Asplenia, a Dog Bite, Capnocytophaga canimorsus
& Sepsis Survival
In December 2008 my life changed forever. A dog bite ended up turning into a life and death battle. The doctors gave me only a 10% chance of survival, and over the months following awaking from a coma, I lost my business, my home, my vehicle and the relationship with my significant other. At 45 years old, I moved back in with my family and am still there today while I continue my rehabilitation.
You might think that all of this would have made me angry, but I actually feel like this is exactly where I'm supposed to be. My dreams now are to run and grow Move Mutt, my non-profit animal welfare organization, and to educate people about the necessary precautions to take while working with dogs if you have no spleen or an otherwise compromised immune system.
The stories that follow were all brought (directly or indirectly) to me through an article written by Idaho Statesman reporter, Bethann Stewart, just 2 months after my ordeal. Her words put my tragedy into a narrative people could understand and sympathize with, and also led people to me who had either lost limbs or loved ones to severe sepsis contracted from Capnocytophaga Canimorsus through a dog bite. These people are the main reason I decided to educate others about my ordeal and to all of them and Bethann, I am forever grateful.
Our stories are in no way meant to frighten people, or to discourage people with asplenia or other immune disorders from owning or working with dogs. They are meant only to educate and hopefully save lives and limbs of those people who are not aware that a dog bite can be deadly. Had I known I was susceptible, $10 worth of antibiotics would have stopped my sepsis in its tracks.
I have been blessed by the miracle of survival against all odds and want to share that miracle. I truly want to help, and maybe everything that I went through happened so that others would be able to get through a horrible, confusing time knowing that they are not alone. It is my sincere hope that the stories on this page will educate and start a much needed dialogue between doctors and patients who own or work with dogs. I also hope that these stories honor those whose lives were lost and those who are still struggling, by sharing their pain and suffering to help others in the future. Please feel free to contact me with stories of your own or more information on asplenia, Capnocytophaga canimorsus or surviving sepsis.
Canine Behavior Consultant
Move Mutt Founder & Executive Director
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WARNING! GRAPHIC PHOTOS & VIDEOS BELOW
Reneé's Story - Dec. '08 - Jan. '09
Dog Trainer Survives Sepsis
Renée Cawley had been bitten many times before, but this time, it almost killed her. BY BETHANN STEWART - firstname.lastname@example.org Published: 03/22/09
The fight broke out over toys. Renée Cawley was exercising six dogs in her Boise backyard when she ducked under an overhang to get out of the rain. She brought a handful of toys with her. The dogs followed her, but now in close quarters, they suddenly were at each others' throats. Cawley responded instinctively - she reached down to pull them apart.
A petite woman in her 40s, Cawley had been bitten so many times during her work with aggressive dogs that she didn't think anything of the bites she got on Dec. 3. But two days after being bitten, Cawley felt disoriented. At the time, her friend, David Currie, had the flu. "We thought we both had the flu," Currie said. His mom, Loralee Gray, took Cawley to the doctor, but the blood and urine cultures showed nothing wrong. As Cawley was leaving her doctor's office, she fainted. She was rehydrated and told to go to the hospital if things got worse.
By the time she got home, a rash had moved up her legs, marbling her skin red and white. "It's the scariest thing I've ever seen," Currie said. Cawley felt like her flesh was being eaten, and her temperature skyrocketed. She argued briefly with Currie about going to the emergency room because she doesn't have health insurance. "She just figured it was an unnecessary expense," Currie said. Gray took Cawley to the emergency room at St. Luke's Boise Medical Center. Cawley was screaming in pain. She doesn't remember it, but she told them to kill her.
From the purplish, dusky, mottled color of her skin, Dr. Tom Ahlquist recognized that Cawley was septic. "Her color was so bad," Ahlquist said. "The problem was not that she had sepsis, but where was it from and how do we treat it." The dog bite was a clue, but when Currie's mom told Ahlquist that Cawley no longer had a spleen, the doctor knew: The cause of the sepsis was Capnocytophaga canimorsus, a common bacterium found in dog and cat saliva.
"The spleen normally does a pretty good job of taking care of it, but without one ... they're easily overwhelmed," Ahlquist said. Cawley's spleen was removed when she was 19 as a treatment for hereditary spherocytosis, an abnormality of her blood cells. Neither her mom nor her younger sister have spleens. None of them had ever been told that a dog bite could kill them.
In the emergency room, Cawley went into cardiac arrest and her kidneys failed. Doctors induced a coma to give Cawley's body the best shot at survival, Ahlquist said.
Cawley's mom, Rochelle, who lives in Las Vegas, got the phone call no parent ever wants to get: Renee was dying, and Rochelle had to get to Boise immediately. "I asked God what I should do," Rochelle said. "One of the things he told me was that I was going to see a healing, so I grabbed my camera." Rochelle and her husband called prayer groups before she left, asking to keep Renee alive until Rochelle could get to Boise. "We were told it was a dog bite and that she had gone septic," Rochelle said. "I didn't comprehend what sepsis was at the time."
