Friday, January 14, 2011

Know the Danger of Sepsis!

Recently, because of my post last week which made a reference to septic shock, I was contacted by the Sepsis Alliance, a non-profit that is trying to help people understand and avoid the danger of sepsis. A google alert highlighted me to them - that I am a survivor of sepsis (going up right to the verge of severe sepsis/septic shock but did not go fully into either).

Since that time, I have become connected to the non-profit, and the physician, Dr. James O'Brien, M.D., who leads many of their medical efforts. Surprisingly, what the Septic Alliance will tell you is that a recent Harris Poll study showed that only 1 in 3 Americans have heard the term "Sepsis," and even fewer understood how extremely dangerous it is. The non-profit is geared toward changing that, since sepsis is a condition that a little education will go a VERY long way.

ANSWER THESE THREE QUESTIONS: While you might know sepsis by another name, "blood poisoning," that might still not get your attention to appreciate the danger of sepsis. Instead, what if I described it with three questions:

QUESTION NO. 1: If you knew there was a very horrible carnival ride that you could go on called septic shock/severe sepsis, that 40% who went on it would die a pretty horrible death after being in an ICU for 3-4 days, and of those that survived, a VAST majority of the remaining people would loose your kidneys, fingers, legs, arms or other organs, would you volunteer to go?

QUESTION NO. 2: What if I told you that any sort of infection you might have (post surgery wound, strep, H1N1/flu, appendicitis, pneumonia, scratch, whatever), at some point if it is left unaddressed long-enough without proper treatment, could fester, go septic, and once septic, at some point it could slide - in a matter of moments - from sepsis into septic shock or severe sepsis, would you feel lucky? What if I also told you that there is not a real scientific way to know at what point people might go from infection into sepsis, then into severe sepsis, in each individual. Would you gamble your life?

QUESTION NO. 3: What if I finally told you that if it is caught early enough and treated properly - all infections can be cured without sepsis. Even septic infections, like mine, if treated quickly enough with IV antibiotics, fluids, and careful monitoring, are survivable without consequences that are so horrible. If you could never go on the ride in Question No. 1 above, would you want that detour instead?

Yes, of course you would. Sepsis does not have to kill or disfigure. You just need to seek medical attention for any infection that is at all bad, make an appointment with your regular doctor when it first seems to arise. If you are at all fearful or suspect sepsis, voice that concern to your doctor, to the ER, to any other medical professional that sees you, so they can rule it out. Sepsis does not have to kill 215,000 Americans each year. It is a medical emergency, but with early detection and treatment, your outcome can be like mine - survival without organ loss or amputations. For those wanting more details, I provide more below.

In a nutshell sepsis is your body's response to a severe infection; once the body believes it is sufficiently endanger, it will cause a series of events that leads to cascading organ failure in short order, that will kill almost 1/2 those that experience it. Does everyone go septic with severe infections? I don't believe it is known, but many people will go septic in such situations at some point. For you to decide where that point is, without medical advise, if decided wrongly, puts you into Question No. 1 above. Once you enter the ride, though, and you won't know when it begins, it is one of the most deadly things you can face.

Clinically speaking, patients are given a diagnosis of sepsis when they develop clinical signs of infections or systemic inflammation; sepsis is not diagnosed based on the location of the infection or by the name of the causative microbe. Physicians draw from a list of signs and symptoms in order to make a diagnosis of sepsis, including abnormalities of body temperature, heart rate, respiratory rate, and white blood cell count. I was septic with a localized, severe pain, a fever that started to show at around 100, a high blood pressure, an extremely high white cell count (13,100), and a high pulse. Sepsis may be diagnosed in a 72-year-old man with pneumonia, fever, and a high white blood count, and in a 3-month-old with appendicitis, low body temperature, and a low white count.

Sepsis is defined as "severe" when these findings occur in association with signs of organ dysfunction, such as hypoxemia, oliguria, lactic acidosis, elevated liver enzymes, and altered cerebral function. Nearly all victims of severe sepsis require treatment in an intensive care unit for several days or weeks. While most cases of sepsis are associated with disease or injury, many events follow routine, even elective surgery. While some patients may enter severe sepsis by shock, not necessarily all do. More frightening is that sepsis can rage in response to incidents as seemingly benign as a playground scrape or a nicked cuticle from the beauty parlor. American hospitals spend approximately $20 billion each year combating sepsis, 40% of patients diagnosed with severe sepsis do not survive. Until a cure for sepsis is found, EARLY DETECTION is the surest hope for survival. If these stats frighten you, and they should get your attention, consider watching the videos on the Sepsis Alliance website at:

For stories of people less fortunate than me, see: Their website provides a lot of great things to look for so you are better informed about sepsis, to save your life and those of people close to you. If you see why I feel lucky surviving sepsis, share this blog with your friends so they know how to be lucky and wise, too.

