I’m still alive… No, really. (A Run-In with Probiotic-Induced Sepsis?)

So a rainbow at night has officially ended up in the Emergency Room three times within the past 12 months. Almost five if you count last month being an extremely close call, and the fact that I very nearly had to go back after this third time.

Let me just say, this is not at all what I invisioned for myself a year ago… Then again, sometimes I don’t think I realize just how bad off (physically) I really am, and how that sets me up for these things.

I have no idea how I could have contracted the stomach bug that’s torn through my family members one by one. We are so, so careful to avoid getting me sick because of what happens. My family knows that the moment I catch anything, it’s straight to the hospital. I’m also unsure if the horrendous headache I got the night before “it” happened, was a sign, or just one of my usual anamolies. All I know is, I woke up on Saturday feeling as if were going to pass out, but since I do that sometimes regardless, I didn’t think anything of it. While you sleep, your bowels are at rest, and when you wake up, they begin to move again: Your digestive tract requires a lot of blood to function and digest, so me feeling lightheaded due to the redirected bloodflow to my colon wasn’t too unusual. But in addition to feeling lightheaded, I was also extremely dizzy.

Immediately after rising, I started making repeated trips to the restroom. At first I thought it was just because of the brown rice I ate the day before, because, well, whole grains do tend to get your digestive tract moving, you know. But after the sixth trip, I sensed things were taking a very bad turn. The dizziness got worse, the nausea started, and nothing was working to ease either ailment. My fever went from 98.6°F to 100.6°F within the span of an hour, and I found myself writing down my medical history on a piece of paper while I still had the ability to either write or be coherent: The inevitable was about to occur. Literally within a span of two hours, I had massively dehydrated, developed a fever of 102°F, a heart rate of 160+, vomited up absolutely everything in my stomach, went to the restroom eight times, become mildly delirious, and my family was calling the ambulance.

This was without a doubt the most severe emergency I’ve had to date. First off, my fever hasn’t gone above 100.5°F in over eight years, no matter what the circumstance or infection; I think it topped off at 102.1°F, which is unbelievable and the equivalent of 103-104°F for someone else. But perhaps the most shocking part was that they had to give me three bags of saline for the dehydration, I only had to urinate once, and it was barely enough to use for their required urine sample. To clarify for anyone not familiar with saline drips/IV fluids: Usually you’ll get one, maybe two bags, and then have to pee every 10 minutes. I was given three liters of fluid and only expelled about an ounce of it. Needless to say the ER staff was beyond baffled. My heart rate topped at 180 bpm lying down, and over 200 when trying to sit up. I was given a constant 2L supply of oxygen, because for some “strange” reason it helped my dizziness, even though my O2 levels were supposedly adequate; not sure what to say about that one…

The other major unnerving thing was my blood pressure actually dropped after the IV infusions, which is.. the complete opposite of what’s supposed to happen. My normal blood pressure is 120/70. However, after six hours of infusing liquids and other drugs into me to stop the fluid loss, my blood pressure dropped to a record 79/45. Their rationale for letting me leave was literally that I was still conscious. Need I repeat that your blood pressure is NOT supposed to do that after three liters of fluid?!

They offered to keep me, but I just wanted to get out of there. By midnight I was finally back home, and having ceased vomiting and everything else, I thought I was safe… We’ll get to the horror that was my bloodwork later.

After much sleep, and.. ugh, an absolutely terrible night of convulsing for hours on end, Sunday brought with it a partial recovery, and my fever finally broke that afternoon. Until that night, when I had a “relapse” of whatever had happened the first time. Once again I was making repeated trips to the bathroom, spiking a fever, and vomiting, until by 7am Monday morning I was overcome by a familiar feeling of dread. My insurance wouldn’t pay for the medicine I needed to stop the vomitting and diarrhea and keep me from dehydrating, until they had an authorization form which could only be obtained Monday thru Friday, and only from my primary doctor. After all the back-and-forth calls and realizing we had no other option, we called the pharmacist with the ER doctor’s prescription to just ask for the pills and pay out-of-pocket: Either I had them, or I was certainly going back to the hospital for dehydration. Soon I had a couple of pills to tithe me over and stop me from losing more fluids, but it wasn’t until much later I’d realize that whole fiasco of trying to obtain the medication was stalling me, with life-saving results. 

