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Sunday, November 17, 2013

SEPSIS!

“What do we say to the Lord of Death?"
"Not today.”  ~George R.R. Martin, A Game of Thrones

   Before Les went into hospital I was surfing through the NHS website and found a big blurb about Sepsis. Apparently this relatively unknown illness is rampant in the UK--especially amongst the very young and those 65 and older, those with cancer and those who've undergone recent surgery. 
   I found another link to the Sepsis Trusts' Survive Sepsis website. The video I watched scared the hell out of me.
   Sepsis is blood poisoning--an infection which gains access for various reasons, to the body's blood supply, traveling throughout the body and attacking vital organs. Early stages feel like the flu: malaise, lack of appetite and extreme tiredness. This can go on for several days upon which it is accompanied by dehydration, slurred speech, fuzzy thinking, very high fevers with nights sweats that soak you, violent shivering, mottle skin, shortness of breath, blue lips, cold extremities, violent vomiting. Think Toxic Shock syndrome.
 I wrote down the symptoms and the "Sepsis Six"--the six timely treatments which save a person's life and tucked it away in my cancer notebook I kept for notes of all Les' appointments and transcripts of all conversations with health professionals regarding his treatment. And then I forgot all about it. 
   Les came home from cancer surgery and was doing well. His appetite picked up, his energy level grew slowly over the initial two weeks and the sunken cheeked, concentration camp look was beginning to recede from his features. He was sleeping well, going for brief walks outside and his sense of humor returned. 
   Les handled his stoma quite well. He changed the bag daily and emptied it frequently. Community nurses came in every day to change Les' bandages and assess his incision sites and general health. Slowly the incision were healing although they were attended by a pale yellow, creamy gunk and started to smell slightly. Now I have a VERY acute sense of smell and often small sour in milk before anyone else can even taste it. The incision in which the bladder catheter protruded from was swollen, red, and concerned me.
   I had a bottle of Hibiclens which I bought from the states. This is surgical scrub disinfectant solution. When I was scheduled for surgery the doctor asked me to stop by the pharmacy and pick up a bottle ($4) and wash all over with it in the morning before reporting for surgery. I also used it for wound after care at home on my incisions. I had three fourths of a bottle left and i brought it with me in my medicine chest when I moved here.  
   Les asked the nurses to call thirty minutes before visiting so he could shower each day. I removed his old bandages, and told him to wash his incision with Hibiclens. The nurses came shortly after assessed his wounds and applied fresh bandages. After he began using Hibiclens, his incisions looked much better and they began to scab over nicely; all except that bladder catheter site. 
   Wednesday afternoon Les seemed somnolent. He dozed and had no energy for a walk. His appetite, which had been building, suddenly disappeared. 
   Thursday I took my exam and Les was alone for four hours while I did some shopping for a grocery trolley and extra track pants for Les. When I returned in the early afternoon, he was awake and had a bite to eat but really wasn't hungry. A new set of community nurses visited and said all seemed well, but my spider sense said something was off. Les was quiet; a malaise fell over him. He slept all afternoon and early evening, and seemed confused and fuzzy in his thought process. I felt Les' forehead and he had a slight fever. He also developed shivers as bedtime approached. I warmed his bed and PJ's with a hot water bottle. He slept all night. 
   Friday morning Les looked terrible. That gaunt, starved look was back. He refused breakfast, had a small bowl of soup for lunch and ate no dinner. He drank water and juice steadily saying how thirsty he felt. It was almost as though Les had narcolepsy. He would nod off in the middle of a sentence and wake up shaking so violently Les appeared to be having a grand Mal seizure. He complained of exhaustion and weakly said he had to go lay down. It was 9:30 p.m. 
   Les called out to me in the middle of the night in a panic! I ran down the boat to our bedroom and I was shocked by the sight: it looked as though someone had drenched Les and our bed with a fire hose! His hair was sopping wet, his pajamas were dripping water. The down duvet was soaked through, Les' pillows were soaked and the sheets were sodden!
   I thought he had sprung a leak somewhere and I was peering closely at his incisions. He thought he had peed the bed but nothing smelled of urine.  I rang the water out of his pajamas in the bathtub, hung them to dry, got him dried off, dressed in clean, dry pj's, changed the bed and got Les settled down with a fresh hot water bottle, dry blankets and I went back to bed. Two hours later it happened again!
