5 ms·

This article is timely - I just returned home yesterday from the funeral of a very close friend who died of sepsis. He was told at the ER that he just needed to

This article is timely - I just returned home yesterday from the funeral of a very close friend who died of sepsis. He was told at the ER that he just needed to go home and rest and that his stomach pain was likely a colitis flare-up. I wonder if there will ever be a "rescue treatment" for sepsis that is based on this research. Lets hope so.

winocm 2y ago
My condolences. I had SIRS/sepsis once and it really is a harrowing experience. It really changed me forever and as a bonus, if not to add insult to injury, my hair now falls out and barely grows. Wouldn't wish it on my worst enemy.
igor47 2y ago
I'm sorry. The same thing happened to a very close friend of mine. Sepsis is a bitch, and also I miss my friend all the time. I hope you have a community to support you in grief.
balderdash 2y ago
This company https://cytovale.com/ https://cytovale.com/ has developed a diagnostic tool for sepsis, while not a cure it hopefully would make cases like your friend’s less likely
- jmort 2y ago
  Also https://inflammatix.com/ https://inflammatix.com/
zeagle 2y ago
A lot of drugs and efforts to treat sepsis/SIRS with inflammation have fizzled in trial. Tocilizumab, JAK inhibitors, and particaularly dexamethasone with its low NNT in COVID were interesting ones and suggest there is something to it but a complicated issue.
Pxtl 2y ago
Its horrifying how many stories sound like that, like the recent story woman who got parasitic worms from Hawaiian food that crept upwards from her legs gradually causing pain until they made it to her brain and only then the cognitive impairment made doctors take her seriously. She kept getting sent home too. It's infuriating how many problems in our lives are met with a shrug. edit: I'm a jerk, I forgot we were talking about somebody close to you. I'm sorry about your friend and I hope you're doing okay.
- JumpCrisscross 2y ago
  > It's infuriating how many problems in our lives are met with a shrug If you know anyone in medicine you know they are swamped by hypochondriacs, frauds and crazies. Absent clear diagnostic criteria--or a person privately funding the search costs, with time and money--it’s infeasible to expect a collectively-funded system to explore every potential case like an episode of House MD.
  - throaway89 2y ago
    This is pretty hand-wavy. I was diagnosed with a rare disorder. My doctors said surgery was the only option and that it would be fine after. As it turns out, there's a radiation therapy that is 80% successful, been practiced around the world for 20 years with no serious side effects (including cancer), AND is practiced regularly by a RO here where I live. I had to find out about him by myself because my doctors didn't do anything other than look up my condition and give me the most common treatment option. In my case surgery usually makes things worse and is NOT advised other than as a last resort. My doctors didn't know any of this, because they didn't do their research.
    - cma 2y ago
      Or could be they knew the surgeon and send them business
medimikka 2y ago
Rescue treatments are symptomatic. Which makes a lot of sense, if you consider what (medically) constitutes "sepsis." Any ED resident on their first week on the job should know how to diagnose sepsis: Temp >38°C (100.4°F) or <36°C (96.8°F), Heart rate >90, Respiratory rate >20 or PaCO₂ <32 mm Hg, WBC >12,000/mm³, <4,000/mm³, or >10% bands, Infection (suspected or present). Double down on the blood work, take liquor, empirically give antibiotics (less and less useful, given resistances), drop temperature (paracetamol), add fluids (drops heart rate, ups blood pressure), wait for labs. It's not hard, and I am so very sorry someone with sepsis signs was sent home. Sepsis is also a fast bastard. Meaning, from pathogen entering the blood stream to organ damage and conclusively death can be less than half an hour. That's the ones we can't catch. The guy with the ulcer, the person who injects things, the girl who didn't see a dentist about her developing abscess, the man who stopped his HIV meds... that's the ones I didn't in the past three weeks. I got them too late, or didn't see them until the ambulance unloaded a dead person. Sepsis is a bitch. A total and utter bad player, something we drill into every resident from day one. Sometimes Mrs. Goodforall comes in with a light chest tightness and leaves on a hearse, sometimes Mr. Bluebird presents with nausea and crashes into a full on septic shock minutes later. Any one of those I can prevent, I will. I am, however, not God. Just a ED jockey with an infectious disease background. I'm probably the best hope my patients have, which isn't much, but it's something.
- Madmallard 2y ago
  What about the research surrounding high dose vit C, thiamine, dexamethasone or whatever that concoction was?
- jasongill 2y ago
  Thank you; yes, he had a clinical history of colitis and other stomach issues, and had visited the ER due to abdominal pain over a weekend. On Tuesday he collapsed at home and was gone. I don't know what transpired with the doctor (and didn't want to pry too much with the grieving family) but it sounds like it was just missed or his symptoms misunderstood. I heard grumblings that the doctor was at fault but I don't fault them - things just happen and while it is sad, it just happens.
- 2y ago

winocm 2y ago

My condolences. I had SIRS/sepsis once and it really is a harrowing experience. It really changed me forever and as a bonus, if not to add insult to injury, my hair now falls out and barely grows. Wouldn't wish it on my worst enemy.

