This is an update on a recent post about an infected toe, an incident I now realize could have turned much more serious. I am writing this for the Faces of Sepsis page at Sepsis Alliance. Sepsis, also called septicemia, can result from routine surgery or a minor scrape. It is an immune response to a bacterial, fungal or viral infection. It can advance quickly, and serious cases are often fatal. The best defence is early detection, so I am sharing my story.
On a Saturday evening after a busy day that included a long walk in new shoes, I realized my right baby toe had been sore for most of the day. It was a bad itch like I have sometimes had with athlete’s foot. On inspection, the toe was red and slightly swollen. This had also happened once before when I had athlete’s foot and it broke the skin. It had become infected, and I knew better than to ignore it.
I checked my medical clinic’s website and found they had a walk-in clinic from 12 to 2 next day, Sunday afternoon. Before bed I took my temperature orally to see if it was up. It was 35.5°C, on the low side, but that is typical for me.
Next morning the toe was a little more sore and swollen. The discoloration had spread and the corner of my foot was a sickly lilac. My temperature was 36°C.
My partner and I arrived at the clinic at 11:45 a.m. Danny waited in line so I could register while I sat and rested my foot. The clinic is usually pretty quick, but that day we had to wait at least an hour. We hadn’t had a proper breakfast. By this time we were both getting hungry, but I was also running out of energy. Danny suggested stopping for lunch at a restaurant on the way home.
“I’m getting really tired,” I said. “By the time we get out of here I’ll just want to go home.”
I might have twigged that something was wrong, because under normal circumstances I never decline an offer to eat out.
I finally got to see the doctor. She just glanced at my toe and asked a few questions. Had I had any injuries recently? None that I was aware of. She prescribed Cephalexin.
“If the red moves further up your leg,” she said, “go to the hospital.”
By now it was almost 2pm. Danny and I stopped at the pharmacy to pick up the prescription. At home I took my first dose around 3pm. We ordered pizza and watched some TV, but my appetite was not normal. I didn’t finish all my slices.
After lunch I needed to get some work done because I was planning to attend a writers’ conference starting on Tuesday. I was beginning to worry that my foot would prevent me from going.
Mid-evening, Danny came into my office and said, “Should we think about supper?”
Still feeling off, I said, “I’m sorry. I’m not hungry. Can you fend for yourself?”
I worked a little longer. About 8 pm I decided I should have a snack before winding down. I went down to the kitchen and fixed a plate to take to bed and read for a while.
Downstairs was a little cooler than my office, and the slight temperature change broke my equilibrium. I got the chills. By the time I got upstairs to bed I was trembling uncontrollably. My temperature was 37.8°C, not a high fever but the worst I have had in many years.
I crawled under the covers and tried to warm up, but the shaking continued. I couldn’t eat. I was incredibly thirsty and downed the partial glass of water by my bed.
I started to hallucinate. I saw the front windows of my family cottage superimposed on the bedroom wall. I also thought my mother, who died five years ago, was there in the room with me.
I tried to call Danny but he could not hear. My voice was weak and he was down in the kitchen with the fan running in the range hood. Too weak and shaky to get out of bed, I started to get scared.
I reasoned this had to do with the infection, so it was a good thing I was already taking antibiotics. I talked myself down from anxiety. Eventually I was able to call Danny and ask him to stay within earshot. Eventually the trembling stopped. I was able to eat something and read for a while before going to sleep.
Thanks to the antibiotics, Monday morning I felt much better. The toe seemed a little less swollen. Healing progressed. My energy returned and the sore foot became manageable. Tuesday afternoon I caught the bus to Toronto for the writers’ conference.
At the banquet on Wednesday evening I met Marijke Vroomen Durning, a nurse turned health care writer I knew from the online freelance community. When I told her what had happened, she said that I had been headed toward sepsis. She explained that when an anaerobic bacteria gets in the bloodstream, the body can react and go into overdrive. It can progress quickly from a minor wound and cause death within a few days.
Fortunately, I did not delay seeing a doctor but headed to the clinic as soon as I saw signs of an infection. My condition could have deteriorated further had I not already started antibiotics when the fever hit Sunday night. I was lucky, and hope this story will encourage others with an infection to get medical attention as early as possible.
For more information about sepsis and its symptoms, visit Sepsis Alliance.
[Update 06/15/2013: I corrected this post to clarify that sepsis is not an infection, but the body’s reaction to it. I also added a paragraph about the hallucination, which I had mentioned to Marijke but forgotten on first writing about the experience.]