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| Fall River County Weed and Pest Supervisor Steve Smith works at his desk after being away from it for several weeks due to a serious illness. Curt Nettinga/Hot Springs Star |
Resident fights back after life threatening illness
HOT SPRINGS – As each person maneuvers through life, there are speed bumps which must be overcome. Some are larger than others.
In this instance, the ‘bump’ that Steve Smith has endured would rival Harney Peak.
While there were some warning signs, Smith was hit with a life-threatening challenge on February 6, one from which he is still recovering.
“There really wasn’t anything remarkable about the day,” he said recently. “I had been feeling a bit off for awhile, but I thought it was the flu or something. I didn’t think I needed a doctor; I was still walking around.”
What Smith, 58, was feeling was the effects of a condition known as Ketoacidosis, which can lead to diabetic coma or even death. In Smith’s case, he slipped into a diabetic coma and hovered near death for nearly two weeks.
How it got started
Ketoacidosis means dangerously high levels of ketones. Ketones are acids that build up in the blood and appear in the urine when a person’s body doesn't have enough insulin and is a warning sign that a person’s diabetes is getting out of control.
“When they got me into the hospital, my blood sugar was 1,200,” Smith said. “They told me that most people don’t live when it gets past 800.”
Smith, who is the Fall River County Weed and Pest Supervisor and shares a building with the Extension Service next door. And it was because of Karen Jamison, office support staff at the Extension office, that Smith had agreed to see a doctor.
“He had been feeling down for a few days and I finally made him an appointment,” Jamison said. “I’m really glad I did.”
While Smith was home cleaning up for his doctor’s appointment, he collapsed. When Jamison was unable to reach him, she sent co-worker Mark Fanning. Fanning was unable to get into Smith’s apartment and called the police.
“They found me on the floor,” Smith said.
In the hospital
Smith was taken to Fall River Hospital and transferred immediately to Rapid City Regional, where he was accessed and stabilized for the first of five surgeries he would undergo. At some point, either after he collapsed or perhaps before, Smith had suffered a stroke over the left side of his body as well. It may have precipitated the collapse.
The surgeon found that the Ketoacidosis had perforated Smith’s large intestine (colon) in numerous places and forced its removal. He had been bleeding internally and had rampant infection in his abdominal cavity. Then his kidneys shut down.
“I guess I wasn’t doing too well,” said Smith is his normally understated way.
With his colon gone, Smith was fitted with a colostomy. But due to the serious infection he had, his incision was left partially open. “They sliced me from here to here,” Smith said, pointing to spots at the bottom of the center of his ribcage to below his abdomen.
He was taken to the Intensive Care Unit, where he would spend the next 12 days. During that time he had four more surgeries. Before the surgeon began the first three of those procedures, he brought a document to Smith’s sisters to sign.
“He told them, ‘We will do everything we can,’ or ‘He may have little hope to live,’” Smith said. “That’s how bad it was. It was a real rollercoaster.”
He developed a staph infection in the stitches, setting him back further in his recovery and causing him additional problems.
“I think the staph infection, along with the drugs I was on, made me see things,” Smith said. “Like I would look in the mirror and see multiple noses all over my face; or I could feel wooden blocks attached to my head, things like that.”
Smith also said that one time, when he was being taken down to dialysis at the hospital, he believed that the person was throwing him away with the garbage.
“I was thinking some pretty weird things,” he said.
He had visitors, but doesn’t remember them or a lot of other things that happened during that time.
“I stopped up to see him,” Jamison said. “If his sister wouldn’t have been sitting in the room I wouldn’t have known it was Steve, that’s how much different he looked.”
After three weeks in the ICU he was transferred to a different floor and began the arduous task of reclaiming his life.
Recovery
When Smith entered the hospital he carried 290 pounds on his 6-foot, 6-inch frame. He was a big guy. But the effects of his fight for life left him like a shell of his former self. “When I was in ICU, they told me I had dropped to 222 pounds,” he said.
“The worst part of the recovery was having my stitches and wounds cleaned,” Smith said. “They would stuff yards and yards of this gauze with a light bleach-like solution into places where there was infection, then pull them out the next day and replace them. That really hurt.”
Smith still has two sessions of wound care each day at Fall River Hospital. “The chunks of gauze are much smaller and I guess it doesn’t hurt as much.”
He also undergoes regular physical therapy, to recover the strength on his left side. “I am up to 10 reps with a seven-pound weight over my head,” he said. “I’m improving slowly.” While he said his right side is also weak, “That’s from lying there inactive for a long time. The left side weakness came from the stroke.”
Smith said that he really has no appetite; that food just doesn’t really taste good, but he knows he must eat to regain his strength. “I think the lack of appetite might be from the drugs too,” he said.
He adheres to an 1,800 calorie per day diet and must pay careful attention to his carbohydrate intake, as carbs are converted to sugar. “I also have to give my self four insulin shots per day now,” he said.
For a guy who pretty much ate what he wanted, having a limit on his calorie count is a new thing. “I used to like to go to Dairy Queen and get a Blizzard,” he said. “Now I am limited to a small dish of ice cream. My doctor said that a little bit won’t hurt me. I’m not out of the woods yet, but I am getting stronger.”
Looking back
“I didn’t pay attention to what my body was trying to say,” Smith said. “If I was smarter, I would have paid attention. I took chances and didn’t take good care of myself.”
He had been told by his eye doctor that his blood pressure was a bit high and he should get it checked. One of his sisters had also been diagnosed with diabetes, but his test at that time was negative.
“Looking back, I had all the symptoms for diabetes,” he said. “I was thirsty, my vision was blurry and I was tired.” Those symptoms are also warning signs of the onset of ketoacidosis
“But, like I said, I was still walking around, so I ignored the signs and didn’t treat them.”
Looking forward
“I guess my advice would be to be aware of what your body is telling you,” Smith said. “Mine was telling me that it wasn’t feeling well, but I ignored it and it nearly cost me my life.” Smith estimated that it had been three or four years since he had seen a physician.
“Take the time to see a doctor,” he said.
For the immediate future, Smith hopes to continue to improve. He has built his weight back up to 231 pounds, but is still gaunt looking. “These jeans used to be pretty tight,” he said, showing the extra fabric in the thigh area. “They aren’t anymore.”
Smith said that he is now cleared to drive, as long as he stays on the nice smooth road. “Doc won’t let me get off where it is too rough,” he said. “He’s afraid that I may break open my incision.” Smith said that he has also gotten the green light from his doctor to apply for a deer license this fall.
“I guess that’s a good sign, huh?” he says with a wry smile.
Good news indeed, for someone knocking loudly on death’s door three months ago.