WATCH: 'I am half a woman now, but not in my mind'

By YOU
07 July 2017

Don’t feel sorry for Shaninlea Visser.

Don’t feel sorry for Shaninlea (Shan) Visser.

She lost half of her body to an infection and doctors predicted she'd never be able to walk again -- but she's proved them wrong.

The fact that she’s now living without both forearms, her nose, the front part of her mouth, her lips and a portion of her tongue, couldn’t stop her.

“It was wonderful,” says Shan (34) from Port Elizabeth where she’s learning to use her body again at the Nurture Aurora Hospital’s rehabilitation unit. Ruan Lundt fitted her prosthetic limbs on Friday after the amputation caused her body to go into sepsis shock and intravascular blood coagulation.

“He quickly took it away to make a few adjustments,” she adds. She was busy with physiotherapy when a woman brought her prosthetic limbs back. Ruan had warned her that she would only be able to stand on her prosthetic legs, there’s no way she’d be able to walk so soon.

“No,” she told him determinedly. “I’m going to walk today,” and then put her words into action.

PHOTO: Supplied PHOTO: Supplied

“I walked the whole length of the gym and then the whole way to my room. And then back. We were all in tears. It was an unforgettable feeling!”

Her father, David Rogers, drove the whole way from Langebaan on the West Coast to Port Elizabeth in the Eastern Cape to fetch his only child when she was discharged from hospital on 7 July. “She’s going to break away to spend time with me and recover from all her operations. It’s only a matter of time before she has to be operated on again,” says David, and adds how proud he is of his brave daughter.

What happened to her was a shock to everyone. But the way that she’s rising above all the traumatic things that have happened to her is an inspiration to everyone.

On 5 January Shan arrived in Port Elizabeth from Durban. She worked for a transport company and was in Port Elizabeth to help open a new office.

She settled in at her boss’s house on 17 January and suddenly started feeling sick, throwing up and even lost consciousness in the bathroom. The next morning at 8am she couldn’t even get out of bed.

At about 3.30 am she wanted to go and drink water but fainted between the kitchen and dining room. A colleague who was coming to check on how she was doing, raced her to the Life St George hospital.

“My hands and feet felt like they were on fire, but when the nurse arrived she told me they were ice cold.”

Two weeks later she felt as though she’d “woken up from a coma”.

“Welcome back,” said the doctor. That was when she knew she was seriously ill.

She can’t remember anything about those first two weeks in ICU, says Shan. David still kept a diary to help her put the pieces of the puzzle back together.

“At first we thought it was a stomach virus,” recalls David. But within days it became clear that she was fighting for her life, her kidneys had stopped working.

“A normal person has between 150 000 and 450 000 blood platelets per millilitre of blood. At one stage Shan only had 16 000,” says David, a retired director of an environmental rehabilitation organisation.

PHOTO: Supplied PHOTO: Supplied

There were times in the hospital where they were certain they were going to lose her. But she kept fighting and survived. “I might be only half a woman, but not in my mind.”

At first, the doctors thought she’d only lose her fingertips and toes, but the gangrene in her tissue kept spreading. They also put off the amputations for as long as they could to check if the gangrene stopped and started to repair itself.

“They wanted to amputate as little as possible, it was a last resort,” says David. It was heart-breaking to see what was happening to my daughter. You feel so helpless.” A while later the nurse covered her body in sheets. “She couldn’t understand why she couldn’t do the things she had been doing, that she couldn’t just get up off the bed,” says David. A few days later they decided to show her how her hands and feet looked.

“It was black,” she recalls. “Nobody told me about how my face looked,” she adds. Until someone let slip that she’d need to get plastic surgery for her nose and lips where dead tissue had to be cut off.

“You’ll have to lose both your hands and feet or you won’t make it,” was the doctor’s prognosis. For the sake of her 11-year-old daughter, she told them, “do what you need to do”.

“I am half a woman now, but not in my mind.”

People who want more information about Shan’s condition contact her uncle Rob Nicholson on Robdtm@vodamail.co.za.

