Five years ago next week, my husband almost died of septic shock.
To set the stage – at the time this happened, I was only 31 years old and he was 37. We had two small children, ages four (a preschooler) and eight (third grade). I’ve talked about this story before in my writing and comments, but this will be the first time I’ve gone through the details of what it’s like to survive through a catastrophic medical event. This may get a bit long, so I hope you’ll stick with me. After going through my story, I’ll tell you all about the financial implications this event had – it’s the reason I’m so passionate about emergency funds and emergency plans; health, disability, and life insurance; and total debt freedom. Given that I haven’t written out the entire story before, I wanted to both to honor his five years of recovery and share with readers the full story behind why I’m so passionate about all of these things.
Every year, about 250,000 people die of septic shock. It’s essentially your bodies overwhelming response to infection. If left unchecked, even for a short period of time, it will cause your organs to shut down and you will die. The fatality rate is over 50%, and some sources have it as high as 70-90%.
This was the event that was the catalyst – the pivot point – for everything that followed. After this, nothing was ever the same again. My outlook on life, work, and money, completely changed.
When Everything Went To Hell – What a Real Emergency Is Like
Back five years ago, my husband had just had an abdominal surgery, and was supposed to be in the hospital a few days recovering from it.
We had scheduled the surgery for when I had a week off from my MBA in mid-March so I could spend time with him at the hospital. While my fellow students were enjoying their spring break, I was preparing to hang around a hospital all week. I also took a few days off work, fully expecting him to be home by the weekend – in the hospital for maybe 2-3 days total. I had brought lots of things for him to do, thinking that he would be laying around bored, recovering a bit more each day. How wrong and naive I was.
But instead ,that surgery went horribly wrong.
The first sign things were not going well was during the original surgery. It was supposed to be laparoscopic and take about 2 hours. About an hour into it, the surgeon came out to me and told me they had to do it as an open surgery instead. And instead of taking two hours, it took four. But they told me it went well overall, and brought him upstairs to the hospital floor
For a few days, he seemed to be getting better, but then he started getting worse. He wasn’t able to walk around, like you’re supposed to after surgery. He started to feel more and more pain. He started running a fever. The hospital seemed pretty dismissive of this, thinking he was just a complaining patient. After all, he was young and looked healthy. He must just want more pain meds. They did take some blood samples to check for infection, but that would take a few days. And those were days he didn’t have.
Sunday came and he was looking even worse. His doctor told me that if he wasn’t better by Monday, they would do a CAT scan. When I visited him, I was scared. He was in so much pain he couldn’t get out of bed. His stomach was hot, hard, and red-none of which it’s supposed to be. He told me he had been shaking in the middle of the night, and around noon I saw it. He was having tremors so bad he was shaking the bed-like a seizure. That terrified me. Something was very, very wrong. I have zero medical expertise but IT WAS JUST NOT RIGHT. I called urgently for the staff to come and help him.
They decided to prep him for a CAT scan that evening instead of waiting until the next morning. After prepping for the scan, they brought him down in a wheelchair. I went downstairs (to get a coffee I think) and when I came back up he was back in his room. So were 5 other people. The Physician Assistant (PA) told me that he had to have another surgery, and his surgeon was on the way to the hospital already. They got him back into bed and wheeled him down to the surgical center-we were running down the hall. I had never before seen people in a hospital move so fast.
There was a second emergency surgery at 8 PM on a Sunday night.
I made an urgent call to my mother, who was watching the kids, as we ran down the hall to the surgical center to tell her that I wasn’t going to be home for a while and to let the kids sleep over. My sister in law had happened to come for a visit right when we found out he was going in for this surgery. So luckily I wasn’t alone.
By the time we got to the surgical center, his surgeon was already there, prepped, and waiting. She must have driven down there like a madwoman. It had only been maybe 20 minutes since the CAT scan. Remember, this is 8 PM on a Sunday. The surgical center was empty except for us, the surgeon, and the anesthesiologist. They brought him in and my sister in law and I went up to the waiting area. We were soon joined by my husbands parents, and we all waited the two hours until the surgery was done.
