September 12, 2018 at 12:53 AM
Xavier Cunningham and his buddies were climbing into a treehouse when a wasp landed on his hand.
The children had stumbled into a massive yellow jacket nest Saturday afternoon in a neighbor’s treehouse in western Missouri, and Xavier, who was at the top of the ladder, tried to swat one of them away. But in the process, Xavier’s stepfather said, the 10-year-old lost his balance and fell face-first to the ground — right where he and his friends had stuck a long metal meat skewer they had found.
“He fell down on it,” Shannon Miller said about his son, explaining how the skewer impaled the young boy’s cheek and drilled through his skull.
“He said he felt something hot and burning in his face and then saw the end of it and immediately knew what had happened,” Miller said, adding that Xavier got up covered in yellow jackets — with a long rod protruding from his face — and started running toward his house, wailing, “ ‘Get them off me! Get them off me!’ ”
“I think the yellow jackets were more painful for him at the time,” Miller said.
Xavier’s surgeon said the skewer entered the boy’s face under his eye and traveled several inches through his skull, but it did not puncture the skin at the back of his head — and it missed all his major arteries.
Miller said he was not home at the time. Xavier’s mother rushed him to a hospital near their house in Harrisonville, about 40 miles from Kansas City.
Miller said doctors there told them that they were not equipped to handle such an injury and the boy was taken by ambulance to Children’s Mercy Hospital in Kansas City — and then to the University of Kansas Hospital.
While Xavier’s medical team worked to devise a plan, Miller said he and Xavier’s mother stayed up all night, praying and singing and watching the boy sleep to make sure that he didn’t pull the metal skewer out of his face.
“That was the hardest part,” Miller said. He said Xavier would sleep only minutes at a time, then wake up in a panic, asking, “Am I dead? Am I still alive?”
On Sunday morning, he went into surgery.
Koji Ebersole, director of endovascular neurosurgery at the University of Kansas Health System, said the medical team’s first priority was protecting Xavier’s airway; because the skewer had hit his jaw muscles, he could not open his mouth for medical personnel to insert a breathing tube, so they had to find a way to go through the boy’s nose.
The second priority was to get the skewer out as cleanly as it had gone in. Although the device had penetrated Xavier’s skull, it had missed the major arteries in that region — the carotid artery and the vertebral artery, as well as nearby blood vessels — so the surgeons did not want to damage the same areas by pulling it back out, Ebersole said. The surgeon added that the skewer did puncture one of Xavier’s jugular veins but that it had closed the wound, keeping the boy from bleeding.
He said it “barely missed everything,” calling the scenario “one in a million.”
An army of surgeons specializing in ear, nose and throat (ENT) neurosurgery, pediatrics, trauma and more, worked hours to remove the skewer. Ebersole said the team made an incision on the side of Xavier’s neck to expose the vessels so they could be ready to control any bleeding, then using X-ray imaging, slowly started to pull out the rod.
“We were worried about how hard to pull the device because it was buried so deeply,” he said, but “after an inch or so, it started to move more freely.”
And the surgeons were able to remove it.
Ebersole said Xavier will be sore for a while and may experience some voice changes because the skewer was so close to his vocal cords, but the surgeon does not foresee any significant impairment.
Ebersole said “the depth that thing passed through the skull and this child being awake and talking and alive” was exceptional. And the image of the skewer piercing through Xavier’s skull?
“It’s flabbergasting,” Ebersole added.
Miller, the boy’s stepfather, said when Xavier woke up from surgery Sunday afternoon, the first thing he asked his parents was, “ ‘Is it out? Is it out? Is it out?’ ”
Miller said he credits Xavier’s medical team — and God — for his son’s survival.
Xavier is still recovering in the hospital, but is expected to go home this week.