North & South – June 2019

36 | NORTH & SOUTH| JUNE 2019

downhermusclestoreleasethesugars

andaminoacidsthatenabletheliverto

makenewproteinstofightinfection.

“Prettymucheverythingwasdeterio-

rating:herheartbeat,herrespiration,her

oxygensaturationlevels,”saysMilne’s

husband,AlexWheatley.“Ihadtoshake

herandsay,‘Takea fewdeepbreaths–

youroxygenlevelsaregettingtoolow.’

Shewasstartingtogointoorganfailure.

Onceyouseethemonitors,it’sprettyob-

viouswhenyou’reina downwardspiral

andif youdon’tarrestthatdownward

spiral,there’sonlyoneoutcome.”

ButMilnewaslucky.Doctorssayher

treatmentwasa textbookexampleof

promptandeffective– andlifesaving–

care.About25%ofpeoplewhocontract

sepsiswilldiefromit.Officialfigures

under-representthereality,because

ofthewayinfection-relateddeaths

arecodedbytheMinistryofHealth.If

youdiedofmeningococcaldisease,for

example, you’d have sepsis, but your

Thefirstcellstoarriveatthefront-

linesareneutrophils,whichkillthe

invadersbyeatingthem– almostlit-

erally.Whentheneutrophilsareover-

whelmed,astheywereforthefirst

coupleofdaysinMilne’scase,thebody

rushesmoreandmoreofthemtothe

battleground.Butthesetroopsbecome

lessdiscriminatingaboutwhattheykill.

Notonlyisthebacteriatargeted,but

healthytissuecomesunder“friendly

fire”.Thebodynowhastwofoes:the

bacteria’stoxinsanditsownimmune

system.Damageisbeinginflictedon

multipleorgansinnumerousways.

Milne’sinflamedbloodvesselswere

leakingfluidintohertissues,causingher

bloodvolumetodropdangerously.To“fill

thetank”,doctorshadtopumpherwith

intravenousfluids,causingvisiblebloat-

ingastheexcessseepedintohertissues

throughleakycapillaries.Atthesame

time,herlimbswerevisiblyandrapid-

ly wasting as her immune system broke

W

hentheheadaches,cold
sweatsandtheshakes
started,MirandaMilne
hopedshewasn’tcoming
downwiththeflu.Hourslater,whenher
temperaturespikedat40°C,herblood
pressureplummetedto79/59andher
kidneysbegantoshutdown,sheproba-
blywishedshehadbeen.Milnewasnot
battlinga virus,buta life-threateningim-
muneresponsetoinfection– whatdoc-
torscallsepsis.Asshewaswheeledinto
TaurangaHospital’sintensivecareunit
inApril2014,thesepsiswaswinning.
Aminorgynaecologicalprocedure
ata privatehospitalearlierthatweek
hadallowedtheusuallyharmlessente-
rococcusbacteriatomigratefromher
reproductivetractintoherbloodstream
andwreakalmostfataldamageonher
body.Thishadputherimmunesystem
intohighgear,triggeringa cascadeof
chemicalmessengers demanding the
body respond.

JAMIE TROUGHTON

TaurangainfectiousdiseasesspecialistDianeHanfelt-Goade(left)withformerpatient
MirandaMilne.WhenMilnearrivedatthehospital’semergencydepartmenton 11 April
2014, she was hours away from being “past the point of no return”, says Hanfelt-Goade.