igor47 2y ago

I'm sorry. The same thing happened to a very close friend of mine. Sepsis is a bitch, and also I miss my friend all the time. I hope you have a community to support you in grief.

balderdash 2y ago

This company https://cytovale.com/ https://cytovale.com/ has developed a diagnostic tool for sepsis, while not a cure it hopefully would make cases like your friend’s less likely

jmort 2y ago
Also https://inflammatix.com/ https://inflammatix.com/

zeagle 2y ago

A lot of drugs and efforts to treat sepsis/SIRS with inflammation have fizzled in trial. Tocilizumab, JAK inhibitors, and particaularly dexamethasone with its low NNT in COVID were interesting ones and suggest there is something to it but a complicated issue.

Pxtl 2y ago

Its horrifying how many stories sound like that, like the recent story woman who got parasitic worms from Hawaiian food that crept upwards from her legs gradually causing pain until they made it to her brain and only then the cognitive impairment made doctors take her seriously. She kept getting sent home too. It's infuriating how many problems in our lives are met with a shrug. edit: I'm a jerk, I forgot we were talking about somebody close to you. I'm sorry about your friend and I hope you're doing okay.

JumpCrisscross 2y ago
> It's infuriating how many problems in our lives are met with a shrug If you know anyone in medicine you know they are swamped by hypochondriacs, frauds and crazies. Absent clear diagnostic criteria--or a person privately funding the search costs, with time and money--it’s infeasible to expect a collectively-funded system to explore every potential case like an episode of House MD.
- throaway89 2y ago
  This is pretty hand-wavy. I was diagnosed with a rare disorder. My doctors said surgery was the only option and that it would be fine after. As it turns out, there's a radiation therapy that is 80% successful, been practiced around the world for 20 years with no serious side effects (including cancer), AND is practiced regularly by a RO here where I live. I had to find out about him by myself because my doctors didn't do anything other than look up my condition and give me the most common treatment option. In my case surgery usually makes things worse and is NOT advised other than as a last resort. My doctors didn't know any of this, because they didn't do their research.
  - cma 2y ago
    Or could be they knew the surgeon and send them business

medimikka 2y ago

Rescue treatments are symptomatic. Which makes a lot of sense, if you consider what (medically) constitutes "sepsis." Any ED resident on their first week on the job should know how to diagnose sepsis: Temp >38°C (100.4°F) or <36°C (96.8°F), Heart rate >90, Respiratory rate >20 or PaCO₂ <32 mm Hg, WBC >12,000/mm³, <4,000/mm³, or >10% bands, Infection (suspected or present). Double down on the blood work, take liquor, empirically give antibiotics (less and less useful, given resistances), drop temperature (paracetamol), add fluids (drops heart rate, ups blood pressure), wait for labs. It's not hard, and I am so very sorry someone with sepsis signs was sent home. Sepsis is also a fast bastard. Meaning, from pathogen entering the blood stream to organ damage and conclusively death can be less than half an hour. That's the ones we can't catch. The guy with the ulcer, the person who injects things, the girl who didn't see a dentist about her developing abscess, the man who stopped his HIV meds... that's the ones I didn't in the past three weeks. I got them too late, or didn't see them until the ambulance unloaded a dead person. Sepsis is a bitch. A total and utter bad player, something we drill into every resident from day one. Sometimes Mrs. Goodforall comes in with a light chest tightness and leaves on a hearse, sometimes Mr. Bluebird presents with nausea and crashes into a full on septic shock minutes later. Any one of those I can prevent, I will. I am, however, not God. Just a ED jockey with an infectious disease background. I'm probably the best hope my patients have, which isn't much, but it's something.

Madmallard 2y ago
What about the research surrounding high dose vit C, thiamine, dexamethasone or whatever that concoction was?
jasongill 2y ago
Thank you; yes, he had a clinical history of colitis and other stomach issues, and had visited the ER due to abdominal pain over a weekend. On Tuesday he collapsed at home and was gone. I don't know what transpired with the doctor (and didn't want to pry too much with the grieving family) but it sounds like it was just missed or his symptoms misunderstood. I heard grumblings that the doctor was at fault but I don't fault them - things just happen and while it is sad, it just happens.
2y ago