Sepsis Rush Hour

Sepsis made an attempt to delay our arrival at the bigger hospital by taking the help of the evening rush hours, but in vain. Although, the hospital was just half a kilometer away, it took us around 10 minutes to reach it. That isn’t much considering that it usually takes 30-40 minutes during the rush hours.

We got down at casualty and wheeled my mom in. She was immediately attended to by the medical personnel and put on oxygen and other necessary medical paraphernalia. One of the staffs of the casualty asked me to get the registration done next door and get a file. I did. The casualty medical officer after checking my mom started questioning me about my mom’s medical history. First, he asked if my mom had asthma. I replied negatively. I told him that she was suffering from breathlessness since morning and that she hadn’t passed urine the whole day. I also told him that my mom was having fever and chills since Sunday and had tooth infection since last Thursday. I also reported that she had undergone angioplasty around 4 years ago. He asked if my mom had tuberculosis. I said that it must have been more than 40 years ago that she had suffered from tuberculosis. I also gave him the reports of the blood tests that we had got done a day before.

After getting all the medical attention and the oxygen mask, my mom seemed to be at ease. The medical officer gave me a chit and asked me to go to the other end of the corridor of the hospital at a counter. I went there. The person there told me about the charges of ICU and asked me to deposit 20,000 so that my mom can be admitted. I didn’t have even 2000 in my pocket. I went back to the casualty ward. I told Mrs. Kumar about the deposit amount and she said that she had called up her 2 sons to come to the hospital. She told me that her younger son was already on the way and called him again to get his credit card to pay the deposit.

We waited for my mom to be taken to the ICU. It was taking some time. I inquired with the medical officer why it was taking so long for my mom to be taken to the ICU. He replied that bed was being prepared for her in the ICU. Suddenly, Mrs. Kumar realized that the delay must be taking due to the non-payment of the deposit. She protested against the medical officer for the delay and told him that we had got my mom’s angioplasty done in another reputed hospital by an eminent cardiologist without paying a single penny in advance; that we had made the payment on the day of discharge. The officer relented and ordered my mom to be taken to the ICU immediately.

Once in the ICU, I was asked to sign the necessary admission papers including some consent forms about which I was explained in brief. As the exigency of the situation had turned me into a zombie, I signed all the papers without giving a thought to any of the explanations. All I wanted was my mom to get well soon and return home.

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Sepsis Storms

Thanks to the siesta that sepsis had taken on Wednesday, I slept soundly that night. My mom also had a refreshing look on her face. Everything seemed alright.

At around 11 a.m., my mom realized that she hadn’t passed urine since she got up in the morning. She informed me and was worried about it. I pacified her by saying that as she had high temperatures and had also sweated a lot besides not taking enough liquids, she was dehydrated. I asked her to drink a glass of water. Later, Mrs. Kumar advised giving coconut water. She volunteered to get it as she was going to the temple. But, she took an age to return. I was angry. Anyhow, we gave the coconut water to my mom. No relief.

My mom didn’t have fever or chills. She only had slight body pain. Nothing seemed unusual. But, she was getting tense as she was not able to pass urine. I called up our family physician. He also advised giving her coconut water. It was lunch time. We forced my mom to have lunch so that she could have her medicines. But, she wasn’t able to eat much. She was getting restless more and more. We put her to bed. She felt a little better. After sometime, she got up and went to the toilet to try to pass urine. But, she came out gasping for breath. Her heart was racing. She wasn’t able to speak.

My mom complained of upper back ache and asked me to massage it lightly. I did. She felt better. As I was supposed to go out for some work, my mom told me not to go anywhere and sit by her side. I assured her that I was not going anywhere leaving her in such a state. Mrs. Kumar informed me that my mom was not able to sleep peacefully last night. The whole night she was sighing and seemed to be in distress.

