Surviving sepsis — a quiet killer

Stan Tkaczyk thought he had the flu and took to bed. His back hurt as well, but he chalked it up to a recent workout. Stan was actually passing a kidney stone — and a resulting infection ultimately led to sepsis.

Sepsis is an extreme response to an infection, and it’s the leading cause of death in U.S. hospitals. The causes vary. “It might start out with a urinary tract infection, or bronchitis that led to pneumonia,” said Dr. Andre Vovan, Chief of Service for Critical Care at Hoag Memorial Hospital Presbyterian and Executive Medical Director for Clinical Effectiveness, Providence St. Joseph Health, Southern California.

Days passed, and Stan felt neither better nor worse. “One week after I started having flu symptoms, I started shaking uncontrollably.” Stan and his wife Barbara decided to call the paramedics.

Stan’s vital signs were normal and although the paramedics offered to take him to the hospital, he decided to stay home. The infection is extremely difficult to diagnose. “It’s called death in disguise,” said Stan. “You don’t know that you’re dying — but you are.”

When Stan’s shaking returned the next day, Barbara took him to the emergency room at Hoag in Newport Beach. Soon after checking in, he went into septic shock. “I took a bite of sandwich and don’t remember anything else. It went bad fast.”

They didn’t know at the time, but Stan and Barbara ended up at a hospital that’s been developing better sepsis practices for some time. Hoag uses specific protocols to medicate sepsis patients and offers specific guidance to emergency department and other hospital physicians on how to care for them. Hoag also has a sepsis nurse on staff, who ensures that the patient is safely cared for in the emergency department and ICU through all stages of the infection. Dr. Vovan subsequently introduced these protocols to other Providence St. Joseph Health hospitals.

These efforts and focused care have paid off. “We have seen increased compliance, decreased mortality, and a better use of hospital resources,” said Dr. Vovan.

These changes have a huge impact on the larger California community. Providence St. Joseph Health is a 50-hospital system, the third largest non-profit hospital system in the U.S. These lifesaving sepsis practices are now spreading across all 50 hospitals and beyond.

While Stan was in a medically-induced coma, Stan’s wife Barbara took charge. Nurses told her Stan could probably hear what was going on, so she played his favorite radio station and visitors told him his favorite stories. Stan woke up five days into his coma while his favorite song — Elvis’ “Viva Las Vegas” — played.

“When I opened my eyes, with all these tubes in me, I thought, ‘What’s going on?’” Even after Barbara explained what had happened, Stan didn’t grasp the gravity of his situation. “I’d never been on death’s door. You don’t think this can happen to you, that something could kill you that quickly.”

Once he was out of his coma, the recovery began. It was rough. “On the first day when I tried to walk, all my muscle tone was gone. I’d never experienced anything like that in my life, where I was reduced to nothing.”

Stan pushed himself mentally and physically to get out of the hospital as soon as possible. When he returned home, even walking up the stairs was a challenge.

Like many sepsis survivors, Stan needed plenty of time to recover. “Lots of people come out with severe weakness,” said Dr. Vovan. “They might feel depressed or even suffer from PTSD because it’s a pretty severe illness.”

Three years after his brush with death, Stan still marvels at his journey. “Recently, I was working out and reflecting on how far I’ve come, from when I couldn’t even begin to think about lifting a weight, walking on the treadmill. Now I’m doing it with strength.”

Now, Stan tells his story in hopes of educating others about this elusive infection. His advice? “If you don’t feel good, go to the doctor. Anybody can get sepsis. No one is immune to it.”

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