I am a survivor: The devastation of Healthcare-Associated Infections
My Story: Mary Millard, M.Ed.
Up until the fall of 2014, I was a healthy 55-year-old with an exceptional life. I enjoyed playing beach volleyball, running with my dog, and hiking in the Blue Ridge Mountains when I wasn’t busy obtaining my graduate degree in education and training. My goal was to train nurses.
One day and out of the blue, I started having small bouts of rapid heartbeats and sought medical care. A cardiologist prescribed medication to help regulate the rate. Because I was very healthy and only in my mid-fifties, I was sure the medication would help. Unfortunately, it did not. On a particularly bad day, when my heart felt like it was going to jump out of my chest and indigestion seemed to be at its worst, my husband and I decided it was time to seek emergency treatment at a nearby hospital.
I was hooked up to monitors, my blood drawn, and had a CT scan. Eventually, I was given a diagnosis showing a 6.3cm ascending aortic aneurysm and a partially collapsed aortic valve. The cardiothoracic surgeon said it was a genetic issue, as there were no underlying diseases or health issues. I was admitted for an aneurysm repair and valve replacement surgery.
An unexpected occurance
I was admitted for surgery to do repairs and a new valve. One day before the surgery I went into full cardiac arrest as the valve had been partially collapsed for months and backwash had built up in a coronary artery. I only know what happened after the arrest from seeing my medical records and hearing the accounts as told by my doctors, PAs, and my husband.
They took me to the Cath lab on my floor because they feared my aneurysm had burst. When I was placed on the table my heart stopped completely. A cardiologist tried the paddles three times, but no luck. My code lasted 6 minutes and 45 seconds as they scrambled to get life support equipment together. I was attached to an extracorporeal membrane oxygenation (ECMO) machine. This is a life-support machine that circulates and oxygenates your blood while an external pacemaker beats your heart.
According to my husband (who was there every day), the ECMO was in place for three days. On the fourth day, the nurse informed him my heart had started beating on its own! He thought, “this is finally over,” and felt immense relief that my surgery was finally coming. After 2 weeks of intensive physical therapy, they wanted the surgery as doctors were nervous about the aneurysm having snaked a camera down my throat every day to look at it.
Open heart surgery
Five days after the surgery, I was placed in step-down with the possibility of going home soon. On the fifth day, my husband noticed that I was speaking in a confused manner, was feverish, and could not hold my head up. A stroke code was called, and a 7 hour workup ensued. At the end of the workup my blood pressure was only 30 over 10 and my heart rate was 12 BPM. I was rushed back to the ICU.
Septic shock reveals the HAI
It was not a stroke. I was in acute septic shock and once again coded. I was revived and treatment started. My groin wound was purulent and not healing. Something was wrong. Wound cultures showed that I had contracted Multidrug-Resistant Pseudomonas aeruginosa. The entry point of the infection was in the left groin wound, where I had been connected to the ECMO machine. I learned about how this happened later, from my infectious diseases doctor. I spent another 30 days in the ICU under intensive treatment. Pseudomonas creates a sticky biofilm on surfaces. It resides in this biofilm on my graft, valve replacement, tricuspid valve ring, and groin graft (from the ECMO cannula).
The aftermath
After a week of duo antibiotic therapy with Tobramycin and Cefepime, it was decided to reopen my sternum so the surgeon could attempt to clean out the chest cavity from infection residue, debride the aortic graft to attempt a biofilm removal, and perform an Omental flap procedure (where they take part of the tissue from your abdomen to place in your chest cavity to nourish for healing).
A slow and painful recovery
Recovery was slow, and I was kept in another medically-induced coma to help. Once I was brought around, I had already spent 82 days in the hospital. This was bittersweet because it brought crippling fear and confusion. I still had no concept of date or time at this point, and realized with dread that my legs would not work. I could not stand or use my hands or speak above a whisper.
Before they could send me home, I underwent physical therapy, so I could walk enough to get up the three stairs on my back porch. It was very difficult and painful, as being bed-bound for months and the damage the septic shock did to my limbs made it hard to even sit up in bed. Talking was also a struggle as I was intubated for most of my hospital stay and allowed no liquids, so I could only barely manage a whisper for many weeks. It was also very humiliating to be on a diuretic and unable to walk to the restroom, and this caused me a lot of frustration and shame.
By the time it was all over, I had spent a total of 82 days in the hospital.
Why I tell my story
I went into the hospital for a treatable aortic aneurysm. It was a local research hospital where my husband had worked on the university side for years. I was confident in my cardiothoracic surgeon and his team and understood that I would be home in about ten days. It sounds silly now, but my biggest fear was choosing a tissue valve, as I did not want to be on Warfarin for the rest of my life. Never in my life did I think an infection could change things so much. I cannot run any longer, have bad days of fatigue, and have had dozens of procedures due to the infection, the heart, or the sepsis damage. Being on lifetime antibiotics causes other infections to creep in and destroys your kidneys. To my shock even as a nurse I never realized how prevalent infections were in a healthcare setting. My goal is to stop this from happening to other and became a speaker to help raise awareness on this problem and try to help prevent others from going through this.
Mary Millard, M.Ed.
Mary is a retired nurse and a 2-time sepsis survivor who has become a public speaker to raise awareness
of antibiotic resistance and the danger of the prevalence of bacterial infections in the healthcare setting. Since her infection, she has studied microbiology, epidemiology, and worldwide statistics on infections as
well as costs to patients and health centers. Mary also speaks to antibiotic stewardship and visits the
U.S. Congress annually to meet with its representatives and committees to help ensure funding for new
research, novel therapies, and the antibiotic pipeline. She has also been featured in journals by the IDSA,
Women’s Health, Harvard Health, and New England Journal of Medicine as well as having her story on
websites by many in the healthcare realm. She resides in Louisiana, USA with her husband and pets and is now working on a book regarding her story to help others and give hope to those living with infections. Read more about Mary here.