Friday, January 7, 2011

Catherine Wicker: You Are My Hero!

“When I was a child, I spoke like a child, I thought like a child, I reasoned like a child. When I became [an adult], I gave up childish ways.” 1 Corinthians 13:11 The quote above speaks to most of us, regardless of our religious beliefs. For most of us the quote reminds us of the carefree nature of our own childhood. Frankly, most of us become “grown-ups” when we first fully understand the complexities of life and the uncertainty of it all, when we are no longer able to live relatively carefree. Many children do not get such an experience, though. For some of these children, as with many extremely special things in life, they are like diamonds and other precious metals and gems – by the force of great pressure, their most precious light might shine brightly and provide a beacon to the world. One such beacon and star is Catherine Wicker. Catherine is a 14 year old freshman at Westwood High School, in Austin, Texas. If you were not paying attention, Catherine might appear at first blush like most young people. She is not.

Since the tender age of 5, Catherine had to give up her “childish ways,” and at the age of 10, Catherine had her colon surgically removed because of her health condition. Ulcerative colitis is an auto-immune disease and is caused by an abnormal response of the body’s immune system. The disease is marked by inflammation and ulceration of the colon, symptoms can include bloody diarrhea and severe abdominal pain. In severe cases, patients may in fact have their colons removed; most often, though, the condition only strikes adults this badly and not children so young as Catherine.

While such a condition itself would cause most adults many decades older than Catherine to lose heart in life because of the complexities that it can bring, Catherine at such a young age did not. Catherine simply dug in deeper and became more determined to show that her life had significant meaning and found the joys remaining to her. She has achieved that result. As a poet I could offer words capable of expressing things as beautiful as Catherine’s spirit, but as a lawyer I know that overly worked words do little in comparison to the facts.

Not too many years ago, many may know that I experienced diverticulitis and was on the verge of septic shock in an Austin ER at the age of 39. I was highly fortunate in surviving since septic shock kills a majority of those that suffer it. For many that do survive, they often may lose their kidneys or other organs; I did not but did develop IBS and have other recurrent health problems since that time. I came to understand better that life is fragile and the thought of losing organs was very scary even for me. I had, at least, enjoyed many opportunities up to that point without as much concern. I cannot imagine the weight that more expansive conditions could cause to a person so much younger.

Imagine your own life with such difficulties! Imagine being limited in activities that others enjoy, such as a basic party or a carefree vacation as a child. At such an age, if you are limited, your peers also cannot easily understand why you cannot join them, or how your life must be! Imagine the fear of standing out in such bright light and the desire that most would have to hide in the shadows and suffer silently. Catherine has stood strong and tall, even at her small stature.

In 2004, when Catherine was in the second grade, she stood in the halls of Congress to lobby for the efforts of the Crohn’s and Colitis Foundation. The foundation chose her as one of its two national Local Heroes (now called the Comeback Kids Award) several months later. In 2006, Catherine returned to Congress with her dad, Paul, to again lobby for legislation needed by adults and children with her condition. The following year, Catherine then set her sights on the Texas Legislature, initiating efforts for the Restroom Access Act, HB 416 of the 80th Regular Session, which became law in 2007.

For a bill that was hotly contested by businesses concerned about its effects, Catherine made sure to bear witness on how the bill impacted the needs of children, like herself, and adults, who have a health condition that can, without accommodation, be debilitating. On April 10, 2007, Catherine testified before the House Committee on Public Health for the Restroom Access Act. Catherine later also testified before the Texas Senate. How many of us have taken on the legislative process to help others with such courage? Anyone? I asked Rep. Mark Strama, the author of HB 416, for his thoughts on Catherine. With deep respect and admiration for her, he relayed this to me:

"When I give speeches to students about the government process and how a bill becomes a law, I tell them the story of how Catherine Wicker, while a fifth grader at Caraway Elementary in my district, convinced me to file legislation to help people who, like her suffer from intestinal illnesses. She then testified for the bill in both the House and Senate committee hearings on the bill, lobbied the bill through both houses of the Legislature, and stood next to the Governor as he affixed his signature to the newly created law. She changed the law in Texas to the benefit of 35,000 Texans who suffer these illnesses, and she did it when she was 10 years old. She has since lobbied me to buy Girl Scout cookies for troops overseas and to pass a resolution honoring her favorite teacher. She never stops.
"When she began working with my staff on the legislation we passed together, I remember someone asking her what she wanted to be when she grew up (as if she wasn't already grown up), and she said, 'I want to be chief of staff to a member of the House of Representatives.' Made my chief of staff happy! I remember when we attended the bill signing together 6 months later, and the Governor asked her what she wanted to be when she grew up. She didn't hesitate: 'Governor.'"
Mark Strama, Member, Texas House of Representives, Dist. 50.