   After a repeat of drying. cleaning, re-bedding and a refilled hot water bottle we both slept through to 8 am this morning. I woke with a very bad feeling and decided I was going to observe Les closely and call the doctor if he seemed in any way worse.  My mind kept replaying the violent shaking spell and his mental disorientation.  
   Les didn't want to eat any breakfast. 
   "Baby you have to eat. You've lost thirty pounds since surgery and you have no fat left on your body. If you don't eat you begin the process of muscle wasting and you won't recover Les. Please baby, please eat."
He forced down half a piece of toast, part of a small bowl of organic oatmeal and a glass of orange juice. All morning he shivered. About lunch time I looked back through the cancer notebook and found the Sepsis notes. Immediately I knew Les had Sepsis and every moment we delayed brought him closer to death--and he was totally clueless. 
   Of course he wouldn't listen to me. I was overreacting, blah, blah, blah.  I wanted to call an ambulance. Les wanted to wait for the visiting Nurse, especially since today it was Jeremy who was scheduled and he is a favorite of ours. He is a good nurse who has gotten to know Les well. I reluctantly agreed. 
   Jeremy arrived about 1:30 p.m. and as soon as he came in the door I said, "Jeremy Les is extremely ill--I think he has Sepsis." The nurse quickly kicked off  his shoes, came inside, examined Les and agreed. He left for the office to talk with his supervisor about what we should do next. Fifteen minutes later Jeremy called me and told me to call the community nurses main number, explain Les' symptoms and I would be patched through to a doctor. 
   I called the number and it rang, and rang, and rang, and rang--endlessly until finally after over thirty rings someone picked up. I explained who I was.
   "Hello, yes my name is Mrs. Jaqueline Biggs. My husband Leslie is quite ill and needs immediate attention. He had surgery for rectal cancer on October 16th and has been home recuperating since October 31st. Since this past Wednesday he has slipped into a malaise. He is exhausted, has no appetite, suffers from violent shivering, extreme night sweats, he is confused, disorientated, dizzy, has mottled skin, cold extremities, cyanotic lips, and Oh my God he just threw up violently--twice! He has Sepsis and needs immediate treatment."
   "Okay Mrs. Biggs, I will pass on your concerns and an out of hours doctor will ring you. If you don't hear anything shortly then call 111 and they will tell you what to do next."
   I wanted to call and ambulance ASAP but again Les declined and we argued about it. He begged me to wait for the doctor to call. I waited for thirty five minutes and finally snapped.
   "I am an American Les. We don't stand around waiting while health care professionals endlessly discuss the merits of someone's symptoms until they die. WE DO something! I'm done and I am calling an ambulance NOW!"
   A paramedic arrived to the boat about twenty minutes later, took Les' vitals, took notes and called an ambulance. The out of hours doc called and spoke with the paramedic and then apologized for taking over an hour to return my call. She said the nurse who referred my call told her Mr. Biggs probably had a mild infection and was feeling unwell." UNBELIEVABLE!!
   We arrived to Watford General Hospital A and E about 4:45 p.m. The emergency room doc took his vitals, listened to my description and nodded affirmatively when I concluded, "He has Sepsis." Broad spectrum antibiotics were started intravenously right away. As I waited in the hallway for them to get Les settled in an ER bay bed, a paramedic came out to speak with me. He told me the ER physician thought Les had Neutropenic Sepsis--a side effect of the radiotherapy. Son of a bitch...something else the oncologist neglected to enlighten us regarding.
   Finally I stepped inside the blue curtained cubicle with my best beloved. Les was scared and broke out in tearful anxiety attacks, his lips thinning in a rictus grin of fear, hands shaking uncontrollably. I tell you now that death was in that room with us--a faint presence seeking a more permanent outline. My heart was in my throat but I hid my fear and swallowed my exhaustion, stroking Les' face, holding his shaking hands and reassuring him we were where we needed to be now. It was natural to be frightened, he has been through so much...
   We were in the A and E for just under two hours. a physician came and gave Les a very thorough exam. This medical doctor was a very young man who looked just like Harry Potter--I kid you not! He even wore the same eye glasses as Harry. He said Les' urinalysis showed infection bacteria were multiplying in his bladder. I said I was sure the bladder catheter was the main infection route. 
   Les is resting now in the Watford General Hospital Acute Assessment Unit where he will be given more antibiotics through his IV, and they will watch him closely for the next three days.
   80,000 people lose their lives annually to Sepsis; 30,000 of those in the UK. Please, please follow the links on this post and learn all you can about it. It may be the difference between life and death for someone you love.

