Everybody at Kaleida Children's Hospital knows Jacob Cogar.
A little boy with a big personality, the active 7-year-old has been in and out of Children's for the past 2 1/2 years. He is being treated for a rare blood disorder known as TTP (thrombotic thrombocytopenia purpura).
While Jacob's ailment is both serious and mysterious, most of the time he does not let the daily blood tests or frequent treatments get him down.
"We call him the mayor of Children's Hospital. He is everywhere, and everybody knows him," said Elsie Dawe, executive director of the Children's Hospital of Buffalo Foundation, the institution's fund-raising arm.
Dawe said that sometimes Jacob has turned up sitting at the hospital security desk with the guards, giving directions to visitors. On occasion, he has gone to medical meetings with the resident physicians and talked them into ordering subs and pizza for him.
During some of his hospitalizations, Jacob even managed to get on the ambulance's two-way radio when he was being transported for treatment to Buffalo General Hospital or Roswell Park Cancer Institute.
"He is unbelievable," said Dawe.
Because of his special health problem, Jacob is one of many youngsters from across Western New York who require the medical expertise available only at Kaleida Health's Children's Hospital.
Jacob is one of seven children of Jeff and Vicky Cogar of Barker in northeastern Niagara County. His five brothers and sister range in age from 2 to 17.
"Jacob copes with it (his illness) very well. He is a people magnet," said his mother. "If something had to happen to any of our kids, I guess it is best it was him. He makes a lot of friends, and everybody adores him."
While many children might not relish a lengthy hospital stay, Jacob has learned to make the best of it.
"He knows (Buffalo Sabre) Rob Ray personally. He (Ray) got in to see him at least once a week. He has said hello to Jacob on television during a hockey game," said Mrs. Cogar.
Jacob even "looks forward to going back for treatments," his mother said.
Jacob's blood disorder was diagnosed after his mother became alarmed when red spots began appearing over most of his body. The spotting, a condition known as petechiae, turned out to be caused by a low blood platelet count.
Medical experts say that when the platelet count is low, it allows blood from Jacob's smallest blood vessels to seep into his skin, producing the spotting. Complications can include massive internal bleeding or stroke, as well as severe anemia.
"The disorder is potentially life-threatening," said Dr. Barbara Bambach, a specialist in pediatric hematology and oncology at Children's.
Bambach said the disorder most often occurs in adults.
"In adults, it eventually goes away, but people can die from it -- from a stroke or spontaneous bleeding or inner-cranial hemorrhage," she said.
Jacob initially was treated with medication but eventually developed a resistance to drugs used in two different courses of treatment.
His current treatment is a process called plasmapheresis, which cleanses his blood.
"He gets hooked to a machine that takes his blood out to filter the antibodies which we think cause the disease," said Bambach. "Then his blood goes back into him."
While she appreciates the care that Jacob receives at Children's, Mrs. Cogar still wonders about his diagnosis.
"It took them well over a year to determine his ailment. He is the youngest known case in the country," she said. "From what I understand, the condition is most generally found in women over the age of 40 and the treatment usually works. Jacob has not responded that well."
After spending nearly three months as a patient in Children's, Jacob returned home earlier this month. However, once or twice a week, his mother takes him to Buffalo for a plasmapheresis treatment.
When he is home, Jacob attends first grade at Barker Central School.
"He doesn't have any restrictions when his blood count is OK," his mother said.
A home health care aide visits Jacob daily to draw blood to check his platelet and hemoglobin counts.
"They have to make sure they don't drop drastically like they have in the past," Mrs. Cogar said.