Nurse eaten alive for five years

Waking from a fog of anaesthesia, Sandy Wilson found she was a patient in one of the hospitals where she worked as a nurse.

She remembered having a baby, and being told she had got an infection. But nothing could prepare her for what lurked beneath the sheets.
  
Flesh-eating bacteria were eating her alive.

''When I looked down at my belly, basically all the skin was gone and I could see my internal organs,'' she said. ''I remember seeing my intestines. I thought, 'There's no way I can live like this ... This is a death sentence.'''

In all of medicine, few infections are as feared as this one. It strikes out of the blue, especially obese people, diabetics, cancer patients, transplant recipients and others with weak immune systems, a growing group of Americans. It kills 20 per cent of its victims and horribly disfigures others.

It used to be caused almost exclusively by one type of strep bacteria. Now there is a scary trend: drug-resistant superbugs like the staph germ MRSA increasingly are able to make ''flesh-eating'' toxins and cause nightmarish infections like Wilson's.

To treat it, doctors cut away dead tissue, but the infection often advances after they think they have got it all.

Inch by inch, it devoured the 34-year-old Wilson. Spleen, gall bladder, appendix. Part of her stomach and ultimately, all of her intestines.

Over five years, she had countless surgeries, including an unusual organ transplant. For much of that time, she lived in hospitals and rehabilitation centres, fed by tubes and unable to give her young son a bath, to read him a bedtime story, to tuck him in at night. She lost her marriage and endured unimaginable pain.

''It was like I was rotting from the inside out,'' she said.

''It was like something out of a very strange science fiction movie,'' said her mother, Dottie Howarth of Columbia, Maryland, also a nurse. ''I was very afraid that she would not make it through this.''

No-one knows how Wilson got necrotising fasciitis, the infection's formal name. The ordeal began after her son, Christopher, was born by cesarean section on April 1, 2005. She developed a clotting problem and was given blood components pooled from hundreds of donors.

After several weeks, she went home but lasted only two days. Fluid built up around her C-section and her blood pressure plunged. She sought emergency care at an hospital in Annapolis, Maryland, and was rushed into surgery, but doctors quickly closed her up once they realised what she had.

They sent her to Baltimore's Shock Trauma Centre, a state-of-the-art hospital specialising in the most dire, life-threatening cases. It is part of the University of Maryland Medical Centre, where Wilson worked as a pediatric emergency nurse.

''I remember vividly'' how sick she was, said Dr Thomas Scalea, Shock Trauma's physician-in-chief. ''Some people don't live. Sometimes you do the best you can do and the disease is bigger than the medical care. The fact that she was a nurse at our place, that she had just had a baby, all of that made it very, very hard.''

For two weeks, Wilson was kept sedated while surgeons sliced away rotten tissue and drained vile fluid.

''I can't tell you the number of times I operated on her; probably 40, 50 times,'' Scalea said. ''Every time we went back, we just hadn't got control.''

Once Wilson was stable, the doctors gathered her family to wake her and break the news.

Wilson remembers peering under her hospital gown and seeing what looked like yellow Saran Wrap over her intestines.

Loopy from the painkillers, she thought she was in a sci-fi movie ''and that they were turning me into a robot.''

She feared her baby was dead, that it was somehow her fault, and that she was being punished. Her family brought him to see her through a window, but she accused them of borrowing a baby from the hospital. They took pictures of Christopher at home with newspapers showing the current date, like kidnappers do to prove a captive is alive. She remained unconvinced.

Finally, when he was several months old, they put her in isolation gowns and brought him to a conference room. A tiny arm poked out of his blanket.

''I have a freckle on my right arm and he has one on his left in the same spot. I remembered that,'' Wilson said. ''That's when I thought, 'OK, he's here; he's real. I've got to get back home to him, to get better now.'''

But the germs had only just begun to ravage her.

As 2005 neared its close and she was being discharged from a rehabilitation hospital, she fell ill again. She had developed fistulas - holes in her bowel that let its contents leak out to her skin. She spent the next two years in Shock Trauma or the rehab hospital, trying to heal those open wounds. Her family brought Christopher to visit a couple times a week.

She found comfort from Reiki, a Japanese healing and self-improvement technique, acupuncture and guided visual imagery, alternative therapies that she said gave her a sense of control when she was so helpless.

She has had surgeries to graft skin and to connect the transplanted bowel to what remains of her colon so she would no longer need to wear a bag to collect waste. The last of these operations, everyone hopes, was in February.

''My life now is pretty normal. I am enjoying spending every moment I can at home with my son,'' Wilson said.

She has a bold goal: to return to work, possibly to the hospital where she went from nurse to patient and, hopefully, to nurse again.

''I would like to be able to help someone else who has gone through this.''

- AP