perspectives
By Mary Millard, M.Ed.
The Devastation of Healthcare-Acquired
Infections: A Patient’s Story
In
the fall 2014 I was a very healthy 55-year-old who
had never been hospitalized and was very active,
playing beach volleyball, running with my dog, and hiking in
the Blue Ridge mountains. I also attended graduate school
and earned my degree in education and training.
Out of the blue, I started having small bouts of atrial
fibrillation, and after a few visits to local cardiologists and
being prescribed some rate-setting medicine, my situation
was not improving. During a very bad day of feeling like
my heart was going to jump out of my chest, and some
indigestion, I went to the ER at a major university hospital.
A CT scan revealed that I had developed a 6.3cm ascending
aortic aneurysm and a partially collapsed aortic valve. This
was deemed a genetic issue by a thoracic surgeon, as there
were no underlying diseases or health issues.
I was admitted for what they said was an aneurysm repair
and a valve replacement but a day prior to surgery, my valve
collapsed completely, and I went into cardiac arrest. After
coding and three attempts with the paddles that failed, an
extra-corporeal membrane oxygenation (ECMO) procedure
was implemented; this is where your heart and lungs are
bypassed with a machine that circulates and oxygenates your
blood, and an external pacemaker makes your heart beat.
After three days, my own heart started beating again, so
ECMO instruments were removed and two weeks of recovery
ensued. Doctors feared the aneurysm would burst, so the
open-heart surgery took place.
Four days after the surgery, I was placed in step-down,
with the possibility of going home soon. On the fifth day,
my husband was visiting and noticed I was speaking in a
confused manner, was feverish, and could not hold up my
head. After a stroke code was called and a neuro workup
of seven hours ensued, it was finally determined that acute
septic shock had set in and I was rushed back to the ICU.
Mary Millard in the ICU.
8
Wound cultures showed that I had contracted Pseudomo-
nas aeruginosa, a Gram-negative bacterium that creates a
sticky biofilm on anything that is not your DNA in the body. It
resides in this biofilm on my graft, valve replacement, tricuspid
valve ring and groin graft (from the ECMO cannula). I then
underwent another opening of my sternum so the surgeon
could attempt to clean out the chest cavity from infection
residue, debride the aortic graft to attempt a biofilm removal,
as well as perform an Omental flap procedure. This is where
they take a large section of inner abdomen to place in my
chest cavity and around the graft to nourish for healing.
My care will always be reactionary and ongoing,
and we had to get used to the “new normal.”
Recovery from the septic shock was slow and I was kept
in a second medically induced coma after that. Once I was
brought around, I had already spent 60 days in the hospital.
Before they could even send me home, physical therapy had
to try to get me to walk enough to get up three stairs on
my back porch. It was very difficult and painful, as being
bedbound for weeks and the damage the septic shock did
to my limbs made it hard to even sit up in bed. Talking was
also a struggle, as I was intubated for most of my hospital
stay and allowed no liquids, so I could only barely manage
a whisper for many weeks. It was also very humiliating to
be on a diuretic and unable to walk to the restroom and
this caused me a lot of frustration and shame.
Coming home was difficult, as I had to learn to walk
again and be on IV antibiotics for another month. My care
is ongoing and to date I have had: 22 CT scans, 102 W
Rays, six additional surgeries, 16 ECHOs, 27 ER visits, nine
rehospitalizations, and monthly blood draws and cultures.
The Pseudomonas is permanent and the only oral
medication to suppress it is Ciprofloxacin. I was on 1,000
mg a day and six months after discharge went septic again
and was then placed on 1,500 mg a day. The Cipro has
caused skin cancers due to photosensitivity and much tendon
damage. My care will always be reactionary and ongoing,
and we had to get used to the “new normal.” I stay strong
by working out at a gym and eating as healthy as I can to
continue the fight to live.
Mary Millard, M.Ed., is a retired healthcare worker who
now studies microbiology and epidemiology since contracting
the infection. She travels worldwide sharing her story to raise
awareness of healthcare-acquired infections, and the problem
of antibiotic resistance. Her website is: https://marymillard.org.
march 2020 • www.healthcarehygienemagazine.com