As my mom was feeling a little better after lying down for sometime, we thought of giving her a bath so that she could feel fresh and pouring warm water on her abdomen may also assist her to pass urine. Mrs. Kumar kept a stool in the bathroom to bathe my mom and also check whether pouring warm water on her abdomen helped her in passing urine or not. It didn’t.

After coming out from bath, my mom sat on the French window soaking in the sun for a few minutes. Then, Mrs. Kumar applied hair oil and started braiding my mom’s hair. But, even before she could finish braiding, my mom felt restless and asked her to stop. I escorted her to the bedroom while Mrs. Kumar kept braiding the hair and finished it when we reached the bed. I massaged her back and asked her if she would like me to take her to a hospital. She nodded. But, I wasn’t sure. Just then one of my cousins called up. He asked where we were as he had called at home and no one had answered. I told him that we were at a friend’s house. He thought that we were enjoying a holiday and said so. I told him that it was not as he thought. I told him that my mom was not well so we had come to our friend’s house. He told me to take care and hung up.

Finally, I decided to take my mom to a hospital, as she was gasping for breath and had not passed urine since she got up in the morning. I thought that at the hospital she would be put on oxygen and drips that would help her breathe properly and hydrate her allowing her to pass urine. This would improve her condition in a few hours and she may return home. I told her so and asked her once again if I should take her to a hospital. She agreed.

I got up and took out money from my mom’s purse while Mrs. Kumar took the house keys. We put on our slippers and rushed out. Although, we didn’t feel any urgency, this whole act of taking the decision and leaving the house for going to the hospital seemed to have happened in a blink. The hospital was right opposite the gate of the colony, but the distance from our building to the gate was long. So, Mrs. Kumar went to hire an autorickshaw.

At the hospital – a small polyclinic, in fact – my mom was connected to the regular medical apparatus that are used in cases of emergency. The resident medical officer came and checked my mom. Within a minute he turned around and asked me if I was her son. I replied in the affirmative. He asked me to follow him out of the room. I did so. He told that my mom’s condition was very critical and she had to be immediately put on a ventilator as her oxygen saturation level and blood pressure were critically low. He asked me to take her to a bigger hospital as they didn’t have ventilator facility.

The words “critical”, “ventilator” & “immediately” hit me in the head and started ringing alarm bells in my mind. As I said earlier, while we were at home, we didn’t feel there was any urgency. We just didn’t hurry up things. Still, it just didn’t take long for all this to happen – the taking of the decision to visit the hospital, the trip to the hospital, the hospitalization by the medical personnels and the doctor’s advice. It seemed everything happened in a minute. But, the urgency that I felt after the doctor reported my mom’s condition made me realize that I was running out of time and my mom out of breath. I had to take quick decisions.

The hospital that we usually visited and was just 3 kilometers away from our old house was now 30 kilometers far. This small hospital didn’t have an ambulance. I had never arranged one before. Cab would take nearly 2 hours. It was evening rush hours. And, it would be foolish to take someone running out of breath so far after a doctor’s advice for immediate ventilation.

There was a bigger hospital just half a kilometer away. But, neither Mrs. Kumar nor we knew about its credentials. Time now seemed to be rushing away. It wasn’t allowing us to contemplate any other options. It seemed to warn us that we had to take her to this nearby hospital or else. The doctor, I and Mrs. Kumar just succumbed to this exigency and decided to shift her to this hospital. As also to the only means of transportation readily available i.e. an autorickshaw.

From the decision taken at home to take my mom to hospital to the hiring of an autorickshaw to take her to another one, all seemed to have happened in a minute. Were we ahead of time or did we lose precious time? Only time could tell.

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Sepsis's Siesta

Sepsis had ensured that the previous night was a feverish one. Although, my mom was allowed short naps, I was not allowed to sleep. It must have been around 6 in the morning when I went to bed.

