Will Hernandez
In the days that followed, there was a sharp, aching pain in her left side. She was experiencing chills, her son would not latch on for breastfeeding and she did not feel well enough to eat. McFarland, 20, knew her symptoms were not normal.
McFarland, who lives in Elyria, went to the emergency room at Cleveland Clinic’s Fairview Hospital, where a CAT scan detected an infection. She woke up four days later, on June 21, and was told she would need to have a partial hysterectomy. McFarland had a streptococcal blood infection, which causes toxic shock syndrome and can ultimately lead to sepsis.
Sepsis is a life-threatening blood infection. When the body releases chemicals into the bloodstream to fight an existing infection, sometimes the body can damage its own tissues and organs, resulting in inflammation.
“It was all completely new to me,” McFarland says. She had never heard of sepsis before.
Sepsis is rare in a case like McFarland’s, says Dr. Michael Taylor, an intensive care doctor with the Cleveland Clinic. Her infection started in the uterus.
“She is a young and otherwise healthy person, so that’s what makes it unusual.” -Dr. Michael Taylor
“That shows that sepsis can affect anybody, even though it’s usually the very young, the very old or people with pre-existing medical problems.”
Will Hernandez
Postpartum sepsis tends to be more common in developing countries – another aspect that makes McFarland’s case uncommon. Though McFarland’s infection started in the uterus, postpartum sepsis can also be the result of a urinary tract infection, pneumonia or the entry point of a cesarean section becoming infected. Other complications include prolonged labor and an extended period of time between the woman’s water breaking and the birth of the child, according to Sepsis Alliance, a charitable organization run by health care professionals.
During her treatment in the intensive care unit, McFarland was immediately connected to IVs for fluids, Taylor says. In many cases, a patient’s blood pressure will drop and his or her blood vessels can break and leak, causing swelling and puffiness.
“Her kidneys were not working normally,” Taylor says. “Patients can become malnourished because of this, and the body can’t metabolize normally.”
Research from the past 20 years shows that the rapid administration of fluids and antibiotics within the first hour of diagnosis is essential. A 2006 study by Critical Care Medicine showed that there is a 7.6 percent increase in the chance of death for every hour that passes before treatment begins. Over the years, Taylor says the biggest problem in the treatment of sepsis has revolved around spotting and recognizing the symptoms and putting the patients on antibiotics early enough.
McFarland spent time in the intensive care unit battling a blood clot that resulted in a longer stay. She was unable to leave the hospital until July 20, about a month after she was admitted. Taylor says it is common for the critically ill to develop additional conditions, so McFarland’s team was not blindsided by the blood clot. She was prescribed blood thinners and took the extra time to regain her strength.
McFarland’s heart muscles weakened and her cardiologist told her that her heart would remain enlarged and that the partial hysterectomy was necessary, as there would be too many complications in any future pregnancies.
In the end, McFarland says she learned to trust her gut instinct.
“If there’s any type of pain you feel that’s not normal, don’t second-guess yourself,” she says.
“They told me I made it to the hospital within hours before I would have died.” -Nalani McFarland
Now, months later, she says she is feeling as healthy as ever and is excited to go back to her normal routine and enjoy life with her new baby.
Sepsis Symptoms
Sepsis is the result of an infection, so symptoms may mirror typical infection symptoms such as diarrhea, vomiting and sore throat.
“It’s common to think you have the flu at first,” Taylor says.
Here are other symptoms to watch out for:
- Shivering or fever, body temperature above 101 degrees Fahrenheit or below 96.8 degrees Fahrenheit
- Extreme pain or discomfort
- Clammy or sweaty skin
- Confusion or disorientation
- Shortness of breath
- Heart rate above 90 beats per minute
Courtesy of Centers for Disease Control and Prevention
Who’s at Risk?
- The very young and very old
- Anyone with a compromised immune system
- Anyone who is already very sick, or in a hospital’s intensive care unit
- Anyone with wounds or injuries, such as burns
- Anyone with invasive devices such as catheters or breathing tubes
Courtesy of the MayoClinic.org
Sepsis and Prevention
Sepsis can be caused by any infection, including bacterial, viral, fungal and parasitic. Good and consistent hygiene can prevent most infections, as will vaccinations that help combat viruses such as influenza. Sepsis cannot always be prevented once an infection is detected, so preventing the infection itself is vital. The Centers for Disease Control and Prevention reports that 35 percent of sepsis cases stem from pneumonia.
It is also essential to treat urinary tract infections quickly, clean skin wounds and avoid infections in hospitals by making sure doctors, nurses and anyone else who enters your hospital room washes his or her hands.
Recognizing the Impact of Sepsis
Each year, around 1.2 million people in this country alone will be diagnosed with sepsis, and one-third of them will die from it, Taylor says, so it’s important to recognize and acknowledge that impact.
“Sepsis is one of those (infections) that not a lot of people know about,” he says. “When you look at just the sheer number of people it affects and kills, it dwarfs many of the conditions people know more about. There are all sorts of medical issues that deserve lots of attention when you look at the numbers, and sepsis is huge.”
Hannah Bealer is contributing writer. Feedback welcome at feedback@cityscenemediagroup.com
