Girl Who Lost Limbs to Infection Has More Surgery

Jessica Lynn Esquivel, the 6-year-old Imperial Beach girl whose arms and legs were amputated after a case of chickenpox led to a secondary infection and then to toxic shock syndrome, underwent surgery again Monday night, medical officials said.

This time, the operation was to graft skin “over the distal end of her amputated limbs,” said Mark Morelli, a spokesman for Children’s Hospital, where Jessica remains in critical condition in the intensive care unit.

“The graft is being made to form healthy and fresh tissue at the distal end of her arms and legs,” Morelli said. “This indicates continued small improvement, since Jessica is now strong enough to undergo this next step of surgery. Then, in a few weeks, after the tissue heals, we’ll face another step in the process of rehabilitation.”

Jessica contracted chickenpox March 27, and, by the time she was admitted to the emergency room of Sharp Memorial Hospital on April 1, showing a fever of 104 degrees and complaining of aching legs, she had incurred a secondary infection that brought about a rare case of toxic shock syndrome.

She experienced full cardiac arrest, in addition to liver, kidney and respiratory failure. However, Dr. Brad Peterson, the physician supervising her care, said he expects her to have full liver, kidney and respiratory recovery.

Nevertheless, on April 18, because she had no circulation in her arms and legs, doctors at Children’s decided to amputate her legs at the knee and her arms at the elbow.

Her parents, Felix and Lisa Esquivel, hopeful that their daughter will one day be able to walk, write, and draw with the use of prosthetics.

Dr. Mark Magulac, a pediatric psychiatrist, has been appointed by the hospital to work with Jessica and her family and to aid in the transition to prosthetics. Magulac said the first step in a case such as Jessica’s is the family coming to terms with what happened and adjusting to the obvious limitations.

“There was so much bad news the first night she was here, it seemed like we wouldn’t have any choices,” Magulac said. “The most important thing a child like her needs is something she’s already got--and that’s parents who are really invested. A lot of my job is guiding her mom and dad through the emotional and medical maze of understanding their options.

“It speaks to the strength of these parents that they wanted a fully rehabilitated child; they realized they just wouldn’t have the kid they had before. They showed a strength in coming to terms with what was available. And, Jessica has shown a lot of strength and adaptation herself.”

Magulac was uncertain when Jessica might begin to wear and use prosthetics. It’s also uncertain when she will return to Oneonta Elementary School, where she is enrolled in kindergarten. Principal Bob Eaton said Monday that school policy has been not to address the subject of Jessica’s illness with her classmates unless they ask.

They have been asking.

“A lot of stories have appeared, in newspapers and on television, and sure, families are aware of it,” Eaton said. “We try to answer the kids’ questions honestly and matter-of-factly, without dwelling on it. I validate their statement, I say, ‘Yes, she has been very, very ill, but we hope she gets back as soon as possible.’ ”

Eaton said the Jessica story has dominated the school’s emotional life.

“We went from the point of her illness being a routine case of chickenpox, to fearing she might not make it at all, to hearing that her limbs were amputated,” he said. “Then, as she remained in various stages of comas, we were just looking for any sign of hope. All along, we’ve grasped at any good news.

“She’s just a sweet, bright little gal with a lot of enthusiasm and a lot of energy, who’s very, very interested in school.”

Eaton said a fund-raiser for Jessica is scheduled from noon to 7 p.m. Sunday at Oneonta Elementary, which is at 10th Street and Grove Avenue in Imperial Beach.

Morelli, the hospital spokesman, said a trust fund for Jessica has been set up through the Union Bank in Imperial Beach. Anyone interested in contributing may write Union Bank, 900 Palm Ave., Imperial Beach, CA, 92032.