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The Rapid Lethality of Sepsis: A Personal Account

3/28/2025, 6:20:22 PMMale25-34

Almost eight years ago, my father passed away unexpectedly, and it has lingered in my mind whether sepsis could have been responsible for his sudden decline. His health journey began with surgery on a Monday, followed by a deep sleep from which he never awoke by Saturday. This procedure was not his first; it was approximately his fourth or fifth operation on that same shoulder joint. His initial surgery involved a complete shoulder joint replacement, after which he experienced a fall on ice, leading him to catch himself with his arms—resulting in another surgery to repair the shoulder. Unfortunately, complications arose when an infection set in. A subsequent surgery aimed to eradicate this infection, but it persisted despite medical efforts. For weeks, he was hospitalized, with the shoulder incision remaining open and sealed with some form of plastic. He was connected to various machines that fought to prevent the infection from recurring. The medical team even consulted an infectious disease specialist to help combat the issue, yet another surgery was required. I still find myself wondering about that infection. Did it have a specific name? In any case, he returned home that week, visibly fatigued and unwell—reactions that were entirely expected given his ordeal. That particular Saturday coincidentally marked my 20th birthday. Although I was away in college at the time, I learned from my mother that he seemed particularly out of sorts. He appeared so exhausted that he struggled to keep up with simple activities. In a moment of self-reflection, he expressed regret, asking my mother if it was indeed my birthday, lamenting, "What kind of father am I for forgetting my daughter’s special day?" It seems likely that if sepsis were at play, it might have affected his cognitive functions and memory. Understanding his state, my mother suggested they take a nap together. Tragically, she woke from her rest, but he never did. We have assumed sepsis was the cause of his passing, yet we declined an autopsy, believing his body had endured enough suffering. Could there have been alternative explanations? Would sepsis typically present more symptoms prior to death? In hindsight, I wish we had opted for an autopsy. Was he battling sepsis the entire time, or was the infection recurring? For context, my father was a 45-year-old male at the time of his passing.

Multiple SclerosisLupusInternal Medicine

Answers (1)

Cony

3/28/2025, 6:20:44 PM

OpenHealth AI

I'm truly sorry to hear about your father's passing and the impact it has had on you. It's understandable to have lingering questions about sepsis and the events surrounding his health at the time. Let's address your concerns and questions about sepsis and infections.

Main Points:

  • Sepsis Overview: Sepsis is a severe and sometimes life-threatening response to infection.
  • Possible Symptoms: It often shows signs such as confusion, rapid heart rate, fever, and extreme fatigue.
  • Infection Details: The specific infection he had, especially after multiple surgeries, can lead to complications including sepsis.

Explanation:

Sepsis occurs when the body’s response to an infection starts causing widespread inflammation, potentially leading to organ failure. Your father's situation, involving multiple surgeries and an ongoing infection, poses a risk for sepsis, especially if that infection was resistant to treatment or not properly addressed at times.

Upon reflection, it is indeed common for sepsis to not present with clear symptoms right before a sudden decline, especially in complex medical cases like your father's. Signs of sepsis can vary widely; while many experience clear symptoms, others might display more subtle changes, such as fatigue or confusion. Given the context you provided, it’s possible for conditions like fatigue and cognitive changes to manifest without very overt sepsis symptoms.

Next Steps:

  1. Consider Information Gathering: If you wish to learn more, you might reach out to healthcare professionals familiar with your father's medical history, such as those who treated him. They can provide insights into the nature of his infections and treatments.
  2. Research Sepsis: Explore resources from credible organizations like the CDC or WHO to fully understand sepsis, its symptoms, and risks associated with post-surgical infections.
  3. Reflect on Family Health: Since sepsis can have genetic factors, keep this in mind as you discuss family health concerns with your relatives or future healthcare providers.

It's completely natural to have questions and seek understanding, especially following such a profound loss. If you feel comfortable, consider sharing your reflections and feelings with supportive friends or family members—it might help with your healing process. If you have further questions or need clarification on any specific aspects, feel free to ask.

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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. 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