[Closed] Lungs and sudden death 🙁

Sorry for your loss.

Two friends in our circle have had severe lung infections resulting in fairly long stays in hospital.

Thankfully, both of them survived their trips to ICU - both seemingly recovered in a couple of days once the docs got the cocktail of drugs right. Neither of them know what caused it.

Guess, just trying to say there's a lot of it about and some folk are just unlucky. No reason to any of it.

Saxon Rider.  I’m sorry to hear you have lost a friend and especially so young. I have no answers, but I’m thinking of you.

My sister had the same with a post op infection which led to sepsis and ARDS or acute respiratory distress syndrome. There is a 40-50% mortality rate and prompt admission to the ITU is vital.

She survived after 8 weeks of ITU care. Sadly whilst there, they a deadly melanoma was missed which eventually took her a few years later. Where she does in the same unit.

How on earth can an otherwise healthy young woman develop a lung infection so severe that she has to be put into a coma, then apparently recover, only to succumb completely?!? Undetected heart conditions and aneurysms and sudden strokes are all terrifying potentials, but lung infections that they think have been cured?

We've come to think of medicine as something of a magic bullet. It probably started with penicillin which appeared initially to be just that. Unfortunately this is erroneous, the human body is complex and interactions with pathogens and treatments throw in another layer of complexity meaning that rather than a treatment being a cast iron cure it might work for some and not for others. We are incredibly robust and difficult to kill in some ways and ridiculously vulnerable in others.

SaxonRider - Sorry to hear of your loss.

I work as a Critical Care Nurse and unfortunately what happened to you friend is not uncommon.

Obviously without knowing the full details I'm making assumptions, but quite often we see overwise healthly younger people become very unwell when admitted with respiratory infections. Overwise healthly people will ususlly 'compensate' for an infection and it's when this compensatory mechanism reaches its limit that patients suddenly become very ill.

The prognosis is often poor because such patients have often got very little 'left in the tank', so to speak, and they can rapidly fall into multi-organ failure.

Really sorry to hear about this. Nothing else I can say

It's not like putting your car into a garage, diagnostics done and sorted, we tend to simplify things like this, just an infection? No such thing unfortunately. The human body is exceptionally complex.

Sad for your loss Saxon. 😞

I always think of humans as simply hanging by our little threads over the abyss...

Sigh. Bike ride anyone?

This pretty much happened to my father a year ago 🙁

There seems to be an absolute tipping point between everything ok with no real issues and hospital. Dad ended up attached to device firing 60 litres of Oxygen per minute up his nose but the fibrosis of his lungs had damaged too much tissue and that ended up not being enough.

Yup - lost my dad in similar circumstances too. He had pneumonia but they took him off the full face oxygen mask as they said he was over the worst and should be out of hospital in the next couple of days. When I waved goodbye to him on the Thursday night as I walked down the hospital corridor I had a feeling something wasn't right. My mum called me at 8.30am on Friday morning to say he died in his sleep.

Very sad tale. RIP your friend.

We tend to think that the only things that will take us quickly are heart attack, cardiac arrest or haemmorhagic / ischemic stroke. Sadly there are a lot of other conditions that can prove fatal quickly.

Back in the late 90s, I suffered from pulmonary vasculitis. This is an auto-immune disease that attacks the blood vessels in the lungs. Within a couple of days I had become a very sick, hypoxic mess. Oxygen sats down to 66%. Only ICU support and a lot of imaging found the culprit before I corked it. I underwent intensive steroid therapy which cured the condition.

My friend had some kind of ulcer a couple of years ago, got infected, which spread and turned into sepsis and they died, all the space of a few days.

My OH also go very ill with a bacterial infection (mastitis whilst breast feeding) and I then got something similar in my knee (septic bursitis) both requiring a week or so on IV antibiotics. For my OH they had to try several before finding one that works.

It seems the only real cure at the moment is antibiotics, and there is increasing resistance due to overuse...
https://www.theguardian.com/environment/2018/feb/08/huge-levels-of-antibiotic-use-in-us-farming-revealed

We’ve come to think of medicine as something of a magic bullet. It probably started with penicillin which appeared initially to be just that. Unfortunately this is erroneous, the human body is complex and interactions with pathogens and treatments throw in another layer of complexity meaning that rather than a treatment being a cast iron cure it might work for some and not for others. We are incredibly robust and difficult to kill in some ways and ridiculously vulnerable in others.

A really well worded paragraph...
Sorry for your loss OP..it must be awful trying to understand something that may not actually have a feasible answer.

DrP

A really well worded paragraph…

I'll come clean and admit that the ideas if not the wording are mainly lifted from Atul Gawande's 2014 Reith lectures. These are well worth listening to if you haven't already.

https://www.bbc.co.uk/programmes/b04bsgvm

Sorry for your loss.

