By Josh Gross, SI.com Inside MMA
Former WEC champion Cole Escovedo suffered from a staph infection in 2007. First diagnosed as an ingrown hair, the disease nearly shut down his body. After Escovedo, Leopoldo Serao and Kevin Randleman also had bouts with MRSA
Perched above the ring after professionally battering a man for the first time in three years, Cole Escovedo’s tortured legs quivered under his slender frame.
In the span of a week during the first month of 2007, Escovedo went from thinking a spider had bitten him on the forearm to coping with a bladder swollen to the size of a small basketball, and the fear that accompanies paralysis.
Three visits in as many days to Fresno-area hospitals accomplished little except making Escovedo aware of an uncomfortable allergic reaction to morphine. The spider bite? An ingrown hair, he was told. And muscle spasms were apparently responsible for the inability to walk. The pain, however, was so agonizing it could make a man cry who never did.
“Security almost threw me out because I decided they’re not kicking him out anymore,” recalled Escovedo’s mother, Laura Robitschek, following his return to the ring in May. “All I could keep thinking was there’s a spider bite and it’s gotten into his bloodstream. But nobody was listening to what I was saying.”
Escovedo, who turns 28 in August, learned at the last possible moment that a rampaging staph infection was shutting down his body, not poison from a Brown Recluse or Black Widow. When an MRI uncovered a blockage of his spinal cord, he was transported in the middle of the night to see a neurosurgeon. Any delay in treatment would provide Methicillin-resistant Staphylococcus Aureus (MRSA) — an easily transmitted drug-resistant bacteria known to cause skin, blood, joint and bone infections — time to permanently bound “The Apache Kid” to a wheelchair.
Escovedo, who reigned as the first WEC featherweight champion before UrijahFaber took the belt in 2006, faced two options: hope an extensive course of antibiotics would do the trick against an evolving superbug, or undergo emergency surgery aimed at cleaning out the infection. Neither were guarantees..
“I’m in too much pain. I can’t take pills and hope it works. Cut me open and I’ll take my chances,” the fighter told doctors.
Made from a scalpel and 17 staples, a zipper of a scar along his spine remains proof of Escovedo’s war with MRSA.
So, too, are those shaky legs.
For athletes competing and training in close quarters, MRSA has grown particularly loathsome over the past decade.
Similar to other staph infections, MRSA is an “opportunist,” said Jeff Hageman, epidemiologist at the Centers for Disease Control and Prevention. Predominantly entering the body through cuts or abrasions, MRSA, which moved beyond healthcare settings into the general population in the late 1990s, is best treated early by the trio of incision, drainage and antibiotics.
Key to avoiding the trouble of stuffing gaping wounds with gauze are common sense preventions. Maintain good hygiene. Wash workout clothes rather than stuff them into gym bags (the moist climate can act as a breeding ground for bacteria). Stop sharing personal items like towels and razors. These and other simple steps should considerably lower chances of falling victim to staph. Yet, the ease with which it spreads, particularly for those in MMA’s high-contact world, and its adaptability make MRSA a brutally tough foe to put away.
“It’s dangerous,” said Michael Popp, Escovedo’s trainer of 10 years at Pacific Martial Arts in Fresno, Calif., who’s seen groups of fighters become casualties to staph multiple times a year. “Our rule is if you think you have an ingrown hair, you give it one day. If it hurts any more, you go to the doctor.”
Even when symptoms remain barely visible, MRSA sometimes progresses so fast it can knock the healthiest person out of action before they realize what happened.
In the bout following Escovedo’s return, his first fight at 135 pounds in 15 professional appearances, promoters put together a five-round middleweight championship. Brazil’s Leopoldo Serao went to bed the night before the event with a small bump on the middle finger of his right hand. The following morning Palace Fighting Championship promoters postponed the fight because Serao’s hand had swollen to four times its normal size. Three slice-and-clean treatments and a month off the mat were required before Serao could legitimately think about getting back into the gym. He should consider himself fortunate.
Eight months after Escovedo began his battle with MRSA, former UFC heavyweight champion Kevin Randleman became the next victim. Randleman released photos on the Internet of a gruesome, baseball-sized hole beneath his right armpit that offered a small window into his musculature. While two of his organs shut down as he battled to remain alive, pictures of the extensive damage to Randleman’s appearance drew the most attention.
In some MMA camps, such as Las Vegas-based fight factory Xtreme Couture, the mere mention of MRSA is enough to reveal a cache of mops and bleach-spiked water. While maintaining clean training environments helps combat skin infections common to MMA gyms and wrestling rooms, being overly cautious about the environment won’t matter if proper attention isn’t paid to personal hygiene and skin-to-skin contact, Hageman said.
Tim Lueckenhoff, president of the Association of Boxing Commissions, said the impact of MRSA on combat sports will be brought up for the first time to the group’s assembled membership during next week’s convention in New Orleans.