At 10 PM, the surgeon came out and said everything had gone well and my husband was in recovery. She said that they may send him to the ICU for monitoring, or back to the hospital floor – they weren’t sure yet. So we waited another half hour or forty five minutes in the waiting area. Then they came in and said he was having “a bit of trouble” and was going to spend the night in the ICU.
Little did I know what had actually happened during that time-I wouldn’t find out until later. After the surgery, his oxygen and blood pressure levels crashed to horribly low levels. He had gone into septic shock from infection, was unable to breathe, and his blood pressure had crashed terribly. They literally ran him down too the ICU. The ICU staff threw the surgeon out and started massive interventions – some of which I didn’t know existed. They put 20 bags of fluid into him to try and stabilize his blood pressure. They put an IV into his neck (did you know they make neck IV’s? I didn’t.), and put him in a coma and on a ventilator. This all took several hours.
My in-laws and I were in the ICU waiting room and I was getting more and more anxious. Remember, I don’t know anything right now about what’s going on, just that he’s in the ICU. One of the ICU staff came out with a form for me to sign outlining all the interventions they were doing. When I asked how my husband was, they told me they were getting him comfortable. Of course what they were really doing was trying to save his life.
After midnight they let us in to see him. It’s a sight I will never forget-he was in the ICU, in a coma, on a ventilator, with a neck IV and regular IV’s, with five or six different IV poles behind him – each of which had five or six bags of something on them. There was a TV in the room that had his stats- oxygen, blood pressure, pulse rate. One look at those and even I, not a medical professional, could see they were just not right. His blood pressure was 60/30.
We all stood around and talked with him for a bit, letting him know we were there. Then we all headed home to rest up for the next day. Driving home, I gave the biggest scream. I was absolutely terrified. I went to my parents house, where my kids were, and tried to get some rest. But I got maybe two hours sleep.
Then he was in the ICU for a week, in a coma, on a ventilator, on massive amounts of drugs, fighting to stay alive.
This week is burned into my mind-it’s probably the one week of my life where I can remember every moment clearly. The next morning, on two hours or so of sleep, I had to get up and get the kids off to school. It was Monday, and I was supposed to return to work. After the kids were off to school, I went home and sent an urgent email begging my boss and a co-worker to call me as soon as they received it. They did, and I told them what had happened and that I wouldn’t be coming in. I sent over all my meetings to my co-worker, set my out of office, and declined every one on one meeting. After this I would keep them updated through early morning e-mails.
Day one – I went back to the hospital to spend the day. My mother, grandmother, and mother-in-law made arrangements for alternating watching the kids. There were ICU nurses in his room all day. A social worker and a priest both came to visit the room. I was pretty much a wreck all day. I sat next to him, held his hand, talked to him, and just stayed silent. This was the day I learned he had gone into septic shock. I didn’t really know what that was, so when I was out of the room I googled it on my phone. Don’t ever google septic shock. At one point, the ICU nurses told me to go home for a while and try to get some rest, because I was in bad shape. I did go home, and I tried to rest, but no dice. I returned in the evening, somewhat calmer, and stayed until around 8
The intensivist (intensive care doctor) said something to me that day that’s been my motto whenever times are tough. “We all wish this hadn’t happened,” she said, “but it did. So now we need to move forward.”
Day two – First thing in the morning I called to see how he had done overnight. No change. Family members were coming and going, visiting for a bit. I couldn’t eat anything and was surviving on coffee. I spent quite a bit of time on the phone with my sister and brother in law in Florida, updating them on what was going on. And I was just sitting there with him. No real change in his condition. This was the day my eight year old son asked when Daddy was coming home. I had to tell him that Daddy had gotten very sick and the doctors had made him go to sleep for a while to get better. I began to think how I would tell my kids that their father had died.
