Thursday, September 8, 2016

Illuminate: Sepsis Experience

The emergency room gurney chases the hospital floor the entire distance to the ICU. A posse of medical staff quickly trail behind. My eyes scan the ceiling, attempting to count the blurred tiles in my disoriented state. Puffs of air from the vents breathing for surrounding patients resonate in my ears. The monitor tracking my vital signs sings a frantic tune. Fluorescent lighting directs the path to my room. In the midst of the ICU hustle and bustle, the fine line between life and death is illuminated. Those lights cannot reveal all though, the bacteria ravaging my body being a prime example

Since relocating, I had been avoiding the hospital like the plague. That is something I try to do regardless, but even more so after the move. Becoming acclimated with unfamiliar doctors and hospital is overwhelming. My family and I were simply fearful of the unknown. As of last Thursday my efforts had failed. I was admitted to the "new" hospital for the first time to battle my second bout of sepsis ever. 

Amid the germ fest, my mom and I reluctantly entered the ER waiting area where I was taken immediately to triage. The ER was a pleasant experience. Well, as pleasant as can be expected anyways. They did not gawk at me like I had three heads after stating my diagnoses, took extra precaution to protect against Mast Cell Disease triggers, contacted the pharmacist at my previous hospital to ensure all was covered from a medication standpoint, and then they obtained both peripheral and central line blood cultures for suspected blood infection. With my condition rapidly declining and the high anaphylaxis risk, the little ER trip turned into a week long ICU admission. 

The proceeding hours following the transfer to ICU were probably some of the worst of my life. I was miserable between the combined symptoms of all of my health conditions, high fevers, and added pain of infection. Aside from praying the broad spectrum antibiotics started were tolerated the correct ones for the bug, there was nothing to be done because pain medications are too risky while already trialling antibiotics. The cultures grew gram negative rods within twelve hours. Antibiotics were adjusted. It is a total miracle I have tolerated multiple antibiotics without major anaphylactic catastrophes!

The bacteria was eventually narrowed down and identified as Enterobacter Cloacae a few days later. The origin of the sepsis is unknown. There are two possibilities. The most likely being that my disease has left my GI tract so compromised that the bacteria translocated from my gut and spread to my bloodstream. 

Regardless, my Hickman had to be pulled. The catcher is that I needed another placed once cultures were clear. I do not have a promising track record for anesthesia. At all. The radiologist was willing to place a new line with local anesthetic (lidocaine) only. We were all unsure how I would respond to that with my Mast Cell Disease. It needed to be done though. 

Lets just leave it at this: lidocaine is not my friend. About ten minutes into the procedure, I began to feel my infamous "throat burning" sensation and I knew a mast cell reaction was on the horizon. The burning turned into tachycardia and arrhythmias, aching tonsil on the side of the injection, flushing, facial swelling, nausea, tremors, hacking up a lung, etc. 

But...the line is in! They got the lidocaine reaction under control quickly. My body seems to be halfway cooperating in the sense that I am not rebounding horribly. The situation really could be worse than it is. 

I am currently home on a hefty course of intravenous antibiotics. There are multiple follow up appointments within the next couple of weeks. The plan is to work with GI doctors to heavily focus on healing my gastrointestinal tract to hopefully prevent a repeat of this incident. Enterobacter is a nasty bacteria to fight. The care I am receiving is impressive. 

Sepsis is my worst nightmare. To battle it twice, only a year apart, takes its toll. I am uncertain of the purpose, but my hopes are that the reasonings will be illuminated in due time. 

I am grateful to be alive and thankful for all of the prayers.