Sepsis Question

[sunnyday123]

I have a family member in the hospital, he was admitted last night. He has sepsis, cellulitis, and they think pnuemonia. His blood pressure has been low, around 74/40, up to 123/56 and then it will go down again. They're giving medication for that, plus anti biotics and fluids, as well as a ventilator since he was having a hard time breathing. He had a fever of 103 last night, but it's down to about 99 now. He cut his leg a little over a week ago, and was treating it at home-not a gash, just a cut. It's been red and warm, and the last few days he kept saying he was cold and couldn't warm up, so this infection has had time to spread. He's 69 years old and just finished treatment about 4 months ago for prostate cancer. Does that affect anything?

How bad is this? I want specifics, not "bad". I know it's bad. I have to know how bad. If this infection continues, does it affect organs? The doctors still don't know what's causing the infection exactly, but one of the Drs. did say it would be a good idea to "mobilize" family that was out of state. He's in critical condition in ICU.

Has anyone ever dealt with this? What was the outcome?

 

[booger73]

If you're asking whether it would be a good idea to call everyone in, then 'yes'.. call everyone in..

Depends on how many organs aren't working.. heart - BP.. is he on bp support meds/pressors.. how is his kidneys are they working.. how much oxygen % is he on.. what's his infection count, etc, etc, etc

Hard to tell you otherwise without real numbers, but.. if he's hypotensive (low BP), on a vent, with a fever of 103.. then you're looking at the 30-60% chance mortality area

 

[HeatherH]

I'm sorry about your family member. I wish I could share a good story with you, but...my father died from a septic infection. It is very serious. Organs can shut down quickly. My father also had been treated for prostate cancer, but it wasn't the cancer that killed him. It was the sepsis.

I fervently hope that your family member has a better outcome.

 

[pigletgirl]

I had an older family member go thru this about 3 years ago. It was definitely a touch and go situation.

The problem is that the infection can affect the function of the vital organs (liver, kidneys, lungs, heart, brain, ect) and don't work as effectively and/or not at all.

It definitely was a long recovery and to this day (he is alive) he still have tons of problems with his lungs and kidneys. He has a tracheostomy, and is on dialysis.

Many prayers and positive thoughts are headed your way!

 

[Tosie]

It happened to my dad and sepsis is what killed him. He got an infection while in the hospital, came home for 1 day, and fell into a coma the next. He died less than a week later.

Sepsis is extremely serious and I pray that your family member will be OK. But if I were in your shoes, I would have everyone ready to move on a moment's notice.

I'm so sorry your family is going through this.

 

[cabanafrau]

Yes, it is very serious and the outcome may not be good, so family should be notified.

However, it just very well may work out fine. The MIL of a very good friend was critical w/ a sepsis infection shortly before Christmas, on a vent, very, very grave prognosis. She needed colon surgery to have any chance, but wasn't in any shape to have the surgery. Fortunately they were able to stabilize her just enough to have the surgery. She is still recovering, but doing very well.

Don't give up hope and pray boldly. I know it helped my friend's MIL.

 

[sunnyday123]

Thank you all for your honesty. I just don't like to be blind sided on things like this.

Are there any questions that I should ask the drs? It's my Father. I had to sign a consent form for an AV line this afternoon, and they are thinking of doing a CAT scan of his leg to see if there is any dead tissue. The Dr also asked me if he had any wishes regarding dnr's. I just really don't want to deal with this.

 

[cabanafrau]

Thank you all for your honesty. I just don't like to be blind sided on things like this.

Are there any questions that I should ask the drs? It's my Father. I had to sign a consent form for an AV line this afternoon, and they are thinking of doing a CAT scan of his leg to see if there is any dead tissue. The Dr also asked me if he had any wishes regarding dnr's. I just really don't want to deal with this.

Don't give up hope and pray, pray for his doctors and nurses, too.

 

[Ohiodislover]

I would probably ask about his kidney function...Check his foley bag, and ask the nurse about his urine output. It is a good indication whether or not his organs are failing.

Also, make sure they are turning and repositioning at LEAST every two hours. Often hospitals are lax about this and it results in wounds. It doesn't take long for a serious wound to develop, so watch to make sure they do it, and go get someone if they aren't.

Did your dad ever have advanced directives, or discuss what he wanted as far as feeding tubes? Not a pleasant subject, but one you might need to make.

