Amanda Woodrow has just one message: ‘Sepsis really can strike anyone at any time…it doesn’t discriminate.’ 

A keen competitive runner, cyclist and gym-goer, and now working as a researcher in acute and complex mental health, the then 28 year old from Edinburgh was to see a routine procedure take a terrifying turn for the worse. 

In August 2017 Amanda received a routine contraceptive injection – of a treatment that she had been on for several years. On this occasion, however, the injection didn’t just give her the usual two-day discomfort that she was used to. Amanda initially didn’t think much of it, until she developed pain and a lump at the injection site a few days later. She contacted her GP who told her that this was normal and that it was likely to settle down. The GP also directed her to look at bodybuilding websites because of occurrences of the same kind of issue in competitors who inject steroids.  

Over the next week she found herself becoming breathless, however, and felt drained of energy during her usual track running sessions. She was struggling to get around and to keep up her usual daily tasks and she developed hives, where her whole body itched. She often felt dizzy and, standing in the kitchen in the middle of a conversation with flatmates, would have to lie down. General standing up soon became difficult and she began to experience nausea and fainted when she tried to go to the bathroom, waking up on the hallway floor. Amanda took the decision to call NHS 24 who explained that it was probably an allergic reaction and that she should wear loose clothing, take ibuprofen and see her GP in the morning. The morning came and the only appointment that she could get was at 5.20pm – the last one of the day. Amanda managed to persuade a friend who was a teacher and was luckily on summer holidays to travel through to Edinburgh and accompany her to the surgery. Too scared of vomiting in a bus or taxi, it took an hour for Amanda and her friend to walk just over a mile to the appointment. Once there, the GP took her blood pressure, asked her to stand up, then immediately sat her down and called A&E at The Royal Infirmary in Edinburgh. The GP said that she had no idea what was wrong with Amanda but that she needed to get to hospital as quickly as possible. Amanda managed to persuade the GP to give her an anti-sickness drug before she was prepared to leave in a taxi. 

Once at A&E, Amanda explained the pain that she had been experiencing since the injection. She was also fortunately able to provide a daily written record of symptoms that she had kept once she realised that something wasn’t right. There was some speculation that Amanda might have contracted Lyme disease after a trip to the Highlands, despite the fact that she hadn’t noticed any ticks. Nobody seemed to think that a link to the injection was likely, so medics were having to consider other potential causes. The team took blood cultures and hooked Amanda up to an IV saline drip before moving her up to a ward in the middle of the night. There the nurse told how important it was that she urinated soon. They were unable to give her a blanket although she was shivering. ‘I felt like I was freezing half to death,’ she recalls, ‘My whole body felt sore but I wouldn’t let the nurse give me morphine as I was still so scared of being sick. I was up and down all night trying to pee but several bags of saline later there was still nothing there.’ 

In the morning a nurse came in to give Amada a bowl of hot water to wash and a toothbrush to clean her teeth. She remembers staring at them and being baffled – in her confusion she had no idea what they were for or how to use them so just lay back down. Later that morning she was moved to the acute medical unit and her friend came back to see her – mid conversation Amanda vomited into his Sainsbury’s carrier bag. She says that she otherwise doesn’t remember much about that day as her confusion got markedly worse. She was eventually sent for a scan which confirmed that her kidneys and liver were shutting down. Fortunately, lucid enough to ask the radiographer why he hadn’t scanned the hip where the injection had been, he did so despite the fact that it hadn’t been on his request sheet. Amanda recalls that he didn’t say much at the time but that she later found out that the scan had revealed a large abscess at the injection site. She knows that there was talk of surgery straight after the scan but the paperwork for this was somehow missed during the shift changeover resulting in a delay. Fortunately her friend had stayed on and was concerned enough to flag down a doctor and nurse after the shift change. With Amanda’s oxygen saturation now at just 90%, and as she started to lose consciousness, both medics sprang into action. 

It was at this point that sepsis was mentioned for the first time and Amanda says that she had no idea what it was. ‘I do remember being upset as I didn’t understand why they had started inserting needles and tubes into my arms, catheterising me and talking about surgery. I remember calling my parents around midnight and telling them I had sepsis (I gather I said ‘Probs best if you don’t Google it but they’re saying you need to come to the hospital’). 

