Paul's Heart

Life As A Dad, And A Survivor

Archive for the tag “pneumonia”

Surviving Sepsis


This is definitely a post you will want to share.

Heavyweight champ, Mohammad Ali. Muppet creator Jim Henson. Superman actor Christopher Reeve. Academy award winning actress Patty Duke Astin. Actress Tanya Roberts. Model Anna Nicole Smith. Singer Etta James. Actor Jeff Conway. Former president George H.W. Bush. They all share one thing in common, all passed away from complications related to sepsis.

I have three very serious triggers when it comes to health: cancer news, cardiac news, and sepsis news. Why? Because I have personal experience with all of them. This is the part where I also clarify that I am not a doctor, and I am relying on my own personal experience with the things that I am going to say.

The sports and racing worlds were rocked last week at the sudden passing of Nascar racing champ, 41 year old Kyle Busch. Though initially the cause of death was not stated, probably for no other reasons than waiting for final test results, his cause of death has now been stated by his family as severe pneumonia and sepsis.

Immediately, social media warriors came out with their moronic comments, “did he get the Covid vaccine?” (how are we still dealing with this stupid and false question yet?), “incompetent doctors,” and so forth. These stupid comments were coming out before even saying anything about Busch’s death. Several social media personalities are calling out that “something is not right”. Rather than learn about a condition, it is much easier to just give conspiracies and assumptions more fuel.

To be clear, I am not a racing fan, but I am drawn to news, when something occurs that I can relate to. As explanations began leaking out, that the young driver was not feeling well, having something like a cold, and that he had requested a shot (of what? it was not stated) following the race he had just won, it was the next symptom that triggered me. I know, because it happened to me. I had been there and done that. The difference between me and the social media warriors, I kept my opinion to myself until the official word came out. Makes the score Me = 1, Social Warriors = 0. It accomplishes nothing to say something just for the sake of saying something or to jump out in front, and then be wrong.

Busch was reported to be coughing up blood. The most common cause of this is an infection, such as pneumonia, which has also been stated he had with his cause of death. As many of us are probably prone to do, we blow off respiratory and cold symptoms, and just chug through. We are also reluctant to go to the hospital or seek medical care, preferring to just ride it out, or just “get a shot.” Soon after, it was reported that Busch had died. This was no cold. I knew that. I told those around me, I am guessing he had pneumonia and did not know it, and then went septic. Delays in emergency medical care are usually fatal. I say “usually”, because…

Back in March of 2012, I won’t give the exact date as it is a personal date to me, I was taken out of my house at 3am on an ambulance stretcher. I woke up suddenly in immense pain, and began spewing vomit relentlessly and violently. I was hallucinating. And then I passed out. The only thing else I remember, was being rolled out of my bedroom, passed my two young daughters, looking horrified that something had happened to me.

I do not know how long I was out, but when I came to, I was told that I had pneumonia, and was septic. I knew what both meant, I just couldn’t believe it, because when I went to bed that night, I felt fine. I had an exhausting week, working 60 hours, I had school board campaigning that had to be done for the upcoming election, I had a school parent fundraiser to prepare for that weekend, and my daughter’s birthday at the end of the week. I didn’t get to sleep a lot, and my diet had a lot to be desired, as in, I desired to eat, just did not get to. But when all was said and done, following the birthday party, sure, I was exhausted, I ate some food, and went to bed around 11pm, without any ill feeling of what would come four hours later. And then it hit me, four hours later, no warning.

The wild thing is, I had not learned my lesson, nine months later I would have another diagnosis of aspiration pneumonia, this time diagnosed as “double pneumonia.” Yep, I had it in both lungs. I was not septic this time, but my same stupidity of denial and grit could have easily led to it. I went to work that morning, feeling like shit, drove there, got to the parking lot, and then said to myself, “I can’t do it.” I drove back home, crawled into my bed with my winter coat on, curled up under the covers, which is where I was found 8 hours later. Back to the hospital.

This behavior is not good. Trust me, I know it. But when it is all you know, this toughness, at all costs. Besides my pneumonias, all three of my heart surgeries and my carotid artery surgery, ALL related to my cancer treatment history, and I still do not react properly and timely.

