Porter (September 2007)

Update 10/06/08 

****** May be disturbing to some readers: Contains information from the autopsy report & some medical references that may be disturbing for some people.  CLICK HERE FOR STORY******
Below contains the brief overview for those who do not want to read this story.

Brief Review

In June, we finally received the autopsy report and had the opportunity to sit down with the medical examiner to go over any questions or concerns we had. Unfortunately, the autopsy report didn't give us any answers, but it was able to rule out other events or causes of Porter's death.  We learned conclusively that Porter did not die as a result of suffocation or seizure disorder. Dr. Raven's hypothesis was that Porter died from a lethal arrhythmia (myocarditis) brought on by the Influenza B virus.  She noted that this was a sudden event that would not have shown any indications.

What happened to Porter?

It has been hard to accept that such a young and health boy such as Porter would die at such a early age. There just is no reason for such a tragedy. Many people have asked us "what happened"? They are often just as puzzled as we are as to how life could end so early and so abruptly. We have decided to add this section to Porter's memorial website to share what we know. It continues to be difficult to wrap our heads around what has happened and we realize that telling people of Porter's passing is not always enough.

We cannot express how lucky we do feel for having the week with Porter that we did before he died. We often find ourselves saying we could not have planned that week better if we had known. Porter was moving to the new "Two's classroom" and was having difficulties sleeping through the night. We thought it would be best to have more "mom and dad" time while he made the adjustment. Mike got permission to work five eight-hour shifts and be home by 4pm each day. Becky arranged her schedule so that she went to work at 10am each morning. This allowed a lot of time in the morning to sleep in, eat breakfast together, watch Sesame street and play with toys before heading off to daycare. Mike and Porter went on a bike ride to the park on Monday, cleaned the garage together on Tuesday. On Wednesday Becky took the afternoon off because of her sinus infection and made dinner for both Mike and Porter. We all did a bit of playing and spending time together. On Thursday Mike said Porter was running a bit of a fever and the two took a nap. Afterwards, Mike gave Porter some Motrin and he was up and running around as usual when Becky got home. We let him stay up an hour later because of his late nap, and the three of us played cars, blocks, and ate some goldfish crackers. We both gave Porter a bath and Becky read him three of his favorite stories instead of just one or two. Porter was happy as a clam. We both gave Porter a kiss goodnight and told him how much we loved him. While it is hard to manage without our precious Porter we feel so fortunate to have had such a perfect last week with him.

Medical Examiner's Report
Dr. Raven, Washoe County Corner's Office

Dr. Raven stated that she has never seen a case quite like this with a two-year old child. She stated that the autopsy report was completely normal and she did not see any indication of abnormality. She did a number of tests including tissue samples, physical examinations of organs and it wasn't until she did the cultures that she got a positive test for influenza B. She contacted the Center for Disease Control (CDC) and spoke with the pediatric flu specialist who confirmed that "sudden death" is possible from influenza B. Dr. Raven stated that the cause of death, as a result of influenza B, could have been a seizure or arrhythmia. Both of these situation would not have been apparent at autopsy, but would cause a sudden death case. She noted that there was no indication that Porter suffered or struggled and that is the reason "sudden death" was stated. This indicates that Porter was most likely sleeping and had no idea that anything was wrong "that is why he didn't cry or wake you guys up." She reiterated that there was "absolutely nothing you could have done." She said in some cases she often questions "why didn't they do this or do that," but added that because Porter's autopsy was completely normal there really was no indication, even after death, that there was cause for alarm. She stated that she felt for us, but there just wasn't anything we could have done.

When I mentioned that I had found the Families Fighting Flue website, she stated that "a lot of those children have positive autopsies for infection or pus or fluid around the heart and Porter didn't have any of that meaning he died a sudden death." She said the other possible explanation for this situation is Sudden Unexplained Death in Childhood (SUDC), but because Porter had a positive influenza B test (RNA virus), she went with that because it gives us an answer and is possible. She noted that some of these cases never get answers, and in Porter's case there was some probable cause "whether or not that is what actually occurred." Dr. Raven stated that in cases where the autopsy reveled some abnormality they will often take tissues samples of that specific organ to learn more about the cause. In Porter's case there wasn't anything specific obvious so they took "random samples of tissue." The specialist at the CDC was interested in a specific sample of the heart and she did take sample for that doctor. She noted that this doctor is interested in these specific cases and I let her know we were more than pleased that there was someone who wanted to learn more about preventing these deaths. She added that they had no reason to take tissues samples of everything because the autopsy was normal. While there could have been some underlying cause or defect to test everything would just be too time consuming and expensive. Dr. Raven stated that because influenza B could be an underlying cause they did not look for additional causes. She let us know she would keep us informed of any new information.

When I told her Porter was vaccinated against the flu she noted that she had "saw that." She added that she has seen "four or five" deaths in the area as a result of this particular flu virus. This virus was not one protected by the flu vaccine, and it cannot protect against all strains. When asked if we should be concerned about a genetic weakness to the flu which should cause concern for future children, she noted "don't be worried about that." She said that which it is difficult to tell us "not to worry about it" this is such a rare case that we really don't know about the genetic makeup of this situation and will most likely not know.

She said that the toxicology report will most likely not tell us anything different. She said she sent away for a drug screening (for illegal drugs) and Motrin levels, which she was not really concerned about, thus went ahead with the cause of death as "Sudden Unexpected Death in Childhood with an underlying cause of influenza B." 

Sudden Unexplained Death in Childhood (SUDC)

Sudden Unexplained Death in Childhood (SUDC) is the sudden and unexpected death of child over the age of twelve months, which remains unexplained after a thorough case investigation is conducted. This diagnosis is often one of exclusion, which means that all other causes of death were ruled out and the death is unexplained. In 2001 the SUDC program began doing research in the area of SUDC and continues to look for ways to explain or prevent these deaths. Many of these deaths have features similar to Porter's circumstance. Porter had a slight fever the night before the was easily treated with Tylenol or Motrin. Much like Porter many of the SUDC children all had some type of virus or bacteria in their system that did not appear to be directly related to the child's death. Almost all the children died in their sleep and were all found in similar sleeping positions. While they still do not know what causes these deaths, the program continues to reach out to families affected.

What Happened on March 21, 2008?

****Please be advised that this story is not for the faint of heart. It is highly emotional and contains very descriptive information that may be disturbing for some readers*****
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