There was no way for Rochelle to be prepared for what she saw when she got to St. Luke's. Cawley's hands and feet were solid black as if frostbitten, as were her ears and nose. When Rochelle arrived, doctors were talking about amputating the black parts. "You always think the worst phone call you can get is that your child has died," Rochelle said. "But what if your child has to live without her hands and feet? How is a mother to make those decisions?" Rochelle called the prayer trees, and they prayed that Renee wouldn't lose her limbs.
Then she set about documenting what was happening to her daughter. "One of the things I was really adamant about was I was going to take pictures of where she was at and where she was going," Rochelle said. "I just pulled back the covers and started taking pictures." Every couple of days, she would take pictures of the same places.
Then the unexpected happened. During the three days Renee was in a coma, the color began to return to her black feet, hands and nose. By the time doctors brought her out of the coma, just her ears and two fingers on the hand that had been bitten were black. "It's a true miracle," Rochelle said. "She was in total cardiac arrest. Her kidneys were gone. You don't come back from that."
The doctors waited several more days to see if Renée's fingers would come back, but they didn't. Her right index and ring finger had to be amputated. "It didn't bother me. They had to do it for me to survive," Renee said. "It's amazing what I've learned to do already." Ironically, Rochelle Cawley had lost two fingers on her right hand in a lawn mower accident. "My youngest daughter was joking with Renée that you start looking like your mother when you get older," Rochelle said.
Cawley was released from the hospital only 18 days later. Then came the start of the long, arduous task of rebuilding her life. Among the challenges she faces are short-term memory loss, nausea and night terrors. She still has open wounds that take her two hours to clean and bandage. She's exhausted all the time and doesn't know how she'll pay all the medical bills.
"I'm just so thankful she's alive with most of her body parts," Rochelle said. "This is information that people without spleens need to know. If (Renee) knew, she never would have been training aggressive dogs without taking the necessary precautions."
Since the incident, Renée said she's met half a dozen dog owners without spleens who never knew how dangerous a bite could be. Renee's pet services business, Reining Cats and Dogs, which she worked hard over the past two years to develop, is on hold until she recovers. The three buildings that Currie bought on Orchard Street for the business will have to be sold.
But Renée gets strength from her three dogs: Trinity and Hawk, 6-year-old Australian shepherds, and Clifford, a 2-year-old Akbash dog. On her computer, she keeps photos of Brazilian model Mariana Bridi da Costa, a 20-year-old who died in January from a sepsis infection. Doctors had amputated both of her hands and feet, and removed both kidneys trying to save her life.
"It's difficult for me to look at, but I shouldn't be here," Cawley said. "There's a reason I survived this against all odds. My time here is not done."
Judy’s Story - November '04
The Dog Bite, Three Years Later
It was a Saturday night in November, 2004. I was exhausted from a long, blustery day at Manning Dog Training, and was getting ready to relax with my hubby and a glass of wine when the phone rang. It was a friend of my sister's, telling me that Judy (my sis) was in ER at the Toppenish Hospital, and suffering from kidney failure. Something about a dog bite. An hour later I was waiting at Memorial Hospital for her arrival via ambulance. Her situation was too serious for Toppenish to handle. She was in respiratory arrest, and had to be incubated. I was told, when she arrived and was admitted to Intensive Care, that she was "gravely ill" and had a 5-10% chance of surviving.
This started with a little dog bite three days earlier. Judy, a readjustment counselor at the Yakima Vet Center, had been bitten on the right hand by a client's small, healthy dog. The laceration was only half an inch long--so insignificant that she didn't even think to have it treated by a professional. But three days later, when she was having dinner with friends in Toppenish, she fell ill and spent the night with them because she was too sick to drive home. The next day, her friends drove her to the Toppenish hospital. She was out of her head with a raging infection. After being transported to Memorial, Judy spent three weeks in ICU. The diagnosis: "Severe Sepsis," an overwhelming and devastating bloodstream infection caused by toxic bacteria. Sepsis causes the internal organs to shut down, and you start dying from the inside out. It is extremely hard to treat, even with the best antibiotics, because the results and complications are so far-reaching and horrendous. The cause :Capnocytophaga canimorsus, a sneaky, opportunistic bacteria in the saliva of the dog that bit her.
She was comatose for several days. She remained on a ventilator for 10 days. She was unable to speak, eat or swallow, so they fed her through a feeding tube up her nose. The toxins in her body caused huge blisters on her extremities, like those of a burn patient. The fingers of her right hand, along with all her toes, began to turn black due to circulation problems (lack of blood supply) caused by the sepsis. Her kidneys stopped functioning and she required dialysis every day. Her heart was defibrillated twice. The prognosis was grim.
After three weeks she was airlifted to Harborview in Seattle, and admitted to the Burn Intensive Care Unit so her wounds could be treated. She remained there for three full months. During that time she had four fingers amputated on her right hand, and all ten toes removed. She required extensive skin grafting where the "burned" tissue had been removed from her legs, almost down to the bone. The donor site for the skin was her back. And then there were five weeks of physical and occupational rehab, during which she re-learned how to walk and how to use her fingerless right hand.
Judy's huge wounds took nearly a year to completely heal. She is deeply scarred from the waist down and suffers bouts of severe nausea, probably from internal damage. She takes daily medication for pain, blood pressure, depression, and stomach things; and she can't walk farther than a hundred feet or stand up for more than five to ten minutes. She misses gardening, walking her dog, and riding and playing with her horse. She cries easily, and often. All this from a half-inch dog bite between her thumb and index finger...