I don’t remember exactly at what time I got up. My mom had exorcised the horror of last night and was feeling very much better. I sent her along with Mrs. Kumar to get a malarial parasite and complete blood count test done so that it could be finalized whether to start treatment for malaria or not. Although, all the symptoms of last night (fever, chills, body pain & retching) indicated that it was malaria that my mom was suffering from, there was still a nagging doubt that it could be something else. My mom had pain in her upper back and some uneasiness in her chest. These symptoms along with the retching of last night made me suspect angina also. She also felt constriction in her chest. It was if her ribs were crushing her. But, then, my mom had always felt such type of constrictions in her chest due to the strong antibiotics that she was prescribed whenever she felt ill. However, as my mom was feeling a lot better, except for the slight pain in her upper back, I left for home after having my lunch.

In the evening, I received a phone call from Mrs. Kumar. She had brought the blood test report. No malarial parasite was detected. But, the WBC had shot up to 24,700. She told me to report it to our doctor. I had a vague idea that a high WBC count was good for boosting the immune system and fighting diseases. Therefore, I refused to call the doctor and told her that it might be the medicines which my mom was taking that must be increasing the WBCs. It must be remembered that my mom was being treated for her rotten tooth, hence, the rise in WBCs to fight the infection in her tooth was considered by me to be obvious. Sepsis was not suspected and the word “sepsis” was never known to me. I knew the word “septic”, but not “sepsis".

When I returned to Mrs. Kumar's house, my mother had already had her dinner. Mrs. Kumar told me that my mom was alright and that she had even sat the whole evening and chatted with their neighbour. I was happy that my mom’s condition was improving and sepsis was subsiding.

Wednesday, 24th Feb, was a very peaceful day for me what with all the tense moments that I had had since Sunday. Or, was it just the lull before the storm?

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Sneaky Sepsis

Sepsis must have been very happy with the fact that we did not suspect it to be responsible for my mom’s illness. Although, the malarial parasite blood test done the previous day was negative, we still suspected malaria to be the main culprit as my mom was having fever and chills.

The day of Tuesday, 23rd Feb was uneventful. My mom, though weak, was mostly afebrile. She only complained of slight body pain, especially, upper back ache. She had to visit our family physician in the evening. The dispensary of our family physician is around 30 kilometers away. We had to first travel to the railway station, take a train and then take a cab to the dispensary. Being a strong-willed woman, my mom managed this journey.

After examining my mom’s spleen, our family physician said that she doesn’t seem to have malaria. But, if her fever & chills continue, then he will start malarial treatment. It was a relief to know that my mom was not suffering from malaria.

Now, as we were to return by train during the peak rush hours, my mom boarded the women’s compartment as usual. When I met my mom on the railway platform after reaching our destination station, she told me that she’s getting chills. She asked me to hire an auto rickshaw immediately. But, getting an auto rickshaw during the peak hours is very difficult. However, we managed to hire one within five minutes. But the traffic slowed down our journey. As my mom started shivering, I put my arms around her and held her tightly. It took an eternity to reach our friend’s house.

As soon as we entered the house, I asked our friends to cover mom with a blanket and take out the heat pads. Sitting on the bed, my mom was shaking terribly. Her whole body was trembling vigorously. We applied the heat pads to her back. I put my arms around her and held her tightly from behind to stop her trembles. She felt the heat and asked me to remove the heat pad. We applied another heat pad to her face and then on her palms. For around 15-20 minutes, the situation was very tense. All of us were trying to stabilize her condition and provide her warmth. The chills that my mom suffered before this one were very slight in severity.

Finally, we succeeded in stopping her chills and trembles. She sweated and felt warm. And, we all relaxed our nerves a bit. But, this was just the end of one terrible episode. Another started immediately. My mom’s body started searing. Her temperature shot up to 105°C. This was checked by two different thermometers. Earlier, when she was trembling, we provided heat to her body. Now, we started the cooling process. Blanket was removed. Ice & napkins dipped in icy water were being applied. Ceiling fan was switched on and run at full speed. I called up our family physician and reported my mom’s condition to him. He said that the drugs were not affecting her and that we should start treatment for malaria. I asked him how I would do that. He knew that it was not possible to start treatment for malaria immediately as it was very late in the night. No dispensary in the area would be open to dispense the treatment. So, he asked me to start the next day.