My grandmother was unresponsive, and on a vent for 2 weeks, many years ago, because of a septic ear infection. She came out of it, and lived many many many productive years, so don't give up hope

 

[LuvOrlando]

My 10 yr old DD just survived a blood infection this past November. Swine Flu started Friday, then it went to Pneumonia which spilled over into her blood and by Monday morning she was in the hospital on 2 kinds of IV antibiotics. By dumb luck we ended up in the Pulmonologist office who recognized the Pneumonia and got her on oxygen & into the ER where they saw it in her blood right away & got her started on IV. Thank God she is fully recovered at 100%, no sign at all she was ever that sick with the exception of her IV scars which will fade long before my memory ever does. I was just staring at her in amazement over this little fact when she was at a Basketball game the other day. I really thought I was going to lose my baby for a while there. The human body is capable of miraculous healing sometimes, first she was born a preemie at 28 weeks and now this... my own little miracle bless her heart.

The reason they do not know what it is yet is because it takes a while for the sample to culture out. My DD was showing signs of improvement after the 48 hr mark but before the 72 hr mark. Apparently they have no choice but to best guess antibiotics until the culture comes back and that takes days. Unfortunately someone with a blood infection does not have days.

DD's infection was, thankfully, not a MRSA. These bacteria are the antibiotic resistant kinds and cause many deaths. Even if the infection is not MRSA it is still often lethal, my DD's blood infection has something like a 25% mortality rate. I am grateful I was too hysterical to research that little fact before she was already showing signs of improvement, it would have killed me with even more worry to know early on.

If they think you need to get family there it could be the infection either isn't responding or is already too advanced and shutting down organs.

I will keep you and your family in my prayers, sometimes we are all just at the mercy of God & nature and all you can do is pray. I am so terribly sorry you are going through this, it is a nightmare.... my heart breaks for you.

 

[booger73]

1) how are his organs doing - specifically heart and bp (is there any need for bp support?) - no extra support = better
2) is his infection counts coming down (white blood cell, "wbc" counts) ? yes = better
3) are his other organs stable = kidneys (creatnine).. oxygenation % (lungs) = more than 2 organ systems not working = "bad"
4) if he has an infection in his leg, do you think they will need surgery (if there is dead tissue = worse, and almost certainly would cause him to die if not operated on)?

Trying to decide dnr is a personal/family and difficult issue, I'm sorry it's been left to you currently.. the best way to think about it is to see if you can remember what he would have liked.. did he ever talk about being on life support.. did he ever watch a tv show like er and say 'oh i would never want that'.. is he the type of person that is a fighter no matter what, or is he the type that 'if it's time it's time..' people anguish over dnr.. but most people mistakenly think it's the "DNR=no treat", which is totally not the case. It's more, 'do we try to heroically resucitate things when things are really going bad' - if things are going bad enough to cause his BP to drop/heart to stop, etc.. it's very very unlikely that 'coding' (cpr, meds, etc) him is likely to help..

We don't know his prefunctional status, but if he even survives a 'code' realize he might not even get back to that.. and could have other severe things (mental function, lung damage needing a trach, kidney problems requiring dialysis, tube in stomach for feeding), etc, etc.. the chances of someone 'coding' and leaving a hospital in great shape is <1.. and more than often it just 'prolongs' some things - and at times even causes more anguish..

No one can really tell you what to do about that, because it involves so many personal, familial, even religious, faith, situational and other data - there is no 'wrong' choice.. the best way to look at it is trying to respect their wishes as best you can.. some people also talk about 'not escalating care - i.e. don't add more if this happens'.. and also de-escalating care.. 'we won't do this if this happens..' the clearer you can be about all issues the better.. although lots to think about and at this point, probably not something you want to or can really get a grasp of right now..

please call your family and other people because the best support right now (hopefully) is each other

 

[disneyfan007]

Yes this is very serious. My hubby went septic and ended up in ICU for approximately 3 weeks after having colon surgery. The main organ that was attacked was his kidneys, they came very close to shutting down. He was on dialysis daily. Before he came home they installed the ports so he could continue dialysis. After that his creatin levels straightened out and he never had to go for dialysis again. He does have to monitored by a kidney doctor twice a year as he has lost some kidney function but not bad enough for dialysis. Somehow I have it in the back of my mind that at some point as he get older that this may not be the case and dialysis will be brought back. Might just be my paranoia, no doctor has ever stated that, but I am afraid to ask.

