'I thought I had flu but just hours after ringing the doctor I was on a life-support machine'
David Carson woke up one morning feeling under the weather. Days later, he was in a coma. He tells Nick Duerden why everyone needs to know about the deadly effects of sepsis
In early April 2013, David Carson awoke with a sore throat. "Nothing to write home about," he decided, and went off to work. By the weekend, he says, "I began to feel as if I was getting the flu. My wife, a nurse, said we should perhaps call the doctor, but I told her I'd be fine".
He wasn't fine. A few days later, he agreed to call a doctor, to whom he attempted to explain his symptoms as best as a man that doesn't like to cause a fuss can.
The doctor told him to take paracetamol and go to bed, and that they would meet again in the morning. There wasn't any paracetamol in the house, so his wife went out to get some. "And by the time she got back, I was in a bad way," he says.
Within six hours of that initial phone call to his doctor, David, then 61 and working as a trainer and mentoring consultant, was on a life-support machine. "While I was in the coma, the consultant said to my wife that I was the sickest person in the hospital, with the least chance of survival." His wife and their two grown-up sons were distraught as the hospital staff attempted to prepare them for the worst.
Although he didn't know it yet, David was suffering from sepsis, a life-threatening condition that arises when the body responds abnormally to infection.
If not treated quickly, the end result is multiple organ failure. Some 50% of cases, in both adults and children, develop after a bout of pneumonia, but it can also follow a urinary tract infection, a burst bowel - or even an insect bite.
The TV presenter Gloria Hunniford contracted sepsis after cutting herself with a kitchen knife.
The Portadown-born Rip Off Britain presenter, who was 73 at the time, was cutting up lamb as she prepared dinner when she cut herself and ended up with sepsis.
The nasty cut was through to the bone but Gloria saw her GP the next day and was prescribed non-pencillin-based medication to prevent any infection.
Although her doctor warned her to keep a close eye on the cut, she later developed a fever and was hospitalised for 10 days where she was put on an IV drip. Thankfully she made a full recovery afterwards. If spotted early enough, the disease is easily treatable with antibiotics - but spotting it early enough is the problem.
It isn't always easy to spot, in part because so many of us are still ignorant of the condition.
It nevertheless affects a great many: more than 150,000 people a year in the UK alone, killing some 44,000. This figure is higher than those for prostate, bowel and breast cancer combined.
"If someone believes they might be suffering from sepsis, then the clock is ticking," says Dr Ron Daniels, a full-time NHS consultant in critical care and also the chief executive of the UK Sepsis Trust.
"They have to act fast. If we took 100 people who all had the condition, about 85 to 90% of them would, with early intervention, probably avoid having to go into intensive care altogether, and could be treated on a general ward quickly and effectively."
But 10 to 15% of that number, especially those that have a genetic susceptibility to it, would continue to develop multiple organ failure.
"And, sadly, a proportion of those would die even with the very best care in the world," says Dr Daniels.
"We cannot pretend that we can save everyone from sepsis, but we do conservatively estimate that we can aim to save between 12,000 and 14,000 people in the UK every year simply by getting the basics right."
To better combat it, sepsis needs a broader profile.
This is now happening. Last month, the illness made headlines when an NHS England report concluded that both GPs and the NHS out-of-hours helpline 111 failed to identify sepsis in a 12-month-old baby boy from Wales, who had died in 2014.
The UK Sepsis Trust is now actively lobbying both the Government and the nation's hospitals to raise awareness further still.
It is a condition that can affect anyone anywhere, but children under the age of five and the over-65s are at more risk.
Signs to watch out for include flu-like symptoms, lethargy, persistent rashes and, in babies, a dry nappy for more than 12 hours.
Last autumn, the illness received some unexpected exposure during the Baftas, when Jason Watkins collected his award for Leading Actor.
During his speech, he paid moving tribute to his two-year-old daughter, Maud, who had lost her life in 2011.
Watkins didn't make it explicitly clear how she died, but Google did, and in subsequent weeks Watkins was discussing his family's tragedy on national television shows. He now campaigns for greater awareness through the UK Sepsis Trust.
"We set up this trust after I watched a 37-year-old man succumb to it, leaving me to tell his wife and children that he wouldn't be coming home," says Dr Daniels.
"It hit me that something had to be done about this, because there had been opportunities to rescue him that were missed. We need an internal education programme, and also to talk to people externally. We need to make everyone aware because the earlier we catch it, the faster the recovery."
David, originally from Scotland but now living in Northamptonshire, eventually came out of his sepsis-induced coma after three long weeks. "When I woke up, I could barely move," he says.
"I felt like I was stuck to the bed. I could see that my legs were black.
"I couldn't lift my hands up, but I noticed that my left hand was swollen enormously. The fingers were also black."
The consultant explained that multiple organ failure had restricted blood flow, with dreadful results - he would have to have both legs amputated from below the knee.
He was told that it was likely his fingers would self-amputate, but they didn't, and he suffered with them for another year before the tops of three fingers from each hand were surgically removed. In the space of just a few weeks, his life had changed irrevocably.
He now had poor feeling in his fingers, and everyday routines such as tying shoelaces became problematic. Worse was to come.
After being discharged from hospital, he failed a medical, which meant he was unable to return to work, and because their house was not sufficiently wheelchair-friendly, they had to sell their family house and move.
The psychological effects were considerable.
"I had to have about a year's worth of counselling," he says, his voice breaking, "but it helped me a lot to talk about things. What happened has rocked me, and knocked my confidence.
"It's simple things such as looking in the mirror when you get dressed in the morning and being reminded again that your body image has changed so much. It's quite a shock, still."
Over the past year, David has been working with the trust in a voluntary capacity, speaking about his experiences.
He has talked to police officers about overcoming adversity, and also visited schools. "I didn't think 13-year-old kids would be very interested, but they really engaged," he says.
"I never really pushed myself to go and talk to people, but they asked me to do it. They said I was an inspiration because I was up and about, doing things. But I didn't really have a choice, did I?"
Previously, he had also been a drummer in his local church group.
He had to stop after his illness, but a friend has recently helped to modify his kit, and he is back playing again.
"It's good for me," he says. "I always liked playing the drums. I'm glad I still can."