After a feverish attempt to bring down my mom’s temperature, we succeeded in bringing it below 100°C. But, it was still not normal. I don’t remember exactly whether my mom was able to drink the warm milk that we gave her during the chills or not. But, I do remember distinctly that my mom had vomited a little. Now, the thing is that I have forgotten when it was – during the chills when she tried to drink warm milk or when we gave her Crocin tablet during fever. This retching, combined with body pain, fever and chills strengthened our belief that it was malaria that was responsible for my mom’s illness.

The whole night she was febrile. I kept awake to sponge her body with cold napkins. Her temperature was having a roller coaster ride. Sepsis was enjoying the terrible, Tuesday trauma that we were suffering from.

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Mosquito Menace

Due to the fever and chills that my mom suffered a day before, I suspected that she may have got malaria. The number of mosquitoes in our vicinity, or rather, in our house had increased in the past few days. Sleeping was never peaceful at nights with mosquitoes buzzing over our heads and stinging behind our ears, on our foreheads and under our chins.

Now, malaria is very deadly if not treated early. But, its diagnosis is very difficult. The blood test done usually does not detect the parasite causing malaria. If the parasite is Plasmodium falciparum then it is more dangerous than Plasmodium vivax. But, still blood test has to be done. So, I planned to get a malarial parasite blood test along with a complete blood count test done on the morning of 22nd February and show the report to our family physician in the evening.

Mrs. Kumar, a very close family friend had called us the previous day. When she came to know that my mom was not able to get up and do any house work, she advised that we should come and stay with them for a few days. She called us again in the morning and asked us to come to her place. She said that we could get the blood tests done at the hospital located opposite her residence. We agreed.

When we reached the hospital at around 1 p.m., Mrs. Kumar was waiting for us. We got the blood tests done and went to her house.

In the evening, I took the blood test reports and first went to my heart surgeon with whom I had an appointment. I showed him my mother’s blood test reports also. No malarial parasite was detected. But, the WBC count was a bit high at 13600. He said that there was nothing to worry and that my mom had some minor infections. That’s all.

After leaving from my heart surgeon’s clinic, I went to our family physician’s dispensary. He saw the reports and continued the same medicines that were given by his assistant. But, asked me to bring my mom the next day so that he could check her and prescribe accordingly.

When I returned from the dispensary, I came to know that my mom had high fever – something around 105 F - in the evening. But, as my mom felt better than the previous day, i.e. Septic Sunday, though a little weak, I planned to return home by Wednesday. But, Sepsis had other plans.

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Septic Sunday

The pain and the pus made a lot of fuss on Sunday, 21st February. After having our breakfast, I logged in to my computer. A little later our cleaning maid came and started doing her work.

I went to the living room to get something and saw my mom lying of the sofa. I asked her whether she still had the toothache. She replied in the affirmative. I took out a heating pad to apply heat on her cheek so that she would feel better. When I touched her face it was already hot. She had high fever.

I shifted her to my bedroom, kept the heating pad away and took out ice packs. I also poured cold, refrigerated water in a bowl, soaked a small napkin and put it on her forehead. I kept one ice pack on stomach and applied another on her head. The ice packs were difficult to handle. So, I took out more napkins. I sponged her abdomen, both her arms and her face with the napkins continuously. I took her temperature. It was above 104 F. Maybe, 105 F. I gave her one tablet of Crocin.

As my mom felt that the strong medicines that we got from our doctor’s dispensary were responsible for pulling her down, she did not take them.

As she was in no position to get up and cook, I ordered our meals from a nearby restaurant. By meal time, she felt a little better due to the Crocin tablet that I had given her. We had our meals and then she went to sleep. She again skipped the medicines that we had got from our doctor’s dispensary. Two doses of strong medicines – maybe, antibiotics – missed.

