Surviving sepsis

SPECIAL REPORT: For World Sepsis Day today, Detective Senior Sergeant Ian Foster tells Phillipa Yalden about his fight back to health from the life-threatening condition.

Detective Senior Sergeant Ian Foster remembers his son yelling 'Never give up' at him through tears as he struggled to breathe, passing in and out of consciousness.

Ian was a in a critical state suffering from life-threatening sepsis that had taken over his body.

At the time, in June last year, he believed he was having a heart attack. But it would turn out to be one of the signs of sepsis, a life-threatening condition that causes organ failure due to an uncontrolled immune response to infection.

For the typically fit and healthy, football-playing father of two, that Sunday was the start of a long journey to recovery.

A year on, Ian is sharing his story on World Sepsis Day (Friday 13 September) to raise awareness and help people recognise the signs.

"I didn't know what the signs and symptoms were. I never thought it would happen to me, but it can happen to anyone."

Ian, 49, was working the late shift in the Waikato District Command Centre at Hamilton Central on Thursday June 15 2023 when he began to feel off. He spiked a temperature and began shivering.

The next morning he went to the GP and was told it was likely to be a virus. He was due to fly out on a family trip to the United Kingdom that Monday, so prioritised rest, hoping to kick the illness with paracetamol before departure.

"On Saturday I didn't get out of bed, I felt rough. On Sunday, I thought I should get up and get some food in me ahead of the trip on Monday."

At home with his 12-year-old son, Ian was sitting in a chair when things began to spiral. His heart rate quickened. He had stomach pain and struggled to breathe. Cellulitis appeared on his leg.

He asked his son to grab his Garmin watch. His heart rate was 122bpm resting. Grabbing his phone, he called his wife, simply saying 'help me'.

"My youngest stood there asking me if I was dying. I said 'no'. I thought I was having a heart attack."

That's one of the signs - a racing heart. And delirium. From there it's all a bit of a haze. Ian passed out for a while and recalls his wife arriving home with their eldest son.

He stood there yelling 'Dad remember your five things - never give up'.

"He just screamed it at me through tears. That's what woke me up."

An ambulance crew arrived and administered oxygen. "They were really switched on to sepsis. They had a discussion over giving me antibiotics and they did in the end. I've been told that decision is what helped save my life."

Ian was taken to hospital in a critical condition and sepsis was confirmed. Ian says doctors were unable to identify if the initial infection was viral or bacterial as antibiotics meant it couldn't be identified in blood cultures and testing.

Thinking the antibiotics would take care of it, Ian believed he'd be walking out of hospital the next morning. It would be more than two weeks, with five days in HDU, before he would leave the hospital.

Ian with a therapy dog in High Dependency Unit at Waikato Hospital.

Sepsis is an overreaction of the immune system to an infection. It essentially becomes toxic and attacks the body, tissue and organs. The underlying infection can be bacterial, viral or fungal.

Ian suffered severe muscle damage. He lost 14kg and the ability to walk. His white blood cells were destroyed. During his initial stay in HDU, he thought he was having a heart attack three or four times.

He suffered from pleural effusion, where the blood leaks into the lungs, triggering panic attacks because of the feeling of drowning when lying down.

"It was pretty tough on my boys and my wife, seeing me like that.

"I didn't realise how intense the recovery would be. They told me it would be months before I could walk properly."

Ian made a goal for himself - to walk out of hospital. He set small goals, using a walking frame to take small steps. Reaching the end of the corridor was an achievement.

"After just over two weeks in hospital I walked out, but it very nearly killed me."

For the first few weeks, Ian could walk a maximum of 600 steps a day. He was eating three times the food he typically would but was not gaining weight. Doctors said it was likely to be two months before he would regain muscle mass.

Ian set a goal to play in the final footy game of the season - six weeks away.

"I couldn't kick a ball more than six inches without extreme pain."

Ian was advised to start reformer pilates, a key to assisting in his recovery by developing muscle.

"I got to the six-week mark and played two seven-minute periods of the game."

Ian returned to work on light duties in August and was signed off to return to full duties in October. He says brain fog was one of the toughest parts of the recovery - in the early stages he struggled to recall people's names or do a simple Sudoku. It has mostly cleared, but a year on he still has moments.

"They said 18 months is usually how long it takes to see what comes right."

Realistic targets helped Ian get back on to the football field.

The early signs of sepsis can be subtle, says Sepsis Clinical Nurse Specialist Cam Howard, who worked with Ian during his stay at Waikato Hospital.

The most common signs include muscle aches, shivering, low or hot temperatures, reduced urine output and quickening heart rates and confusion.

It can be caused by viral infections such as influenza, COVID and colds, bacterial or fungal infections, which causes the immune response and can be more serious than suffering a heart attack and stroke at the same time.

"These toxins get dumped into the blood stream, damage the lining of the blood vessels and they become dilated and porous. The toxins then seep into other organs and tissue including the brain, heart and other vital organs.

"The cumulative effect of toxicity, inflammation and damage can leave longer-lasting effects even after the acute sepsis event has passed. More than half of people who survive sepsis will go on to develop Post Sepsis Syndrome (PSS) - this includes ongoing medical, physical, cognitive and psychological deficits or diseases."

Ian cannot thank the staff in Ward M4 at Waikato Hospital enough for their care, and Cam for her care throughout. "They were amazing."

Ian will never know what virus triggered the sepsis. Early recognition and treatment are key to mitigating damage to organs, body systems and limbs, and overall survival.

Sepsis can happen to anyone, even if you don't know what triggers it. "If you notice symptoms just ask 'Could it be sepsis?'," says Cam.

"I'm lucky to be on the right side of the stats," says Ian. "Thankful for the ambulance crew who saved my life."

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