Cairo Vargas was living a typical teenage life when a sudden cardiac arrest upended everything. A multidisciplinary care team, strong faith, and determination from Cairo has put him on the path to recovery.
Cairo Vargas, a healthy 16-year-old diagnosed with asthma at a young age, had a normal day at school on Oct. 19, 2021. But after playing basketball with some friends, he arrived at his grandmother’s house suddenly unable to breathe. The series of events that happened next shaped Cairo and his family for the foreseeable future.
“My mother called the ambulance,” said Moira, Cairo’s mom.
As the ambulance arrived, Cairo suddenly went into cardiac arrest. While in the ambulance, the EMTs performed quick CPR. Ultimately, this CPR saved Cairo’s life and added to his miraculous recovery.
The ambulance took Cairo to Rochester Regional Health (RRH), where he then suffered another cardiac arrest upon arrival in the emergency room. Cairo received CPR once again.
“My brother was at the hospital at that time and called me. Without saying so many words, he said ‘you need to get here, this is serious,’” said Moira.
Facing it all with Faith
As a woman of faith, Moira and her family took comfort in the act of prayer. Her hands were tied as a parent, as there was nothing she could do for her child but pray and be there for him.
“My heart was ripped out of my chest,” she said. “All I did was pray. I fell to my knees and started praying to God.”
RRH contacted Golisano Children’s Hospital (GCH). That is when Adam Dziorny, M.D., Ph.D., assistant professor in the Department of Pediatrics, Critical Care, first met Cairo.
“I was the one to pick him up from RRH. As an attending, we take those calls for critically ill children that need to be transported. When we get a call like that, our transport team requests a physician to attend as we never know how stable or unstable the child may be,” said Dziorny.
When Dziorny met Cairo in the emergency room, he was quick to note that RRH did a phenomenal job stabilizing him.
“We got him on our transportation ventilator and got him to GCH as fast as we could,” said Dziorny. Cairo was still recovering, so the risk of post-cardiac arrest issues remained top of mind for the transport team.
Once Cairo and the transport team arrived at GCH, and he was admitted to GCH’s Pediatric Intensive Care Unit (PICU), Dziorny had the heavy task of talking with his family. He had to level with them, saying they don’t know what will happen in the next few days, or in the future.
“His mother was very distraught, rightfully so, but understanding. It was critical for us to provide stability for the next 48-72 hours,” said Dziorny.
Cairo was placed on a ventilator and experienced several complications during his stay in the PICU; both steps were to be expected for a patient as sick as he was.
Early in his course of treatment at GCH, Cairo had a mucous plug in his lung that required a bronchoscopy, which is essentially a camera and suction placed down his endotracheal tube to clear out this plug. The pulmonology team and ear nose and throat (ENT) team assisted on this successful operation. Later that same day, Cairo developed pneumothorax — a collapsed lung that occurs when air enters into the pleural cavity (the space around lungs) and causes pain in the chest and difficulty in breathing — and needed his first chest tube to clear that air.
“This really became a highlight of the efficacy of our subspecialties collaborating on this complicated patient and his case,” said Dziorny.
A Truly Multidisciplinary Effort
Post cardiac arrest, many patients are at risk for neurology complications as the flow of blood and oxygen to the brain decreases. The GCH neurology
team closely monitored Cairo’s status. They helped interpret his monitor to ensure he wasn't having seizures and played a large role in sharing MRI findings with Cairo’s mom. Throughout his stay, Cairo struggled with nerve damage that impaired his movement and speaking, which the physical medicine and rehab team worked tirelessly to mitigate.
Cairo eventually required a second bronchoscopy with the pulmonology team when his airways collapsed and showed lots of secretions that needed clearing. He also had a persistent fluid build-up in the lungs, which the surgery team drained using a second chest tube. In addition, this fluid build-up became infected with Methicillin-resistant Staphylococcus aureus (MRSA) bacteria, caused by a type of staph bacteria that's resistant to many of the antibiotics used to treat ordinary staph infections. Fortunately, the infectious disease team helped to manage his antibiotic therapy and treat the infection.
Throughout all of this, the palliative care team spoke with his mother regularly, listening to her wishes and desires as there was talk of a tracheostomy if he was unable to come off the ventilator successfully.
Fortunately, that scenario didn’t play out. His team finally extubated him successfully on November 7 with no breathing issues.
“The doctors said this was a miracle,” said Moira.
His second chest tube was removed, and after he stopped receiving sedation medications, he left the PICU November 10.
What kept Cairo’s mom positive during such a tumultuous time?
“We received a lot of bad news, one thing after another,” Moira said. “I kept saying ‘keep the faith’ and that my son was going to be okay. I prayed for the doctors as well.”
After Cairo’s time in the PICU, on November 10, he was transferred to GCH’s Children’s Tower, on 8 North, where he stayed for the remainder of his recovery at GCH. Among others, Lauren Solan, M.D., MEd, associate professor of Pediatrics, and Sherry Philip, M.D., associate professor of Clinical Pediatrics, Pediatric Hospital Medicine, helped care for Cairo on 8 North.
“When Cairo came up to us, he was stable, but still in the in-between phase. His brain was still recovering from his cardiac arrest,” said Philip.
At this point, Cairo was not verbal or following commands, but was starting to move more.
“Every child is different. For me, the hardest part is, you never know how they will recover,” said Philip. “I share the same faith as his family and got the opportunity to pray with them. There’s no guarantee when we discharge patients to rehab if they’ll walk, talk, or eat again.”
Miraculous Progress Turns Out to Be ‘the Most Amazing Thing’
While on 8 North, teams worked with Cairo actively each and every day.
Along with his surgeons and pulmonologists, Cairo was treated by medical specialists, physical therapy, occupational therapy, speech therapy, and child life specialists. Thanks to the multidisciplinary care that he received throughout his stay, Cairo began to turn the corner.
“The most amazing thing for me,” said Philip, “was one afternoon, a week and a half after he came to us, he was being supported in a chair and harness, and using his hands to work with the therapy teams, following instructions purposefully. It was a miracle to see the progress. Even if he hadn’t made the recovery he did, his life would still be as meaningful and we are grateful we were able to serve his family during their journey.”
The day-to-day nursing staff on 8 North also significantly contributed to his recovery. They stayed at Cairo’s side, along with his family, every step of the way.
"His family educated themselves to help build his strength and communicate with him,” Solan said. “One day, the nurses placed him in his chair, facing out to the unit. He was so happy, just smiling and engaging with everyone who walked by. He didn’t give up, and that was impressive to see.”
Along with the support of his doctors, nurses and family, Cairo’s classmates raised over $3,000 for him in support of his recovery. Well wishes and notes from friends covered the walls of his room, evidence of how adored he was by his peers.
After almost two full months, Cairo was finally discharged from GCH on December 2 to a rehab facility.
And now? Cairo is doing great. He’s a very eager 17-year-old kid who loves his friends, church and, of course, basketball.
His family now works to shed light on asthma awareness. They want others to be aware so that this doesn’t happen to their child.
“All I asked was for people to pray for my son. I don’t need anything else. He’s not a good kid,” said Moira, “he’s a great kid.”