There are four types of pneumonias: the common ones, viral and bacterial, and then two others fungal and mycoplasma. The viral one would easily have been suspected, as Busch claimed to have a cold, so he could have had anything from RSV to Covid, or even just a cold that got out of control, a viral pneumonia. For me, mine was bacterial, aspiration pneumonia. What is aspiration pneumonia you ask? Aspiration is when you inhale or swallow other than air, into your airways, common with people with reflux, food, saliva, etc. Have you ever drank something too quick and it “went down the wrong way” causing you to cough uncontrollably? That is aspiration. Your lungs are not meant to have anything other than air. In my case, not only do I have reflux, I also have something called a Venker’s Diverticulum in my esophagus, which as a result of my radiation therapy for my cancer, causes food and liquid to get trapped in my esophagus. If it stays there trapped, guess what happens? The body breaks the food down there and becomes bacteria, which gets inhaled into my lungs, and becomes aspiration pneumonia.

Because I was unaware of this happening, and feeling as I “normally” did, I continued on as if nothing was happening. And this should have been a fatal mistake from what I was told. It got so bad, according to my doctor, bloodwork confirmed, via the lactate acid level test, I was septic for over 48 hours. I should have been dead, not having gotten the necessary IV antibiotics I needed.

You need to understand how quickly sepsis starts and spreads. It needs a source, the original infection. Once the original infection gets too bad, and again, this could be a sinus infection or a cut, and the body’s natural immune system cannot keep up, the germs or bacteria or toxins of the infection break loose and enter the blood stream. And if you remember anything about health class in school, the blood stream goes to the heart, and from the heart, pumps out to the rest of the body. Imagine if you have ever seen a fire spread, or a hurricane devastate a coastline in real time, this is what sepsis does, and quickly. The body continues to get overwhelmed, causing widespread inflammation throughout the body, blood vessels get damaged, blood clots form. And once this happens, blood and oxygen get blocked, causing organs in the body to fail. This is called septic shock. Again, this happens all so very quickly. Sepsis is not the infection, but rather the reaction to the initial infection, whether it be pneumonia, a cut, a bite, or a cold.

And understand just how common sepsis really is, yet rarely talked about. According to the CDC, nearly 2 million people every year develop sepsis. To put some perspective, rememeber the numbers of Covid diagnosis? I will go smaller. Hodgkin’s Lymphoma has about 50,000 new diagnosis each year. Of those diagnosed with sepsis, over 350,000 die. This is a lot of deaths, and yet, sepsis does not get the attention it deserves and needs. I will bet anything most reading this post will not know how to watch for it.

Time, or TIME as the acronym is spelled out, begins the moment the doctor suspects sepsis. By then, sepsis is already so far ahead, the patient racing towards death if treatment not given soon. Busch was already not feeling well nearly a week earlier, and at no time was sepsis suspected. Could it have been? Perhaps. But unless you specifically bring up, “hey, I want to be checked for sepsis,” medicine isn’t just going to volunteer to look for it.

So I understand what happened and how to Busch. And it is sad, he was only 41 years old. Like I said, men, and women, do a lot of denying, a lot of “pushing through,” and depending what is happening, can be wrong, fatally wrong. And it is in moments like this, when it is fresh, we should be educating everyone on Sepsis. Because it is more common than we realize. A paramedic friend told me, so many people die of sepsis in the hospital unknowingly, because it is not something normally checked for. According to the AAMC, sepsis is the 3rd leading cause of death inside hospitals. Hospitals do not assume you have sepsis or will develop it. They are waiting for symptoms.

So realizing that the dead cannot talk, how about those who have survived sepsis? Singer Madonna. Actor Billy Porter. Actress Ashley Park. Survival in the hospital when being able to treat is 80% and drops rapidly without.

No one with the ability and resources wants to talk about it? Okay, I will do it, as I always do, one person at a time, always with the hopes it makes a difference to at least one person. As I said, I have survived sepsis, and I know others who have. I also personally know some who have died from sepsis.

Awareness, Pneumonia 101. This by no means will be a full tutorial in learning about pneumonia and sepsis, but it will be more, and easier to understand, so you can be better to watch out for.

I have already mentioned the four types of pneumonia, and at least how you develop aspirational pneumonia. As for the others, there is community acquired (catching a virus from someone else), hospital acquired, ventilator associated (why doctors do not want you on a ventilator for long), and health care associated.

Just as there is for recognizing a stroke, there is an acronym for helping to recognize someone with sepsis. But again, the key is, you have to recognize it, not blow it off or tough it out. The acronym is TIME.

T = temperature, usually very high

I = infection, tough to recognize if we cannot see it, or feel sick

M = mental decline

E = extremely ill (refer to what happened with me above), crazy level of pain

(image AI generated)

Let me tell you, the pain was ridiculous. The vomiting would not stop. And I definitely saw some “weird” stuff in my head. I was in bad shape, and clearly had been for some time. This is just one of several episodes I danced a little too close with death.