Catherine heart and brilliance is, however, not limited to only governmental affairs in her afternoons after elementary, middle school, and now the ninth grade. While she was at Canyon Vista Middle School, Catherine was selected as its volunteer of the year from Round Rock Independent School District. Although the school district stated that she collected 5,000 letters, Catherine would make sure to correct the report so we know she only collected about 3,000 and then she did a cookie pack of 1,000 c-rats for Operation Cookie. Catherine, after all, is a leader in the Girl Scouts and honesty and integrity are important to her. Catherine has been a Girl Scout for 9 years and has earned the highest award as a Junior Scout (Bronze Award) and as a Cadette Scout (Silver Award). Catherine is currently working on prerequisites for the Gold Award which is the highest award in Girl Scouting.

Over the years, Catherine has also been active in Austin Adoption Day, an annual event of the Austin Bar Association, Child Protective Services, CASA of Travis County, and other affiliated organizations. Being a proud “big sister” to Anna who was adopted, Catherine helped collect toys for several years for the children being adopted at Austin Adoption Day, as well as throughout the year in Austin. The Austin Bar Association recognized Catherine in its February 2006 edition of the Austin Lawyer for her efforts. Another year, Catherine selected Austin Adoption Day to receive gifts at her birthday party. Catherine’s family has a tradition that if she or her sister want a large group of friends to come to a birthday party, they choose a charity to receive the gifts. Catherine and her sister love the idea and the charities are certainly happy, as well, because Catherine and Anna know they have received a lot of blessings already. Catherine would likely tell you that she wants to help children who are less fortunate than herself. With Catherine now in high school, her leadership is growing in the community.

Catherine was selected to be a member of the Youth Advisory Council at Dell Children’s Hospital. Catherine is also a part of Girls Giving Grants, where each girl donates $100 and the group pools all the money together and awards one grant to a charity. This is her age group's equivalent of Impact Austin. Catherine earned her $100 by babysitting last summer. She is also a manager for the Sun Dancers at Westwood and is in the school choir.

Life continues to be much harder for Catherine then most adults, let alone children, regardless of their age. Catherine's serious health problems continue even now, with other complications are on her horizon and even more surgeries likely. She misses school frequently for her illnesses, and for more visits to specialists than can be remembered, who are either trying to address her known issues without certain resolution, or trying to solve other issues also causing her problems still unknown or identified. For Catherine, there may not be a "magic pill" that many of us grew up expecting and wanting - that when you take it, you feel good the next day or next week, and get to go back to playing for weeks, or months, or years. For Catherine, her life will likely always be much harder than most others.

My own health struggles over the last several years have taken a toll, not from simply any individual condition, but the lack of those long periods where I could simply relax, enjoy life, and be. The mental toll on myself has been tough at time, and my struggles has been relatively short term and less serious when compared to Catherine's. However, I try to take courage and strength from knowing that there is a young woman out there, who since the age of 5, has carried more struggles than I may ever know. I also hope that she understands that the world is cheering her on, sending her love, and that she is not alone for she dwells in the hearts and hopes of not only those who knows her, but also those that read this story, or otherwise hear about her amazing courage and spirit.

Catherine, I think I speak for countless people beyond the boundaries I can easily describe, who would tell you, in the words of Bette Midler, "Did you ever know that you're my hero?" You are.

UPDATE:  In 2012, Catherine was recognized by President Barack Obama for her volunteer activities.  For the President's Volunteer Service Award, she performed 284 volunteer hours.   She also participated in Mark Strama's Leadership Academy and was able to meet Sarah Weddington, with whom Catherine is photographed above.  Through her activities, she continues to be increasingly known in Austin and elsewhere for her exceptional character, leadership and intelligence.


Monday, January 3, 2011

Remembering Lori Tullos Barta (ABA)

Lori Tullos Barta (Posthumous)
2011 David H. Walters Community Excellence Award
Austin Bar Foundation
To be awarded Jan. 29, 2011
Four Seasons Hotel, Austin

For those who might like to know, my friend Lori will receive the above award from the Austin Bar Association posthumously on January 29, 2011. For people who would like to read the nomination that was submitted by so many, I have found a way to post it here. For more information about the event, see The text is small, but if you click on the individual pages, they become a little easier to read. Laura Sharp is entitled to a large portion of the credit for organizing and drafting this eloquent nomination. Thank you, Laura. Shannon Meroney also helped a lot with the nominations, so thank you, Shannon, as well. When Lori was transferred to Seton Main, Shannon was a huge help in making sure that the Seton staff gave her extra special care.

Addendum: I have posted an additional tribute email to Lori at Additionally, I will be posting a video from the Austin Bar Foundation Gala on YouTube so check back here for that, as well.

Addendum: The Austin Bar Foundation Gala video is at: