The Devastation of Healthcare-Acquired Infections – I am a Survivor
My name is Mary Millard and I became a volunteer board member at the Healthcare Surfaces Summit after being invited as the keynote speaker the previous year and telling my patient story. Yes, I am a patient who lives with a chronic healthcare-acquired infection. The Summit is a group of researchers, infection prevention nurses, medical device manufacturers, as well as people who create innovations to help prevent infections. This collaborative is very important to me as they understand that a multi-pronged approach to infection prevention is the only way we can tackle this growing problem. This is my story and you should know it can happen to anyone, even those that are healthy.
Up until the Fall of 2014, I was a very healthy 55-year-old with an exceptional life.
I enjoyed playing beach volleyball, running with my dog, and hiking in the Blue Ridge Mountains; when I wasn’t busy obtaining my graduate degree in education. Because I had never been hospitalized before, I wasn’t even aware of the dangers of healthcare-acquired infections…. yet.
However, one day and out of the blue, I started having small bouts of rapid heartbeats and thought that was quite strange and sought medical care. After a few visits to a cardiologist I was prescribed medication to help regulate the rate. Again, because I was very healthy and only in my mid-fifties, I was sure the medication would help. Unfortunately, it did not. On a particularly bad day, when my heart felt like it was going to jump out of my chest and indigestion seemed to be at its worst, my husband and I decided it was time to seek emergency treatment at a nearby hospital.
Both of us were consumed with fear and uncertainty as the medical staff tended to me. There I was—hooked up to monitors, having my blood drawn and a CT scan completed. Eventually, I was given a diagnosis. I had a 6.3cm ascending aortic aneurysm, and a partially collapsed aortic valve. After further discussion a thoracic surgeon identified the problem as a genetic issue, as there were no underlying diseases or health issues.
So, I was admitted for what they said was an aneurysm repair and a valve replacement. Two days prior to surgery my valve collapsed completely and I went into complete 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 beats your heart. After three days my own heart started beating again, so the ECMO instruments were removed and two weeks of recovery ensued. Because the doctors feared the aneurysm would burst, the open-heart surgery took place.
Four days after the surgery, I was placed in step-down, with the possibility of going home soon. Then, on the fifth day when my husband was visiting, he noticed that I was speaking in a confused manner, was feverish, and could not hold my head up. A stroke code was called, and a six-hour Neuro workup was ordered. Acute septic shock had set in and I was rushed back to the ICU.
Wound cultures showed that I had contracted Pseudomonas 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). It was later explained to my husband that this all happened from a contaminated surface. The entry of the infection was in the left groin wound and likely the ECMO cannula had been contaminated from sink splash when it was temporarily laid down on the counter. It was a healthcare-acquired infection.
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 an Omental flap procedure. This is where they take part of the tissue from your abdomen to place in your chest cavity to nourish for healing.
Recovery from the septic shock was slow and I was kept in a second medically-induced coma to help. Once I was brought around, I had already spent 55 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 bed-bound 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.
By the time it was all over I had spent a total of 65 days in the hospital. Please stay tuned for more chapters as I explain how this was just the beginning of a very long and tough journey that is still being traveled today……