Lisa Hakala
I was about five months postpartum and breastfeeding. One Sunday morning, my right breast hurt fairly badly, and I felt lousy. I knew I had mastitis. (I’d had it twice before.) My regular OB/GYN was out of town, but the on-call OB/GYN covering for him called in oral antibiotics for me. My husband went and picked them up and I started taking them immediately. (Sepsis and Pregnancy & Childbirth)
Three or four hours later, my right breast hurt more, and the red infected area had spread. Also, my temperature was going up (at that point, 101 degrees). I called the covering OB/GYN back — she was very irritated that I’d bothered her again, told me that it could take up to 48 hours for the oral antibiotics to work, to see my regular doctor if I wasn’t better by Tuesday, and not to call her again.
Concerned, my husband called our general internist, who was useless.
Now, here’s where I was/am really lucky: My mother was staying with us and she’s very, very science savvy. She knew about and was worried about sepsis, so she called my sister, a breast cancer surgeon, who lives across the country. My sister said to circle the red area on my breast with a marker, so we could see if it was really spreading. A couple hours later, it had definitely spread, my whole breast was excruciatingly painful, my temperature was over 102 degrees, and I was deteriorating mentally — I just kept crying, over and over, that I didn’t know what to do, and that I just wanted to be left alone in a dark room.
My mother and my family debated whether I needed to go to the ER. They sought my opinion, but all I could do was cry (in pain? in fear? in fever?). My mother announced that if she couldn’t get anyone to take me to the ER, she’d call 911. All I really remember is that I insisted that before going to the ER, I had to email my boss that he wouldn’t be getting the case memo he was expecting the next morning — I can’t explain why I felt that was so critical, when I couldn’t even take responsibility for my own health crisis, except that I was so sick, I couldn’t think straight.
By 9 pm that night, I was admitted to the ER. My temperature was over 104 degrees, my white blood cell count was over 28, my entire right breast was read, inflamed, and dimpling, and I struggled to answer basic questions like my name and birth date. Due to my sister’s advocacy (she insisted the ER call her as soon as I was admitted), the ER was all over my sepsis. I literally spent no time in the waiting room; I was taken straight back to a treatment room, within 20 minutes, my blood had been drawn, and within 45 minutes, I had a central line and was getting IV antibiotics (vancomycin).
Of course, I was admitted to the hospital with a diagnosis of sepsis from mastitis, and spent the next four days getting IV antibiotics. Thanks to my mother’s and my sister’s sophistication and persistence, my sepsis was treated promptly — before I had any major organ failures — and I made a full, fairly easy recovery.
All my doctors — including my regular OB/GYN (who was back by then), my internist, the infectious disease specialist, my sister (the breast surgeon), and the surgeon who put in my central line — uniformly advised me to stop breastfeeding, because another bout of mastitis could kill me. My infant son’s pediatrician was in accord — she said formula was fine, and I’d be nuts to risk my life just to breastfeed. I cried as I took the drugs to stop lactation, but I didn’t seriously consider not taking them. (Lactivists tried to change my mind on that, claiming, “breastfeeding is the most loving thing a mother can do for a child.” Apparently, my life, and my child growing up with his mother, mattered less to them than breastfeeding, but that’s another story.)
Overall, I received excellent care at my hospital. My only criticism — and it’s a big one — is that the hospital (the same one where I’d delivered my baby five months earlier) refused to let me use a breast pump to relieve terrible engorgement the entire night I was admitted. The hospital said it didn’t want one of its breast pumps contaminated with whatever bacteria had caused my mastitis and my sepsis. Not only was that selfish — it’s a hospital for heaven’s sake! — but my breasts were so engorged — and so full of pressure — that the antibiotics had trouble getting to the underlying infection site. So, refusing me a breast pump actually jeopardized my health. (When the ID specialist found out, he read the riot act to the maternity care unit.) Unfortunately, I was too sick and weak to fight that one that night — the next day, my husband brought my, ahem, hospital-grade breast pump from home.
Here’s the thing I hope others reading this take away from my story: If something seems really wrong, go to the ER and ask about sepsis. Do NOT just let some irritated, on-call doctor on the phone bully you into waiting a few days for oral antibiotics to kick in. If I (actually, my mother) had obeyed the on-call OB/GYN that Sunday, and I had just grown sicker and sicker until Tuesday, statistics say I probably would be dead now.
Waking up healthy one Sunday morning, developing mastitis and then sepsis, and being told I might die, was among the most terrifying experiences of my life. It all happened so fast; I hadn’t done anything wrong, and — but for my mother’s and sister’s insistence in taking me to the ER — I probably would have died. Seven years later, I still think about that every day. And, every day, I am grateful.
