Sepsis Round 2

Thank you so much for the outpour of prayers and encouragement. The past week has been scary and chaotic. Last Thursday night (after a very normal day), I began to experience severe, full-body nerve pain & aches, extreme sensitivity to touch, chills/sweats, shaking/rigors, an increased headache, ringing in my ears, blurry vision, and cognitive confusion.

I tried my usual “rescue meds”, adamant to avoid the ER, but when my mom took my temperature we decided that it was safest to head to the emergency room.

When we got there, my blood pressure was dangerously low which prevented me from getting many pain medications. It bounced between 80/30 and 55/46 which concerned the ER physician. 

A plethora of tests were run including a chest CT, chest x-ray, abdominal CT, D-dimer, EKG, echocardiogram, an ultrasound of my gallbladder and liver, and a lot of blood work. 

The physician seeing me in the ER was most alarmed by my lactate (lactic acid) blood level which was 6.0 mmol/L (standard range is 0.5 – 1.6 mmol/L). Lactate is a chemical naturally produced by the body to fuel cells during times of stress. Apparently, this level of lactate is harmful, indicates organ dysfunction, and is commonly associated with sepsis. Additionally, it creates a build-up of lactic acid in the bloodstream called lactic acidosis which decreases oxygen delivery and causes tissue hypoxia. My blood work showed other concerning abnormalities including high ALT which indicated that my liver was in distress.

In hopes of raising my blood pressure and decreasing my lactate level, my medical team kept administering boluses of IV fluids (4.5L total).

In treating my high lactate levels and low blood pressure, I was fluid-overloaded and my body was so preoccupied with the infection that it didn’t adequately distribute the influx of fluid. After a lot of coughing and difficulty breathing, another chest X-ray was taken. It showed that I had developed pleural effusion (a buildup of fluid between the layers of tissue that line the lungs and the chest cavity). My doctor said my lungs looked like saturated sponges (not a term desired to describe my lungs).

 Even with an oxygen mask running at a rate of 10 liters per minute my O2 saturation was in the 70s and 80s. The physician in the room observed me for a long time and said that if my oxygen saturation didn’t improve I would have to be intubated. Hearing this was among the scariest moments of this week. Gratefully, throughout the night, my oxygen levels increased to a healthy enough level, and intubation was avoided. 

My blood cultures returned showing my port was infected; positive for E. coli. Luckily, my medical team suspected sepsis from the start of my hospitalization and started me on two broad-spectrum IV antibiotics in the ER. There was some concern because of the amount of antibiotics I have taken in the last year for infection (potential resistance), but thank God they did what they were supposed to do. Each day I am getting better. 

Repeat blood cultures were taken, and I await the results to determine if my port must be removed. The infectious disease team expects my cultures to be negative since the antibiotics seem to be working well; and, in that case, they think it will be safe to keep my port.