50 comments:

Neil Corbett said...

Well done you! What would Les do without you?
10 years ago we lost a very dear friend to this. By the time we got her to hospital it was too late. The PRIVATE hospital had told us that she would be more susceptible to infection while undergoing chemo, they didn't tell us if she got an infection it could kill her! Nor did they take any notice when she rang them and told of her flu like symptoms etc, just told her to contact her own doctor if it continued.
Many hospitals now give their cancer patients a 'fast track' card with instructions to go to A&E at the first sign of infection, flash the card to receive immediate treatment! Obviously Watford are again 'wanting'.
Good luck, keep fighting.
Kath (nb Herbie)

Bryce Lee said...

Oh Sh*t! This too shall pass and all "will" be well.

Anonymous said...

oh my god...oh my god...shaking my head. Don't listen to Les anymore...when you're sick your (I'm speaking about myself now) judgment can Not be trusted. Sepsis gets soooo bad so quickly. Very scary. We hope your next post is good news. Jaq .. I do, I really do, know something of what you are going through. My former husband had to be carried off our sail boat (I don't know how they did that)to go to the ER and it was a life and death situation. My heart goes out to the two of you.
Love ... Pullman Karen

Carol said...

Our thoughts are with you both and hope that Les improves quickly now.

Jaqueline Biggs said...

Oh Kath how tragic to lose someone to this sudden onset illness when it it is avoidable. I had heard of Toxic Shock syndrome in the States in the late 70's and early 80's but didn't really know what caused it.

I am so deeply grateful Les and I found each other. He is teaching me patience (not that I asked for that lesson) and I am taking care of him. Someday we will get back to the thing we love best--cruising.
Love JaqX

Jaqueline Biggs said...

Hi Bryce,
I have hope now that Les will survive.
Love JaqX

Jaqueline Biggs said...

Oh Karen,
It was so surreal. He was clueless about the danger he was in and I didn't trust my instincts at first because I am in a foreign country and things are just enough different over here to make me pause...I know you know how it is my darling. Thank you for your continued friendship and love across all these miles.
Hugs to you and Jim,
Love JaqX

Jaqueline Biggs said...

Thanks Carol. I will pass them on to Les. Thanks for being such a stalwart friend. Love to you and George.
JaqX

Jennie said...

Oh Jaq I am so sorry to hear this latest news. Well done to you for your persistence and getting Les the treatment he needed. I hope there is better news in your next post. Take care of your self in the few moments you have. Jennie and Chris, nb Tentatrice.

Adam said...

It really is one thing after another, isn't it. You're both in our thoughts -- and we're hoping for much better news very soon.

Jill, Matilda Rose said...

Hang on in there guys This IS going to be OK. Remember you need to eat and sleep too - you're no good to him if you collapse!
xx

Sarah said...
This comment has been removed by a blog administrator.
Mike in Garnet said...

Us foreigners do expect things to happen a bit faster, just as well!!!
As Pullman Karen said, don't "discuss" it with Les, just do it, much better to be safe in in hospital, than dead in bed!

KevinTOO said...

The best thing you can do you did... you rang 999 and saved Les!

Keep strong Jaq, we're here for you both to call on if you need us.

Hugs,
Kevin & Harry

Anonymous said...

Oh Jaq. What an ordeal you are going through. Thank goodness Les has you by his side. I wish I could reach out and hug you both. You are in my thoughts and prayers.

