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Sepsis Is a Severe, Life-threatening Complication for IBD Patients

It’s Sepsis Awareness Month, so I’m discussing what sepsis is and how it is often a complication of inflammatory bowel disease (IBD) and colorectal surgery. According to the World Health Organization (WHO), “sepsis arises when the body’s response to an infection injures its own tissues and organs, potentially leading to death or significant morbidity.”

WHO statistics show that more than 30 million people contract sepsis each year, and 6 million die from it. But aside from all these scientific terms and statistics, what is sepsis?

To me, sepsis looked and felt like the following: It all started with a 103-degree fever, a high pulse well into the 130s, low blood pressure hovering around 70/30, and a high white blood cell count of 27 to 28. Just a few short days after surgery, I was rushed to the operating room to locate the source of my infection. Doctors kept me in ICU isolation between exploratory surgeries to clean out abscesses and visits to interventional radiology to place drains.

I received a daunting diagnosis: sepsis. I had to remain on intravenous antibiotics for the next several months and let the drain remove excess fluid collections to prevent further infection risk.

Discharge day came a few weeks later with a garter around my leg securing the drain running down my back. The drain emptied into a bag attached at my ankle. My husband lovingly referred to me as Minnie Mouse because of my new tail, which gave me a reason to keep connecting antibiotic after antibiotic to my PICC line every eight hours. I kept pushing myself to move forward, but the most excruciating element of all was flushing and debriding my infected abdominal cavity with saline, and later, hydrogen peroxide.

My drain supplies. (Courtesy of Tina Aswani Omprakash)

It was horrifying, unnerving, and beyond what any patient should have to do to herself, especially while knocking at what felt like death’s door. But I knew it was either this or I could lose it all: my life, my family, my everything. So, I kept on fighting my battle with sepsis until the wound finally closed.

In my gastroenterologist’s office after my discharge with sepsis and a drain/PICC line. (Courtesy of Tina Aswani Omprakash)

The sepsis finally came under control, but I was left in limbo between life and death while also having to build my life anew yet again. Sepsis has plagued me multiple times in my years of colorectal surgery recoveries.

It is important to note that the risk of contracting sepsis is higher for IBD patients than the average population. Many patients with IBD are immunocompromised, anemic, and malnourished. IBD-related surgeries also leave IBD patients at risk of abscesses and infections, which leave patients even more vulnerable to sepsis.

It is hard to pin down a sepsis diagnosis because its onset is often so sudden that it requires emergency medical care. However, if you are exhibiting the following symptoms, please contact your care provider or call 911 as soon as possible as these may be indicative of sepsis:

  • High fever or low temperature and shivering
  • Altered mental status, confusion, and disorientation
  • Difficulty breathing and rapid breathing
  • Increased heart rate
  • A weak pulse
  • Low blood pressure
  • Low urine output
  • Bluish skin discoloration/lack of oxygen flow
  • Extreme body pain or discomfort

The key is to act quickly to get proper treatment and to work on prevention going forward. Sepsis can turn into septic shock within hours. We can prevent the condition by staying up to date on vaccines, taking care of chronic conditions, and practicing good hygiene, such as hand-washing and bandaging cuts, wounds, and infected areas.

Although many aspects of sepsis are horrifying and life-altering, I survived thanks to multiple specialists who handled my septic condition immediately upon its onset. I advocated for myself when I recognized that I was extremely unwell and needed urgent medical attention. Patients and their families alike should be aware that sepsis can easily worsen an already bad flare-up or surgical recovery. Most importantly, they should seek assistance right away.

Own your Crohn’s and own the functionality of your body, for you alone have the best understanding of when you feel well or unwell. Recognize when some aspect of your body feels off enough to say, “I need help right here, right now.” And in this way, perhaps the severest cases of sepsis can be avoided.

**Column originally published in IBD News Today on September 20th, 2018:**

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My name is Tina and I am from the NYC area. My background is in legal and compliance for financial services. Due to the severity of my Crohn's and multiple extraintestinal manifestations, I have been rendered unable to work. I have served as a case study for a number of renowned doctors and surgeons across the country. I hope that the research done on me helps current and future populations of IBD patients. In a world where the #metoo movement has erupted, I believe it is high time for patients like myself to speak up about the ravaging aspects of chronic illness and disability. The intent of this blog is to give those suffering in silence and in shame a voice that creates greater awareness and acceptance of our daily struggles. I own my Crohn's and my goal is for you to as well!