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The lost urine sample, and how it almost killed me

Hello! I am the marketing and communication lead here at Active Medical. A position that is under constant scrutiny, because I don't have a professional healthcare background. No hard feelings about that, as I am given a reasonably fair shot at proving myself.

Image: Our marketing and communication lead is not a healthcare professional, but has healthcare experience, as he is amassing in this post motocross image (broken pelvis in three places.) What do you think, should that count?

But, having no professional healthcare background, doesn't mean I don't have healthcare experiences:

1) I was born with a cleft palate, or a hares lip, which necessitates a number of surgeries.

2) I have also been in hospitals as a patient on numerous other occasions.

A motorcycle accident, appendectomy, and more.

3) I have on several occasions been the father of a patient.

I have two daughters, one born premature, and one almost losing her life to acute kidney failure without the doctors and nurses realising it, which lead me on a journey to find out if something can be done about Healthcare better understanding children's compensatory mechanism, which again lead me to our founder Professor Can Ince, and the world of the Microcirculation.

4) I have been the son of a patient, the brother of a patient, the partner of a patient, the family of a patient, and the friend of a patient.

I.e. A visitor and a next of kin.

5) I am also an owner of a patient:

Our dog “Valiant” spends his days being prematurely born, run over, eating rat poison and generally trying to kill himself.

Annus horribilis.

My hospital experience is exemplified by the year 2013. Either as a patient, as the father of a patient, or as a son, I stayed or visited our regional hospital for over 150 days.

Maybe I should have understood the way the year of 2013 was going to go, when I had to spend new years eve and the first days of the new year as a patient, because of the story I am now going to tell you - about how a lost urine sample almost killed me.

After having been sent to hospital because he got a brain haemorrhage on a trip to Paris to see a big trotting race with his best friends, my father was wrongly diagnosed with inoperable cancer - which turned out to be Staphylococcus aureus eating on his spine.

This - because a French doctor hadn't read Atul Gawande's "The Checklist Scenario" - ended up with my father being infected by an IV needle.

The result was four months at the hospital, with aggressive antibiotics treatment. I visited every day.

That same year, on a dark Norwegian winter evening, my mother was walking their dog. She stepped off a small ledge, and broke her shin bone and knee in the most advanced way possible - if you got to do it, do it properly I guess?

This led to a long stay at our regional hospital because she needed several surgeries to get everything back together. And then an extended stay because a Norwegian doctor hadn't read Atul Gawande's book, ending up in her getting infected by an IV needle.

She stayed in hospital for about 2 months. I visited every day.

My first born baby girl Mathilde entered this world the same year. This after her one and only sign of impatience to date. 1 month prematurely.

Both my partner and I stayed with Mathilde in the hospital for a week.

Quite convenient for my father, as he was at the hospital already, fighting the battle against his spine eating Staphylococcus aureus. To visit his newborn grandchild he only needed to take the elevator up three stories.

Well, back to the story of the lost urine sample:

It was Christmas evening, and in Norway we celebrate this on the correct day, which - if you have to ask - is the 24th of December.

I had the whole family as guests in our house in a rural part of Norway. The food was Norwegian stick meat of lamb, the snow was falling like cuddly big pieces of cotton, and the Christmas carols played softly in the background. This was when I noticed what I thought was stomach flu.

I made it through Christmas evening without too much embarrassment. But the whole debacle continued the day after and the day after.

In Norway we are very few people living on a big piece of land, necessitating a system with regional hospitals and local ERs.

I went to the local ER to see if I could get anything for my troubled state. The doctor was very thorough, and she found out that I probably had pelvic inflammatory disease. And that I needed to go to the hospital. This is when it all started.

At our regional hospital, they wouldn't rely on a urine sample taken by the doctor at the local ER. So they quickly threw that away. And wanted to take their own.

I didn't have any urine left. At least that was what it felt like. And I said so. Then a hospital doctor took the time to thoroughly explain to me how vital this urine sample would be. As they were going to put me on broad spectrum antibiotics right after it was taken, and they would need the pre antibiotics urine sample to be able to cultivate the bacteria, so they later could get a specified antibiotics to fight my disease. If I had one at all.