Amanda woke in intensive care, where she stayed for the next couple of days. She was initially treated with broad spectrum IV antibiotics – around 15 bags per day, three of each kind. At that point, as far as she is aware, she also received 11L of saline and ‘was like a water balloon’. Because the surgery had been on one hip, Amanda was lying on her opposite side and the fluid in her tissues migrated to that side of her body. Weighing around 10kgs more than when she had arrived at the hospital, for the next week nurses were with Amanda almost hourly to empty her catheter bag. ‘I was on some really intense IV antibiotics,’ she explains, ‘as, despite removing the abscess, they didn’t know what bacteria was causing the issue.’ (It was eventually found to be staphylococcus.) Amanda underwent a second surgical procedure some two days later to ensure that all of the abscess had been removed which it had, along with a large chunk of gluteal tissue. 

Unfortunately, Amanda developed pneumonia at this point, which meant that she was unable to breathe for around a week without supplementary oxygen. Her potassium levels became critically low and she remembers the words ‘deranged liver function’ for a number of days post-surgery. She was therefore given a different oral antibiotic for the pneumonia and effervescent potassium tablets plus Oromorph and paracetamol for the pain.  

Amanda recalls having horrific nightmares in hospital and was unable to sleep or function without a fan as her temperature remained high until well after discharge. The day after she walked to the bathroom for the first time in a fortnight she was finally discharged, with around 20 tablets to take per day. Post-discharge was also the first time she Googled what septic shock was, ‘And I could tick off every single symptom,’ she says. She describes a feeling of devastation – until recently she had been a strong runner, having a bit of an ‘odd’ time with her health, and was leaving hospital barely able to stand, never mind walk the length of the car park to go home. 

It wasn’t until she was at home that Amanda says she really understood how serious the complications and lifelong effects of sepsis could be. She then realised how lucky she had been. She ultimately had only four weeks off running (two weeks as an inpatient and two weeks after discharge). She subsequently suffered hair loss and her skin later started to peel. Even now, five years on, she still suffers from recurrent infections. ‘I’ve been put on vitamin B12 injections for energy/fatigue, but beyond that my life is completely back to normal – there are so many points at which my story could have ended differently.’ Amanda says that she finds it astonishing that she was unwell for a fortnight before even getting to hospital, and how things then started to decline very quickly. She subsequently went back to visit the GP who sent her to hospital who of course knew about sepsis. ‘It was great to have a discussion about it. If only we’d known the signs and symptoms sooner though the situation might not have become so severe,’ she says. 

At the point that she was diagnosed in the acute medical unit, Amanda says that she didn’t have a clue what sepsis was or what was happening to her. She recognises that with the level of confusion she was experiencing at that stage in her illness it is unlikely that she would have had the capacity to understand or to make decisions about her medical care. ‘Possibly fortunately, I also don’t remember much about my family’s reaction. They were there in intensive care when I woke up, but I didn’t get a sense (or don’t have a memory) of what they said. I know my mum would have gone online to understand more, but we didn’t talk about what it meant or what might happen,’ she explains. 

Amanda knows that she was told by the surgeon that if he didn’t do the surgery immediately she might not make it to the next morning. Two junior doctors – fellow runners – with whom she later shared her discharge letter told her how lucky she was to have survived at all. She is therefore under no illusion about the poor outlook at the time, but is grateful that the final outcome was as it was. 

‘I’m back to running regularly and I completed my PhD (I was in Year 1 when this happened)’ she explains. ‘I also represented Scotland at an international road race this year. I do still seem to be more susceptible to infections, and I need the B12 supplementation to help with energy, but happily I don’t seem to have any other long-term effects or consequences.’ 

Amanda’s friend who was with her in hospital won a prestigious short story writing prize a couple of months after she was discharged and he donated his prize money to Sepsis Research FEAT in both of their names. She has followed the charity’s social media accounts ever since and has kindly  shared content about sepsis every September during Sepsis Awareness Month. ‘By sharing my story I hope that I can help people to understand that sepsis really can strike anyone at any time – I was otherwise really fit and healthy – it doesn’t discriminate. If my story can help raise awareness of the condition and the symptoms and help stop other people suffering such severe illness, that’ll be a huge positive.’ 

Amanda believes that ignorance about sepsis is potentially dangerous given that the condition can progress so quickly. ‘It’s crucial for people to recognise the symptoms and act fast,’ she says. ‘I also think it’s really important to keep pushing your GP if you know something isn’t right – one GP sent me home telling me that I’d be fine. Around a week later I was in intensive care. Don’t worry that you’re bothering them or wasting their time – get things checked if you’re concerned.’