Rosalyn Kaplus

Survivor

It all started as a lovely dinner at a Thai restaurant on a Friday night, February 2008. I ordered my favorite, spicy, hot Volcano Shrimp.  A thick, red lava sauce covered my delectable entrée. That evening was soon to erupt into a flow of trauma I will never forget.

I couldn’t stop throwing up and assumed I had food poisoning. Shaking and scared, I was rushed to the emergency room. I was so anxious, I could barely breathe. I thought I was dying. No one else sensed my urgency. I waited like all the other patients. I looked at my watch. Frightened, freezing and shivering, I was cold even with a sweatshirt on.  I vomited repeatedly.  My heart raced. I thought I’d faint. Quickly, I gave the nurse all of my medical history and information- insurance company, contact numbers and health care proxy.

“Yes, I have a living will.”  When the nurse finished with the routine intake, she asked me to give her a urine sample. I couldn’t pee, so I was catheterized. Then, I blacked out. A few hours later, a CT scan revealed the source of the problem-a 4 mm kidney stone. (Sepsis and Kidney Stones)

To my surprise, I was sent home to pass this infinitesimal stone; that’s standard procedure for stones less than ¼ of an inch. It didn’t matter how awful I felt. No one showed very much concern; however, my problem was, or became, more significant than the small crystal of calcium-oxalate, like a speck of silica sand.

“It will pass. It’s small.” This itsy bitsy granule happened to be a very big deal. My tiny kidney stone acted like a stopper and urine backed up into my kidneys.

“Drink plenty of fluids. It will pass. You’re throwing up from the pain.” When I got home and tried to follow the nurse’s instructions, I couldn’t keep anything down. I even spewed out the prescribed painkillers. Delirious, I didn’t even recognize I had pain nor did I know the kidney stone was jammed in with pus. I was not aware that infection had set in and unstoppable complications were evolving, silently and swiftly. No antibiotic had been prescribed. My temperature was low. I got colder, weaker, quaking and moaning with fear and helplessness.

Less than 24 hours later, by Saturday night, my daughter drove four hours, down from Orlando. She sensed I was in grim condition. She called the ER; then dialed 911. By the time I returned to the hospital, I was in a coma on the threshold of death.

Immediately, a cardiac catheterization test revealed my diagnosis; the findings indicated the simple kidney stone developed into septic shock. So severe, that my heart was affected. I was admitted to ICU in grave condition. My prognosis was not good.

What is septic shock and how did this happen to me?

My condition developed into wider complications from urosepsis. Luckily, my cardiologist recognized sepsis’ imminent impact. He promptly gathered a team of specialists to treat my rapidly deteriorating condition: urologist, pulmonologist, an infectious disease doctor, immunologist, hematologist, neurologist, general surgeon, and the intensivist, who runs the intensive care unit. A vigil to save my life commenced. I was too young to die at age 59.

On Sunday, my daughter and brothers were notified that I might not make it through the night. My whole body was shutting down. My liver wasn’t functioning; my lungs needed mechanical assistance, my heart became enlarged, even my brain swelled. My limbs and face were gigantically bloated from cell destruction. Essential IV fluids, antibiotics and steroids were administered. My back was red and dotted with pinpoint splotches.

Sepsis was directing my blood to the most important organs and away from my arms and legs. Sepsis caused micro-clotting of my left hand and left foot, stopping essential circulation. Everything was out of balance.

On Monday, the urologist surgically inserted a ureter stent to open the blocked channel and to drain the infection. In ICU, nurses hovered, monitors measured, a respirator breathed for me and IVs dripped. I was not aware of anything. I was literally out cold.

My family, friends and even my former husband prayed for my survival. They observed as my fingers and toes turned from blue to black. I was starting to physically die. Medication cocktails were injected and prayers were invoked to keep me alive.

Inexplicably, my status improved incrementally and my grave condition was upgraded to “critical.” After ten days in ICU, the intubation tube was removed and I could breathe on my own finally. Slowly, I regained consciousness.

“You’re a miracle,” the doctors and nurses exclaimed, as one by one, they encountered me responding. I thanked them constantly for my survival as I became more aware and interacted with increasing joy and laughter. I thanked God for answering their prayers.

Then a hand surgeon appeared one night. “You’re one lucky woman,” he said as he un-wrapped my bandaged left hand. I was horrified to see my fingers blackened. “How did I get burned?”

“That’s not a burn. That’s the result of lack of blood flow like in frost bite.”

“Will my hand get better?”

My mind needed to get in sync with my body and to understand how I was assaulted by this mysterious immune reaction.  I looked at my mummy-like, frozen fingers and silently mourned. “If they don’t get better, will you need to amputate?” I asked him.

“I’m not sure what tissue is viable. There’s necrosis where its’ all black. Let’s wait and see.”

Eventually, I was moved to a step-down unit; then, on to rehab for a few weeks. When I returned home, I needed a caregiver for two months. I regained my strength and ability to walk again. I readied myself for the dreaded amputation.

When I awoke from hand surgery, I was actually relieved. The skilled doctor only amputated one knuckle and nail and he chemically debrided the dead tissue from two other fingers. Once the decay was removed, there remained one shorter finger and two thinner digits, trimmed almost down to the bone. I was left with limited range of motion. My thumb recovered to almost normal and my pinky was still pink.

Additionally, brain swelling (encephalopathy) caused me to have cognitive problems. I couldn’t count backwards! Ironically, I remembered a lot of phone numbers; yet, I couldn’t do simple adding and subtracting.

I know how fortunate I am to have survived this psychological and physical ordeal. My mind and spirit were temporarily affected by sepsis’ stubborn effort to take control of my being. I was determined to resume my life and recoup my power. I still needed a caregiver for months; however, I learned to change my own gauze dressings. I started hand therapy once the wounds healed. I became more independent and needed less and less round the clock care.

When I recovered enough to begin daily living on my own, I started a quest to understand this deadly, quick killer. As I searched the internet, pecking the keyboard with my right hand and left pointer, I discovered the Sepsis Alliance website and immediately contacted the founder, Dr. Carl Flatley.

I admired his dedication. He’s determined to increase public awareness of the prevalence of sepsis and how early intervention can save lives. His mission is to honor his daughter, Erin, who died from the ravages of sepsis at age 23.

I am thankful that I was fortunate enough to survive the travail over dire illness. After a year of emotional and physical struggle, hand therapy and rehab, I am grateful to have returned to a more normal life. When I couldn’t even hook my bra, put on my own sneakers or drive, I thought I’d be forever dependent on someone else. Now, after two years, my limits are few.

When I share my sepsis story with others, people relate tales of their loved ones: Susan shared the surprise of her husband’s incident, “he only had a tooth abscess; his jaw puffed up; he was septic and had to be hospitalized.” Joan related with dismay about her step-son’s tragedy, “he got a cut at the beach; the spot turned black and he died the next day.” My insurance agent recounted with angst that her brother had complications from diabetes, “his limbs were swollen and he had purple spots all over when he died… sounds like he, too, may have had sepsis.”

At age 91, my mother had a bladder infection and temperature for one night; she succumbed and died the next day, most likely from sepsis. It was not noted on her death certificate. Rarely is sepsis indicated as the actual, official cause of death; therefore the public is not informed of sepsis’ widespread mortality rate. What is listed is “natural” or “unknown,” as the cause or the originating disease is noted; when really, sepsis is the ultimate cause of the death. Sepsis is when the body breaks down, physiologically, cell by cell with a cascade of destruction.

I am writing a book of my personal account of surviving sepsis so that more people will know:

Superstitiously, I no longer eat Volcano Shrimp.

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