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A life almost ended by sepsis, and a warning to others to know the risks

Dorothy Vienne grew up on a farm, so she didn’t think twice about taking a small taste of the raw ground beef that sat in her fridge for several days before using it to make chili last Super Bowl Sunday.

“My grandmother was from a German-Danish background and we’d eat beef tartare, raw,” said Vienne, 80, a retired elementary school teacher who lives in Elma.

The split-second decision almost killed her.

She felt strange for a couple of days, then early next morning, she got chills, felt clammy, and started shaking uncontrollably. In the moment before she passed out, she had the sense to call 911.

By the time she arrived by ambulance at Mercy Hospital in South Buffalo, Vienne’s blood pressure was 54/28 – less than half what it should have been. Her lungs, liver and kidneys began to fail. Lesions that would torture her for weeks began to form inside and around her mouth.

Vienne and her son, chief medical officer for a regional health insurer, believe the taste test – and a second decision to cook and eat the chili afterward – cascaded into an E. coli infection that wrought sepsis on her body.

“I didn’t know what sepsis was,” said Vienne, 80, a former elementary school principal in the Ken-Ton district.

Most people who have heard about the body’s extreme reaction to an infection likely know a story or two about how sepsis spread to a few patients in a hospital or nursing home.

“About 80 to 90% of people who come to the emergency room with sepsis developed it outside of those settings,” said Dr. Kevin Shiley, Catholic Health medical director for infection prevention and control.

The elderly, the very young and those with a compromised immune system are at higher risk. Those with diabetes, like Dorothy Vienne, or with chronic lung or heart disease, also are more prone to sepsis, though it can strike almost anyone.

Regardless of where it starts, sepsis can be debilitating, and sometimes lethal. More than 250,000 Americans die from the condition each year – more than breast cancer, prostate cancer and HIV combined.

“It is an equal opportunity killer,” said Dr. Richard Vienne, an executive with Univera Healthcare. “It sees no race. It sees no socioeconomic status. It sees no age. A Cleveland Indians baseball player (outfielder Leonys Martin) got it last year, a perfectly healthy professional athlete.”

Sepsis can start with something as simple as bacteria or a parasite that travels from raw or spoiled food into the digestive tract, or a bacterial, fungal or viral infection that enters the body through a small cut or by other means. It can spin out of control within a few hours or days.

It’s why Dr. Vienne, his mother and the public health community want people to know about ways the condition evolves, the symptoms that suggest you might be in danger, and the importance of treating those symptoms as an emergency.

“People tend to think, ‘The symptoms will pass, I’ll just wait,’ ” Dr. Vienne said. “Time is of the essence with treating this.”

Dorothy and Dr. Richard Vienne encourage others to adhere to "sell by" dates on packaged meats and understand the rules for freezer and fridge guidelines. (Robert Kirkham/Buffalo News)

Stay safe

He and Shiley shared several ways to prevent sepsis:

A consistently healthy diet and exercise is a good place to start.

Don’t smoke, and if you do, quit: Tobacco use raises the risks for many serious diseases, including sepsis. The New York State Quitline can help; call 866-697-8487.

Get immunized: About one-quarter of those hospitalized for sepsis got it while they had pneumonia, Shiley said, so it’s particularly important for those at risk to get the pneumococcal and influenza vaccinations. These lower the risk for sepsis, as do the recommended course of immunizations for children.

Wash your hands: This is important especially before you eat and after you use the bathroom.

Food prep and cooking counts: Separate raw meats from other foods when preparing them. Quickly rinsing off a cutting board or plate enough to kill bacteria that can spread to other foods that make contact with them. Thoroughly wash fruits and veggies. Cook meats and other items that can spread bacteria to appropriate items. If you don’t know the proper temperature, check out foodsafety.gov.

Take antibiotic prescriptions as directed: “If you don’t complete the antibiotic, you may create a resistant organism,” Vienne said, “and we’re starting to see more antibiotic resistance out there.” Take comfort in washing your clothes: Have a favorite shirt or pair of sweatpants you pull on after work for days on end? The bacteria could brush against a cut or sore. “Things like that increase the risk of developing skin and soft tissue infections, which could lead to sepsis.”

Don’t delay first aid: Cuts and scrapes should be washed, cleaned and bandaged promptly. Shiley said he can list “hundreds of cases” where men kept working on their cars or in their yard after a small wound and ended up in the emergency room.

These tips might sound easy, he said, “but of course, they’re not, because if they were, everybody would be following them. But they’re really is beneficial.”

The state in 2013 instituted a Stop Sepsis Campaign that requires hospitals to screen incoming patients for sepsis. Hospitals also have stringent cleaning, vaccination and quarantine requirements designed to help prevent the spread of sepsis and other disease.

Most importantly, if you or someone you love experiences key symptoms of sepsis – fever, shivering or chills, elevated heart rate, rapid breathing, clammy skin, sudden disorientation or confusion – get medical help right away.

“The same way they tell people to come into hospital at the first sign of a stroke or heart attack, timing is everything with sepsis,” Shiley said. “The longer people wait, the less opportunity for us to resuscitate them.”

The quick action the Vienne family took after sepsis struck saved the family matriarch. Doctors used a combination of IV fluids, antibiotics and increased oxygen to beat back the rampant E. coli infection.

It wasn’t easy. Dorothy Vienne narrowly avoided being placed on a ventilator to help her breathe. She spent 12 days at Mercy Hospital – all but two of them in intensive care – and another week in a Lancaster rehabilitation facility. The lesions that formed on her mouth took several weeks to heal but tenderness lingers from a rash formed by oxygen lines that leave her cheeks a bit too rosy.

Dorothy Vienne has slowly regained her strength and embraced her new lease on life. She and her husband, Richard Sr., embarked this week on a cruise along the Northeast U.S. and Canadian coasts – but not before their son urged his mother to take steps to avoid infection.

“You may have escaped previously but it’s all about mitigating risk,” he said. “You’ve got to be very vigilant.”

•••

What is sepsis?

Sepsis is the body’s extreme reaction to infection. It can cause tissue damage and organ failure. Worse, the risk of death from sepsis climbs an average of 7.6% with every hour that passes before treatment begins, according to the National Institutes of Health. Many of those deaths can be prevented with rapid diagnosis and early treatment.

How common is it?

More than 1.5 million Americans get it annually and about 250,000 die.

What are its symptoms?

Any one or combination of the following:

  • Confusion or disorientation
  • Shortness of breath
  • High heart rate
  • Fever, shivering or feeling very cold
  • Extreme pain or discomfort
  • Clammy or sweaty skin

Who’s at risk?

Everyone, though the very young or old, and those with chronic illnesses or weakened immune systems are most at risk. Wounds, injuries, and invasive devices including  catheters or breathing tubes, also raise the risk.

Are all cases the same?

No. Viruses, bacteria, fungi or parasites all can spur sepsis and the results can strike different organs and body systems in different ways.

How dangerous is it?

Even with aggressive antibiotic and resuscitative measures, severe sepsis – or septic shock – carries a high mortality rate compared to many other common diseases. The incidence appears to be increasing in the U.S.; the causes of this increase may include an aging population, drug-resistant bacteria and weakened immune systems.

Sources: Sepsis Alliance (sepsis.org), CDC

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