My name is Jennifer Mulvihill, and I am very fortunate to say that I am a survivor of severe sepsis and septic shock. (Sepsis and Septic Shock) I can only hope by sharing my experiences that my story could save another life with early recognition. All my experiences have occurred recovering from various procedures that I have endured such as a hepatic trisegmentectomy (75% of my liver removed), embolization (procedure to stop me from bleeding to death as I was in hemorrhagic shock), and a diverting loop ileostomy (the end of my small intestine brought up to the right side of my abdomen). Looking back at all the education and discharge paperwork that was provided to me in the hospital as a patient, it did not prepare me for the severe sepsis symptoms that I was going to exhibit and what my next steps should have been in obtaining care.
I was instructed for all three discharges to monitor for redness, tenderness, warmth, drainage, fever, or swelling around the surgical site, and to call the provider if I exhibit any of those symptoms. My first experience was recovering from my liver resection. I was two weeks post-op, and the midline staple incision was healing nicely. Of course, I was beyond exhausted as I had just lost a large portion of my liver and I was recovering from acute hepatic liver failure with symptoms of fatigue, nausea, loss of appetite, and a general sense of feeling unwell. So, it was very difficult to delineate if my fatigue was exacerbated from my acute liver failure or severe sepsis.
I went to lay down that evening having an overall general sense of feeling unwell and abdominal pain. In the middle of the night my Labrador dog Daisy kept gently nudging her nose against my lower legs in attempt to wake me. I remember saying to her in a very confused state to stop as I was afraid she would get too close to my abdominal incision. She was persistent in waking me and when I started to come to, I could feel my body on fire. I knew at that very moment I was running a high fever.
Getting up out of bed was such as challenge as I had no strength in me. My Daisy girl helped to push me out of bed. As I attempted to walk into the kitchen to get a thermometer, I could not catch my breathe. I was breathing as if I was trying to blow out birth candles over and over. I was able to get to the thermometer and my temp was 103.7. At that time, I decided to call the hepatology department to talk to the on-call provider to give me instructions on what to do next. I was instructed to call 911 and go to the nearest emergency room as my symptoms of high temperature, difficulty breathing, sleepiness, and difficulty to arouse were all symptoms of severe sepsis.
When I arrived at the hospital, I had imaging done demonstrating a superinfection around my liver requiring three drains to be placed, and a stent in my bile duct. My pressure was significantly low requiring multiple liters of IV fluid boluses. My blood cultures showed positive for enterococcus faecalis a gram-positive bacterium that is usually found in the gut. (Sepsis and Surgery, Sepsis and Bacterial Infections)
Fast forward two years after my recovery from my liver resection, I had an ileostomy placed due to significant delay and loss of function in my gut motility within the entire large intestine. I was at least two months post recovery from my ileostomy procedure and all my surgical incisions had healed up. I was on total parental nutrition 14 hours out of the day and had a tunneled central venous catheter on the right side of my chest. (Sepsis and Invasive Devices) It was one day after Thanksgiving, and I was feeling very tired as I had just cooked a large meal for the entire family. I went into work that Friday morning and my fellow co-workers kept saying to me my coloring looked bad and I should get some rest.
I opted to leave work early for some rest. Later that evening when walking around I started to blow out those birthday candles again. Walking a few steps, I could not catch my breathe. I checked my temperature, and I had no fever. I was having an overwhelming sense of feeling very unwell and I was very lightheaded. I had told my family I was going to lay down and gave myself a bolus of fluid. This was a normal routine for me to give myself a liter of fluid if feeling dehydrated or lightheaded.
Within a few minutes of the transfusion, I had an entire body chill come over me and my body was shaking uncontrollably. My husband checked my temperature, and I had no fever. He ended up taking me to the emergency room given all my other symptoms. My systolic blood pressure was 40-60 and diastolic pressures below 30. After many attempts to get my blood pressure up by the emergency room staff with IV fluid boluses I ended up with an arterial line and a Levophed drip to treat my life-threatening low blood pressure.
I eventually spiked a temp above 102.0. I was later diagnosed with severe sepsis/septic shock related to a perforated stomach ulcer. So, when I look at the acronym TIME (Temperature, Infection, Mental Decline, and Extremely Ill), it’s about ME (Mental Decline, and Extremely Ill) for myself. The temperature starts late for me, and I did not exhibit any external signs of infection such as redness, tenderness, warmth, drainage, or swelling around the surgical site. I initially exhibited extreme fatigue, an overwhelming sense of feeling very unwell, and difficulty breathing. These were very life altering events and I will always take TIME for ME now and I can only hope many others will to fight the battle against sepsis and improve survival rates. I have attached the picture of me celebrating for the first time in two years being line free.