Nick Lembo, who oversees the ABC’s MMA committee and has long been a proponent of the sport during his time as counsel for the New Jersey State Athletic Control Board, periodically mails out an article on communicable diseases published by one of the commission’s licensed ringside physicians, Dr. Sherry Wulkan.
“It’s a tough problem for a commission to oversee because all it takes is one person and it can spread like wildfire,” said Lembo, who takes regular visits to licensed gyms where he supplies fighters with information on how to keep clean.
In response to the influx of MRSA, a growing industry of gels, soaps and lotions are currently being marketed directly to 12 million active wrestlers, jiu-jitsu players and martial artists in the U.S.
Guy Sako, a 33-year veteran of amateur wrestling in Ohio, invented Defense Soap in 2005 as a way to combat common skin diseases. Though the full-time police officer designed the first bar soap of its kind with wrestlers in mind — namely his kids — Sako believes the problem of infection is worse among mixed martial artists.
“We’re not in wrestling season and we’re setting records everyday for sales,” said Sako.
Despite Sako’s objections, CDC endorses basic soap and water.
A week after surgery, Escovedo started pestering his neurosurgeon about returning to training. The message back: take it easy kid, it’ll be a miracle if you ever walk again. Forget fighting.
“They were so adamant, I really didn’t think Cole would be able to walk,” said Popp.
If there was something Escovedo could not do it was forget about fighting. As a practical matter, prizefighting was his only regular method of paying rent and buying groceries. In a deeper sense, fighting “is what Cole was born to do,” said his mother.
The road to recovery started with basics, though it wasn’t long before push-ups and jumping jacks could no longer hold Escovedo’s interest.
Prior to battling MRSA, Escovedo had fallen in consecutive fights against Faber, Jens Pulver and Antonio Banuelos. He’d been beat up, knocked out, finished. But nothing was going to get in the way of a return to MMA — not even faulty legs that gave out on him at random moments.
As MMA grew in popularity throughout California, the then-teenage Escovedo became one of the first fighters out of the state’s fertile Central Valley to gain a following. Eleven wins in his first 12 fights promised big things, but three losses in five months put a halt to that.
Stepping back into the gym after surgery and a six-week rehab, Escovedo demanded that his first day include heavy sparring. “He said, ‘Put me in, I have to see if I can do it,’” Popp said. “He fought real good. He fought through the rounds, but he had to damn near be carried out of the ring.”
For a time this is how it went. Escovedo, embarrassed and ashamed that he needed to learn how to walk again, pushed the limits of a war-torn body.
“It would be like if I sent you a text message and you only got every other letter,” Escovedo said. “That’s how my brain was. It would send the message to my legs, my legs would only get every other impulse, so I’d be walking in a mall and my leg would give out and I would fall.”
Hard training — there wasn’t any other kind — sometimes meant Popp caught Escovedo hiding in a corner trying to conceal the fact that his legs wouldn’t stop shaking.
“It’s a real confidence killer,” admitted Escovedo. “It makes me question everything I’m doing. But my coach tells me to push through.”
Thoughts of a rematch with MRSA rarely enter Escovedo’s mind. With education and prevention, it’s fallen away from an everyday concern. Each training session ends with a proper scrubbing. In fact, he’s under sponsorship to a company that produces specialty soaps and cleaning products designed to battle bacteria and other nasty things floating around a gym.
Escovedo considers his case a cautionary tale, and a lawsuit filed against the hospitals and doctors responsible for what he called a misdiagnosis appears headed towards a settlement.
“The Reaper tried to get Cole a couple times,” said Robitschek at ringside, her son’s legs still weak from balancing on the ropes. “He hasn’t yet.”
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Cases of the deadly superbug MRSA are still on the rise in one in 10 hospital trusts, while one in five still have increasing rates of C. difficile, an official report shows.
By Kate Devlin, Medical Correspondent
The report by the National Audit Office (NAO) sparked criticism of a “lamentable lack of progress” on measuring other potentially dangerous bloodstream infections which are also on the rise but are being neglected because of the concentration on MRSA and C. diff.
Cases of MRSA have fallen by half across the country since ministers set a national target in 2004, while C. diff rates have dropped by one third.
Over the past six months, 18 mothers and 19 newborns have become sick with a dangerous bacterial infection soon after being released from Beth Israel Deaconess Medical Center, triggering a state investigation that uncovered serious problems with the hospital’s infection control practices.
Ten of the infected patients became so ill that they required hospitalization. Two of those had serious complications.
The most recent of the staph bacterial infections, a type resistant to many common antibiotics, was identified earlier this week. Continue reading
It can all begin with something so simple such as a shaving cut. The MRSA organism may have been living on that person for some time, with no symptoms being demonstrated. However, once that shaving cut appears, the bacteria can enter the bloodstream. Then MRSA becomes much more serious.
The most commonly used test to identify MRSA colonisation is the culture. A swab is taken from the patient and is then cultured. Swabs are usually taken from the nose, though they can also be collected from wound sites or skin lesions on people with known MRSA infections. The culture is a definitive test and usually takes one to two days to complete.