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Brew: Sheffield, England.
Dana Sedgewick, mother of three, was shaving her bikini
line as she normally did during her self-care routine.
She grabbed a new razor expecting nothing out of the ordinary.
Shortly after shaving, Dana felt odd.
In an interview with Hotspot Media, she said "I felt unwell
and noticed a little pimple on my groin which kept bleeding.
I didn’t think anything of it as
I often got a rash from shaving,"
She brushed it off.
Little did she know, that tiny little pimple
would send her through the ringer of a 9 day
coma, nearly cause the amputation of her legs,
and put her into a fight for her very life.
Let’s get into it!
A couple days after she shaved, Dana began feeling dizzier
and more nauseated, so she decided to visit her doctor.
They took a swab of the rash, and
prescribed her a course of antibiotics.
Believing it was just a simple skin infection, medical
professionals thought that it would clear up without issue.
Unfortunately, her rash only grew worse.
Bloody and nasty, it started spreading across her legs.
Shortly after going on a course of antibiotics, Dana’s
doctor called with the swab test results, saying her
infection was more severe than they initially thought.
She returned to the hospital so medical staff
could examine her skin more closely, but when
her husband Mat dropped her off, she collapsed.
Dana was rushed to the trauma unit at the North General
Hospital in Sheffield where they finally diagnosed her.
She had a condition called “Necrotizing Fasciitis”.
In Dana’s words, “By the time I got to the hospital,
my legs were covered in black, rotting flesh.
It was touch-and-go as to whether I’d make it”.
She was hurried into the operating room where surgeons
attempted to remove the dead flesh on her legs, and replace
it with healthy skin from her back to try and save her legs.
If they were unsuccessful the infected tissue would continue
to spread, damaging her flesh enough that amputation would
be the only solution to keep it from killing her outright.
But she wasn’t out of the weeds yet because of the
infection; Dana developed sepsis, which is when the body’s
immune response to an infection begins attacking itself.
Her kidneys suddenly failed, then her heart stopped,
and doctors gave her a 30% chance of survival.
Medical staff decided that her best chance to get
through this was to put her into an induced coma.
She ended up sleeping for 9 days.
Narrator: Ara-socks, Dune.
He who controls the socks, controls the universe.
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Brew: Oh no, it’s in the movies now?
Chill: Y’know, the one with Timothee Socklemet and Zendaya?
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When Dana awoke, she didn’t know what was going on.
She says “my legs were covered in bandages
and I had no idea what had happened.
I thought I’d been in a car accident, but when
the surgeon asked me if I remembered shaving,
I suddenly recalled trimming my bikini line.”
In the end, what was just a small infection spot
on her groin led to a fight for her very life.
One that left her legs, as she describes, in a horrific state.
“All of my muscle had rotted away, and
I had a crater of skin near my groin.
I felt like I was going to throw up,” she said.
Today, Dana has undergone at least 26 surgeries
to repair the damage of the infection.
In an interview with Snopes, she said that she
hoped that her story would help raise awareness
of sepsis, a common complication of infections
which almost took her legs, and her life.
She also admitted that she was immunocompromised prior to
her infection, which likely contributed to the severity.
So what is “necrotizing fasciitis” anyway?
Known shortly as NSTI, necrotizing fasciitis is
a specific kind of soft skin tissue infection.
Necrosis is the death of body tissue, and
fascia is the soft tissue that surrounds all
of your organs, found just underneath the skin.
So, in broad terms, it is an infection
that kills the tissue around your organs.
Necrotizing Fasciitis is caused by bacteria,
usually Streptococcus and Staphylococcus, although
it can also come from polymicrobial infections.
Streptococcus is the same bacteria that causes strep
throat, while staph is a common bacteria found on the skin.
Either of these, if they get into an
open wound, can wreak havoc in your body.
From a bug bite to a bad burn; a paper cut to
a pimple popped, any wound can become infected.
In fact, even a bruise can become infected.
That being said, most surface level infections
like these are mild, and when we inevitably get an
infected wound, our bodies’ immune system handles it.
That is, until it doesn’t.
Now, staph and strep can be passed from person
to person, however it’s only through close
contact, like touching a person’s open wound—
—Quick tips with Brew, don’t rub your open wound on things.
Even then, it’s rare that an infection is contagious
unless a person has a compromised immune system
due to conditions like diabetes and alcoholism.
In the United States, NSTI only affects around 4 people
per one million, however, in some parts of the world,
depending on the robustness of their health care systems,
that number can grow as high as 10 in every one million.
Often colloquially referred to as a “flesh
eating disease”, the term isn’t technically true.
The disease doesn’t eat tissue, it only looks like it does,
but if your skin turns green before it starts sloughing off...
I’m not sure if the difference matters.
Symptoms usually occur shortly after an injury
in which the skin is broken or bleeding.
You may experience skin that is red, swollen, and hot
to the touch, as well as fever, nausea, and diarrhea.
You may also experience a pain that is vastly
disproportionate to the size and severity of the wound.
If you have pain that improves before suddenly becoming
much, much worse then you should go to the hospital.
Infections of this kind can spread quickly, tissue
slipping off before you know it, and as we saw in Dana’s
case, it can become life threatening in an instant.
In severe cases it can trigger organ failure and sepsis
before medical staff can even determine what’s going on.
One of the major struggles with diagnosis is
differentiating from non-necrotizing skin infections.
