It was so sudden. From feeling unwell at Christmas lunch to life support by Boxing Day. By minutes, by degrees, by escalating seconds, a deadly infection was taking hold.
Christmas 2018 was a big, hot, hectic family lunch for the O’Dowd family. The shrieks of children opening presents, the Sydney temperature climbing towards 30 degrees Celsius, crackers and corks popping.
As usual, Mick O’Dowd was in charge of the barbecue.
“It was super busy because we had the whole family here,” he tells Australian Story.
Normally he would start the day having a couple of cans of Guinness with his father, Vince. But Vince noticed “Mick didn’t seem to be involved in the conversation, he wasn’t like himself”.
In the driveway, Mick’s four-wheel-drive ute was packed and ready to go. Once Christmas was over, he, his wife Katharine and their two children would be hitting the road for a glorious four weeks of camping in the Victorian high country. A mechanical engineer, Mick had modified the vehicle, adding a fold-out kitchen, shelves and drawers.
“It was going to be the holiday of a lifetime with the kids,” Katharine says.
In those busy, happy, pre-Christmas weeks, Mick had felt pain in his right glute but had put it down to being an avid cyclist; he must have pulled a muscle.
While he was cooking he began to feel “really hot and uncomfortable”.
Mick was taking Nurofen, stretching, lying down, sitting, but with everything he tried it hurt more. “It just seemed to be getting worse and worse,” Katharine says. Her mother, Margaret Young, had never seen Mick going to lie down as he did that afternoon.
By that night, the pain, says Mick, had become “excruciating”. The only thing to do was to go to emergency.
Christmas night was a slow night at Canterbury Hospital. By the time a nurse came to see him, Mick was moaning in pain. “I remember being outside leaning up against a brick wall just trying to breathe through the pain,” Mick says. Endone “didn’t really do anything”.
An examining doctor diagnosed sciatica.
At 7:00am on Boxing Day he was discharged and sent home with painkillers. Katharine was surprised. She could see he was still in a lot of pain.
The emergency doctor had advised Mick to see a GP if the pain got worse, but being Boxing Day they couldn’t find an open medical centre.
They could not have known they were wasting precious time, time in which everything that was to follow could have been reversed. Or that it would be a year before Mick would go home again.
Mick doesn’t remember much after that. Driving to the hospital, he felt as if he was dying.
Back at Canterbury Hospital, his blood pressure was low, his heart rate was high, his breathing shallow.
Things suddenly got serious. He was moved into the resuscitation ward and then transferred to Concord Hospital, which was bigger with more resources. A stunned Katharine “still didn’t understand what was happening”.
‘My hands were completely black and withered’
Mick was diagnosed with sepsis, an overwhelming immune response to an infection that spreads throughout the body, affecting multiple organs.
The infection was racing, Mick’s body was shutting down. Intensive care staff were giving him doses of medications that were, says emergency surgeon Paul Della Torre, “virtually unheard of”.
Mick was on life support. He had a 20 per cent chance of making it to the morning.
“The doctors explained that the initial infection in Mick’s muscles was strep A myositis, just a very common bug that had somehow made it into Mick’s bloodstream and had attacked his muscles,” Katharine says.
“So that in turn led to septic shock and multiple organ failure.”
Mick was one of 55,000 Australians who contract sepsis every year, at least 7,000 of whom will die.
“It causes more deaths than some of the common cancers we know about … but more than half the population have never heard of it,” says Simon Finfer, who manages the Australian Sepsis Network.
He says every hour you delay diagnosis and treatment, the risk of someone dying increases by about 8 per cent.
“If they don’t give you the correct medical treatment in a very small window, it can be deadly,” Mick says. “The death toll is higher than the road toll. The sooner you get to it, the better off you will be.”
Because he was fit and resilient, Mick’s body fought and responded in small incremental amounts. “At no point in time did we think it was hopeless,” Dr Della Torre says.
It seemed like a miracle to Katharine when he woke from his coma on New Year’s Day.
And Mick knew, straight away, he knew.
“I was looking at my hands and seeing how black my feet were,” Mick says.
“I just remember looking at my hands. They were completely black and withered. I just thought, ‘OK I’m going to have to have amputations because it is dead tissue and that’s the only way I am going to survive this.'”
“Mick’s limbs were dying,” Katharine says. “I was devastated.”
But Katharine was determined that Mick would survive.
“She’s a special person,” Mick’s father, Vince, says. “I don’t think anybody else would have had a love for somebody that she had for him.”
‘A typical young family’
Mick and Katharine, a mechanical engineer and urban planner, had met 11 years earlier on an internet dating site.
It had a comprehensive questionnaire and he was the first person she was matched with. They met in a coffee shop and hit it off.
“I thought he was a really interesting guy, very able to carry on an interesting conversation and interested in what other people have to say. Also pretty comfortable in himself.”
He was very fit, into cycling and scuba diving, and they shared passions for the outdoors, camping, cooking and travelling. Her friends could see that he made her laugh.