Alistair

Jo (Boatwoman) said...

OMG Jaq. Thank god you went with your instincts.
Give Les our love and we hope now he is on antibiotics he will pick up very soon.
More often than not our instincts are always correct. He is a very lucky man, as he already knows.

Love of love and hugsss Jo & Keith xxxxxxx

Carol Ives said...

Jaq
Well done for getting him early intervention. This is what Sharon died from although hers was TPN line site and not cancer related. I hope all remains well. Big hugs



Pip said...

If we were religious we'd be praying for you both, but as we aren't, all we can do is send our love and thoughts.
Pip & Roger xxx

Ken and Sheena said...

Very sorry to hear this, Jaq.
You did the right thing.

Les, tell death to bugger off!
We all want to see you back on the boat again.

Geoff and Mags said...

Oh JaqX
So sorry to read of this last incident. After all you've both been through these last months this must be heartbreaking. Still, you being there for Les will make sure he gets the best possible treatment. Chin up.
Geoff

jercher said...

Oh my gosh! How scary!! Thank goodness for your spider sense, Jaq. I don't think you are ever wrong when you listen to it!!

Hope the IV antibiotics give Les some relief very quickly. What an ordeal for both of you!! So glad you got Les to the hospital when you did.

We've a candle burning for Les. Sending healing thoughts and lots of love from the snowy Palouse.

Jaqueline Biggs said...

Hi Jennie,
Thanks darlin' and I will pass on your good wishes to Les.
Hugs to you and Chris--and MareleyXX
Jaq

Jaqueline Biggs said...

Yes Adam it is. As my daughters liked to say when they were teenagers, "If it's not one thing it's your mother!"

Thank you both for your good wishes and we hope if you are ever cruising nearby you will stop in for a cuppa and some cake.
JaqXX

Jaqueline Biggs said...

Hi Jill,
Yeah--I collapsed on the bed last night in my clothes and slept for several hours. I've showered today, eaten, visited Les, and I am going to bed early.

Thank you for your concern and positive thoughts.
Love to you, Graham and the mutts.
JaqXX

Jaqueline Biggs said...

Will do Mike--will do!!
Love JaqXX

Jaqueline Biggs said...

Thanks guys, for your support and care. Hugs to you both harry and Kev.
JaqXX

Jaqueline Biggs said...

Thanks Alistair. We'll have that hug and your blessings.
JaqXX

Jaqueline Biggs said...

Hi Jo,
You are correct on all counts!
Love to you and Keith and we are so glad your news was good!!
JaqXX

Jaqueline Biggs said...

Carol Ives my darlin' I am so so sorry to hear that your dear friend Sharon died from something that is avoidable if caught early. What a terrible waste and how very tragic.

Les is mending now and we hope you come visit again sometime soon.
Love JaqXX

Jaqueline Biggs said...

Pip and Roger we will take all your positive thoughts, love and good wishes which are as worthy as any religious prayers. Thank you for continuing to hold us in your thoughts.
JaqXX

Jaqueline Biggs said...

Ken and Sheena,
We have defo told death to take a holiday somewhere else. I know I did the right thing--I just wish i Had done it a bit sooner. Les was on death's street--not quite at the door--and it was shocking how quickly he deteriorated. Things are looking up now.
Love and hugs to you both,
JaqXX

Jaqueline Biggs said...

Thanks Geoff. It is heartbreaking indeed. Five steps forward, two steps back. Ah well at least we know for sure we are not in this alone mate.
Chinned up!
Love to you and Mags,
JaqXX

Jaqueline Biggs said...

Hi Bear and Jer,
You knew I was thinking of you when I said, "Spider sense" didn't you? :)

Thank you for the candle and I can just picture the loveliness of the Palouse draped in winter finery! (I will appreciate that Angel Poop for you!!)
Love and BIG hugs to you both,
JaqXX

Anonymous said...

Oh my God/ess…Jaq, you and Les continue to be in my prayers.
I do know (now) about sepsis, as my former landlady died last December from it, after self-medicating what she thought was just flu.
By the time she got hospitalized, her organs started shutting down and they couldn’t do much, even in Spokane. She died within the week.