Since NSTI progresses from bad to worse so quickly, it’s
imperative that medical staff know how to recognize it.
To illustrate just how difficult it is to get a reliable
diagnosis, we can look to the story of Rob Erke.
Rob, a British Columbia resident, was working at his
family’s trailer repair company on July 1st, 2018.
Aw heck that’s Canada Day, eh?
When he felt a pain in his shoulder.
With some discomfort, he pulled down his shirt to find
a small lump on his shoulder that was painful to touch.
He was a little concerned, so he went to the hospital.
The doctor there tested for an infection, but found that
it was likely just a small irritation, so he prescribed
Rob some anti-inflammatories, pain meds, and sent him home.
Three days later, on July 4th, Rob started feeling ill, and
the lump grew into an alarming size, and a giant problem.
With intense pain, Rob went to the ER, but there
were long wait times, so he chose to return home
and wait a day to visit his family doctor instead.
The following day, Rob’s doctor told him that it was a
bacterial infection, prescribing him a course of antibiotics.
He was also booked for blood work,
and x-rays, then sent him home.
Two days later, a week after Canada Day, Rob awoke
with a fever of 39.7 celsius, or 103.5 fahrenheit.
His lump had also grown even larger,
and now sported a gross purple hue.
His wife, Eilish, unsuccessfully attempted to
bring down his fever, and once he was asleep,
she called an ambulance against his judgement.
Thank the gods she did though.
Rob was brought into the operating room to
undergo surgery to remove the infected area.
Another surgery the following day allowed
doctors to remove a large chunk of his shoulder.
He was supposed to undergo a third surgery the day
after that, but the doctors decided against it.
Eilish said that “It turned out that it was quite bad and
that his blood was absolutely septic, and they said if I
hadn’t brought him in right away it could have killed him”.
She continues telling the Langley Times that surgeons were
forced to “put some kind of packing in him that’s got a
pump that draws all the stuff out because they can’t seem
to get ahold of the infection that’s in his blood still.”
Unless the infection is totally cleared from his
system, he’ll be in danger of going back at any moment.
So after a grueling 8 day ordeal, Rob now faces plastic
surgery to repair the hole left in his shoulder from
flesh that had to be removed, but he’ll likely not
put off a trip to the hospital as quickly next time.
His wife said that it was very frightening for
her to know that a seemingly invisible illness
could have taken her husband so quickly, saying
“Like he didn’t have a scratch, a bite or nothing.
They still have no idea how, or why, he got it.
And he’s a big guy who works outside,
he doesn’t even really get sick often.
So for him to be taken out that
quickly like that is very scary.”
Rob struggled to find a correct diagnosis,
and since the infection spreads so quickly,
that mistake could have cost him his life.
An article from Dr.
Paul Cohen and Dr.
Nicholas Musisca, entitled “How do we misdiagnose
and mismanage necrotizing fasciitis?” illustrates
the many ways that Necrotizing Fasciitis can be
mistaken for other conditions, or overlooked entirely.
First, Cohen and Musisca write that the
infection has unreliable risk factors.
They note that many physicians assume only
obese, diabetic, and immunocompromised people may
contract the disease, but that isn’t entirely true.
Of course, like we’ve said, those conditions
increase your risk, but anyone can come down
with a bad case of flesh eating bacteria.
Just ask Rob.
Second, some doctors also falsely believe that
a patient’s history will be able to accurately
point to an inciting incident, like an injury
or some other kind of point of contact.
Unfortunately, studies show that up to half
of cases do not have an “inciting incident”.
Like with Rob’s case, medical staff never
actually found the root cause of his case.
Third, diagnosis is difficult because not only
are NSTIs rare, but also, most of the visible
signs only show up as the disease spreads.
One review of cases found that the most common signs
of NSTIs, which are swelling, pain, and skin rashes,
are the same signs “indistinguishable to those
found in non-necrotizing cellulitis and abscesses”.
So the early stages of the disease are often
misunderstood as something as serious as it is.
Cohen and Musisca argue that intense pain
should be seen as a red flag, and not, as many
doctors write off, as signs of opioid abuse.
Lastly, they point to an overreliance on a system called
LRINEC, which stands for Laboratory Risk Indicator for
Necrotizing Fasciitis, which was made in 2004 to help
medical professionals identify necrosis in skin infections.
Basically, it has a set of criteria designed around levels
of certain chemicals like sodium, glucose and C-Reactive
Proteins in the blood, but as it turns out, diagnosing based
on these criteria are only accurate around 48-82% of the time.
Without treatment, the death rate is 100% so it’s
paramount that you are treated as soon as possible.
Even after diagnosis, mortality rates from
necrotizing fasciitis are often higher than 30%.
Much of this can be attributed to particular strains
of strep and staph that are meaner than others,
but anything that impairs your immune system can
make the infection much deadlier, such as old age,
diabetes, chemo, surgery, and other conditions.
All of us are probably going to have an
infected wound at some point in our lives.
Usually they’re nothing to worry about, and you
might just feel a little bit of discomfort as your
body deals with unruly bacterial and viral visitors.
That being said, it’s good to avoid
infection altogether, obviously.
Make sure to disinfect any open wound you may receive with
an antiseptic, or apply antibacterial cream like polysporin.
In the end, the most important thing to remember about
Necrotizing Fasciitis is to get to the hospital as quickly
as possible, and know the symptoms so you can ask your
doctor to check for infection before it can get any worse.