“I shouldn’t have lived through it,” Katie said, reflecting on her fight with E. coli poisoning.

On an early summer evening in 2016, Katie Ruffolo, a 36-year old mother of three, was battling diarrhea. She had no idea this signaled the start of an E. coli poisoning that would eventually attack her kidneys and stop her heart three times. Before it was over, doctors would debate whether she faced a partial recovery or death. Her prognosis was bleak.

The next morning, Katie called her doctor and was told to go to her clinic outside Milwaukee and give a stool sample. The doctor didn’t give her any medication, worried that whatever was causing her diarrhea could be made worse with antibiotics — something doctors later attributed to saving Katie’s life. 

While dealing with this mysterious illness, Katie also was watching her three children while her husband was out of town on a guys’ trip. Luckily, her husband returned by the time Katie’s diarrhea had turned bloody. On June 14, Doctors admitted Katie to West Allis Memorial hospital in Milwaukee.

Hospitalization

Because Katie had already submitted a stool sample to her doctor, the doctors in the emergency room were quickly able to figure out what was wrong. On Wednesday, June 15, results came back from the stool sample and E. coli 0:0157 was identified.

Thursday morning, Katie was transferred to the intensive care unit because her kidneys were beginning to fail. “My keratin levels were going up and they knew I was going to need dialysis at some point,” she said.

 Death’s door

On Friday, July 17, Katie was moved to interventional radiology, wher they do small procedures, so she could have a port put in for dialysis. But when she lay down, her heart stopped. She coded for 15 minutes. “What they think happened is that the fluids that built up in my body were not flushing through. They told me it basically had drowned my heart and stopped it.”

 The doctors were able to revive Katie, but there were other major concerns, such as brain damage from oxygen deprivation. She was placed on a ventilator for the next two and a half days.  Doctors also started cooling her body and then slowly warming it up. This technique is called therapeutic hypothermia.  It is used to prevent or lessen brain damage. 

Heart stops again

Sunday the 19th, Katie’s blood pressure fell and she coded again, this time for only a few minutes. Miraculously, later in the day, Katie opened her eyes and responded to questions.

Thanks to her parents being able to watch her children, Katie’s husband was able to be at the hospital constantly. He only left when forced to. But then, over the weekend of July 17-19, her parents found bloody stool in Katie’s 2-year-old’s diaper. The  2-year-old and 7-year-old were tested and found to have  E. coli poisoning. Fortunately, neither case was severe. “Thank God they just weren’t sick. They just needed to get tested until it was gone. So obviously we all ate something. And it obviously affected me way more than it affected them,” Katie said.

For the next few weeks, doctors worked to keep Katie alive.

“I remember one of the doctors telling me that they would start the day with 10 or 12 of them around a table talking about what they were going to do, just to keep me alive.”

Katie’s white blood cells and platelets went up and down, so she continued to get blood and platelets transfusions. Doctors had to drain her stomach fluid and were worried that they might have to remove her colon because it showed enlargement. “They put a gallbladder tube in, which I didn’t know was something they could do, which basically stayed in my body for weeks after that. Just to make sure the fluids coming from there were okay.”  

On June 23rd, Katie’s colon started working again, a good sign that her colon was going to be okay. Meanwhile, however, she was on constant dialysis. 

On June 28th, Katie was able to stop continuous dialysis. They started giving her dialysis as needed. Katie had fevers that would come and go, fevers they would have a hard time controlling.

“I don’t really have much memory of this time; I have little blips here and there of things. But I was also on some pretty serious drugs, rightfully so for pain and sedation. And I had some ICU psychosis happening,” Katie said.

On July 3rd, Katie started making her own urine. She became more responsive and she only needed small amounts of dialysis.