She beat overwhelming odds and not only survived, but thrived. Her life is as "normal" as can be, under the circumstances. She's even re-learned to play the piano (with six fingers) and in fact will provide the musical entertainment at the Yakima Valley Pet Rescue chili cook-off in January. Her ordeal was covered in the Yakima Herald. The story of her recovery was spotlighted in Harborview's 2005 Annual Report. Her case is going into medical textbooks.
More important, however, is what we all can learn from my sister's experience: Don't ignore ANY wound that breaks the skin, ESPECIALLY if it's a bite wound. Cat bites are almost always worse than dog bites. (Cats have a groove in their canine teeth that literally injects bugs right into your body. If you're cat-bit, you WILL get an infection, so get treatment immediately.) But for any bite that breaks the skin, take appropriate action.
Wash the area with copious amounts of HOT water and antibacterial soap to flush out the wound. Better yet, use a Betadine scrub instead of soap. Rinse, pat dry, apply some triple antibiotic ointment, place a gauze pad lightly over the wound, and go to your doctor. If you don't have a doctor, go to a Medi-Center or go to a hospital ER. When you are treated, REQUEST ANTIBIOTICS. A few doctors may be hesitant to prescribe them if they feel the wound is insignificant. Demand them anyway. Tell them this story. It doesn't matter whether the dog that bites you is healthy and has had its shots. It's a natural bacteria in animal saliva that MIGHT make it into your bloodstream. That's where the danger lies.
If you don't have insurance, or have a high deductible, cost for the above treatment will be about $60. This is FAR BETTER than the $1.5 million it cost to save my sister's life.
Gene’s Story Dec. ‘07/Jan. ‘08
Gene Reece is fighting for his life after a simple act of kindness. Both of his legs have been amputated below the knees. His left hand and part of his forearm have been amputated.
Surgeons also removed most of his right hand.
And even with that, family and friends of this community-involved Savannah businessman are not certain of his prognosis.
On Monday, he was listed in critical condition at Joseph M. Still Burn Center at Doctors Hospital in Augusta.
It started with a dog bite.
A week before Thanksgiving, Reece was driving away from a game of golf with friends when he saw an injured dog that had been hit on Windsor Road. Reece stopped to help. As he dragged the traumatized dog to the side of the road, the animal bit him on one hand.
Reece, 63, patched up his hand and headed for Florida, where his daughter and girlfriend were waiting to celebrate the holiday in Orlando.
Within days, the skin around the bite began reacting as though it had been severely burned, and Reece was slipping into semi-consciousness. Reece was airlifted from a Florida hospital to the Augusta burn center.
"Through it all, we felt like his legs were going to be OK," said O'Neil Kenney, a friend of more than 30 years. "And then they said they've got gangrene, and they've got to go. We had been worrying about his fingers.'' The amputation of his fingers and hands came next.
The explanation his family and friends have been given is that sepsis - a blood infection - is spreading through Reece's body. It is creating the burn-like skin problems and compromising his circulatory system, Kenney said.
Sepsis can occur when the body is fighting a severe infection and can set in after exposure to bacteria, virus or fungus.Sepsis has a death rate of 40 percent but doubles in people with weakened immune symptoms.
Reece's immune system was not fully capable of fighting off infection ( Capnocytophaga canimorsus) from the dog bite because about three years ago, Kenney said, Reece was involved in a car accident on Wilmington Island. His spleen had to be removed, which left Reece with a compromised immune system.
As Reece fights the septic shock, friends are struggling to comprehend what's happening.
"Gene pulled over to help this dog and ended up in a coma," said Tommy Brunson, who graduated with Reece from Benedictine Military School in 1962. "It is just not right.''
Kenney and others are setting up a bank account to help Reece's family with expenses. Reece's company, Pioneer Microsystems, which he founded in the mid-1980s, is at a standstill, Kenney said.
"This is a long road, and I don't know where it's going," he said. "It's just horrific.
"There's just nothing here good to grab hold of. It makes no sense."
After battling sepsis that began ravaging his body when a dog bit him a little more than a month ago, Gene Reece died at about 8:30 a.m. Thursday.
Friends were with him Wednesday and knew the end was near.
"He was trying so hard to hold on," said O'Neil Kenney, a longtime friend. "His body just shut down."
American Legion Post 36, where Reece was a member, is providing his burial plot.
Reece joined the U.S. Navy just out of high school and served as a submariner.
A memorial service is set for 5 to 7 p.m. today at St. Peter the Apostle Catholic Church, 720 Concord Road .
A funeral Mass is scheduled for 10 a.m. Saturday at St. Peter, followed by internment at Bonaventure Cemetery.
Reece's generosity is what led his friends to set up a fund in his name to help offset his funeral expenses.
"Gene was generous to a fault," said Tommy Brunson, who had known Reece since they were freshman at Benedictine Military School.
"I guess if he had a fault, that was it - he was always giving away his money."
An account for the fund has been opened at the Bank South branch located at Johnson Square. The account number for the Gene Reece Fund is 3712174.
