Nicole Taylor, 32, got the second opinion of a lifetime. In early 2016, she experienced abdominal pain similar to bouts she’d had with kidney stones and surgery years earlier. But this time, “unbearable” pain wasn’t the only problem. “I couldn’t stop shaking,” Taylor recalls. “I wasn’t urinating. I couldn’t breathe; I couldn’t stop throwing up. I was freezing and couldn’t get warm. I had a fever of 103.” She was confused, too.
Taylor’s fiancé took her to the nearest hospital in their Gloucester County, New Jersey, area. Eight hours later, she recalls, she was sent home from the emergency room with a diagnosis of dehydration and a kidney stone “that would pass,” she was told.
The next day, Taylor was doing even worse. She told her fiancé, “I feel like I’m going to die,” not realizing how close to death she really was. This time, he insisted on taking her to a different hospital — Cooper University Hospital in the town of Camden. It turned out that Taylor had an advanced case of sepsis, a life-threatening infection. “I didn’t know what sepsis was until it happened to me,” she says.
As Taylor descended into septic shock, it was fortunate that a renowned sepsis expert, Dr. R. Phillip Dellinger, practiced at the hospital. After receiving experimental treatment as part of a clinical study, and following a grueling hospital stay, she eventually recovered.
Today, Taylor works for her family business and is a thriving, full-time student. You can read the full story of her harrowing experience, treatment and recovery on the website of Sepsis Alliance, an advocacy organization.
[See: How to Be a Good Patient Wingman.]
Sepsis is nothing to play around with. It stems from an original infection that quickly becomes considerably worse, triggering an overwhelming immune response involving widespread inflammation and the release of toxic chemicals.
“Sepsis is when the body’s response to infection injures its own tissues and organs,” says Dr. Christopher Seymour, an assistant professor in critical care and emergency medicine at UPMC in Pittsburgh. This response, he says, “places other organs in the body under stress: the brain, the lungs, the gut, the kidney and the heart.”
A case of pneumonia, for example, or a urinary tract infection could lead to sepsis. “Our organs don’t function normally in sepsis,” Seymour says. “They’re under threat. Ultimately, we get quite sick, and many of these patients don’t survive. In fact, 1 in 5 do not survive their hospital stay.”
The seriousness of sepsis is often overlooked because it is often mistaken for other infections. “The general public may think of this as a pneumonia or a urinary tract infection that got bad and never really use the word ‘sepsis,’ know what it means or understand that’s why they’re so sick,” Seymour says. But sepsis is the culprit. And it’s common, he says, with, more than 2 million cases seen in U.S. hospitals each year.
Sepsis can be triggered by many types of infections — bacterial, viral, fungal — and can affect many parts of the body. It could stem from a severe skin infection in a nursing-home resident with a bedsore, while even rare cases have been reported of kids getting a scratch allowing bacteria eventually to invade their bloodstream.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
Sepsis is the third most common cause of death in the U.S., killing between 230,000 and 370,000 patients yearly, says Dr. Craig Coopersmith, director of the surgical intensive care unit at Emory University Hospital and a professor of surgery at the Emory School of Medicine in Atlanta. Prompt recognition is critical. “If it’s not treated early, the chance of dying goes up significantly,” he says.
Certain groups are more vulnerable, with infants and the elderly at highest risk. In addition, people with conditions such as cancer or diabetes have a greater chance of developing sepsis, because of their higher risk for infections. People with suppressed immune systems, such as transplant survivors or people on steroid medication, are also more prone to infection, and then to develop sepsis.
Sepsis usually starts at home, not in the hospital. While it can be a hospital-acquired infection, about 80 percent of sepsis cases occur in the community.
Say the Word
Young, healthy people get sepsis, too. Tragically, that was the case for Rory Staunton. He was 12 when he died of sepsis in 2012. Rory had cut his arm while diving for a ball during gym class at his New York school. The seemingly minor wound turned into a systemic blood infection.
Rory’s story — including a series of symptoms overlooked by health care providers and missed opportunities for lifesaving treatment — is chronicled by his family on the Rory Staunton Foundation website.
When it comes to possible sepsis, the luxury of watching and waiting doesn’t exist, says Ciaran Staunton, Rory’s father and co-founder of the foundation dedicated to raising public awareness, improving medical diagnosis of sepsis and putting rapid treatment protocols in place in hospitals and clinics.
If you suspect you or a family member might have sepsis, speak up, Staunton says. “Ask your doctor; ask your nurse,” he urges. “At the hospital, ask the person who’s giving you or your loved one attention: ‘Could this be sepsis?'”
According to a foundation graph citing U.S. health agency figures, sepsis kills more Americans than breast cancer, prostate cancer and AIDS combined.
Sepsis Signs
The following symptoms could be due to any number of causes. In combination, however, they might mean sepsis:
— Fever is sign of the body responding to infection. Shivering and feeling extremely cold can occur.
— Confusion or altered mental status can result as the brain is affected. Breathing much faster than usual is a sepsis hallmark, as lactic acid levels rise in the blood.
— Rapid heart rate is another sign; blood pressure may drop. “Low blood pressure can manifest in feeling dizzy or lightheaded, or passing out,” Seymour says.
— Low urine output is also common.
— Pale or mottled skin is another indication.
The best way to survive sepsis is to prevent it altogether. To avoid sepsis, take routine steps you would to prevent any infection. For instance, seniors who get the recommended pneumonia vaccination cut off that particular path to sepsis.
Within hospitals, infection-control measures from low-tech hand-washing to high-tech sanitation systems can reduce the spread of infection from one patient to another. If infection occurs and sepsis follows, early recognition and antibiotic or other antimicrobial treatments are crucial.
[See: 9 Extra Safety Assignments for Hospital Patients.]
An anti-sepsis effort in Rory Staunton’s name was recently backed by new findings in the June 15 New England Journal of Medicine. Study author Seymour and others looked at results from a 2013 New York mandate — known as “Rory’s Regulations” — requiring all state hospitals to use evidence-based protocols to identify and manage sepsis within a three-hour time frame.
The study results, based on more than 49,300 adult patients with sepsis treated at 149 New York hospitals between 2014 and 2016, are encouraging. Early sepsis treatment increased and death rates fell from 30 to 25 percent during the study period. More rapid identification of sepsis and antibiotic or other antimicrobial treatments were the game changers associated with reduced death rates. In 2016, Illinois enacted a law requiring state hospitals to be better prepared to recognize and treat patients with sepsis or septic shock. New Jersey may be next state in line to mandate sepsis protocols.
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The Seriousness of Sepsis originally appeared on usnews.com