Day three – My brother in law called to say he was coming up from Florida. Still wasn’t eating. More coffee, more morning e-mails to work, more more people coming in and out to visit. I started to see some improvement-they were able to take him off the blood pressure stabilizing medication and he had less total IV’s. There was a patient next door, a 20 year old dying of lupus, that kept the ICU waiting room full at all times with visitors. She would die the next day.
Day four – Brother in law came up from Florida. They started trying to reduce the medication keeping my husband in a coma, but every time they let him wake up, he was completely freaking out. Of course he was still on the ventilator with that neck IV, likely in tremendous pain, and completely disoriented. My four year old son told me that night that he missed his “four family”, meaning he wanted all four of us being home. It broke my heart.
Fortunately, he was able to come off the ventilator and out of the coma five days later, but was hospitalized for another week with various procedures (abscess drain, lung drain, drugs for an ecoli infection, etc.). Then he had to go to a live-in rehabilitation facility for two more weeks.
The fifth day, when I got to the hospital, my brother-in-law was already there with him – and he was awake! And not freaking out! I’ve never been happier in my life than I was in that moment. He was still on the ventilator, but after we’d been there for an hour, they asked us to step out so they could remove it. When we got back to his room, he was able to talk to us. We were all so happy that we didn’t realize for a bit that he had no clue what had happened. He didn’t realize what day it was until his mother made a comment that I hadn’t left his side for days. He looked at us and asked hoarsely “What day is it?” We were all silent for a moment until I replied “Thursday”. He just stared and said “I lost a week of my life??”
When you hear stories of medical catastrophe, they usually end one of two ways. Either the person involved doesn’t make it and they pass away, or they make it and get better. I know just how lucky I am that it ended in the “get better” way. But what I didn’t realize was that recovery from this kind of thing is more of a “two steps forward, one step back” kind of process. He came off the ventilator, but the next day they had to put him back on more powerful oxygen because his O2 levels weren’t stable. He started hallucinating, and vomiting bile – the result of an abscess. After going on the hospital floor, he seemed to be getting better, but slowly. Turned out he had a large amount of fluid around one of his lungs, and had an ecoli infection. They started him on a unique kind of antibiotics (the hospital staff said they rarely saw it on the floor), and had the head of infectious disease for the hospital come and help care for him.
He had to go to a rehabilitation center-the youngest patient there – not only to recover and get physical therapy but also for the 24/7 skilled nursing care. In fact, he spent Easter there that year, although he was able to come home for about two hours for a brief visit. He ended up back in the hospital again toward the end of that time, with another minor infection, but then was able to come home. The first time he set foot inside the house, it was over a month after he had left for the hospital. The trees had turned from bare winter into springtime glory. Once in the house, he looked at me and asked “is this a dream?”.
The two left pictures were taken at the rehabilitation center’s Easter celebration for their residents. The one on the right is from when my husband was able to come home for a few hours in the afternoon on Easter to visit.
Once home, he had visiting nurses coming every few days, constant doctor appointments, physical therapy, a wound-vac, more drugs than I can count, and eventually – another surgery with another hospital stay and more recovery. There would be another, more extensive, reconstructive surgery a few years later. Now, five years later, we can look back and say that he recovered. But at the time, it was always uncertain.
I can’t emphasize enough just how much septic shock disabled him. When he came home after a month away, he couldn’t even walk up the stairs. We had to put the bed in the living room for months. I had to remodel the bathroom so it had a walk-in shower, because he couldn’t step up over a tub. He was only 37 years old, and had been perfectly healthy before this all happened.
Going Into Crisis Mode – Putting A Tiered Emergency Fund and Emergency Plan Into Action
I remember when it occurred to him how much financial trouble this was all going to be. See, this was right smack after the Great Recession when many were still unemployed. His factory had closed and at the time he had been receiving unemployment payments. Because he was in the hospital and unconscious, he couldn’t file and for obvious reasons couldn’t look for work. He wasn’t eligible for SS disability, and didn’t have disability coverage. He called me one night in a panic, a few days after he woke up from the coma, telling me that he couldn’t file for unemployment and he was really worried.