Busch did not know or suspect he had anything more than a cold. The diagnosis of pneumonia is simple enough. Simple use of a stethoscope to hear “crackling” in the lungs, sometimes you can hear with your naked ear pressed against the chest, and a chest x-ray will confirm pneumonia. Diagnosing sepsis is a little more complicated, and unless they are looking for it, will go overlooked. There are these tests: CBC (complete blood count), blood cultures, organ function (because your organs start to shut down when sepsis progresses), imaging tests, and as mentioned, the lactate acid level testing.

Once diagnosed, it will be only the highest broad spectrum IV antibiotics that will save a person from sepsis. And the only place to get that done is in the hospital. And NO, and I want to be clear, IVERMECTIN WILL NOT TREAT SEPSIS!!!! I can’t believe I even have to say that.

So now you see why Busch’s death is really so tragic besides his age. He knew he was sick, just not how sick, and got worse, rapidly. And whoever was responding to him, for “the shot”, was also wrong, wrong in that decision, and wrong for not insisting Busch go to the hospital.

When a tragedy like this hits, we need to talk about it, not wait “because it is too soon,” or worse, not even talk about it. Sepsis can be prevented, just as strokes and other medical crisis. But only if we know what to look for.

Bravery


Bravery is defined in Merriam-Webster as courage.

I decided to look this up today.  A co-worker was having a conversation with me, coming to find out everything that I had been going through in just the last several weeks.  And his comment to me was, “You’re really brave.”  And I looked at him like I was almost hoping for a hint of sarcasm or even some foolery.  But for once, he meant it.  And then he repeated it, “You are brave.”

The first time I heard it, I was uneasy.  I was hoping the conversation would end, but when he said it the second time, I knew that I had to deal with it.

In my life, I am hard pressed to find even one instance in my life where I could be defined as brave.  I have never fought in any armed service.  I have never broke up an attempted bank robbery.

But when people find out that I have beaten cancer, had open heart surgery, two cases of pneumonia (one with sepsis and the other double pneumonia), kidney stones, all kinds of late issues from my treatments, I get, “You are brave.”

When I think of “bravery”, I think of men and women who run into a burning building, police officers who put themselves in harm’s way every day, an airline pilot flying a human missile loaded with hundreds of lives, a teacher shielding her students from a lunatic’s bullets.

No, I am not brave at all.  I simply did what I had to do.  I have two beautiful daughters who I know love me so much, it would devastate them to lose me.  I have no choice but endure if my body and mind are capable of doing so.  In the second half of my life, I have met so many people who have faced relapses of their cancer, multiple cancers, those who struggle with their survivorship from the treatments that saved their lives, and sadly, those who lost their battles.

I have always said that I would not go through anymore treatments if my Hodgkin’s Disease came back, that is, until my daughters came along.  One of my dearest friends has faced nearly 50 surgeries all having to do with her surviving her cancer treatments, this along with a battle with a secondary cancer.  With so many close calls, not just near death, or in some cases, flat lines, she continues to trudge on to this day, not only a proud mother, but the happiest grandmother, something that she never thought she would ever see.

I do not know how she would react if I told her that she was brave.  I know on occasions when I have talked with her on the telephone, I have told her that I was speechless for words to how I felt with her continued struggles and survival.  It would be easy for her to give up I think.  She has been through so much.  But the fact is, she has not given up.  It is with her example that I can never make that decision either.

And so, I am watched periodically, whether month to month, quarterly, or annually.  There are things that have been identified and can be dealt with.  I go to my appointments not afraid, but confident in my caregivers that things will be dealt with sooner than later.  That is not bravery, that is trust.  As for the all-of-a-sudden stuff like the pneumonias, the cardiac issue, some kidney activity… a little luck does not hurt either.

The Roles Of Vaccines


Vaccines.  We all got them as babies. and then, we had to get more in school.  I remember waiting in my first grade assembly line, we were getting our measles booster.  It was this loud air-powered gun that hit your flesh without any kind of warning.  It hurt like hell and left a round imprint on the outside of your biscep.  But other than tetatnus shots, these on average would be the last vaccine’s many would see.

The concept was simple.  Get the shot of the disease you are trying to prevent (either in live form virus or dead)  which would then trigger your body into an immune response, making antibodies to help fight off a future infection.  This is how getting the measles shot, chicken pox vaccine’s prevent getting the actual disease, but if by chance you get the disease first, if your body’s immune system is working properly, and with some luck, you will survive and build up immunity on your own.  This is why most people only get Chicken Pox once, or do they?