I had a friend's mother die very quickly on holiday. Otherwise v healthy, 52 years old.

Police even suspected foul play, very distressing for everyone but they were only doing their job.

My neighbour is a retired gp, soon as i explained the symptoms he diagnosed an embolism in the lungs. He does do the crem job where he has to check all causes so he is well qualified to comment.

Short version. My gf nearly died last November. Total organ failure. Luckily she pulled through, and has almost totally recovered now. If she had been admitted a few hours later, she would have died.

Longer version.On the Saturday, we were at the FoD trail centre for the first time, she was struggling getting up the hills. Sat down afterwards, she said she was really tired and aching.
On Monday she said she was coming down with something.Tuesday she did her part time job. Wednesday was a full day at work, she had it off, feeling unwell. On Thursday she felt the same, her friend came round, took her to the Doctors, who sent her to the hospital to be checked out. The hospital sent her home, saying she had exhaustion, and gave her some cocodamol for the aching legs.
She was lying in bed a lot, but did get up occasionally, just like someone with flu symptoms.
Friday she didnt get out of bed. On Saturday, I saw her for the first time in the daylight, and was quite shocked, she was yellow. I insisted that we get some medial help, so rang 112, who were quite indifferent. I rang again a hour later, and this call handler did take notice, and sent a paramedic round. He looked at her, and immediately said you're going to hospital NOW.
Into casualty, which was remarkably quiet, to be met by indifference. She was yellow. And could hardly move. But, they said she was aching from the bike ride (6 miles up some not really big hills!) Blood tests were done, then we had 3 people come to ask us what protein drink she had been drinking. Err, none. They didnt believe us. So 2 more came to ask the same question. It turned out later, that the protein level in her blood was very high, meaning either you're taking in far too much protein, or, your kidneys are failing. They didnt consider that her kidneys were failing, they just assumed she was drinking protein drinks as she was a mountain biker who went up big hills!
By this time, I had been googling the symptoms, and had come up with a very credible diagnosis - Weils disease/Leptospirosis. We kayak most weekends, so are at risk of it.
I asked the Staff to check this out, but they pretty much dismissed my thoughts by saying 'anyone can google symptoms, that is such a rare disease, it wont be that'. They put her on a drip, then said there is nothing else I can do there, so come back in the morning when they expected her to be a bit better.
At 1.30am I got a call, she was transferred to the Intensive Care Unit for observations. Come and visit from 1pm. At 11am Sunday, I got another call, get here immediately, there has been a change.they wont say any more over the phone.
She had been fitting that morning, so mush so that they thought she was going to have a heart attack, so they put her into an induced coma. It was only then that they realised this was very serious. She had been drip fed some mild anti-biotics, but now she was on pretty much every type of antibiotic possible and on dialysis as it was clear the kdneys were failing.

To say I was shocked was an understatement. The Consultant had me in an office, told me to ring all of her relatives if they want to see her, as they werent sure if she would last the day. Believe me, that is not something that you ever want to hear, making the calls was very difficult.
Luckily, the dialysis was starting to help, and late on Monday she was brought out of the coma. Dialysis came off on Wednesday after many transfusions. She was in hospital for another 2 weeks, and had to take various tablets for 3 months.
The Consultant told me if she had come in to the ICU 4 hours later, she would not have survived. He'd already told me on the Sunday that she was as close to death as you can get while still being alive.
This all came from infected rat pee, that she had somehow got into her, in a very small amount. We think it was getting out of a boat on a canal side, then having dinner with it on her hand.
So, it happens, at FoD doing the trails on a Saturday, the following week in ICU, nearly dead.
She's fine now.It took a long time to recover, even now she struggles a bit on the bike.

Alanl - Sounds like your partner and you went through the wringer, glad to hear she is doing well though.

Oddly enough about a month ago I looked after a patient who had been admitted to our ITU with very similar symptoms to your GF and given I also kayak and fish, and the patient had recently returned from a fishing holiday, I sent of a blood sample for a Leptospirosis screen, which it later proved to be and thus we treated him for.

Unfortunately there are a great many things that such symptoms could also be and in the process of differential diagnosis, Leptospirosis would come very far down the list. Its only because of my knowledge of the disease based on my own hobbies that I considered it.

Most medical teams would consider Meningitis or Sepsis as the most likely candidates, but there are other possibilities as can be seen here.

https://online.epocrates.com/diseases/91335/Leptospirosis/Differential-Diagnosis

Condolences to the lady's loved ones.

There's a scoring system that is used for people admitted to hospital with pneumonia. It's called curb65 and if you score 5/5 you have a predicted mortality within 30 days of around 50 percent. In hospital. On treatment. Feels like a slight exaggeration to me but it HAS been validated.

SR's colleague could only have scored 4 as she wasn't over 65 but the point stands - severe chest infections can be really nasty and will take a long time to recover from if they don't kill you