By the end of Monday night I was finally on my way to a real recovery, and I even got a Migraine late that night and felt almost normal because of it: To think, after all of that, a Migraine! Something so commonplace…

Today has been.. difficult. I’ve been on oxygen all day, and am just very.. uncomfortable, and very dizzy. But no where near as uncomfortable as this weekend, of course! Four days since, and I think being on oxygen all day is actually the best case scenario.

One year ago this week, my immune system crumbled and I developed a very “determined” candida overgrowth. I’ve been fighting it ever since. Well, after eight months on various antifungals, a month on Sporanox, and those couple of weeks on Vitamin C, followed by practically everything in my colon being evicted… My tongue has never been more healthy and pink. I honestly think the candidiasis may be completely gone. But as for my bloodwork…

Every time I’ve been hospitalized (or near-hospitalized) during this long fight, it’s been during my Lyme-flare week. So it would make sense that my neutrophils were high (fighting bacterial infections) and my lymphocytes dropped (making room for more neutrophils to fight the bacteria). Yes, every time, has been during a bartonella flare concurrent with my Lyme flare week plus some other unidentified combination of pathogens roaming around giving me random symptoms. That’d be enough to send anyone to the emergency room! Well, every time except this time.

Because everyone is different, I might should mention that my usual lymphocyte count is around 2 k/cmm. Anything from 1.2 – 3.4 is considered normal, but during this hospital visit, my lymphocyte count was 0.3 k/cmm. And my neutrophils, which again fight bacteria, were double what they should have been, higher even than when I’m Lyme-ing.

I’ve never had anything like this happen before. Something that startled me to realize was that I took a probiotic capsule on Sunday night when I was in recovery (out of habit because I’ve been doing so for the past eight months, until about two weeks ago)…and then two hours later is when all my symptoms began to return, albeit at a less-advanced rate. And what did I do on Friday night before I went to bed? Take those probiotics…

Complications from taking probiotics are very rare, and only happen to the immunocompromised and/or severely ill. But I got to thinking, that was really exceptional timing for me to begin feeling ill all over again, just two hours after taking another probiotic capsule. And I really did do everything right to avoid getting that stomach bug that was going around…

SO WHAT IF…

What if it WASN’T a stomach bug that caused my sickness? What if, because my candidiasis has improved so much after taking the Vitamin C, that taking my normal highdose probiotics–that up until now I’ve needed–actually overpopulated my normalizing colon, and invoked an immune response to the probiotics? It was actually just a few weeks ago someone posted on LymeNet about the potential danger of probiotics…that danger being, the very rare but real complication of lactobacillus septicaemia: Probiotic-induced sepsis.

And now in my head I have floating around all these facts that are just too coincidental. My bloodwork clearly shows bacteria being the initiator of my problem; my symptoms weren’t like the rest of my family; I took probiotics the night before this happened the first time; I took them again the night before it happened the second time; my candidiasis was almost cured therefore not requiring the same dosage of probiotics I used to take; I have primary immunodeficiency disease and am a prime candidate for something like this to happen…

To stop and think about this is just.. beyond me. This was one of those experiences where the medical professionals speak in hushed tones outside your door instead of in your room, and this may have been why: I had every single symptom of Systemic Inflammatory Response Syndrome (SIRS), a condition related to sepsis that has nearly all the same symptoms. However, unlike true sepsis, the symptoms of SIRS are related to the body’s immune response to the assumed intruder, rather than the result of the bacterial infection in the blood (sepsis) itself. I don’t have the medical degree to know whether I had this or true sepsis, and unfortunately it’s too late to obtain a proper diagnosis by giving the ER doctors this major piece of the puzzle. I’d bargain for SIRS due to the fact that eliminating the cause–the probiotics–calmed down my symptoms, but who knows. They’re very similar and either condition can lead to shock. Specifically, in combination with my elevated neutrophils, the hypotension + retaining urine after three liters of fluid is a sign of approaching septic shock. And that’s.. really.. I.. I don’t even know. I don’t even know how to process that in my brain, yet. These things lead to organ failure, and septic shock in particular has only a 50% survival rate…

Criteria for SIRS were established in 1992 as part of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. The conference concluded that the manifestations of SIRS include, but are not limited to:

  • Body temperature less than 36°C or greater than 38°C
  • Heart rate greater than 90 beats per minute
  • Tachypnea (high respiratory rate), with greater than 24 breaths per minute; or, an arterial partial pressure of carbon dioxide less than 4.3 kPa (32 mmHg)
  • White blood cell count less than 4000 cells/mm³ (4 x 109 cells/L) or greater than 12,000 cells/mm³ (12 x 109 cells/L); or the presence of greater than 10% immature neutrophils (band forms)

SIRS can be diagnosed when two or more of these criteria are present.