You are the gift to the world, not just to Les, with your attentiveness and intelligence. We’re all grateful for you!

Sending lots of healing prayers and love.
Jane

Ian and Karen said...

Dear Jaq, what a blessing you were on the ball with what was wrong with Les. Always trust your instincts, you are the one who knows Les best and can recognise when things are not right. Take care of yourself now while he is back in hospital. Love to you both, Karen x

Chris said...

Jaq,

I'm sending all the positive energy I can muster. I cried so much reading this most recent blog. Your perseverance and tenacity (along with your spidy sepsis) have hopefully saved your wonderful Man's life.

Hugs from Spokane, WA

Sue said...

Thank goodness you care for him so much.. I have just read this and am in shock. Deary me.. xx

Maffi said...

Oh my Jaq I am sorry to hear all this. He is lucky to have you.

nb Chance said...

Thanks goodness Les has you in his life Jaq! What a terrible shock, we really hope he gets better quickly, our love and best wishes are sent to you both. Big Hugs James and Doug x

Charm said...

Jaq, I am heart-saddened to hear of this sepsis crisis and so, so concerned for Les. Please keep us up to date--indeed, up to the hour, if not the minute.

Damn. If the disease doesn't kill you, the treatment tries to.

Tell Les to hang on, breathe deeply and visualize those bugs getting eaten by white blood cells, like Pac-man.

Love to you both,
Charmaine

Del and Al said...

Oh Jaq, can't believe this. Thank goodness you just went with your instinct. Poor Les, after all he's gone through. Take care and keep your chin up. Thinking of you as always Del & Al xxx

Jaqueline Biggs said...

Hello Jane! Lovely to hear from you Spirit sister and a blessing to know you are holding us both in your thoughts and prayers up in Northern Idaho. Give my regards to The Lady of the Lake please.
Blessed Be,
JaqXX

Jaqueline Biggs said...

Hi Karen and Ian,
Many thanks for your prayers and love. I do trust my instincts mostly but Les does not--yet. Perhaps now he will!

I hope all is well with you both.
Love JaqX

Jaqueline Biggs said...

Hi Chris!
Thank you for your prayers and positive thoughts. I am just putting one foot in front of the other each day as there is so much to come in front of us.

I heard a rumor Spokane has snow! Enjoy it for me will you? We've no snow here--just morning frosts.
Love JaqX

Jaqueline Biggs said...

Hi Darlin' Sue,
Will call you later this morning. I hear through Graham and Jill that you have no internet right now.

Love JaqXX

Jaqueline Biggs said...

Thank you Maffi. If you are coming back down this way you know you can breast up with us and dinner is in the offing. It would be a lovely thing for us both to sit at the dinette and share a good meal with a lovely boater and just chill--normally if you know what I mean! (Well as normal as boaters can be!)
JaqXX

Jaqueline Biggs said...

OoH! A James and Doug hug!! I'll have it!! Thank you for your continued care and positive thoughts guys. We are living vicariously through =the two of you so keep up the social schedule--it is our main means of partying these days!
Love to you both,
JaqXX

Jaqueline Biggs said...

Hi Charmaine! Thank you darlin' for sending us love and light. WE will indeed keep up the fight.

Neutropenia is a lack of white blood cells--they are low as a result of the radiotherapy which is what allowed the infection to grow into Sepsis. I fell like we msut rebuild Les from the ground up in order to re-establish his good health.
Love to you and please say hello to those I know in Van Doren Hall.
JaqXX

Jaqueline Biggs said...

Hi Del and Al,
Chins are up--all three of them! ;)
Thank you for your good wishes and positive thoughts. I believe it all helps.
JaqXX

Anonymous said...

Oh no, please wish him well.

You are so brave and clever I do so admire you and your resilience. Les needs you and your strength now but I hope someone nearby is giving you plenty of hugs to keep you going.

Kath x
nb.bobcat

NB Valerie & Steam Train by Les Biggs

NB Valerie & Steam Train by Les Biggs