“You’re worried about money?” I asked incredulously. “Don’t worry about money right now! Worry about getting better!”
Was I worried about money? Yes. I had set aside some funds to deal with the cost of the surgery. We were covered by a high-deductible health plan, which had both a high deductible ($3000) and a high out of pocket maximum ($7000). I had assumed we would need to pay for that, so it was covered. But in one fell swoop we not only had to pay the out of pocket maximum (ICU bills would total hundreds of thousands before insurance), but also had to pay for the million miscellaneous expenses not covered by insurance. There were new clothes because the old ones would irritate the surgical site, travel and eating expenses at the hospital and rehab center, banisters for the stairs to help him get up and down. Also, I worked full time and was getting my MBA – he had done all the child care while unemployed. Suddenly I also needed to pay for child care for our kids, who were ages four and eight at the time. Hundreds of dollars of expenses were added to the budget at the same time we lost hundreds of dollars in income. What were we going to do?
At this point we went into survival mode. We had an emergency fund, but it was lighter than I liked from him being unemployed (as I talked about in my 20 year journey toward financial independence). The concept of an emergency plan, rather than an emergency fund, was something I was familiar with from all the personal finance sites I read. Since I was familiar with the concept, I was able to sit down and put it into action without too much difficulty.
What’s an emergency plan and how is it different than an emergency fund? The traditional advice around an emergency fund is that it’s there for some kind of large unexpected expense- like a job loss, medical expense, or home repair. I had the traditional three month recommendation set aside. But that wasn’t going to be enough. Not only did we have a job loss, then a loss of unemployment compensation, but we also had a $7k medical expense and over $1k per month additional expense in child care. This was a real, true, hair-on-fire emergency.
The emergency plan helps you deal with all this. There’s an order in which you need to look at your financial options and quickly execute on drastic changes. Making it through an emergency requires quickly increasing your income – and decreasing your expenses – as fast as possible. This will be a temporary process. You’ll be able to re-evaluate as you go to determine if the crisis has passed and you can loosen your belt again. But this is the time for severe belt-tightening and slashing every possible expense. Originally, I was going to outline the steps to creating an emergency plan here in this article, but it’s already quite long (thanks to those who stuck with it!). So instead I’m going to point you over to what I already wrote on this topic. Also, the Bogleheads (where I first learned about the concept of a tiered emergency fund) has some great information on this topic.
When someone tells you that you don’t need an emergency fund because they’ve “never had an emergency where they needed a lot of money”, or that you should just invest your emergency money for a higher return, please ask them if they’ve ever been through a real emergency before. My guess is not – or their idea of an “emergency” is needing to buy new tires for their car. MY STORY is the reason you need an emergency fund and emergency plan. If you’ve ever been through a real emergency like this, you would never recommend investing emergency funds, skipping saving one, or anything else like that.
When you’re sitting in the ICU next to your spouse on a ventilator, wondering how you’re going to tell your kids their father has died, you don’t need to be worrying about how you’re going to pay the bills or whether the stock market is taking your investments.
Thanks to those that stuck with me to the end. Usually, this is the part of the blog where I’ll ask a question and ask you to follow me. But since today’s post is different, my request here at the end is different.
I’ll just ask instead that you consider my situation. Remember, I was only 31. My husband was only 37. Our kids were little. We never thought these kinds of things could happen to someone who was healthy. And we all wished it hadn’t happened. But it did. So we needed to deal with it. And if, god forbid, something like this happens to your or your family- I want you to be prepared. Please make sure that you have the right protections in place for emergencies, disability, health insurance, and life insurance. If you don’t, then don’t beat yourself up over it – just go out now and take care of things. For the sake of your loved ones.