For information on how to make a donation, call the bank at 629-1600 or funds overseer the Rev. Patrick O'Brien at 897-5156.
Paul’s Story - September ‘09
Just a Lick
The main players in our story are my daughter Tamara Bell, her husband Paul Shager and their sons Colby and Dalton Shager. They live in Littleton, CO. They are now aware of Renee Cawley of Boise, ID who had a similar brush with death a year ago and is working to raise public awareness of the danger. She has been interviewed on "The Doctors" out of LA about the dangers of Sepsis in general (the #3 killer in the world). See at the bottom for links to her story.
Tamara had flown to Anchorage the 29th of August to be with her sister Tiffany. Their dad had passed away in NY a few weeks earlier and they were having a memorial service for his friends in Anchorage. Tamara was scheduled to come home on the red-eye flight, the evening of the 6th of September 2009. The call that she had gotten and the content of which was relayed in her call to us was that Paul was in the hospital in Denver in critical condition. Paul & the boys (with 2 of their 4 dogs) had gone camping that weekend in the mountains above Cottonwood about 3 hours from Denver. By Saturday evening he was not feeling well, but the boys couldn’t talk him into going home. By Sunday he was worse. He was turning purple in his extremities, had the shakes and generally looked terrible, so the boys packed everything into the car and convinced him that they had to leave.
Paul tried to drive, but was unable to get far. Therefore, Colby (14) & Dalton (12) undertook the task of getting to Buena Vista, some 15-20 miles of mountain roads away. Colby, with just a couple of lessons in a parking lot, drove and Dalton served as look-out, advising him when too near the side of the road etc. They stopped at a gas station in Buena Vista to inquire about renting an oxygen tank as Paul was having trouble breathing. Between the lady at the gas station (another Renee) and a doctor who had just stopped for gas, they convinced Paul to take an ambulance to the hospital in Salida about 25 miles away. She kept the car and the dogs and convinced the ambulance attendants to take the boys with Paul.
From Salida they airlifted Paul, sedated and restrained because he didn’t want to leave the boys, to St. Anthony's hospital in Denver. Zack, an employee of the hospital stayed with the boys even after his shift ended until their friends from Denver drove down and picked up the car, the dogs and the boys that night. Paul was in septic shock and they did not expect him to make it through the night. Tamara was a basket case waiting for her plane so Tiffany flew back with her. They arrived at the hospital about 7:30 Monday morning. The doctors told her to hope for the best, but to expect the worst. Paul’s mom had driven up from Albuquerque and arrived Monday morning. I drove the 800 mile from Nixa, MO and arrived Monday evening. Paul’s brother flew in from Minneapolis. As Paul’s system had pretty much shut down, they had him in the intensive care unit in a medically induced coma with every sort of contraption hooked up to him. He was on 24 hour dialysis, with his blood being changed out every 4 minutes. Since it took over 14 days to get a culture to grow from whatever was causing this, they started him on antibiotics based on what they thought it might be. As he and the boys frequently camped out, they guessed something in the family of Tularemia or Bubonic Plague.
The actual cause was Capnocytophaga canimorsus, which is not common and is frequently misdiagnosed as Plague. It is treatable, but with the lengthy incubation period, the body sustains a lot of damage and/or fatalities before the right cocktail of drugs are administered. It is a bacteria commonly found in dog (& cat) saliva. Although, not usually a problem, people with compromised immune systems (such as having no spleen) will go into sepsis and peripheral gangrene (which is why his ears, nose, hands and feet were turning purple). Paul’s spleen was removed 12 years earlier. They guessed about a 2 week incubation period from the time the bacteria entered the system, usually by dog bite. Tamara and Paul have always had multiple dogs and never had a problem before. However, Paul’s had been camping two weeks earlier with a friend whose licky puppy probably may have had contact with some open wounds on Paul’s legs while they were camping.
In any case, it hit Paul at a time and place where it could have been fatal without the heroic actions of his two sons. At the hospital, the staff repeatedly told the family that Paul was the sickest person in the entire hospital and they were very guarded about holding out hope for survival, much less any kind of recovery. It felt like an episode of HOUSE as they tried one thing after another. The difference being that it went on like that for weeks. Tamara got very frustrated at hearing that Paul was a medical mystery. Paul was being treated by a team of doctors, each with their own area of expertise. You never knew when the doctors would be by on rounds. Tamara usually missed them when she went to see Paul. Keeping track of them and all they had to say fell to Paul’s mom Elsie Kather who spent 12 hours a day every day at the hospital. The rest of us had our own areas to focus on.
Paul was in the hospital for 6 weeks and was unconscious for half of it. The doctors said that his recovery was nothing short of miraculous. His circulation in the extremities improved to the point that he only lost all ten toes (and some smaller chunks out of his feet). Early on they were anticipating much greater losses. Paul was sort of a heel walker to begin with so that his balance has adapted well. Healing of his feet is a slow process and his doctor says he is doing well, although it is still quite painful. The doctor told him that he would probably be able to ski again eventually.