There are vaccines available for so many things today from polio, HPV, and a new strain of flu every year.  There are also vaccine’s against pneumonia and meningitis.  But these vaccines also have the possibitlity of giving someone a false sense of security.  We have all heard that “this year’s shot does not prevent all flu’s from occurring.”  Measles and polio we are pretty sure it is one shot and done.  We get the MMRV for measles, mumps, rhubella, and varicella (covers chicken pox) so that we do not get the chicken pox.  Researchers now believe that another booster is needed.

Back in the days of  my diagnostics, I had a procedure done called a laparotomy.  This was the diagnostic test being done, which was to determine what stage of Hodgkin’s Disease I was in.  The procedure involves going in through my abdomen, and removing my spleen, some lymph nodes, and a biopsy of my liver.  Involvement of any would determine my staging, and treatment.  When I questioned the removal of the spleen, and how we can live without it, as so many do, I had been told while it does have a purpose, we can live without it.  And we can live without it, I am proof.  Spleen removal was also popular for people who were in car accidents or had other severe trauma with interior bleeding.

When you realize the amount of things that a spleen does:   main function of the immune system filtering out old red cells while holding extra blood, hemoglobin is metabolized so that its byproducts can be handled by the liver, antibodies are removed of their bacteria just as if it were a large lymph node.  Today researchers know that the spleen plays a vital role in recovering from a heart attack by helping to regenerate cells.  The spleen does all of these things, yet we can live without it if we have to.

The bad news is that there are precautions that have to be taken if you become “asplenic” – aka, without a spleen.  Risks of infection and contracting illnesses are much higher.  A simple cut on the finger, some dental work involving scraping away bacteria (that is why we floss people), a co-worker who decides to tough it out rather than use a paid sick day, all increase our risks of not only becoming septic, which for the majority of patients is fatal, let alone those without a spleen.

So what do we do if we do not have this “non-vital organ” that clearly protects us from infections and diseases.  In my case, prior to my splenectomy (part of the laparotomy), I had been injected with the Pneumovax vaccine.  At the time I was told it would be for life.  Since then, the value has been bumped up to needing every ten years or so.  But in my particular case, the Pneumovax has not worked.  Part of my long term cancer surveillance has included monitoring my titers for pneumonia and meningitis.  Titers are simply proof that your body reacted to having been exposed to that particular illness.  My titers showed nothing for either pneumonia or meningitis.  Over a period of 3 years I had received over 10 Pneumovax shots and at least 6 menningicoccal shots.  As far as I can tell, I have been okay as far as the titers for menningitis.  But I am majorly struggling against the pneumoccal titers.

You need to understand,  The Pneumovax only protects against one type of pneumnia I believe.  The problem is, there are many many more types.  So after a bout last year with pneumonia and sepsis, and another bout with double pneumonia, and all of the shots I have taken, my body has still only generated enough titers to show 50% protection.  Simple terms, I am nowhere near the protection I need and am now faced with yet more vaccines.  Now they will try something called Prevnar, which is a pneumococcal vaccine that covers several types of pneumonia to see what that does for me.

It sucks really.  I have gone through all of those vaccines, and twice last year, I came down with severe cases of pneumonia.  Worse yet, I had no obvious symptoms (breathing, coughing, congestion, NOTHING), except by some dumb fluke, my wife took my temperature which resulted in a trip to the emergency room both times, one by ambulance.

At this point, I am scared to have any more junk injected into me afraid of what all that exposure will do.  I have to be TB tested every year, which is basicly done with the skin test, you are injected with TB.  For Flu, you are injected with the flu, either live virus or dead virus.  I can never receive a live virus vaccine, especially like the one from a couple of years ago for the swine flu.  I have been fortunate, having actually had chicken pox, I have not had shingles.  Shingles for a long term cancer survivor, especially one without a spleen is pure torture.  And I know several people who get them many times a year.  The vaccines are not an option because they are live virus vaccines.

So what is my best defense?  You.  Both of us, wash our hands.  Cover our mouth and nose when we cough and sneeze, then sanitize our hands again.  Stay home from work if you are sick.  And while I respect a parent’s right not to have their child vaccinated, you do not have the right to expose my child or have my child become a carrier and infect me.

On my Med Alert bracelet is a lot of information about me.  But there is one important word on there that gets everyone’s attention when treating me… “asplenic”.  This lets every EMT, every nurse, tech, doctor, know that extra precautions must be taken with me if I am being treated.  Now you know.

no to shingles/live vaccines

Post Navigation