Septic shock nearly killed him

Financial advisor Kevin Tang developed a serious inflammatory response soon after he had some teeth extracted. He survived to tell JUNE CHEONG about it

Having his teeth pulled nearly cost Mr Kevin Tang his life.

The 33-year old financial adviser developed septic shock from a simple tooth extraction last year.

Mr Tang had wanted to correct the alignment of his teeth and four of his pearlies were removed to permit the fitting of braces.

He then went home.

Little did he know that an ordinary dental procedure would become life -threatening.

He said: "I started vomiting severely after the extraction. I was so weak I stayed in bed all day.

"I thought it was just food poisoning. It wasn't until I collapsed twice at home one day later that I felt it was something more serious."

As his family lives in Australia, he called a friend who rushed him to hospital.

Septic shock is a serious medical condition which is caused by a person's blood pressure falling to a dangerously low level. The trigger is often a serious bacterial infection developing in the blood. The body will react with an inflammatory response. This is known as sepsis.

If the sepsis is left untreated, septic shock may occur and blood pressure drops dramatically.

This fall in blood pressure will affect the oxygen supply to major organs like the heart and brain. The reduced blood flow may cause the tissues of vital organs. such as the liver or intestines to die.

"In many cases, it s a bacterial organism that causes septic shock, which is the body's response to infection in a severe manner.

"It's an overwhelming immune response and it can affect other organs like the kidneys and liver, said Dr Jagadesan Raghuram, head of the division of respiratory medicine at Changi General Hospital.
 
Besides bacteria, fungi and some viruses can also cause septic shock.

The condition is more common in the very young those middle-aged or older patients with illnesses like kidney failure or whose immune systems are compromised.

Symptoms include fever, dizziness, breathlessness, pain during urination, low urine output and rapid heart rate. Such symptoms may appear within hours of infection to a day later.

The lungs, kidneys and liver are hot spots for bacterial infections that can cause sepsis.

Dr Raghuram said: "The lung is a common site as it communicates a lot with the environment when we breathe.

"Kidneys may have underlying problems like stones while the liver may have problems like gallstones."
 
Hospital settings are not immune from the bacterial infections that cause sepsis.

Septic shock is considered a medical emergency so patients are usually admitted to an intensive care unit (ICU). That was where Mr Tang was taken to on admission.

Treatment includes inserting an intravenous drip of fluids to support the patient's blood pressure level, antibiotics drugs to modulate the immune system and the close monitoring of vital signs.

Dr Raghuram said: "We resuscitate the patient aggressively during their first six hours in the ICU. The idea is to support him through the crisis."

For Mr Tang, it was to be a long struggle. He said: "The next thing I remembered was waking up and my family at my bedside. No one knew if I would survive.

"I was in the ICU for almost three weeks, drifting in and out of consciousness. I was on a drip and fed intravenously. Nearly all my major organs like my lungs, liver and kidneys had collapsed."

Mr Tang tried to stay positive but the daily stream of bad news from doctors' medical assessments and the pain of treatment took its toll.

He said: "Kidney dialysis was painful. There was also a time when they put me on a no-fluid diet for a few days. That was torture.

"I was already so miserable with tubes sticking out of me and undergoing dialysis. And I couldn't even have any water.

The aggressive regimen worked and Mr Tang pulled through. He is considered one of the lucky ones.

The mortality rate for septic shock is between 30 and 70 per cent, said Dr Raghuram. Also 10 to 20 per cent of survivors suffer long-term effects like kidney failure.

Mr Tang's recovery process, which took a year, included re-learning daily activities like sitting up, walking and showering. Fully recovered now, he plays tennis, jogs and swims every week.

He said: "I look back and I'm amazed I managed to get out of something that was so close to death.

"One thing I have learnt from this episode is that whatever you tell yourself to achieve, be it health or happiness, you can do it."