Tuesday, October 12, 2010

Septic shock survivor in Kansas loses limbs but keeps her hope

The intro to a story in The Kansas City Star

As much as some Americans have lost in recent years — jobs, homes, savings — few can lay claim to what has befallen 27-year-old Bernadine Pickering (pictured).

At age 12, she watched the 100-mile-per-hour winds of Hurricane Marilyn toss fishing boats and luxury yachts onto the beach of St. Thomas like heaps of toys. It shredded her native island, leaving 10,000 people homeless.

“It was a doozy!” she said.

Two years later, she watched her mother — poor, raising three young children after fleeing to the U.S. — fight off breast cancer.

Then, 10 months ago, Pickering’s chest and throat began to burn. Heartburn, suggested a doctor. Then she found a rash. She felt dizzy. She got to the emergency room at Truman Medical Center and, within hours, her organs failed. She was placed on life support and fell into a coma.

“Mama, mama. Wake up, mama,” her daughter, Ananda, then 3, whispered at her bedside. “Why isn’t mama waking up?”

Pickering emerged six weeks later from septic shock — the bacterial blood infection that annually kills 180,000 to 250,000 in the U.S. — the Kansas Citian’s extremities black with gangrene.

A surgeon took both feet at the ankles, both arms at mid-forearm.

Despite all that would follow — losses heaped upon losses, dark thoughts on black days — Pickering would discover that, even as a quadruple amputee she was not alone. But also that sometimes life’s greatest blessings are the ones that too often go overlooked.

She lost her job as a hospital secretary. She has virtually no money and lives in cramped federal housing with six family members. She feared no one ever would find her attractive again. Yet …

“Isn’t this a beautiful day?” Pickering chimed on a sunny fall morning.

Her eyes glowed, her smile stretched wide. Standing 5 feet 11 inches tall, with short, curly red hair and a taste for hoop earrings, she once used her arms and legs to play basketball and volleyball. At Kansas City’s Northeast High School, she twirled a rifle on the Junior ROTC drill team.

She maneuvered to get out of the passenger seat of the old Buick that her longtime boyfriend, Cortez Johnson — Ananda’s father — borrowed to drive her to The Rehabilitation Institute, near 31st Street and Baltimore Avenue.

“Come on, mamma,” said Ananda, now 4.

“I’m coming. I’m coming,” Pickering said, laughing.

Her left prosthetic hand is a metal clasping tong signaled by her muscles. Her right is an electronic hand that opens and closes at the thumb. Her feet have been replaced with hard-plastic tubes that pull over her shins and up to her knees like a pair of brown riding boots fitted with white sneakers.

For 63 years, the institute’s therapists have helped victims of some of most difficult strokes and neurological disorders, amputations, accidents and other difficulties regain their movements — and their lives. Multiple amputations from wars or car accidents can be found in hospitals, but quadruple amputees who survived septic shock are rare.

Researchers worldwide, including at the University of Kansas, are trying to battle septic shock.

Victims typically fight off the violent infection and emerge relatively unscathed, or they die. Middle grounds are uncommon — and often tragic.

In 2008, the septic shock of Brazilian model Mariana Bridi da Costa captured international headlines. The brunette, who had twice won fourth place in Brazil’s Miss World pageant, entered the hospital in December with what was misdiagnosed as kidney stones. She developed a urinary tract infection. The bacteria coursed through her blood, erupting into septic shock. She lost her hands and feet and, in January 2009, died just short of her 21st birthday.

“More people die each year from severe sepsis and septic shock than from lung cancer, colon cancer and breast cancer combined,” said Mitchell Levy, a leading expert and chief of the division of pulmonary and critical care medicine at Rhode Island’s Brown University Medical School. “It is a surprisingly common illness that people don’t know about.”

In the worst case, the death rate reaches 60 percent.

“Lots of time, if you come in (to the emergency room) septic, you can go downhill real fast,” said Emanuel River, who researches sepsis at Detroit’s Henry Ford Hospital. “I have seen people die in six hours.”

Pickering’s story is novel, not only because she survived, but also because she has company at the institute. Twice a week, her intense therapy sessions overlap with that of another young mother.