Even though he did not require any further dialysis treatments after he left the hospital, they were not sure that his kidney function would ever be at the normal level. Again he surprised them. Within 2 weeks it was reading normal in the blood tests. Paul may still have some health issues that need to be resolved, but he has been back to vending with Tamara and gets stronger every day. The Sheriff’s office in Douglas County honored the boys for their courageous acts in saving their dad’s life on the 18th of December. The attached picture is one of the awards and with the Sheriff.
Renée Cawley has now been in contact with other people who have experienced this, and Paul is the only other one who survived who did not lose hands and feet as a result. She only lost fingers. It may have helped that both were in extremely good physical condition before this happened. So many asplenic people out there are at risk from their pets and don't even know it or how to be prepared.
Melanie’s Story – July ‘09
The last time I saw my mother alive and happy was on July 4, 2009. She was gone on July 13th. The last conversation I had with my mother was on July 9. She called because she was upset about Michael Jackson. She loved him and was mourning his passing. That was also the last conversation my brother Daryl had as well.
She got bit on Thursday July 9, 2009 around 10:00 a.m. When I got the call that they were taking my mother to the hospital it was Friday around 8:30 p.m. She told them to tell me not to worry or to come out and not to call anyone. She just had a high fever, chills, and a massive headache. She spent about a half hour in the shower, running hot water, because she couldn't get warm and it was in the 90's out. So they told me they would call me and let me know what was wrong. I kept thinking, “Should I go to the hospital?”, but my husband kept reminding me of the time with the baby, and how they would call and let us know if it’s serious. Before I went too, I called Terry. He said she had made herself throw up and she looked better and her fever was gone. But that she wouldn't admit she was feeling better.
They were still in the waiting room.
They mentioned the dog bite and they knew she didn't have a spleen. I would have been there causing a scene for them to get her back if I had gone. I wouldn’t have allowed her to sit there like that without being seen right away. She sat all that night in the waiting room making herself throw up, thinking it would relieve her pain. They thought she had food poisoning at the time so they took the more serious people. Finally, Terry told me she had a bad infection and to call the family. So I made the calls. Everyone is asking for information that I couldn't give because I didn't know.
I was waiting for my husband, Dejan, to get back from running errands and to help get the baby asleep. Once that was done, I could leave and he would stay home with the baby. I'm trying to get dressed and scrambling around the house with everyone calling. When I called Terry back it was 11:45 a.m. He tells me they are putting her on a breathing machine and I burst into tears, unable to move. I frantically tried to find my clothes which took forever. I couldn't do things fast enough. I needed to call a couple people to pass info along to others. I called my husband, begging and crying, for him to come home, right now. He got there within 5 minutes.
When I got to the hospital they were just finishing putting her in a coma and putting in her breathing tube. Terry, Alex and I were the first 3 people they let go in. No one prepared me for what I was about to see. I thought she would be lying there peacefully, but it was completely the opposite. She was unrecognizable. I made it to the foot of the bed. From the bridge of her nose down and her ears were bruised looking. And spotted. Almost black. Her eyes were open and one was yellow, I figured from her liver and the other one red and bloody. She was swollen beyond recognition. I almost fell. I couldn't even look at her. I was sick to my stomach and ran screaming out of the room. Someone caught me and held me, hugging me, and not letting go. Mom’s parents went in next. My grandmother came out pale and passed out in my uncle’s arms. Everyone got a few minutes to go in, all coming out with the same look on their faces and crying. I started talking in my head. Saying “You have got to go back in there. That is “YOUR” mother in there and if she dies you will regret it for the rest of your life if you don't take care of her when she's dying". I was so scared. I've never seen someone in real life like that. Or even been close to anyone that died.
I went back in and this time I got up to her face. Someone told me to talk to her. But, I had the biggest lump in my throat and I couldn't speak. I could only call out "Momma Momma Momma Momma". Of all the times to not be able to say anything to her, I could only cry out to her.
They decided then to airlift my mom from Monroe, N.C. To Charlotte, Carolina's Medical Center. I waited until the Helicopter landed and they had her in the hall, but they had to get her stabilized because all her organs were failing. Her heart had stopped for 30 seconds also when they put her on life support. From what Terry told me she looked her worst before that helicopter ride.
I actually made it to CMC in rush hour traffic before the helicopter did. As soon as they got her in her room and situated we could go in. I was the first in. They started asking about her medical history and I quickly said she doesn't have a spleen. So they tell us she has a strep throat virus that has spread to her body. Then I say she got bit by a dog on the hand and then light bulbs went off on each nurse’s head. She had Sepsis. They shook her chest and said "Judy, Judy can you open your eyes?” And as weird as it was, she opened her eyes and moved her arms up and looked at the nurses. The nurse said "Do you know where you are?" and my mom looked at her and nodded. The Doctor came in and they asked her to squeeze his hand and she did. I was watching from the window outside her room. By the time they let us back into her room she was out again.
She was never conscious after that. But she was able to move her head closer to us as we spoke to her. Especially my brothers, because their voices were deep and soothing. By this time I was finally able to speak to her. She was able to move her eye or her foot a little when we asked her if she wanted us to keep fighting for her. She would indicate "YES" so when the doctors were ready to give up on her we would fight them saying “do whatever you can to save her”.
