Allie and Kayla from child life, and how nice all the nurses are to me.
The doctors in Madera recommended transferring Carlitos to a specialized hospital for better care. The family decided that Shriners Children’s in Sacramento was their best option. Shriners Children’s Northern California is a world leader in providing specialty pediatric care for kids living with some of the most complicated and complex medical conditions.
Jason Heard, M.D., a burn surgeon at Shriners Children’s Northern California, oversaw Carlitos’ first surgery. Due to Carlitos’ condition upon arrival and to prevent the infection from spreading, Dr. Heard had to make the difficult decision to amputate both of Carlitos’ feet. Carlitos’ hands were also damaged, but they were saved, and with therapy they regained full mobility.
“Carlos was very sick when he first arrived at Shriners Children’s, with multiple organs not working and extensive wounds to his legs and hands,” said Dr. Heard. “Carlos was appropriately sad when he was told that we could not save his legs, but remained brave and strong throughout the entire process. He was an extremely hard worker and always faced every challenge head on. He did therapy through excruciating pain, which we ultimately determined to be a septic hip. Carlos was also successful because he had such a caring family that was always by his side, helping push him to the finish line.”
Unexpectedly, when the family thought they were on the final path to recovery, an MRI revealed another bacterial infection in Carlitos’ legs. The infection had reached his left leg and hip, provoking a septic hip. This time, orthopedic surgeons Holly Leshikar, M.D., and Joel Lerman, M.D., worked together to control the infection, and performed a new surgery on Carlitos to prevent future septic complications.
Carlitos’ family lived in Modesto, a two-hour drive from Sacramento. Carlitos’ dad and siblings made the long trips almost every day, balancing work and school to spend time with him while mom stayed full time at the hospital. During these months, the family grew closer, and thanks to friends and extended family, the burden of being away from home was lessened.
But their blood relatives weren’t the only support they found. It’s common for patients’ families to become friends, seeing each other daily in various hospital activities. One day, a physical therapist introduced Carlitos to another patient, Jaziel, a double amputee himself. At that time, Carlitos was terrified of wearing prosthetic legs, fearing he would fall and get hurt again. That changed when Jaziel showed Carlitos a picture of himself riding a horse with his prosthetic legs.
“I could see how his eyes lit up,” said Ana Lilia. “He saw all the new opportunities before him, and I knew he would be okay.”
“Physical therapy was not easy,” Carlitos said, referring to the time he needed to learn how to use his wheelchair and strengthen his arms to move from the wheelchair to the bed.
One day, Debbie Minter, PT, had a surprise for Carlitos’ parents. During a therapy session, she showcased part of his progress using a modified bicycle, where the handles functioned like pedals. Carlitos rode the bike with pride, demonstrating the progress he had made to his parents.
“We all started to cry; it was very emotional,” said Ana Lilia. “I never thought I would see him so happy and natural riding a bicycle again.”
“This is my hospital,” said Carlitos. “I love playing with Allie and Kayla from child life, and how nice all the nurses are to me.”
Research shows that children who are prepared for their medical experiences have less fear, increased cooperation and fewer negative responses. That’s why Shriners Children’s provides child life specialists and recreational therapists (CL-RT) for patients and their families to help reduce the stress associated with healthcare. CL-RT helped Carlitos to cope through play, self-expressive activities and age-appropriate medical preparation and education.
Carlitos is now 7. He is continuing physical therapy to learn how to use one of his prosthetic legs while waiting for his body to heal completely so he can start using both. He has many ideas for the future. He’d love to be a musician like his dad, a police officer or a firefighter. One thing everyone knows about Carlitos is that he will be whatever he dreams.
“I have no words to thank everybody who helped us during Carlitos’ path,” said Ana Lilia. “The knowledge, care and teamwork I've witnessed here is unmatched. To the medical team, Pediatric Orthotic and Prosthetic Services, nurses, child life specialists and environmental services staff, thank you from the bottom of my heart. Shriners Children’s saved Carlitos’ life and restored our family's spirit.”
