Maya Cargile

Survivor

In the year and a half since Maya became sick, I have tried to write her story many times. I have always stopped because it is so difficult to think about how we almost lost her. Yet I know that her story has the possibility to teach others to recognize the signs of sepsis and perhaps help them to save their loved ones. The main thing I think people should know about sepsis, is how quickly it can occur. Maya was sick for only 2 days, but the signs were there. Here is her story.

On Wednesday, March 30, 2011, around 9 p.m., Maya came down with a slight fever. The day had been just like any normal day for a 10-year-old girl. She had gone to school and completed her gymnastics practice without any difficulties. The next day she didn’t go to school, hoping that with rest she could participate in her class marionette show that evening. Maya had a starring role for which she had been practicing for months and did not want to miss it.

By Thursday afternoon, her fever reached 102 degrees, but it came back down to normal with a little Tylenol. We called her teacher who said, if at all possible, she should come in and do the show. Everyone was counting on her, and Maya did not want to let them down. She seemed fine during the show and even went on to attend the ice cream party afterwards with no complaints. However, that night, after she went to sleep her fever spiked to 104 degrees (around 2 a.m.)

Knowing this seemed like a bad fever, I called her pediatrician in the morning and got an appointment for a little before noon. The doctor checked her for strep, for which she tested negative and felt that it was probably just a virus. She prescribed an antibiotic, just in case, and said to bring her home and give her lots of fluids. She said to try to keep the fever down with Tylenol, Motrin and tepid baths. In retrospect, I wish I had been more forceful about my concerns at this point. What the doctor didn’t realized was just how bad Maya was already feeling. I had to literally carry her in to the office because she was feeling too weak to walk. She threw up once in the office and again after we left, inside the elevator.

After I brought Maya home on Friday afternoon, her fever ran between 101 and 104 degrees. She only threw up one more time, but by the middle of the night began to experience diarrhea. During all of this time, Maya was sleeping a lot, yet when she was awake, she was coherent and would drink water. On early Saturday morning (around 2 am), it appeared that her fever had broken and I thought things would start turning around for the better. However, despite her lower fever, she didn’t seem any better and in fact, seemed worse. I would later come to learn that may have been the point when her little body was beginning to give up and she was going into septic shock. Instead of feeling warm to the touch, now her hands and feet were feeling cold.

Something was terribly wrong. Maya seemed more lethargic and her whole body was red. We called her pediatrician early Saturday morning, who continued to say that we could treat her at home with fluids and Tylenol. I accepted this for about 20 minutes and then called back again and said we were taking her to the ER. Maya has asthma and now she was saying that she was having a hard time breathing. All of a sudden she seemed to be decompensating rapidly. I knew she was much worse than we had realized when I picked her up off the couch to bring her to the ER. She had lost control of her bowels and didn’t even know it.

I drove to the hospital as fast as I could. We walked right in without stopping at triage and insisted that she be seen right away. Luckily, the doctor in the ER immediately recognized that something was terribly wrong. The ER nurses were unable to start an IV due to her severe dehydration and needed to call in a nurse from the pediatric ICU for assistance. It took many, many sticks, but they were eventually able to start an IV to draw blood and give her fluids.

The blood tests confirmed the doctor’s hunch…everything was off. She had “thrown” her sugars (prompting worries that maybe she was diabetic), her electrolytes were off, and every other test was off the charts. Her heart was beating rapidly and for the first time, she seemed to be a little confused about what was going on. Still, the doctor tried to reassure us that perhaps she was severely dehydrated and with fluids and antibiotics she would stabilize. The word sepsis had never been mentioned.

Maya was transferred to the Pediatric ICU for close observation, where more tests were done. Despite all the fluid going in, she didn’t seem to get much better. I learned that the fluid was going into what is called “the third space,” which means her body wasn’t processing it.

A young doctor that was on shift in the PICU until 7 p.m. that night continued to monitor her closely, but did not change the course of her treatment. At shift change an older doctor with many years experience came on board. Thankfully he recognized the precarious state that she was in. He kept insisting that she looked “shocky” and without us knowing began to prepare for what was to come. This included having her catheterized so that he could carefully measure how much fluid was going in and how much was coming out.

Around midnight, Maya crashed during the catheterization procedure. Her blood pressure dropped and she became breathless. Because the doctor was prepared, he immediately put her on a ventilator to assist her breathing and started medication to keep her blood pressure up. A line was also quickly put into her jugular vein to better administer the myriad of IV medications she now required. Tests revealed hypotension (low blood pressure), hypocalcemia (low calcium), renal insufficiency and thrombocytopenia (low platelets). A platelet transfusion was done due to the possibility of severe bleeding. She was diagnosed with “toxic shock” another name for sepsis and was now fighting for her life. (Sepsis and Toxic Shock Syndrome) Thanks to her strong spirit and the excellent care she received, she pulled through.

Maya remained in a medically induced coma and on the ventilator for three days while her condition gradually improved. What I remember most about this time was that I was initially in a state of denial about how critical her situation was. I did not want to believe that there was a chance that she would not come off the respirator. Now I know that up to one-third of patients who require ventilation don’t make it. Had I known that at the time, my fear would have been unbearable. After coming off life support, Maya stayed in the PICU for two more days, then remained on the regular ward for a total of 10 days in the hospital while she continued to receive breathing treatments and IV antibiotics.

Tests came back that would tell us that Maya had been dealing with the H1N1 virus. (Sepsis and Influenza) She was not suffering from some obscure and deadly disease; it was simply the flu. Several other children in her class were also out with fevers the week that she became ill, but no one had a reaction like Maya did. Clearly, a flu vaccine could have prevented this horrible ordeal, but it is difficult to predict who will react so poorly to everyday illnesses like the flu. In fact, my older daughter had experienced Swine Flu the year before and was only mildly ill for a few days. I had gotten my children flu vaccines in the past, but not regularly. I suppose that I didn’t really believe that in this day and age, someone could lose their life to the flu. Despite all kinds of follow up testing, we were never able to determine why Maya became so sick, so quickly.

This leaves me with the conviction that we all need to be able to recognize the signs of sepsis. It can happen to anyone, even those who are young, strong and healthy. Additionally, it can happen as the result of very common illnesses, bacteria and infections. I relied on others to tell me the severity of my daughter’s condition. However, there were signs…clear signs and had I known them she would have gotten medical attention much sooner. The signs were there: cold extremities, red skin, high blood glucose, rapid heart beat and most of all, the fever that wouldn’t break. Had I known what was really happening in Maya’s body, perhaps we would not have come so close to losing her.

Suspecting Sepsis can save lives because the sooner appropriate care begins, the greater the patient’s chance of survival. I get scared now, every time Maya has a fever, but knowing that I would recognize the signs of sepsis and keep her safe gives me strength.

Source: by Lisa Cargile (Maya's mother)

Send us Your Story
Learn More about SepsisSupport Faces of Sepsis