SEPSIS takes more lives every year than breast, bowel and prostate cancer combined.
It is a time-critical medical emergency.
But sadly in the UK, there are occasionally failings in spotting cases.
Martha Mills died of sepsis three years ago aged 13 after her symptoms were missed during a hospital visit, an inquest found.
Her parents say their worries were ignored for more than a week as they watched their little girl deteriorate.
Now, after their campaigning, “Martha’s rule” will come into force in most hospitals in England from April.
It means that families will have the right to ask for a second professional opinion when they are concerned for the health of a loved one who is in hospital.
You must call 999 or go to A&E if you suspect sepsis, which is an over-reactive immune response to an infection in the body, which can lead to shock, organ failure and sometimes death if not treated quickly.
Potential symptoms include fever, fast heart rate, rapid or difficult breathing, confusion and body pain.
A baby or young child might have a weak, high-pitched cry that is different from usual.
They may be lethargic, not feeding or passing no urine.
A child may be cold to touch, appear blue, grey, pale or blotchy or develop a rash that doesn’t fade when you press it.
Do not delay seeking medical help – and trust your instinct.
Here is a selection of what readers have asked me this week . . .
Q: Every time I eat, my diaphragm area distends.
I hate it and it really lowers my mood.
I had an endoscopy last year and it came back that I have gastritis.
I have had lots of trouble with my digestive system since I had my gallbladder out many years ago.
I have type 2 diabetes and osteoarthritis.
Can you help?
A: If you’ve been diagnosed with gastritis, treatment may include drugs to reduce your stomach acid and pain relief.
Antibiotics are prescribed if a bacteria called Helicobacter is present.
Untreated gastritis can get worse and lead to a stomach ulcer, so it is worth making sure you are on the right treatment if it is not resolving.
Also, avoid non-steroidal meds, such as aspirin and ibuprofen, and it might help to keep a food diary.
You may see a pattern emerging with certain foods.
Caffeine, alcohol, fizzy drinks, spicy food and rich food can exacerbate symptoms.
Since having your gallbladder removed you may find that fatty foods make you feel more uncomfortable.
If you identify certain triggers you can adapt your diet to reduce or avoid them.
A dietician can help further if you find this difficult.
Finally, it is possible that you could have post-cholecystectomy syndrome, a condition that can follow gallbladder-removal surgery.
Symptoms include stomach pain, diarrhoea, indigestion, jaundice and a fever.
It is thought to be caused by bile leaking into the stomach or by gallstones being left in the bile ducts.
If your GP suspects that this is what is happening in your case, they will likely do some tests, including an ultrasound, to check for any remaining stones.
They may refer you back to the surgical team that did the operation.
Q: FOR a few months I have had a slight pain in my left breast.
I have checked for lumps but not found any.
A while ago I mentioned this to a nurse but she didn’t say much, so I thought it was OK.
But it is still there.
A: You are absolutely right to be vigilant about breast pain that has no good reason to be there and is not going away after two menstrual cycles, even if no lumps are present.
Usually, breast pain does not turn out to be cancer.
It is more likely to be caused by fluctuating hormones, injury or infection.
Some medicines such as contraceptives and anti-depressants can cause breast pain too.
But, in rare cases, cancers do have only pain as a symptom.
If none of the above applies to you, and the pain persists, you should speak to your GP about a referral to a breast clinic.
THIS winter has been rife with viruses.
To help support your immune system, squeeze some lemon in your water, buy a bag of oranges and eat one of them a day, snack on nuts and seeds and make sure to pack your meals with lots of fruit and vegetables.
Q: I’VE got dark brown lumps on my back that look like fungus.
I’m 75 and have had them for years.
My mum had them, too.
Sometimes I can break them away from the skin.
They’ve never bothered me but now they are giving me backache either side of my spine.
Could it be a nervous rash?
A: Rashes are always so hard to diagnose without examining the skin, or at least a picture, and there can be potentially hundreds of causes.
So I must urge you to book a GP appointment to get this fully assessed.
However, from your description, there are two potential causes that I would like to explain a little further.
There is a good chance it could be seborrheic keratosis, which means harm-less warty spots on the skin that can feel as though they are stuck on, a bit like barnacles.
They are a sign of skin ageing and are very common.
In fact, about 90 per cent of the over-sixties have them.
Some may only have a couple though, whereas others have hundreds.
There is an inherited tendency for some people to have more, which means it can run in families.
They are mostly black or brown and have a ridged, waved and sometimes scaly appearance that can make them look like something to do with fungus, but they are not fungus.
You can sometimes break them away from the skin, but this isn’t advised as it can cause infection, bleeding and scarring.
The usual advice is to leave them alone.
The other thing that I should mention is a much rarer condition, Neurofibromatosis type 1.
This is a genetic condition that causes non-cancerous tumours, called neurofibromas, to grow along your nerves.
The neurofibromas tend to be more round and regular in shape – a bit like small buttons that may hang from the skin – and you would not be able to pick them off.
This condition usually becomes apparent in childhood or early adulthood.
However, it can sometimes cause issues for the first time in later life.
This is much less likely in your case, but I mention it concerning your comment about nerves and back pain.
Other skin symptoms which you would expect to see in NF1 are “cafe-au-lait spots”, which are painless patches on the skin that have the appearance of spilt coffee, hence the name.
These are usually present from childhood, and having six or more can be suggestive of NF1.
Another symptom is freckles in unusual places, such as armpits or groin.