By that evening, Terry was completely exhausted. He had to go home and feed all the puppies in the kennels, so he went back to Monroe. Sometime during the night the nurse came in and said she was going to be putting my mom in dialysis, platelets and giving her several units of blood because she's bleeding out. Once she was on the machines we were allowed back in. They gave her a 20% chance of making it through the night. We called Terry to let him know. He wouldn't be able to make it back up there till later because of the kennel puppies, but he came as soon as he could. My brothers David and Daryl and myself would alternate visiting with her or going in together to talk to her and hold her. I told my mother how much I loved her and needed her. Holding up pictures of Anica in front of her eyes in case she could see. I even tried bargaining with her telling her I would be a better daughter. But, nothing worked.
The hospital was great. They allowed all of the family and church people to be in the room a lot. Even during the hours we weren't supposed to be there. I have to say there was between 30-40 people in there. Everyone praying and talking to her telling her how much they loved her and how they were sorry for things that happened in the past.
I believe it was sometime in the afternoon on Sunday that they took her off dialysis. Her numbers looked a little better. Her platelets had doubled. She wasn't awake but now she was moving her arms about and her feet were moving. She even sat up and flailed her arms. I thought she was getting better. While in the waiting room, my husband brought the baby to see me so she would calm down. She started playing with family. She had seen everyone except my mom and she had seen us all crying. My cousin decided to take a small video of her being cute but the instant she started recording Anica, she said "Mawmaw passed away, Mawmaw passed away”. I immediately said no Anica, Mawmaw didn't pass away, but she is very sick. My husband asked me to come home with him to shower and change. This was the only time I left the hospital. I went home to grab a sandwich and shower.
When I got home I noticed a dress on the couch. I asked my husband about it and he said that Anica flipped out. She had to have that dress and no other dress would do. It was a dress my mom had gotten her. I left and went back to the hospital. By the time I got back she was worse again. I had to eat before I went back in because I was worried if I didn't eat and saw, her I wouldn't be able to eat anything. By this time, I hadn't eaten since Friday night.
Later that night Terry went home to feed the puppies and take a nap. I think it was around 1:30 a.m. and they came to ask us what her wishes are for DNR. That her chances were less than 15% of making it through the night. They put her back on dialysis. My brothers and I were so upset by them giving up on her. We went back in her room and my brother jumped all over them saying” I don't care if it takes her a month. You do whatever you have to- to keep her alive”. I asked what the maximum was on blood transfusions and they told me "Well we can't give her 50 bags in a night" my brother said well if it takes 50 bags you give her 50 bags. The family that was left at the hospital had a talk and decided to call all of the family back up there. They had only left about 4 hours before. We all sat there waiting and taking turns visiting her. I finally fell asleep in a chair for about 2 hrs. I was just too tired to go on.
When I woke up everyone was there. Terry spent some time talking to my mom and then came back out to talk to family. Around 12.30 p.m. Terry asked my brothers, Alex and me to join him in her room while he asked her a few questions. It baffled everyone that, while all of my mother’s organs were just done, her brain was still able to function and comprehend what we were saying. When Terry was present she gravitated towards him. Same with my brothers. Not so much me or Alex but she knew we were there.
Back in the room, mom was almost completely still now. Not able to move much. One of her eyes was moving slightly as if floating softly. But very slight. Terry held her hand and told her the truth that she wasn't doing as well as we all told her and that if she couldn't fight anymore and was ready to give up and be with God, then try as hard as you can baby, to move something. As I watched her I wanted her so badly to not move but her right eye jumped straight up and down. I just began to cry. Terry then rephrased the question saying, I want to ask you another question, so that we’re not getting it wrong. If you want to stay and fight it out, try really hard to move something, and if you can't then lie as still as you possibly can. She was so still her eye wasn't even moving.
We knew we couldn't let her suffer any longer. Her body had huge blisters coming up all over from all the liquids going in but not coming out. From what I understand her insides were like jello now. Even if she did pull through, she would lose both arms. Maybe legs. Her lungs were the first to go. My mom’s lungs were bad anyway. Plus she had been on Steroids for her lungs, pneumonia I believe. So they would be unsalvageable. She would need dialysis all the time. Her blood was so poisoned. She would have so many problems. My mother was a worker her whole life. She rarely took breaks. She worked in her Kennel and laid bricks outside up until she got sick. She would have hated to be in a wheelchair having everyone do everything for her.
So now we had to break it to the rest of the family that she has told us she can't do it. Everyone was moved to a closer family waiting room. We all went back to my mom’s room and began to talk and pray over her telling her it’s ok to let go and kissed her goodbye. We asked that they give her Morphine for when they took her tubes and I.V's out. In case it hurt her. Now we could hold her and be closer to her.
All of us hoping that when they took her off the breathing machine that she would start fighting to breath. But she didn't. Her breaths were soft and shallow. I put my hand on her chest. I could barely feel her heart beating. I watched her chest as she took fewer shallow breaths. As her numbers slowly went down. Then they all went flat. At that moment, Terry said she had to outdo us and all of her numbers shot back up for a brief moment as if to say “I heard that". In fact, I think we even had a small laugh, but it quickly went to tears. My mother took her final breath at 2:34 p.m. On July 13, 2009. But because we had to get the nurse back in the room it is marked on her Death Certificate as 2:35.
I have suffered back and neck pain with headaches almost every day for the last 8 years. Constant pain. When she took her last breathes all my pain just left my body. I don't know if the pain left because my heart was hurting more than my body or she took it with her. I like to think she took it with her.
Terry, my aunt and I did all of the planning for the funeral. At this point were still on autopilot. We didn't bury her on Thursday because it was her birthday and there was no way we could put her in the ground on her birthday. I received flowers on July 16th from some friends. When my daughter seen them she said “Happy Birthday” and I said, yes its Mawmaws birthday. That had never happened when she had seen flowers before.
Now, I too want to do something to raise awareness. NONE of her doctors ever said anything to her about the dangers of being around dogs and cats and not having a spleen even though she ran a kennel. I just have no clue how to get this message out there, especially to Doctors so they can warn their patients.
Melanie & Judy in happier times
Mike’s Story April '09
After an nearly fatal infection, Granite Falls man uses all his determination to recover
Mike Moore heard his two dogs, Ember and Sadie, barking and fighting, and rushed to see what was wrong.
He reached down to grab Sadie, a brown Labrador and blue heeler mix, to try to break up the fight. “She just let go of the other dog and nipped me, like maybe she thought it was another dog,” Moore said.
Moore looked down and found a bite mark near the thumb on his right hand. “Just enough to make it bleed,” Moore said. “Damn it!”
He walked inside his house in Granite Falls to rinse off the wound and put some bandages on it.
“No big deal,” he thought.
Two days later, on April 28, Moore was at his job at Spencer LLC, a Monroe cabinet making company. Just before the end of the day, at 3 p.m., he started feeling sick. He walked into the company's finishing room, where shellac and polishes are added to the woodwork, to turn up the heat.
“I was so cold, I couldn't get warm,” Moore said. “I thought I had the flu.”
At home the next morning, he called out to his partner, Karin Coleman. “I told her I needed to go the clinic; something was wrong,” Moore said.
She called the clinic and was told Moore should go straight to the emergency room. His son, Levi, got him out of bed. Moore dressed, putting on his shirt, shorts and sandals.
“As soon as he got me in the light he said, ‘Oh Dad, you look like crap,'” Moore said. Unknown to Moore, his face and body had a bluish tint.
When they arrived at Providence Regional Medical Center Everett, Moore, 47, was put into a wheelchair and rushed to the emergency department.
Four people were in line ahead of them, waiting to be admitted. “Please, something is just not right,” his son said. “Can someone look at my Dad? He's really sick.”
Moore was wheeled into an examination area. Hospital staff began asking a string of rapid fire questions:
Why are you here?
“I'm hot,” Moore managed to reply. “No blankets, please.”
They asked about the scar near his stomach.
“I told him my spleen had been removed.”
They asked about the bandages on his right hand.
“I said I had a dog bite the other day.”
“Then I faded out,” Moore said. “I don't remember anything for the next one-and-a-half weeks.”
for rest of Mike's story.
Miriana Bridi’s Story - December ‘08/January ‘09
Brazilian Model Loses Limbs - Then Life - to SepsisBy Helena de Moura
(CNN) -- The fiance of a top Brazilian model -- whose hands and feet were amputated in a bid to save her from a deadly and little-known illness -- said he believes she will wake up from a coma, noting, "where there is a heartbeat, there is hope."
Mariana Bridi da Costa, 20, was in "very critical condition" on Friday, doctors said, as she fought a pernicious disease that has ravaged her body and forced doctors to perform the amputations and extract part of her stomach as well as both kidneys.
She was breathing through a respirator, officials at Dorio Silva Hospital in the Brazilian state of Espirito Santo said Friday.
"Where there is a heartbeat, there is hope," her fiance, Thiago Simoes, told CNN in a telephone interview.
Da Costa suffered from necrosis, or the fast deadening of tissue, caused by septicemia.
Septicemia, triggered by a bacterial infection, causes insufficient blood flow that can lead to organ failure.
Bridi first sought medical advice after feeling ill in late December. Hospital officials said she was transferred to Dorio Silva on January 3 in "septic shock," a serious medical condition caused by an inflammation.
Bridi was first diagnosed as suffering a urinary tract infection. By the time the infection was detected, it had developed into septicemia.
Doctors decided to amputate first her hands and then her feet after the condition reduced the amount of oxygen being delivered to her limbs.
Dr. Charles Clarke, honorary consultant neurologist for the National Hospital for Neurology and Neurosurgery in the United Kingdom, said the development of a urinary tract infection to septicemia requiring amputation was "very rare."
Just less than one month ago, Bridi was a healthy young woman well on the way to achieving her dream of becoming a world class model.
She placed sixth in the Miss Bikini International competition in China last year and took first place for the "Best in Swimsuit" category. In 2007 and 2008, she came fourth in the contest to become Brazil's entrant for the Miss World pageant.
Simoes said da Costa was on her way to international stardom, signing with prominent model scout Dilson Stein, who brought Brazilian models, including Gisele Bundchen and Luize Altenhofen, to the world stage.
"All the agencies were very interested in knowing her. I know for a fact that they would have loved her because Mariana is beautiful," Stein told Brazil's Tribuna newspaper.
Her fiance told CNN that da Costa woke up from a coma ten days ago and told him how much she wanted to be alive.
"She told me she was praying to stay alive, that she still had a lot to do on this earth, that she wanted to go on with her plans," he said.
"She comes from a humble family and she was the main breadwinner," said Simoes, who refuted rumors that da Costa was dieting and that might have affected her health.
"She never dieted, never took pills...she is a very simple, very warm human being," he said.
Meanwhile, Tribuna reporter Rafaele Gasparini, who recently spent several hours with da Costa's family, told CNN that they were not so optimistic about her condition, which is deteriorating rapidly.
"Her father told me that she is unconscious and her blood pressure is dropping rapidly," said Gasparini.
"Her relatives walked out (in the afternoon), and there seemed to be a farewell mood," she said.
Gasparini said the model was in a "forced coma," which might help her body recover from the physical shock. She was also being treated with noradrenaline. Known as a "fight or flight" chemical that the body releases in stressful situations, noradrenaline produces increased blood pressure and heart rate.
A doctor who recently published an article in The New England Journal of Medicine on the disease, told CNN that little was known about the illness, although it is the tenth leading cause of deaths in the United States.
"We know a lot about what happens once a patient contracts the illness but we know very little about what causes it," said Dr. Greg Martin of Emory University in Atlanta.
"It is a leading health threat in this country, killing at least 800,000 people a year," he said.
Martin said sepsis was a "response" to an infection, which can cause the immune system to lose its balance.
"Basically, the immune system goes haywire after contracting an infection and begins to overreact," he said.
Men were more susceptible than women, Martin said.
News of Bridi's condition spread quickly throughout Brazil and then worldwide. A message on her Web site said the volume of traffic had caused it to crash, and that the site had received more than 15,000 hits in two days.
"The whole world, I repeat, the whole world is touched by the case of Mariana," it said.
The message said they had received "e-mails of solidarity from all corners of the world: Australia, Ukraine, Czech Republic, France, Italy, USA, Russia, etc."
The model's family and friends have urged people to keep praying for her survival. "Mariana is (a) warrior and will win this battle," they said in a statement.
RIO DE JANEIRO, Brazil — One month ago, 20-year-old beauty queen Mariana Bridi was living the dream of many young Brazilian women, trading her striking good looks for a modeling career that promised to lift her family out of poverty.
Then she contracted a seemingly ordinary urinary tract infection. The bacteria spread quickly and inexorably through her body, proving to be extremely drug resistant. In a desperate bid to save her life, doctors amputated her hands and feet. But by Saturday she was dead.
"God is comforting our hearts because he wanted her to be with him now," her father Agnaldo Costa told reporters outside the hospital where his daughter died. "I can't accept that my daughter left us so soon."
Bridi's Web site says she began modeling at age 14 with the hope of giving "a dignified life to her parents."
Her father is a taxi driver and her mother a house cleaner.
By the age of 18, she was well on her way: In 2007 and 2008, she was a finalist in the Brazilian stage of the Miss World pageant.
Her Web site said next month she was to participate in the second stage of a modeling competition held in Sao Paulo by Dilson Stein, the Brazilian model scout who discovered supermodel Gisele Bundchen.
Last year, she took fourth in the Face of the Universe competition in South Africa and she had won bikini competitions across the globe.
The Miss World Brazil organization said she was an example of someone "who knew how to intensely live her life."
Half a dozen memorial groups on Facebook had already sprung up just hours after her death. On Bridi's own page on Orkut _ the most popular Web social networking site in Brazil _ dozens of memorial messages were left.
The course of her illness was swift.
In late December, she fell ill and doctors in her native state of Espirito Santo _ northeast of Rio de Janeiro _ initially diagnosed as having kidney stones.
She returned to a hospital on Jan. 3 in septic shock _ life-threatening low blood pressure _ from the infection that would force doctors to amputate first her feet, then her hands. Doctors said there was little they could do but pump drugs into her and hope for the best.
It was a nightmare scenario for anyone with an infection: Her body did not react to the latest and most potent drugs while the bacteria in her veins spread from head to toe.
In Bridi's case, the culprit was the bacteria Pseudomonas aeruginosa, which is known to be drug resistant.
According to the January 2008 book "Pseudomonas: Genomics and Molecular Biology," edited by Pierre Cornelis, a researcher at the Flanders Institute for Biotechnology in Brussels, the bacteria has the "worrisome characteristic" of "low antibiotic susceptibility." It also easily mutates to develop resistance to new drugs.
Death from infections caused by the bacteria are relatively rare, but not unheard of: In late 2006, an outbreak of the bacteria at White Memorial Medical Center in Los Angeles sickened five infants _ leading to the deaths of two of them.
The bacteria causes about 10 percent of the roughly two million hospital-acquired infections each year in the U.S., according to health officials.
A short statement from the Espirito Santo State Health Secretariat announced her death on Saturday "despite all the commitment of the hospital team."
Her aunt said the hundreds of messages left on her Web site had lifted Bridi's spirit in the past weeks.
"I believe that the serenity on her face came from this spiritual comfort," Oriendina Pereira Wasen said outside the hospital.
Bridi's funeral was planned for Saturday afternoon in the town of Marechal Floriano.