Bill Gammage

Tribute

Posted on November 2nd, 2018

Jen, daughter

I am writing this to raise awareness about diverticulitis and sepsis.

My father went into the emergency room after a couple of days of intense stomach pain and mental confusion. He had been to the doctor in the months prior complaining of pain and was told he was constipated even though he had a history of diverticulitis, and he had a history of mental confusion because of medications, so his wife didn’t immediately think anything new was wrong. He had been taking over-the-counter medicines for constipation and diarrhea, which we now know would have made his diverticulitis worse.

He had been told he had diverticulitis 15 years prior, but it had never come up again in conversations with doctors, and I do not think he mentioned it when he visited urgent care and was told he was constipated. The over-the-counter medicines he took for his stomach pain actually would have made it worse and most likely contributed to the perforation in his colon that caused sepsis. (Sepsis and Perforated Bowel)

When he arrived at the ER, his liver and kidneys were failing, his blood pressure was low, and a CT scan revealed swelling in his colon. They told his wife he had an infection, that the swelling might possibly be cancer, and that he needed more care. He was transferred to a larger hospital and I got on the road to make it to them as we don’t live in the same state. I was able to talk to him on the phone when he was still in the ER and we each said an “I love you”; that was the last time I spoke to me father. He went unconscious shortly after.

Upon arriving to the new hospital, he was taken in for surgery to find out what the problems in the colon were. When I arrived, I asked if he was in septic shock (because a friend of mine had recently survived sepsis and I had done some research, I thought that’s what must be happening), but before that no one had used that word with his wife. The doctors said he was in severe septic shock and they found a large tear in his colon with necrotic tissue. The tear was infected and near a blood vein, which caused the infection to travel rapidly into the rest of his body. They operated to remove the dead tissue and left him with a colostomy. When he came back from surgery, he was intubated. I asked the doctor if that was preventative or if his lungs were failing and he said both. My dad was also on a sedative, pain medicine, and medication to lower blood pressure at that point. His BP was high pre-sepsis. We did not yet understand that he was in a coma; we thought he was sedated from the surgery. No one in the hospital used the term coma at any point, actually, even though my dad never regained consciousness or became responsive.

They then wanted to install a port for his medications, because they were having trouble repeatedly giving him shots and at that point his blood pressure was so low he needed a constant feed. We agreed and since they told us we couldn’t be in the room for 45 minutes while they did that, we left to go pick up his wife’s medications and some clothes. We received a call on our way back that he had gone into cardiac arrest and was dead for 8 minutes until they were able to bring him back. When we arrived at the hospital we met with a doctor and a chaplain. We opted to sign a DNR in case he went into cardiac arrest again because at that point, the neurological damage from the first arrest was likely to be severe and his other organs were still failing.

The antibiotics did not seem to be counteracting the infection. They brought him out of sedation for us to have the chance to “interact with him”, but this really just meant that his body writhed in pain. He could not open his eyes or respond, and he was intubated. We asked them to put him back on sedation very quickly since the only reason they took it off was for us to feel like we could talk to him. It was confusing and they were all making it sound like he would die instantly. He didn’t.

We spent 5 more days in the hospital while they slowly tried to remove him from life support (blood pressure medicine and intubation) to see where he was. His blood pressure finally managed to regulate itself somewhat, but he never regained consciousness. The doctors explained that the first step was to see if he woke up, see if his brain could tell his lungs to breathe, and see if his heart would make it. After that, if he woke up, we would see what the extent of the neurological damage was. They said that the best case scenario involved 6-12 months of rehab therapy. My dad was not the kind of man who followed doctor’s orders and he had many other health problems too. I don’t think he would have agreed to that even if it was a possibility. But, he didn’t wake up.

We finally decide to move him to hospice, as the only thing that was totally clear was that he was in a lot of pain. We thought he would be able to go peacefully once we removed intubation, but it took 3 more days. He received pain medications, but it was still incredibly difficult to watch. He occasionally moaned and his limbs moved. He finally found peace on Oct. 23rd. He was 67 years old.

I share this because even after reading so many stories of sepsis, I was so shocked by everything that happened. I would not wish this experience on anyone. The doctors were helpful, but without my being able to ask specific questions, they did not use medical terms that would allow us to Google and do research. They also tended to speak in very optimistic and vague terms until I began asking point blank questions. This was confusing for us, because it gave the false impression he might somehow be fine at any moment. Even being able to ask some questions, it was incredibly confusing to understand what was happening and to ask for specific steps to be taken. My heart goes out to everyone else who has been down a similar road. I hope that raising awareness can help others avoid my father’s fate.