Fever and leukocytosis are features of the acute-phase reaction, while tachycardia is often the initial sign of hemodynamic compromise. Tachypnea may be related to the increased metabolic stress due to infection and inflammation, but may also be an ominous sign of inadequate perfusion resulting in the onset of anaerobic cellular metabolism.

The moment I woke up on Saturday and my bowels began to move, my body immediately began its attempt to rid itself of the probiotics from the night before. And it kept going until it couldn’t anymore. It mostly succeeded before I got to the hospital. And once I took the second probiotic pill the following night, it began again. I didn’t realize it at the time, but it was because I had no medicine at first–no authorization to get the medicine because it was a weekend–that was, in a manner of speaking, saving me. The symptoms I was so desperate to stop with medication were the same symptoms getting rid of the offending cause of the SIRS (?), and if I’d actually had the medicine to stop my body from doing that… I… I don’t know what would have happened. My body would basically have been stuck with a bomb inside of it, and no way to get it out.

And it’s for situations such as these that I believe, even if things don’t go the way you want them to–like me not understanding why I wasn’t immediately getting that medicine to relieve the terrible suffering I was feeling–it’s always for your own benefit; even if you don’t see it at the time, you will. I did get my medicine, but only after enough of the lactobacillus bacteria in my colon had been eliminated.

I doubt I’ll even be able to wrap my head around this until tomorrow, or later. Just, how things played out, with the information I knew beforehand, the timing of the events, and thus being able to figure this out before I took another probiotic capsule and God only knows what would have happened… I don’t know. What this means for the future, will I ever be able to take probiotics again, I have no idea. What I do know, is that I am one blessed soul, who’s obviously still meant to be here. And it seems my nine month battle with candidiasis is finally over. That’s enough for right now.

a rainbow at night

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5 thoughts on “I’m still alive… No, really. (A Run-In with Probiotic-Induced Sepsis?)

  1. @____@ Jesus, that’s horrible. It’s good you’re home now and you didn’t have to stay at the hospital. It would terrible to be so ill and at the hospital on the holidays, no matter how much the hospital tries to make it a cheery place. <3 I hope you can take probiotics again, because if you can't…that would…be…. Your explanation makes a lot of sense, and oftentimes I think that we know more of what might be going on than doctors. I mean, we're in our bodies all the time haha! I'm glad I didn't know about this until after you weren't in the emergency room anymore. ^^;; -hugs- Glad you're "okay," as in, relatively.

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    1. I.. I’m just glad that the second time I took them, I never got to sleep, so they didn’t get to sit there and anger my body for hours on end like it did the first time…basically resulting in a big “WHAT. HAVE. YOU. DONE.” from my system.

      They did ask if I felt better staying (and had I known what I’d go through the rest of that night I definitely would have, oh my gawd), but… I was in such pain and discomfort and all I wanted was MY bed.

      I’m glad I didn’t know, myself, until the next day when the pieces started fitting together. My hospital’s ER is rather notorious for.. well, not being very efficient, but in hindsight it makes sense that they were so confused at what was happening…and why the staff kept whispering and giving each other paranoid looks then running to consult the doctor. Ah-hah…

      *hugs back*

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      1. I don’t blame you! >.< With the bed thing. Hospitals are just generally scary places to be in, no matter what's happening, even if you're just a visitor. And I can't even imagine with all the ER people not knowing what was going on or what to do. Terrifying.

        My hospital ER's tries, but it's a small community hospital, so they have to ship a lot of people out because they just don't know what to do sometimes. ^^; And sometimes, they nearly kill people by accident with morphine…my friend's mother's heart stopped because the nurse made a mistake with the morphine. She's okay now, though, thank God. I felt bad for both of them, actually, because the nurse was new and overworked and probably felt horrible. /random ramble about my hospital

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