I don’t remember exactly when she started getting chills. But, when she got it, she was shivering terribly. I covered her with a blanket and a mattress. After the chills subsided, temperature rose. This episode kept on repeating the whole day with little respite. I called up our family physician at night and explained everything to him. He said that he would consult his assistant to know what medicines she had prescribed. He called up a little later and asked me to buy one medicine. As I was unable to get the name of the medicine correctly, he asked me to go to the pharmacy and call from there so that he could tell the pharmacist the name of the medicine. I did so and bought a strip of Droxyl Clav 500 (Cefadroxil & Potassium Clavulanate).

After dinner, I gave her Droxyl Clav 500 along with all the tablets that we had got from our doctor’s dispensary except for one that looked similar to Droxyl Clav. One more omission of an important drug, I guess.

That was just what the promoters of Sepsis required for gaining strength – a weakened human body and respite from antibiotic attacks. It was a weekend of celebrations for Septicemia.

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Septic Dread

The toothache was intermittent but there was no swelling on this day, i.e. 20th February. Shall I say that my mom felt better after taking the medicines given by our family physician’s assistant? Yes, indeed, she did feel a little better. But, she also felt a little weaker and after completing the usual household chores like cooking etc., she rested for the rest of the day. Frankly, I didn’t pay much attention towards her illness except for reminding her to take her medicines before and after meals.

Toothaches are generally not taken seriously by people. Although, I knew that they could turn nasty, I was unperturbed after she started taking medicines for it. Sepsis, Septicemia or Septic Shock were strange words never heard before. Now, they are no more strange but dreadful.

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Doctor's Day Out

The swelling on my mom’s cheek had subsided a lot. But, a little pain was there. I don’t remember distinctly whether I gave her a Disprin for the pain or not.

In the evening, we went to our family physician. He was out of town. But, his assistant was available. She gave some medicines to be taken 3 times a day; a few of them to be taken before meals.

That is all that I remember happened on 19th February.

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Tooth Scary Tale

Thursday, 18th February, i.e. exactly two months ago, we had to attend a wedding of one of our family friends. I reached the venue from my work place at the time mentioned on the invitation card. But, the bride & groom hadn’t. So, wasn’t my mom.

After waiting for a few minutes, I called up my mom to ask her where she was. As she was nearing the venue, I went to the railway station located behind the venue to receive her. The bride & groom arrived as I was leaving for the station. At the station, I couldn’t find my mom even after 4-5 trains had arrived and left. I returned to the wedding venue.

While I was still looking around for my mom among the guests, my mom waved at me. She was sitting with the family of the groom. I inquired the cause of her delay. She showed me her right cheek. It was swollen. She told me that she has a terrible toothache and just about managed to drag herself to the wedding. I inquired whether she had taken any medicine for it. She replied that she had taken a Crocin tablet. I told her that she should have taken Disprin instead.

By this time, the whole clan – three generations – of the groom had gathered around us. Since, we were meeting after a long time, kids having grown taller than us, it was a family reunion and, naturally, a lot had to be exchanged.

I started chatting with the mother of the little kid who had passed away last year. I inquired about how it all happened. She said that she just couldn’t understand what went wrong. Doctors had told her that her son was alright and there was no need for further medication for his heart problem. Then, suddenly, he fell critically ill and had to be put on a ventilator. She told me that except for his teeth that were rotten there seemed to be nothing wrong with him.

Rotten teeth are very dangerous, I told her. I explained that if anything happens to the teeth or if there is an infection in the throat, the heart gets affected. I further said that her son, probably, developed endocarditis due to his rotten teeth.

Endocarditis due to rotten teeth. Rheumatic heart due to sore throat. That was what I believed till my mom developed sepsis, suffered from septicemia and had a septic shock.

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