I am an otherwise healthy 28-year-old. But no one is immune from sepsis. It began one day at work in February of 2019. Out of nowhere, I was sitting down and charting at 5 am (I am an ICU nurse), and I just felt sweaty, and could tell my heart was racing. I looked at my Fitbit and it said my heart rate was in the 130s, just at rest. I figured I had a virus, so I put a mask on and tried to press on through the day.
I moved slowly for most of the day, asked for a lot of help from others to get my job done so I could just go home to sleep. Then at 1 pm, I walked through the hall of my ICU, feeling dizzy. My supervisor told me I “looked like death,”pale and sweaty. I sat down and immediately vomited in a trash can. She told me to go home.
At home, I took my temperature. It was 104.2. At this point, I obviously knew something was wrong with me, but I hoped I could just sleep it off.
In the morning I felt just as bad, but also had left lower back (flank) pain. I now knew immediately I had some sort of kidney infection, and knew it was time to go to the ED and get antibiotics and fluids, since I also couldn’t keep anything down without throwing up. Thank God I am an ICU nurse or I would not have recognized the signs and would not have been so lucky.
At the ED, my temp was 103 again. My heart rate in the 120s. My blood pressure in the 70s. I was breathing over 30 a minute. Immediately alarm bells of sepsis are going off in my head. I know I am already meeting multiple criteria. They drew my labs, and my lactic acid was elevated. I told the doctor about my kidney pain, and he blew it off as “probably just a stone” and I did not need imaging. Thankfully it was shift change and after he left I demanded an abdominal CT scan. It confirmed that I had a large 1.7 cm kidney stone that had become infected, so I had pyelonephritis and hydronephrosis. (Sepsis and Kidney Stones)
After getting a couple liters of fluid, my blood pressure still had not come up, and soon I was living my worst nightmare. I had to be admitted to my own hospital ICU so I could get levophed to bring my BP up.
Once in the ICU, I was rushed to have emergent surgery. They were going to place a nephrostomy tube at first but decided against it for some reason, so I got a stent and had my fluid aspirated and cultured. I got more and more fluid intravenously. I think it totaled about 9 liters in two days. I finally was able to come off levophed by day two, but I was so fluid overloaded I could barely breathe. By day three, I had not slept at all, barely eaten, I could not stop vomiting, and I was in so much pain. Zofran was not helping and I kept throwing up my pain medication. In the ICU, we have something we call “ICU delirium,” which is psychosis from lack of sleep, illness, constant alarms, and medications. That is exactly what I experienced next.
After the 5th time in an hour of vomiting, I had a panic attack. The doctor came in, slammed me with versed, and placed a central line in me and started Precedex. When I woke up, I insisted on ativan, phenergan, and IV pain medication since I was throwing up the oral. Thankfully, the ICU doctors have respect for me as a colleague and I got my wishes. I’m sure I was an annoying patient. After that I finally got some sleep for the first time in days.
My blood cultures came back positive for E. coli. I had never had symptoms of a UTI before this, otherwise I might have been able to get antibiotics early to prevent it. (Sepsis and Urinary Tract Infections) Meanwhile, I still had this giant kidney stone and stent causing me pain, but the urologist did not want to remove it until my infection was gone.
I only spent about 8 days in the ICU, but I had a PICC line placed in my arm so I could drive to the hospital every day to get IV antibiotics for two and a half months. I wasn’t able to work during this time, and I fell into a deep depression.
Finally, after my infection was cleared up enough, I had my stone pulverized and removed with basket retrieval. A week after, I got to pull out my own stent (fun!). Finally, I was starting to feel better.
I am one of the lucky ones, because even though I went into septic shock, I was able to recognize my own signs early due to my knowledge as an ICU nurse. If I had waited even one more day, I may not have been so lucky.