Katie’s heart stops a third time

Saturday July 9, Doctors attempted to remove her ventilator and she coded again, this time for a few minutes. “Things had started to look better, but I guess that was kind of the story, you take one step forward and then it would be two steps back. It was just constant back and forth.”Later that day, Katie was the most responsive she had been since entering the hospital. She even got agitated because she wasn’t allowed to have real food. Katie had been on IV nutrition since being put on a ventilator.On July 11th, Katie had her last dialysis. “It wasn’t quite a full month of dialysis but a good three weeks. And my creatinine numbers, the numbers they use to measure your kidney function, were slowly going down.”

Katie remained on and off the ventilator, but she still had difficulty breathing. Doctors finally decided that doing a tracheotomy might help. “They weren’t sure, and they kind of left the decision up to my husband and my parents. Basically, like we can try this and it’s not going to hurt anything. So, they went ahead and did it.”

 ON July 13, they did the tracheotomy. “That was kind of like the magic key. And I needed minimal vent after that. I would go hours and days without it.” During this time, Katie started having physical therapy and occupational therapy. “After you sit in a hospital bed without moving for a month, you can’t move. They had people come in to just get me to sit, or just try and stand, or sit in a chair, or on the side of the bed.”

Coming out of the fog

On July 16, Katie started to feel more like herself. “I pulled out my feeding tube and wouldn’t let them put it back in.” They let Katie try to eat, starting with soft foods like jello and pudding.

When they took Katie completely off sedation, she still had a trachea and couldn’t talk. “I obviously had a lot of questions, but my fine motor wasn’t working the way I wanted it too. I couldn’t use my phone. To type on a phone on that touch screen is really hard. So there was a lot of frustration on my part because I couldn’t communicate what I wanted.” 

On July 21, with her organs stable, Katie was transferred to another hospital in Milwaukee to start rehab. She began therapy for 3-4 hours a day while medical staff monitored her.

 On July 23, Katie’s tracheotomy was removed and after two weeks, on August 6, Katie was released from the hospital.

“once I started progressing I just started to take off. But also, I had my age working for me, being 36 at the time. I was sort of in the sweet spot. Not too young, not too old. I was a physically fit person before that and physically healthy, no other underlying health concerns, thankfully,” she said. 

Home at last

At home Katie received outpatient therapy. “From talking to all the doctors and nurses, I still keep in contact with a lot of them, they said it was a once in a career case. It’s not something they are used to seeing all the time.”

They explained to Katie that in their eyes, she shouldn’t have been able to live through it. They told her it was a miracle that she didn’t have lasting physical limitations or brain damage from coding. Although, Katie explained, it did take a while for her brain to feel like it was back to functioning at the same level.

“The therapist would come and ask what day it was, and I would say, I don’t know. At one point they asked me what time it was, and I looked at the clock and couldn’t make sense of it. They would have me do things, like a puzzle or something and I remember saying, like, I can’t do this, but I know I should be able to do this,” Katie said. 

But eventually it all came back. “At one point the speech therapist dismissed me, because we were working on brainteasers, and she was like, you’re fine. She was like you’re good.” 

Reflecting

Katie has now had several years to reflect on the trauma she went through.

“I guess I never understood how people could die from E. coli. What is that? I think a lot of my family and friends had no idea either. So, I think a lot of people have learned a lot from what happened to me.”

Katie explained that if there was a silver lining to the incident, it was that it educated a lot of people on the importance of food safety. “People tell me they have rethought food and really think about food. I’ve had people tell me they just won’t eat romaine. Because there have been so many outbreaks in the last few years.” 

 Unfortunately for Katie, there’s no way to know for sure what she ate that caused her to get ill. “It is very frustrating in some ways. But not as frustrating as some people think it would be.”

“They ask, ‘What did you eat? Doesn’t it drive you crazy? Did you drive through fast-food at some point? Could it have been baggage lettuce or salad?’ Yeah, I guess. But it’s too many options to know,” she said.

“People want to hope that that can’t happen to them. But the reality is that it can happen to anyone. It doesn’t matter. And food safety is a really important thing.”

Fully recovered, Katie is back to teaching full time with no long-term health issues resulting from her fight with E. coli. Katie is now an advocate for food safety, including a close relationship with the nonprofit public health organization STOP Foodborne Illness.