PHOTO: Supplied PHOTO: Supplied

SEPSIS IN PERSPECTIVE

Dr Jantjie Taljaard, head of Tygerberg hospital’s unit for communicable diseases, answers a few questions about sepsis.

Is it possible to be in a coma for three weeks due to sepsis?

Yes, it is absolutely possible. There are many conditions which can cause a coma. Conditions which affect the brain directly, like meningitis, encephalitis and brain injuries can lead to long coma.

How does it happen that you can lose limbs and even your lips or nose due to sepsis? Is it because tissue must be cut away to kill the bacteria?

Gangrene (dead tissue) can sometimes develop in the toes, fingers and even the tip of the nose due to sepsis complications.

The main reasons for this is that blood becomes thickened during bad cases of sepsis, and that causes very small blood clots to develop. These clots block the smallest, narrowest arteries which carry blood to the extremities of the body. This leads to the tissue in the places normally kept oxygenated by those arteries dying.

In this way, you can also develop septicemia, which is a worse version of sepsis. Shock means that there’s a sharp drop in blood pressure which means that even less blood is being sent to the affected areas. The arteries which lead to these non-essential parts of the body go into shock and blood is then supplied to essential bodily organs like the brain, kidneys, liver, and heart.

A part if the treatment of this form of shock includes medication like adrenalin to raise the blood pressure and prevent brain damage, kidney failure or liver failure. The medication leads to further spasms in the blood flow to the fingers and toes, which can also lead to a drop in blood flow.

The cutting away of tissue is sometimes necessary if the dead tissue affects a large area, like a whole foot, or if there is a secondary infection in the dead tissue or gangrene.

What is sepsis? Is it the same as blood poisoning?

Strictly speaking, it is not the same as “poisoning” but there is an infection in the bloodstream, which causes a germ, mostly bacteria like Streptococcus, Stafilokokkus, E. coli or Klebsiella. Bacteria causes toxins to run into the bloodstream and that causes the body to react and try to kill the infection. This battle in the blood stream leads to a combination of symptoms we call sepsis.

How can you prevent Sepsis while you’re in the hospital?

People can contract sepsis:

  • In the community where they live, also known as community-acquired sepsis, and are exposed to bacteria which is sensitive to front line antibiotics
  • After 48 hours of hospitalisation they can contract sepsis in the hospital, called hospital-acquired sepsis, and is often caused by drug-resistant bacteria. Hospitalisation is viewed worldwide as one of the biggest contributing risk factors to the development of sepsis because the antibiotic is used and many medical procedures are carried out.
  • ICU’s have the highest risk factor and the longer you stay there the higher the risk will become. Other contributing factors are intravenous drips, catheters and any operations (the bigger, the higher the risk).
  • A very important factor is the hand hygiene of hospital staff, like doctors, nurses and even visitors. Patients carry resistant organism on their skin and other surfaces which they spread to their bedding and surrounds. The WHO insists that everyone sterilizes their hands before visiting a patient in the hospital as well as after.

What are the symptoms?

Sepsis usually arrives with a high fever, exhaustion, confusion and depending on where the main focus of the infection is also headaches, a stiff neck (with meningitis) shortness of breath, coughing, chest pain (pneumonia), nausea and vomiting (appendicitis), painful urination, or blood in urine (urinary tract infection)

Dangerous signs include: dizziness, confusion, rapid breathing and low blood pressure.

How does Sepsis look in South Africa?

Sepsis looks the same everywhere – people with the biggest risk of developing sepsis are young babies, older people, people with immune system deficiencies (HIV, diabetes, chronic cortisone treatment, cancer, organ transplants) and people undergoing surgical procedures or using things like catheters and prosthetics.

Because SA has so may HIV sufferers (mostly in the state hospital facilities) and many patients in ICU’s we do see many cases of sepsis. The death toll is high for septic shock in cases where the patient could not get to the hospital in time to receive treatment.

Watch the video here:

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