Sepsis is a serious infection that can cause organ failure and death. If you have sepsis, you’ll need to be hospitalized, and you’ll probably spend time in the intensive care unit (ICU). So, recovery from sepsis isn’t fast or easy.
Michael Ditillo, DO, a surgeon with Banner – University Medicine, explained more about the steps you can expect as you return to health as a sepsis survivor.
Recovering in the hospital
Your recovery depends on you and how sick you are at baseline—the other health conditions you have—as well as how severe your sepsis is. If you were on a ventilator, your first steps would be to get out of bed and into a chair and to be awake enough to interact. “The idea that sick patients need to be in bed is changing. Mobilizing them, even if that means getting them into a chair, makes a huge difference,” Dr. Ditillo said.
“We try to keep sedation as light as possible because we know that gets you off the ventilator faster and decreases delirium. When you aren’t delirious, you interact better, and the more interactive you are, the more physical therapy you can do,” Dr. Ditillo said. Delirium increases your risk of dying within the next 6 to 12 months.
Most people will start working with a physical therapist while they’re still in the hospital. In the past, it was common for people to stay in bed when they were hospitalized, but now we know that walking, or even standing, can help speed recovery.
How long are most people in the hospital with sepsis?
It depends on the other health conditions you have, and how frail you were before you got sick. You could be in the hospital for three or four days or three or four months. Frailty is a bigger factor than age. “Age isn't as important as we used to think,” Dr. Ditillo said. Frailty factors into your body’s ability to fight off critical illness, which is a big predictor of how long you stay in the hospital.
Next steps in recovery
Many people go home when they leave the hospital after sepsis and follow up with outpatient rehab to help rebuild their strength. That’s most common for people who don’t have a lot of other chronic illnesses. If you aren’t healthy enough to return home right away, there are a few options for rehab.
Inpatient rehab is where you move to a rehabilitation hospital, usually for less than two weeks. You’ll have about four to six hours of therapy a day, so this is a good option for healthier people who can manage that much activity. “It’s designed to be a super-intensive, short stay,” Dr. Ditillo said.
Another option is nursing home care, where you’ll get one to three hours of therapy a day. Nursing home rehab stays tend to be longer than in inpatient rehab centers.
If you’re very sick, you might go into a nursing home for a prolonged period. You’ll need nursing staff to help you with daily living activities and rehab won’t be the main focus of your stay.
What you can do at home
Your recovery at home will depend on the strength and stamina you had before you got sick, as well as how your body responded to the infection and treatment while you were in the hospital. Muscle wasting (weakening or loss of muscle mass caused by disease or illness) can impact your recovery. When you go home, you won’t have the same energy level you had before. It might take several weeks or more before you can walk at the pace you used to or climb a flight of stairs without stopping to catch your breath.
If you had a bad case of sepsis, you might not be strong enough to get out of bed and go to the toilet at night without help. “It’s going to take time for you to get back to the way you were before, regardless of how sick you were,” Dr. Ditillo said.
Can you expect a full recovery after sepsis?
The healthier you were beforehand, the faster you’ll recover, and the more likely you are to recover fully. The sicker you were, the more help you’ll need.
“That doesn’t mean you can’t get back to the functional level you had before. That’s the goal. But the frailer you are coming in, the less likely you are to get back to where you were,” Dr. Ditillo said.
One of the unique and long term effects that impacts up to 50% of people who have recovered from a sepsis infection is post-sepsis syndrome (PSS). People who are older, had lengthy hospital stays or who were admitted to an intensive care unit (ICU) are at greatest risk of PSS, which can cause long term physical and cognitive impairment.
Dealing with mental health concerns
If you were in the ICU, you could be at risk for post-intensive care syndrome (PICS) . That’s because the care you need in the ICU can be traumatic. You’re in an unfamiliar bed, you might be strapped down, you’re not eating when you want to, you might have a tube in your mouth and you can’t talk. You must make physical, mental and psychological adjustments.
Having a social worker or mental health professional available can help you adjust to life again and improve your quality of life. They can also help you learn to cope with the changes you need to make after sepsis. For example, you might need a cane. If you already had a cane, you might need a walker or a wheelchair. You might need to use a motorized cart in the supermarket. You might not be able to drive.
“These things make a big impact,” Dr. Ditillo said. “They’re incredibly stressful for someone who could do everything they wanted before.”
How family involvement can help
People with sepsis do better when their families are involved in their care. “We want them to listen to what’s happening, and we want them to contribute. They know the patient better than we ever will, so it’s important to have them as part of the decision-making team,” Dr. Ditillo said. “Being able to have a relationship with the people taking care of your loved one when they're really sick is incredibly comforting. And knowing that they're part of the decision-making, and not on the outside looking in, is very empowering.”
Family members can also help with therapy. For example, they can learn some basic stretches and exercises where they move the person’s arms and legs. “A lot of times, family members are just sitting there all day, not doing much. Giving them something to do is incredibly helpful,” Dr. Ditillo said.
Family members can also help by journaling. Critically ill patients lose chunks of time and that can be traumatic. They might remember flashes, but they don’t always know what was real and what wasn’t. A journal detailing what happened can help them fill in the blanks.
Risk of re-infection
It is important to know that people who have survived a sepsis infection are at higher risk of getting sepsis again. If you notice that you or a loved one has an infection that is not getting better or is getting worse it is crucial to seek medical care immediately. If you go to urgent care or the emergency department, let the health care professional treating you know that you have had a previous bout of sepsis. Sepsis is a life threatening condition. Identifying the infection quickly and treating it promptly increases the chances of a full recovery.
The bottom line
Sepsis is a serious illness and it will take time to rebuild your strength and stamina. While the goal is to get you back to your previous level of health, you may need to come to terms with some long-lasting changes.
Involving your family, working with a physical therapist and connecting with mental health support can help you get the best possible outcome. If you would like to learn more about recovering from sepsis, reach out to a Banner health care provider.
