Part I in a II-part series on Linda Rivera’s battle with E. coli O157:H7.
It’s one of those glorious, fogless summer days in San Francisco when the winds whisk the skies clear and everyone is outside basking in sunlight. From Linda Rivera’s hospital room at Davies Medical Center, you can see the city’s skyline–including the pyramidal TransAmerica Tower–and, if you look down through the thick barrier of evergreens that line the perimeter of the hospital’s property, you can see Duboce Park, where local residents sunbathe and let their dogs run free as trains from the N-Judah line roll by before entering the tunnel that will spit them out on the other side of Buena Vista Park.
A 10-minute walk south of the hospital, the sidewalks of the Castro district are filled with people shopping and enjoying the beautiful weather while just to the north, in Haight Ashbury, tourists plod the sidewalks attempting to recapture the Summer of Love with souvenir T-shirts and Tibetan jewelry. Linda, who actually lives in Las Vegas and has been at Davies since April, hasn’t seen any of it. She only began walking again, with assistance from her physical therapist, just over a month ago.
At 58, Linda is probably the most famous–if one cares to describe it that way–of the victims of the outbreak of E. coli O157:H7 that shut down Nestle’s cookie dough production for nearly two months during the summer of 2009. Rivera, like many people, enjoyed eating the dough raw. Like hundreds of others, she and three members of her family became ill after eating dough from the contaminated batch. Across the country, about 80 people were made seriously ill. Unlike most of the others, or her family members, Linda very nearly died at least three times as a result.
If you saw the photos of Linda in the story that ran in the Washington Post back in September last year or on television, you might not recognize her today. The illness had ravaged her, leaving her pale and wan. Now, with the color returned to her face and her energy levels slowly returning to something approaching normal–although still notably less than 50 percent–she still looks tired, frail even, but she’s pleased to see a visitor even after a full day of physical therapy has left her exhausted.
On the day a reporter came to visit, she smiled warmly and extended a tiny, curled hand in greeting. She was in bed, fully dressed except for her shoes; physical therapy had left her so tired she didn’t have the energy to change into bed clothes and simply crawled right in. Physical therapy is pretty much her life right now. That, and the hospital room she currently calls home.
“There were many times I thought life was over and I was going to pass on,” she said. “There was no hope.”
Actually, hope is the one thing that has been returned to the Rivera family since that day at the end of April 2009 when Linda and other members of her family casually munched on spoons full from a tub of raw Nestle’s cookie dough. But it would be hard won. Within a week, she would be in hospital, struggling just to survive.
“I didn’t know the seriousness of her illness,” said Richard Rivera, Linda’s husband of 13 years. “E. coli. You don’t realize what E. coli is. I used to think of it as a tummy ache.”
Of course, E. coli is more than just a tummy ache. While there are significantly more outbreaks of Salmonella than E. coli each year, E. coli is easily the nastier of the two. Up to 100 people die from the pathogen each year in the United States, according to the Centers for Disease Control and Prevention. Most people recover from it within a week or so but in a few cases, about 5 to 10 percent, victims develop a potentially life-threatening complication known as hemolytic uremic syndrome which can cause a the kidneys to shut down. Most recover after a few weeks but can continue to suffer from additional complications for years afterward but some, notes the CDC, “suffer permanent damage or die.”
Even as Linda’s condition worsened, no one could have foreseen what she and her family would be forced to endure over the following year. A few days after eating the raw dough, Linda began to feel the symptoms of what she thought might be a cold or flu. Soon, she was vomiting and passing blood in her stool.
“God, Robyn, I’ve been really sick,” she told her friend of 23 years, Robyn Treska, over the phone. “I can’t get off the bathroom floor.”
Linda’s condition would not improve. The first time Richard took her to the emergency room, she was vomiting every 45 minutes to an hour, he said, but the ER doctors couldn’t pinpoint the problem and diagnosed her with irritable bowel syndrome.
“That night, it just started getting worse and worse,” said Richard. “And, somehow, during the night, I had fallen asleep–and this was the morning of the sixth of May–she had crawled downstairs and wrapped herself around the toilet in a fetal position.”
“How long have you been down here?,” he asked her. “A couple of hours,” Linda replied.
The Riveras returned to the hospital where Linda was admitted with colitis, an inflammation of the large intestine, and given antibiotics for nearly two days. The E. coli had moved a quarter of the way into her colon; her doctor said he would need to operate in order to remove it. Would she survive without the operation?
“I’m not sure you would make it through the night,” her doctor replied.
Linda survived the surgery and was put into a doctor-induced coma for 10 days, although at one point it looked as if they would lose her. The next 24 to 48 hours are going to be very critical, said the doctor. “The chance of her coming out of this is probably 5 to 10 percent,” he told Richard.
For ten days, the family watched Linda, not knowing whether she would come out of the coma. They played one of her favorite tunes, “Kokomo” by the Beach Boys, and when she began mouthing the words and tapping her feet to the rhythm, they knew she was still there. Physically, she was so swollen, Richard said he thought she might begin weeping fluid through her skin.
While the coma might have been helpful in stabilizing Linda’s condition, it also brought up a harder issue to deal with. What if she didn’t come out? Linda and Richard had told one another they didn’t want to be on life support if that was the only thing keeping them alive, “but we never talked about it giving us a second chance at life,” said Richard.
In a scene Richard still recounts with solemnity, he put the matter to his family to vote upon. It would have to be unanimous, he told their children. If even one person voted against keeping her on life support, then she would be removed from the machinery keeping her alive.
“That was scary,” said Richard. “Thankfully, everyone said ‘yes’.”
It’s hard to say who is more grateful for the outcome of that vote. In her hospital bed, Linda talks about the matter with a profound sense of gratitude. She couldn’t blame her family for having made the other choice but having been through it, she’s come to believe that many coma patients are, indeed, still there, trapped inside injured bodies.
Over the next year, however, there would be more close calls. A priest would be called three times to offer last rites. Linda would spend all but nine days in hospital before becoming well enough to make the trip to San Francisco for physical rehabilitation.
Linda spends several hours each day in physical therapy, an ar
duous experience that leaves her exhausted, both physically and emotionally. But she’s making progress. In early June, with the aid of a walker, Linda took her first steps in nearly a year.
Most important, she’s hopeful. Physically, she will probably never be as strong and as active as she once was, and both she and Richard talk about her probable reliance upon a wheelchair to get around once this is over. The disease has affected more than just her mobility. Her eye sight, her cognition, her physical strength, have all taken serious hits. But neither she nor her family or friends have given up.
“Lots of times I’m angry,” she said. “I’m thankful most of the time, for the chance to do things again.”
Everyone is grateful to have made it through an experience none of them could have imagined.
“She kept fighting,” said Richard, “and kept coming back and kept coming back.”© Food Safety News