If they didn't get the urine sample, he said, I could be in trouble.

So of course I did my important duty, and mustered what I could, and peed in a small container. The container was then very thoroughly tagged. The doctor took it away as if it was made of gold. And I - in no uncertain terms - knew that this urine sample could save me out of some serious trouble. And then they lost it.

The look on their faces.

When a nurse on the ward-round the first morning told me that the urine sample was lost, I remembered the previous doctor's analogy of not having this urine sample would be like: “Flying an airplane in the alps, in fog, with the navigation system knocked out.”

The doctor present at the ward-round tried to comfort me by saying that the urine sample now wasn't that important after all, and that they didn't think my condition was serious. Well, I was feeling a lot better (I was on IV antibiotics) so I decided to believe him.

The next day went along without drama. A new doctor at the ward-round told me everything looked good. But the day after that...

The third new doctor in the same amount of ward-rounds - in the equal amount of days - entered my room in all his close to 2 meter tall glory. He had the stature of a South Pole expedition leader - his white frock waving around him as if caught in a constant local headwind, answering buzzers and looking at messages, seeming way too busy to have time for us patients.

In a deep baritone voice he said in about as humble a tone as when White Star Line Vice President P.A.S. Franklin proclaimed the “Titanic” to be unsinkable:

"Ole-Martin, I have decided that what you have is a normal stomach flu. I will take you off the antibiotics, and you will be fine by morning, and then you will go home."

Well, if he had decided this, who was I to argue?

Going home to my family sounded a far nicer proposition than to be cooped up in hospital being treated for something this triatlon practicing doctor had decided that I didn't have.

So the nurse removed my IV.

A very bad idea.

About an hour later I started to feel bad. Then worse. Then even more worse. Or worser. Or worserer. Or however it's spelled?!?!

Even under the thick, Norwegian duvet, I started freezing.

And even if I was freezing, I was sweating. A LOT.

I rang the bell, and the nurse was going to get a doctor, but it was a busy shift, so it could take some time.

My “worserer” feeling went quickly downwards in a negative spiral.

Finally the doctor came, now a different doctor to the three previous ones, and they ran some tests. Probably a CRP, but I don't remember.

I was getting kind of disorientated.

But I do remember the look on the faces of both the doctor and the nurse when they got the result.

It's the facial expression I imagine you would get, if you are piloting a plane in the alps, in the fog, and then having the navigation system blacking out.

Both the doctor and nurse ran away in what I hope was a carefully orchestrated healthcare professional rapid response manoeuvre, but for untrained eyes like mine, the waving arms and legs looked like panic.

And in the meantime I felt even worse.

I actually felt like I was dying.

We work to be Plan A.

It was my own daughter almost dying of acute kidney failure in 2019 that got me into researching the microcirculation, and then discovering Professor Can Ince, and then got me into our company Active Medical.

It was not my own encounter in 2013 with what the World Health Organisation has called the World's Biggest Killer, with over 11 million deaths a year: Sepsis.

But both experiences are linked.

A blood sample - where the lab result analysing the blood of my daughter showed extremely elevated Creatinine levels - saved her life.

And a lost urine sample almost took mine.

The system with biological samples is very good. Important. Vital. It saves countless lives.

It's also extremely fragile.

A sample can be lost. Misplaced. Or mistaken.

Even by those who have read “The Checklist Scenario.”

On top of that the samples take time to analyse, and the lab can be congested.

For me this feeds my motivation, as it serves as proof of what we are trying to achieve in Active Medical being vitally important.

We work to give you as a healthcare professional a tool to do non invasive monitoring of the microcirculation at the bedside, with our AI giving you a real time analysis.

It will never replace biological samples. But it can be a very good Plan B.

And sometimes - in time critical diagnosis scenarios, such as if you suspect Sepsis, or in fluid treatment in the ICU, where you need instant feedback of what is happening on a cellular level, or in paediatric triage, and more - we will work hard for our solution to be excellent enough to be Plan A.

It's true, unlike you I am not a healthcare professional, and you might rate my words thereafter

But I have healthcare experience.

And that has to count for something.

Don't you think?

By Ole-Martin Lundefaret

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