For Mick’s part: “I just really liked her. I felt really comfortable around her. She didn’t mind me having a few beers, which was good. We would watch sport together, rugby or cricket.”
They went on a holiday to India together. “That was a pretty good test,” Katharine says. “If you can make it around India and still be friends you’re onto a good thing.”
Fast forward to Christmas 2018, they were a typical young family; two kids and busy working. “They were doing the juggle,” says their friend Julia Pressnick.
But now the couple would find out what they were really made of. Who they really were.
‘Quad squad’ gives Mick hope for future
Doctors explained Mick would need to have both his arms and legs amputated.
“I was struggling to understand what that would mean and what kind of life he would have,” Katharine recalls.
She searched the internet and came across a Facebook group for quad amputees called the Quad Squad and a blog by Matthew Ames, whose story was remarkably similar to Mick’s.
In 2013, an infection got into Matthew’s bloodstream and the only way to save his life was to remove all his limbs. He too had a young family and was also an engineer.
“On his blog, he has pictures of himself with his children post-amputations and he’s smiling with his family. It was so important to me to see that having been through that, he was happy,” Katharine says.
He replied quickly to her email. “It gave her hope, an idea of what life could be like,” says Katharine’s mother Margaret.
Mick had all four amputations in one operation. But even then he still had a long way to go. To close the stumps they had to take healthy skin from Mick’s body, creating wounds that needed to heal, to be dressed, and then do it again.
“That period was just difficult, so painful,” Mick says. “I’ve got donor sites — a big one on my chest, I’ve got one on my back, I’ve got one on my side, my left side of my rib cage, and they also took skin from my scalp three times.”
He was in ICU for six months, unable to speak for much of that time because he had required a tracheotomy tube. But day by day, Mick got stronger and better. When they took the tube out, “Just being able to eat again was really good and being able to talk to Katharine.”
It was an emotional day, leaving the hospital after eight months. The staff, says Mick, “who kept me alive” all came to see him off.
“It was hard to leave what had essentially been a second home,” Katharine says.
“The team at Concord went above and beyond. There are no words to describe how grateful we are. It was a huge moment going through those doors.”
And then it was more gruelling months of rehab at the Prince of Wales Hospital. “It’s a step by step proposition,” Mick says. “It’s about setting small goals. My focus was just to get home.”
But now there was Matthew Ames alongside him, online from Brisbane, to guide and advise.
“All through this time, I’ve been checking in with Matt and he’s been telling me what I can expect, how it takes a bit of time to get the right prosthetics,” Mick says.
Katharine says the pair has a fantastic relationship.
“They are both engineers and they have very technical conversations that are very involved. They both have an amazing spirit and amazing determination and an ability to focus on just the next step that they need to take to get through this.”
Adapting to life as a quadruple amputee
A year after that ill-fated Christmas lunch Mick, came home to a new normal.
“It’s hard to imagine sometimes what life was like before this happened,” Katharine says. “But you just adjust each day and look for the positives. I feel lucky every day that we still have Mick.”
And Mick is still Mick.
“He’s still the same guy I fell in love with. Still the same strong, determined, courageous, funny man,” Katharine says.
“He has some new layers of depth I think. And we’re lucky that we have the family and community and friends behind us that we have.”
Mick takes the children to school in his speedy power wheelchair. “I think I’ll have some good mechanical hands in the next few weeks, and once I have arms and hands, it’s on to the legs,” he says. “Then maybe driving a special vehicle in a year or so.”
A few minutes can change your life. Mick and Katharine don’t dwell on those lost hours on Boxing Day 2018 which could have seen things turn out so differently if doctors were trained to look for sepsis, but they and Matthew are determined to raise public awareness so this doesn’t happen to others.
They are working with intensive care specialist Professor Finfer who, through the Australian Sepsis Network, has taken on the role of trying to improve the healthcare system’s response to sepsis.
“This knowledge and expertise and education around the recognition and rapid treatment of sepsis has to be rolled out across the entire healthcare system — the ambulance officer, the general practitioner or the emergency department,” Professor Finfer says.
“And we need people to know when they have an infection to know if it’s something more serious, that it’s developing into sepsis, and they need to get themselves to hospital to get early treatment. To actually say to the staff who meet them, ‘Could this be sepsis?'”
Mick would like to get back to working on cars, to camping and the bush, to scuba diving. He remembers the “magnificent” sunrises on the flat seas going out through the heads of Sydney Harbour.
“It’s just a matter of keeping working at it and just being patient,” Mick says.
“The Google smart home stuff for people with disabilities is fantastic. I’ve got a lot of voice control around the house. I can turn heat on and off, lights on and off, get blinds to go up and down. I’m working on getting curtains to open and close. I can get wheelchair taxis. I’ve got a lot of independence.”
Five years ahead of Mick in his own post-amputation journey, Matthew feels confident about Mick’s future.
“Mick’s the kind of guy who makes those choices to focus on the things that he can do and looks for the opportunities in any situation. So my experience with Mick and Katherine is that, you know, I think they are going to be just fine.”
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