I lost my Darling Wife Patricia, to the infection known as “Necrotising Fasciitis” on 1st September 2004 at 02.00am – an infection I had never ever heard of until then.
The story starts on the evening of the 18th August 2004.
We had thought that Patricia’s problem was a case of mild food poisoning initially, following an evening meal of ham salad, but after 4 days there was no improvement, in actual fact a marked deterioration, which started with nausea and diarrhoea and a sense of lethargy.
Pat had historically been a normal very healthy & fit person, apart from Glaucoma & a touch of arthritis in the leg/arm & hand joints and that would come & go with the weather!
I have to admit to being extremely concerned. Finally after 5 days of me begging her to let me call a doctor, Patricia conceded and finally allowed me to make an appointment for her to go to our local Health Centre in Calne Wiltshire.
We had an appointment for the following day a Tuesday, I arrived home on the Tuesday 24th lunch time, only to find Pat in floods of tears and apparently unable to manage to walk without a considerable struggle, I went straight to the Health Centre and requested a Home visit from the on-call Doctor, who turned out to be my own Doctor, he actually arrived within 20 minutes of me requesting the call.
He examined Patricia, both of us relayed all the symptoms as well as we could and I also mentioned the fact that Pat had a large dark blister appear in the last couple of days, my Doctor seemed fairly sure that this was merely the after effects of a case of Food poisoning, and agreed that it would be wise if Patricia was admitted to Hospital for a 24 hour session on a glucose drip to boost her up and that after 24 hours on the drip all should be well.
An Ambulance was suggested, but as on the face of it, this was only a minor ailment, I suggested that I should take Patricia in myself, rather than incur costs to the NHS unduly, it seemed to us a bit drastic to call for an ambulance to have a stint in hospital on a drip.
So less than 2 hours later at around 4.30pm, in the Great Western Hospital in Swindon, the young A & E dept doctor, a Dr Kenway, who was running the A & E dept had checked over Patricia and within minutes rushed her into the “Resuscitation” room of the A & E dept, frantic testing was being carried out numerous drips were being installed and X-rays were taken.
Dr Kenway appeared extremely concerned at Patricia’s blood pressure, He then proceeded to carry out numerous more tests and due to this doctors diligence, he then enlisted the help of a number of consultants one after the other to look at Patricia (one of which asked me what we were doing in the A & E dept – I got a distinct feeling he felt we were wasting everyone’s time).
One consultant, a Mr Hocken returned time after time to arrange for various further tests to be completed, he seemed extremely concerned, and finally he called me in and it was then that he explained to me that in his opinion, he was pretty sure they knew what was wrong and that if they could not get Patricia booked into a specialist unit in another hospital that could cater for her, that they may have to operate themselves during the night with telephone guidance from doctors in another hospital, they told us that most likely Patricia had only hours to live, this was now approx 8.00pm!
The Doctors at the Great Western Hospital even tried in vain to organise an airlift to speed up the hospital transfer by enlisting the aid of the Wiltshire Air Ambulance, but it was already fully committed.
Less than 8 hours after arriving at the Great Western Hospital Patricia was moved to Frenchay Hospital in Bristol by a normal ambulance, i was advised to go on ahead as they would be passing me en-route at very high speed, I arrived at Frenchay Hospital some 10 minutes before them, without having to exceed the speed limit, I never did find out what caused the delay.
On Arrival at Frenchay approx 1.00 am weds 25th, Patricia was taken to the oncology ward (probably only because it was all a very big rush, and this ward had a bed free) the Nurses transferred Pat to a bed & within minutes Doctors & the resident Plastic Surgeon Mr Lea were busying themselves with more tests and the Nurses then started to prep Pat for Theatre, what seemed like minutes later, I was running alongside as they transferred Patricia (all within less than an hour of arrival) to the “Plastics” operating theatre.
From here on things became a bit of a Blur, during the operation they had to “abort” due to Patricia’s weakening state, during the early hours 3-4 am I really cannot be sure, I was quizzed by the surgeons about Patricia’s health and all her Medical history.
I started to think then that because of her age (Patricia was then an extremely young 70 years of age, however did not look or act her age! More like 50 going on 35) that the surgeons were not going to proceed.
I was told that they were trying their best to improve Patricia’s chances of surviving an operation with massive doses of antibiotics during the next hours, and that Patricia was currently in the ITU dept and if – yes IF she survived then they would then consider restarting the operation later that day.
So Wednesday 25th I was able to sit with Patricia until 9.00 am, I then came home briefly to collect Patricia’s Brother (who until then was totally unaware that Pat was ill at all) whilst the doctors were doing their tests & ward rounds in the ITU.
Patricia returned to Theatre again around noon and was gone for nearly 5 hours, returning from theatre with what appeared to be a form of cling film wrapped around her from just below the Bust area to just above the knee, they had apparently “de-brided” the entire surrounding area of skin and soft tissue/flesh to try to stem the infection. It was then that we were told what Patricia was suffering with – “Necrotising Fasciitis” caused by something as simple as a common abscess and an infection of the streptococcal strain.
We were told that even though Patricia had made it through the initial operation – all carried out by specialist “Plastic Surgeons” that we were an awful long way off from a position where they could give us any hope of a successful outcome.
It would at least be 5-6 weeks before they could tell how Pat would come through this, at this time they had managed to retain all Pat’s vital organs in the area of the “Blister”, but only time would reveal if they had gone far enough with the de-briding, what did concern me was that my Dear Patricia had so much skin removed, that I could not see where they would be able to find enough remaining skin to enable them to harvest in future for grafting onto the affected area.
Over the following week, Patricia was completely sedated and would regularly go to Theatre for dressing changes as this could only be completed in a totally sterile environment, and on a number of these trips to Theatre a certain amount of further de-briding was carried out.
The ITU staff were absolutely wonderful and tended to Patricia’s needs unstintingly, of course Pat was dependant on a dialysis machine and had help breathing with other equipment as the infection had apparently started to shut down Patricia’s vital organs.
What seemed like gallons of fluids & antibiotics were being pumped into Patricia to help her fight the infection, together with what seemed to me to be at least 6 or more massive electrically driven drivers pushing enormous intravenous syringes, set up to continue when each of the large syringe’s empty thus keeping a constant flow.
What actually turned out to be 17/18 hours before Patricia gave up the fight, I was sat with her during the doctors ward round (still in the ITU) I overheard the Consultant telling the junior doctors about Patricia’s situation and that they were fairly confident that they had removed all aspects of the initial infection.
Only time would tell if there would be a secondary infection, yet strangely I had noticed that morning for the 1st time in a week the same aroma that I had picked up upon the day that I had called for a doctor to visit Patricia at home a week earlier, I sensed all was not well, how true that turned out to be.
The moral to this story is, if in doubt, do not under any circumstances assume that you know what you are dealing with, we both thought quite wrongly that things would improve and we were dealing with a tummy ache due to food poisoning, How wrong we were, Patricia is no longer with us & I have to live with the thought that I could have and should have done more!
The strange thing is that I understand only a 1000 cases a year are reported, yet I live in a small town in Wiltshire, I know of 1 other person a godparent to a very good friend of ours who died of this and I also have a very good friend who has survived NF, this tends to make me think that there is probably considerably more than 1000 cases a year, perhaps due to ignorance of the symptoms a large number go undetected and unrecorded and are actually recorded as other ailments when in actual fact they are in reality NF deaths.
Peter J L Townsend