He has traveled a long road and had many surgeries since then. I believe that he is as good as he is going to be. He has never regained the strength level that he was at before.

I fully believe in the power of prayer and family. I will keep you in my prayers and hope for the best.

Hugs to you, I personally know what you are going through. I know this hard, you need to take care of yourself also. I hope you have family, and friends there to support you I don't know what I would of done without mine.

 

[kacaju]

I am so very sorry. My Dad had something similar (he was treated for cancer before he got really sick) so their immune systems are down which is not good.
My Dad and another Man were both in the hospital for the same thing, at the same time. Very strange. They both just happen to get sick and had very similar problems. My Dad lived for 15 months in and out of hospitals and nursing homes. The other man fully recovered and is home.
The other man actually got *sicker* then my dad, but was able to recover.
I actually still keep in touch with his daughter since we spent so much time together in the ICU waiting room!!

My prayers are with you and your family.

 

[VillageMama]

I'm so sorry that you are going through this.

My 13 year old son had sepsis after his appendix ruptured. It was touch and go for a while... he received Last Rites three times.

But I'm grateful to say that he made a complete recovery. It took six weeks in the hospital, massive antibiotics and surgeries and much prayer. I'm sure his age was on his side.

I am hoping and praying that your dear father responds well to his treatments. May you find strength, wisdom and comfort throughout this difficult time.

 

[charming23]

First off to you. It is always a hard situation to se a parent in such bad health and on all sorts of machines.

Second I agree with everyone else about asking about his kidney functions. It is a tell tale sign of what is to come. Also don't be afraid to get a second opinion on things. I only say this because when my dad was sick we had all the Drs at the hospital he was at telling us he was getting better and that the infection (MRSA) that he came in with was gone. Then he went to a nursing home that specialized in patients on vents and dialysis. It was only after the Drs there examined him and found out that he had become septic and his kidneys had basically stopped working on their own. He ended up passing away later on that week after we had "let him go" (made him comfortable but did not do any extraordinary measures like his will stated in this situation).

I know it is hard to think about DNR's and living wills and virtually what is the best option in this situation but make sure you take moments to breath and spend time with him.

Again for you and your family.

 

[Disneylover79]

1) how are his organs doing - specifically heart and bp (is there any need for bp support?) - no extra support = better
2) is his infection counts coming down (white blood cell, "wbc" counts) ? yes = better
3) are his other organs stable = kidneys (creatnine).. oxygenation % (lungs) = more than 2 organ systems not working = "bad"
4) if he has an infection in his leg, do you think they will need surgery (if there is dead tissue = worse, and almost certainly would cause him to die if not operated on)?

Trying to decide dnr is a personal/family and difficult issue, I'm sorry it's been left to you currently.. the best way to think about it is to see if you can remember what he would have liked.. did he ever talk about being on life support.. did he ever watch a tv show like er and say 'oh i would never want that'.. is he the type of person that is a fighter no matter what, or is he the type that 'if it's time it's time..' people anguish over dnr.. but most people mistakenly think it's the "DNR=no treat", which is totally not the case. It's more, 'do we try to heroically resucitate things when things are really going bad' - if things are going bad enough to cause his BP to drop/heart to stop, etc.. it's very very unlikely that 'coding' (cpr, meds, etc) him is likely to help..

We don't know his prefunctional status, but if he even survives a 'code' realize he might not even get back to that.. and could have other severe things (mental function, lung damage needing a trach, kidney problems requiring dialysis, tube in stomach for feeding), etc, etc.. the chances of someone 'coding' and leaving a hospital in great shape is <1.. and more than often it just 'prolongs' some things - and at times even causes more anguish..

No one can really tell you what to do about that, because it involves so many personal, familial, even religious, faith, situational and other data - there is no 'wrong' choice.. the best way to look at it is trying to respect their wishes as best you can.. some people also talk about 'not escalating care - i.e. don't add more if this happens'.. and also de-escalating care.. 'we won't do this if this happens..' the clearer you can be about all issues the better.. although lots to think about and at this point, probably not something you want to or can really get a grasp of right now..

please call your family and other people because the best support right now (hopefully) is each other

Booger, are you in the medical field? By your posts is seems that you work in the hospital. I am just wondering because the info you have given is good.

