Her family can pinpoint the exact day that Hannele Cox's life changed: It happened on June 30, 2006.
"I didn't find out about it until four days later," her mother Amy Cox said. "We were going to the beach and I remember seeing the sore on her hand."
The 8-year-old Hannele had kept the cut on her hand a secret from her mother.
"She liked to 'fish' in the fish tank and when she heard me coming and yanked her hand out, she cut her hand."
Unbeknownst to everyone, when she cut her hand, Hannele had gotten infected with a fish-borne bacterium, mycobacterium marinum.
"It wasn't even exotic fish; it was just neons and tetras," Cox said. "She hid it from me because she was doing something she wasn't supposed to be doing."
Eventually, though, even a breeze across Hannele's infected right hand caused her pain and the family realized something was really wrong. Her mother cleaned and treated the wound with peroxide, but the infection refused to go away.
"I didn't find out about the fish tank history until after the second doctor's visit."
Hannele went through several rounds of antibiotics, each of which seemed to clear up her infection, before it returned again, months later. She endured two rounds of debridement operations.
"Basically the Roto-Rooter of the joints," as her mother describes it. "They remove everything they can."
Prior to her infection, Hannele was passionate about gymnastics, practicing up to 22 hours a week. Although she continued to practice through the pain, her medications ruined her balance, making it too dangerous for her to continue. As a middle school student, she took up club volleyball, before her chronic pain forced her to quit.
"I miss it. I miss going to the gym and having fun, but I know I can't do it because of the pain," said Hannele. "I don't want to get into a sport and have to quit it again. I had to do that twice."
The teachers, staff and fellow students at Cedar Middle have been supportive, but Hannele's frequent absences for medical care have made her stand out from the student body, and the last month of the 2010-2011 school year, her hand too much for her to even use a pencil.
"They can look at me [differently], I don't care," Hannele said. "As long as my friends don't look at me differently."
In April of this year, things took an apparent turn for the worse.
"I caught her in bed with an icepack on her hand," Cox said. "I would have thought from the first time she would have learned to not hide things from her parents."
Now a 7th grader at Cedar Middle School, Hannele was hiding her returned infection from her mother, because the doctors had said if the bacteria ever reached the bones in her right hand, they would likely have to amputate to stop it from spreading through her body.
"I was just not accepting it," said Cox. "There had to be somebody who could treat it."
Frantic Internet searches led her to a doctor at National Jewish Health respiratory hospital in Denver.
"We finally get to Colorado and they determine she had no infection in her hand at all."
Hannele, it turned out, had beaten the mycobacterium marinum at some point, but now had permanent neuro-vascular damage due to the infections and multiple operations.
"Her nerves are swollen," said Cox. "When there's more blood and the veins are swollen" due to activity, "it brushes up against the inflamed nerves."
Hannele is now being treated for complex regional pain syndrome at St. Jude' Medical Center in Orange County. Doctors hope that eventually she will have full use of her right hand without pain.
"It's a blessing that she's going to have her hand," said Cox. "It's just going to be a long, painful road."
As for the 60-gallon fish tank that started it all, it's still in their Oak Hills house, although the infected fish and water have long ago been disposed of, and the tank was subsequently scrubbed down and bleached.
"There's only about 100 reported cases of this happening in California," said Cox. "You're more likely to be hit by a car walking down the street."
Beau Yarbrough can be reached at 760-956-7108 or at email@example.com.