April Strickland

In early 2016 I had a series of procedures related to precancerous spots found by mammogram in my right breast. One of the procedures was a CT with contrast, and the next day I experienced hematuria for the first time in my life. My PCP ran a urinalysis, but the lab lost the sample. My lumpectomy was set for a week later, and I told the surgeon about the possible UTI and lost lab. She assured it was nothing to worry about. I noticed her nose was red that morning before surgery, like she’d been crying or she had a cold. She pulled her surgical mask up and said it was nothing. Surgery was a success, two lesions were removed from deep in my breast near the breast bone.

Several weeks after surgery my incision began to ooze. I called the surgeon’s office and was told to apply bacitracin to the wound. I took my little boy to an appointment at CHKD that day, and then went to a neighbor’s cocktail party that evening. I began feeling ill as soon as I arrived and proceeded to drink glass after glass of water, then excused myself to walk home. I told my

husband I felt like I must have the flu because I started shaking and felt cold and nauseated. My back, what must have been my kidneys, hurt incredibly bad, like labor pains. I laid down and stayed down for hours, shaking uncontrollably. My temperature rose to 102.

I called the surgeon’s after hours line and was told that if my temperature went above 102 I should go to the ER. And I should call the office when they opened in the morning. My temp stayed at 102 all night, and I continued to shake, feeling like I had a sunburn inside my skin. My kidneys hurt so bad I could barely stand it. Hematuria started again as well as my period. I called the surgeon’s office at 8:30 am the next day and was told there were no doctors available that morning, and to head to the ER. I put on work clothes, thinking they’d give me a shot and release me, and I drove myself to the ER. Upon arrival I was taken to triage and assessed: 102 temp, 140+ heart rate, respiration was elevated, WBC were very high.

I was told by the doctor in the ER that I had Sepsis. I started crying and thought I’d done something wrong – Sepsis = septic/dirty in my mind at the time and I thought I must have done something wrong. They tried to determine the source of the infection. My kidneys hurt so badly that I thought it must be that UTI. The doctors were more concerned with my still-healing incision and proceeded to insert a long needle into my breast repeatedly to see if they could extract fluid – they couldn’t. I was admitted and started on Vancomycin, oxygen, and fluids. Blood thinner was started and my legs were put into compression wraps. I had to urinate into a container to measure urine output and blood. Another surgeon visited that afternoon and said he thought we needed to cut into the wound to see if infection was present. I cried again, and couldn’t imagine having to reopen my breast and take out more tissue. My kidneys were failing, my heart rate was erratic, and my intestines were slowing. One of my lungs collapsed and there’s a small nodule in that lung now. Fluid began collecting in my abdomen.

The surgical team cut a wide margin around the wound and debrided the entire incision – they cut out lots of extra tissue. At the bottom of my breast, all the way down toward the breastbone, they found a pocket of infection and sent it off for analysis. The bacteria present was staph aureus, thankfully it would respond to antibiotic treatment. The wound was left open and nurses trained my husband how to clean and pack the wound. It was spring break, and we celebrated Easter in my hospital room. The surgeon who performed the surgery the led to Sepsis finally visited the day after debridement surgery. She seemed angry and said she didn’t know why I got sick.

Two weeks after I was released from the hospital my mother drove me to a post-surgical visit with the surgeon who performed the original surgery that led to Sepsis. She proclaimed that she didn’t know why I got so sick. When I asked why I was so tired she said that she told her other patients who got infections to, “get a cup of coffee and get on with your life.” I was shocked, but

wondered if I simply needed to try to get back on the horse and get on with my life. I tried sitting up and folding my children’s clothing with my mother that afternoon, and by dinnertime my back ached so much I couldn’t stand up straight.

I attended physical therapy, met with a nephrologist for the first time and was told I have kidney disease, which I’ll have for the rest of my life. I met with a urologist, met with my gastroenterologist and had colitis for months after Sepsis. The loss of muscle mass was really surprising and my skin reacted to nearly everything, including my wedding ring – we went through four different wound tapes as I reacted to each one. I can now only use silk wound tape. I reacted to oral sulpha-based antibiotics with a rash that covered my torso, and thrush hit my mouth and throat with a vengeance. Skin on my forearms and calves peeled off.

Home Health visited for a month after I was released from the hospital, and my husband cleaned and packed the wound for five months until it finally healed from the inside out. I started coming to terms with the fact that I’ll have a large scar on my breast and kidney disease for the rest of my life. Once I was back to work I had to regain confidence – so much was lost. Looking people in the eye as they spoke or as I spoke with them was painful – finding words that I wanted to speak aloud was painful. I found myself shying away from activities I once enjoyed. Finding the Begin Again Foundation was such a gift. I felt so lost, and learning that there were others who were struggling to cope with surviving Sepsis gave me purpose: To help as many people as I can.