K K Gupta
Posted on March 1st, 2019
Devansh / Son
All of this started when my Mom and I noticed that my Dad was out of breath on 23 Nov., 2018. We called an ambulance from the small township hospital. On reaching the hospital, he was given oxygen and was stabilised. He was referred to a nearby hospital in the city, some 2 hours away.
We were told that he had renal failure due to chronic kidney disease stage-5. He did not have hypertension or diabetes, and none in my family had ever had CKD. The doctor was even unable to identify the cause of failure and he was put on dialysis. On 1 Dec, my dad started having abdominal distension and a gastrologist was called. He told he had peritonitis and intestinal TB. There was fluid in his abdominal cavity which was drained. Next day, we noticed a rash on his abdomen from where the fluid was drained and the doctor didn’t give it a shot. It started spreading and was so his abdominal distension.
We decided to shift him to India’s largest hospital for further evaluation. We arrived in the ER and he had hypotension (97/63). He was shifted to the ICU for observation but was shifted to a private room on stabilisation on 5 Dec 2018. 2 days later, a doctor came to our room, and told us that he had to be shifted to the ICU again. The reason he told us was that he had sepsis. We didn’t take it as something serious and thought that they had taken him for observation. But suddenly, on 11 Dec at 4 am, we were called to get him intubated. We desperately signed all papers and were told that he had severe pneumonia. They did the bronchoalveolar lavage test and found Klebsiella pneumoniae as the causitive bacteria. (Sepsis and Bacterial Infections)
Next day at night, we were called again and were shocked to be told that he was dying and we can give our goodbyes. He was in severe hypotension, 46/20. His heart rate was peaking at 180 BPM. They gave inotropes in the highest dose possible. We waited outside the ICU, desperately for the last call. 2 hours later, doctors told that they could stabilize him and he was back on 119/82. Then his condition stayed the same and on my birthday, 24 Dec, he was magically weaned off the ventilator but had to use BiPAP. His brain MRI showed a minor stroke. We were told that the prognosis was still poor, but chances of his survival were raising.
Next day, on Christmas, he developed a bed sore. On 26 Dec, his condition again started worsening, the ventilator was again connected and his dialysis was changed to the 24-hour one CRRT (continuous renal replacement therapy). His bed sore again gave him sepsis, but this time with antibiotic resistant staph (specifically, staphylococcus hemolyticus).Not even sensitive to Vancomycin and Collistin. But this time, his weakened body couldn’t fight it off and instead of WBCs raising, they went down to just 3,000. Again we were called for his lowering BP with even all the inotropes, his body was cold, from under his chest. His low platelets caused internal bleeding and his mouth was full with blood. The last thing I remember was his chest being crushed, CPR. After half an hour of tries, they took the last ECG, which was flat. All of his organs had shut down and thus we rejected heart-lung bypass. We gave him our last good-byes on 3 Jan 2019, 3:30 AM.