 

[Disneylover79]

First off for you and your family. I am sorry to hear you father is very sick. I am an ICU RN and I have read these posts and Booger has given very good info. I see sepsis day in and day out, it is a up and down hill battle. If the dr's are asking to you get your family together then please do so ASAP. Sepsis itself is a very nasty infection, and then with his history of cancer his immune system is down and his body will require more support. Like other have said sepsis can effect all of the major organs. When his blood pressure goes low the body will take the blood from the not so vital organs and give it to the heart,brain,lungs, and kidneys.

I do have to respond to a PP regarding turning the patient and to be sure it is getting done and that the hospitals lag in doing this. I just have to add that just because the RN is not physically in the room turning him doesn't mean the bed is not turning him. Yes repositioning him is a part of daily care but if his BP is low and he is not stable they cannot turn him, it will only make matters worse.

Also check to see if the ICU that your father is in does daily rounds, and if so ask if you can join in, this way you can get a lot of info and what is happening to your father. Also if you are home, in the waiting room, or eating a meal and you think of something that you want to ask the nurse please write it down so you can ask the RN or the MD. Please do not be afraid to ask questions, but do remember that the RN is busy so write down a few questions and then ask her when she has a minute, and no question is stupid if you are asking it then there will be an answer.

I also believe that all patients including your father can still hear you, so please talk to him (unless the RN does not want him disturbed), also ask if you can bring in a radio and some CD's he would like to listen to. I personally turn the TV on so that the patient does not just lay in the bed and listen to nothing but the machines working.

Also please be sure to wash your hands when you are entering his room and leave, it will protect you and your father. Please feel free to PM me if you have any questions, I will try and help you. I will also so a prayer for your father and you that you will both be strong through this long process.

 

[sunnyday123]

Thanks again, everyone. I just got back and th Dr wasn't there, they were getting him ready to get a CAT scan on his leg to see if there is anything that needs surgery, although I don't think he would be a candidate for any type of surgery at this point.

He's on medication to stabalize his bp, but to me it doesn't seem to be working. It was in the 120's/56 when we got there, but then went down to 74/46 then to around 90/64....I know this can't be good on his organs. His kidneys aren't functioning where they should be but he did seem to be breathing easier, even though he's on the ventilator, and they said he would probably be on it through the weekend. His color looks a little better, he's not gray like he was this morning, but still pale. The infection hasn't changed, they are still trying to figure out exactly what it is, but he's on about three anti-biotics. They also think he may have an UTI, which I'm sure isn't good for his kidneys.

I just want to crawl into a closet and close the door.

 

[minkydog]

I have a family member in the hospital, he was admitted last night. He has sepsis, cellulitis, and they think pnuemonia. His blood pressure has been low, around 74/40, up to 123/56 and then it will go down again. They're giving medication for that, plus anti biotics and fluids, as well as a ventilator since he was having a hard time breathing. He had a fever of 103 last night, but it's down to about 99 now. He cut his leg a little over a week ago, and was treating it at home-not a gash, just a cut. It's been red and warm, and the last few days he kept saying he was cold and couldn't warm up, so this infection has had time to spread. He's 69 years old and just finished treatment about 4 months ago for prostate cancer. Does that affect anything?

How bad is this? I want specifics, not "bad". I know it's bad. I have to know how bad. If this infection continues, does it affect organs? The doctors still don't know what's causing the infection exactly, but one of the Drs. did say it would be a good idea to "mobilize" family that was out of state. He's in critical condition in ICU.

Has anyone ever dealt with this? What was the outcome?

Sepsis is what killed the Pope. It is an extremely dangerous condition. Call the family in NOW.

Seven years ago my 47yo husband became septic from a sinus infection. He was already immuno-compromised due to long term steroid use. DH was the sickest I have ever seen him and he very nearly died. Everything shut down except his lungs (which was the hand of God, because he has stage 4 lung disease.) He eventually turned the corner thanks to great nursing care-- I will bless those nurses for the rest of my life. His organs regained full function except for his heart--the sinus node in the right atrium(the one that makes your heart continue to beat) was severely damaged. DH got a pacemaker out of the deal and it took him over a year to recover, on oxygen much of that time. And he is fully disabled now, but he is alive and still able to be a good father and husband. We are very VERY fortunate.

I wish you the very best for your loved one. Sepsis is a terrible condition.

 

[minniecarousel]

No knowledge on this, but just wanted to offer support. Calling in some of the rest of your family would help you.

Hang in there.