Surviving sepsis with multiple serious complications

When Laura Lambert started to feel ill on Feb 5, 2017, she thought it was the beginning of a flu infection. She had no idea that it was, in fact, pneumococcal septicaemia and she was about to face the fight of her life—a fight she very nearly lost. Aged just 25 years at the time, Laura, a graphic designer, was attending a weekend ice hockey match in her hometown of Widnes, northwest England, with her husband Charlie and other family members. “I started feeling a bit ill, with a headache”, Laura explains. “Then when I got home, I started to vomit. I thought it was the flu or some winter bug.” She decided to stay on the sofa that night so as not to disturb her husband's sleep or give him the infection. She had to get up several times to be sick, and when morning came, things were about to get worse. “Charlie came in and told me I was covered in a rash all over my body”, Laura explains. “I hadn't seen myself in a mirror, so I didn't know. He suspected meningitis, and when we pressed a glass on the rash it didn't go away, which suggests meningitis. He said we had to call an ambulance, immediately.” A paramedic arrived quickly to assess Laura, and administered antibiotics before minutes later, an ambulance arrived to take her to the nearby emergency department of Whiston hospital, Prescot, UK. “It hadn't really hit me at all how serious it was until I was in the ambulance”, she recalls. “My voice was starting to go, and I suddenly felt very sleepy. The paramedics and Charlie were trying to keep me awake.” On admission Laura was taken straight to the intensive care unit (ICU). What doctors had first suspected as meningitis, and then meningococcal septicaemia, was later diagnosed as pneumococcal septicaemia. Although Laura's family were relieved she had made it to the hospital, neither they nor she were aware that she would remain in that ICU for the next 2 months, or the myriad of complications that would follow. Her kidneys began to fail and she needed dialysis, and also a tracheostomy to help her breathe. She was so unwell that doctors had to put her into an induced coma on the very first day of her ICU admission. There were several moments during these harrowing months that doctors thought Laura would not survive—Charlie and other family members were taken twice to a side room to be told she would be unlikely to survive the night. However, the most daunting of her complications was the tissue damage to both legs and hands that the sepsis had caused. “It was so bad that I had to have my leg amputated below the left knee, and also most of my fingers shortened”, Laura explains. She was also told that there was a 50:50 chance her right leg would be amputated. But first, doctors dealt with the left leg amputation; it wasn't until much later that a decision was made about her right leg. Laura recalls worrying about how she would be able to walk and be independent after. But the most immediate sensation she felt after the left leg amputation was pain relief. “I hadn't realised how much of the pain I was feeling was coming from that leg”, she explains. “But I was so much better in terms of pain that I was even able to watch a film in my hospital bed that same day.” As if all this wasn't enough, Laura was to face another serious setback in her recovery. She suffered a rare allergic reaction to the antibiotic cocktail she was receiving in the ICU, which caused her to develop an extremely rare complication called toxic epidermal necrolysis (TEN). She is thought to be one of very first patients at Whiston hospital to develop this condition whilst under their care. TEN causes skin peeling and sensations that can feel and look very similar to burns. Laura experienced these symptoms, and subsequently had to move from the ICU to the burns unit at Whiston hospital, where she would spend another 2 months receiving additional treatments, such as regular dressing changes and new antibiotics, frustrating her recovery from the original sepsis episode. Doctors had finally decided, before Laura left the ICU, that they could save her right leg by reconstructing it using tissue and skin from her left thigh. “Because the right leg had lost a lot of muscle and tissue during the sepsis, the doctors needed to rebuild it using a flap; a piece of skin and fat from the left thigh”, she explains. But due to her stay in the burns unit, the procedure was delayed until she could leave. She then moved to the plastic surgery unit for the right leg reconstruction. This complex surgery required general anaesthesia, and afterwards intensive physiotherapy so that Laura could learn to move again. “Physiotherapists were with me from the start, helping me to adjust to everything that was thrown at me”, Laura explains. Firstly, she had to learn to sit up again and just move generally after such a long period in the ICU had caused her to lose muscle tone everywhere. Then gradually she progressed to trialling prosthetic legs and other walking aids and frames. Despite all these complications, Laura's spirit was never broken. Much to the awe of Charlie and her family she focused not on what she had lost, and the battle still ahead, but instead on how lucky she was to be alive. “I've always been the kind of person who just gets on with things”, she explains. “My family, I think, were surprised, expecting me to be down a lot of the time because of what happened. And I did have one dark moment. But other than that, I just took it a step at a time and did what I needed to do to get back to normal life. It was hard for them as they were hit with the ups and downs of my care. Not knowing if I would make it. It was especially tough on Charlie who was at home for so long without me.” When, in June 2017, it was time for Laura to leave hospital, she faced a choice. To go home, which she desperately wanted to do, and receive home-based physiotherapy (with time limits), or she could instead move to a rehabilitation centre in nearby St Helens hospital (called the Seddon Suite). In the end, though she felt emotionally torn, she knew the rehabilitation centre was the only choice, because it would enable her to have intensive recovery and make her transition back to life quicker in the end. “I had to learn to walk again, even to eat again, because I had been fed with a tube for so long in hospital”, Laura explains. “I've always had a fast metabolism and struggled to gain weight, so in the centre I had to drink these high calorie protein shakes all the time.” She spent 3 months in the centre, patiently regaining her strength and her ability to walk. “I was determined to walk out of the centre myself, without a wheelchair or other assistance and arm-in-arm with Charlie—I managed to do it”, Laura proudly remembers. Home life required some adjustment—she initially used a stair lift that was fitted for her by the local council. But she became used to her prosthetic left leg and rebuilt right leg, and now walks normally everywhere. One of the most surprising parts of Laura's story is that she returned to work in December, 2017, just 3 months after leaving the rehabilitation centre. “I wasn't just going to mope around, doing nothing”, she explains. “At first I had reduced hours at work, which were then gradually increased, but now I'm full time in the office just like everyone else.” Laura's colleagues knew her well before this major health crisis, and have been very supportive. But now, even 6 years later, she does get a little anxious meeting new people and sometimes feeling worried what they will think and about explaining her story to them. “But it's always fine, there is really no need to worry”, she says. Laura now volunteers for the UK Sepsis Trust, the charity dedicated to raising awareness and helping people who have suffered with this life changing condition. She is helping to run the support group in her area, which has just got started. She wants to help raise public awareness of sepsis. Laura and Charlie also host an annual charity ball to raise the profile of sepsis and much needed funds to support the UK Sepsis Trust. “Most people just don't know what sepsis is, or think it's something that only happens in hospital”, she explains. “Although I did not survive the experience without some serious complications, it could have been worse and I could have died. But if that day, when I'd started to feel unwell, I'd had any idea that it could be sepsis, doctors could have intervened sooner. We still don't know what caused me to develop sepsis. What I do know now is that sepsis can happen to anyone, anywhere, just like it did to me on what had been a normal Sunday afternoon.”