Deadly currents: How an infection from the Whanganui River nearly killed meby Gareth Eyres
Photographer Gareth Eyres first kayaked the Whanganui River in the 1970s, and has returned many times to paddle this New Zealand taonga. Then, in 2013, the river he loved almost killed him. Not by drowning or running rapids – but by infection. This is his story of near-death by river.
We put in 12km below Taumarunui, and kayaked about 20km, before selecting a campsite on a grassy bench above the river. After setting up camp, we had the obligatory bucket-wash on the bank, then a long swim in the river. We all commented on how clear and warm the water was.
The following morning, the river was shrouded in mist. Across from us in the eddy was a raft of foam about five metres by five metres and around 25cm high. It was creamy coloured with brown streaks and looked suspiciously like dairy-shed effluent. No early-morning swims for this crew!
Within 36 hours, I started coming down with a urinary tract infection. When I got home two days later, I took myself to my Warkworth GP, Dr Steve Maric, for urine tests, which came back confirming E. coli was the primary infection. That clear, warm water we’d swum in wasn’t so clean, after all.
After a long course of antibiotics, the infection showed little sign of clearing. I was referred to a urologist in Auckland who, after a brief examination, told me I had cystitis and to change my diet (no caffeine, alcohol, chocolate or spicy foods), whereupon he sent me home.
Things didn’t improve, even with the diet changes. Not only was my bladder and urinary tract painful, but the pain had also spread around my pelvic girdle, from the base of my spine to the tip of my penis. This wasn’t just inflammatory pain, it was nerve pain – the stuff even morphine doesn’t seem to touch.
After about a year of trying everything in the dietary book, I was referred by my GP to another specialist for a second opinion. This time, the urologist seemed more concerned about my condition and ordered a cystoscopy, a procedure done under general anaesthetic when the bladder is distended with a sterile solution and a flexible scope inserted to check out the bladder walls.
The news wasn’t good. At around 65 per cent inflation, I was told, my bladder walls had started to bleed. Scarred by the infection, my bladder had lost elasticity; its volume was, effectively, down to about a can of beer before I needed to urinate.
A cocktail of drugs followed: alpha-blockers, antibiotics, anti-inflammatories, painkillers. Of the pain medication, gabapentin was the most effective. This drug is prescribed for nerve pain, but it’s primarily an anti-epileptic medication used to treat seizures, with drowsiness and memory loss among a host of side effects. It dulled the pain, but it also dulled my brain. I started to become disengaged from my partner and friends, drifting in a fug of pain and a drug-filled haze all of my own. Nights were the worst. Exhausted and desperate for sleep, I would spend the night climbing in and out of bed, often up to 10 times, visiting the toilet. Urinating was agony. I was at a loss as to what to do next.
Before the infection, I’d been riding my bike more than 100km per week; in the year before, I’d paddled kayaks and rafts for 1000km on rivers and the sea in New Zealand and the US. In my late 50s, I was pretty fit.
Now I was part zombie, adrift on a sea of perianal pain. My bike sat in the garage. I couldn’t begin to think about sitting on it. After an hour of paddling, even sitting in my kayak was painful. Work was only possible in short bursts. I’d gone from being an active outdoors photographer to an invalid, and there didn’t seem a way out.
The couch became my refuge. I searched the internet for answers. I tried natural medicines, physiotherapy and acupuncture. Some treatments worked a bit, some didn’t. The inflammation spread to my lower back and walking became extremely painful. I was a mess.
Then, in October 2016, there was a change. And it wasn’t a change for good. One Saturday, after a light lunch of mussel salad (mussels bought fresh the day before and well within the use-by date), I started experiencing abdominal pain and nausea. I immediately thought, “Shellfish poisoning.”
Three days later, I was still sick and my brother urged me to visit my GP. Bloods and urine were taken and I went home to rest. At 10:40pm, the phone rang. It was Dr Steve. He said, “Get out of bed and put some clothes on, pack an overnight bag and wait by your front door. There’s an ambulance on the way to take you to North Shore Hospital.”
I was tired and grumpy, and tried to get out of it. I don’t like hospitals at the best of times. They’re full of sick people. Maric said, “Look, your CRP is 320. A normal person’s is one to two. You’re very unwell; get in the ambulance and go to hospital.”
C-reactive protein (CRP) is a blood test marker for inflammation in the body. CRP is produced in the liver; high levels are caused by infections and long-term diseases, but a CRP test can’t show where the inflammation is located or what’s causing it. Other tests are needed for that.
In hospital, more blood was taken, IV antibiotics administered, urine tested (by this time, my urine looked like badly brewed coffee) and I was in bed on the ward for three days.
The infection was finally pinned down as Klebsiella pneumoniae, a bacterium that normally lives inside human intestines, where it doesn’t cause disease. However, if it gets into other areas of the body, it can cause a range of different illnesses, including pneumonia, diarrhoea, upper respiratory tract infection, osteomyelitis, meningitis and septicaemia.
Maric was right, I wasn’t well. I had septicaemia. Luckily, the first flight of IV antibiotics worked and I began to improve. Interestingly, when the antibiotics started to act on my septicaemia, the urinary tract infection symptoms all but disappeared. This got me thinking. I called my urologist and asked, “Is it possible that what’s causing my UTI and bladder pain is lurking somewhere in my body and coming out when I’m run down? Could this cause regular but difficult-to-trace problems?”
He confirmed this and said: “Next time you have a flare situation with your UTI, call me and I’ll see if a long course of antibiotic treatment clears it up.”
Christmas came and with it a flare. I started on a six-week course of antibiotics, which quietened things down a bit, but I was glad to be finished with it. By then, I was sure I didn’t have a living bug in my body. But I was worn out. I took the summer off and worked on my fitness, swimming and kayaking in the estuary at the bottom of my garden. I started to feel better – not right, by any means, but better than half dead, which is what I’d felt in October.
In late March this year, I got an opportunity to take a raft down the Waimakariri River in Canterbury. We were going to tackle the Coast to Coast section… 56km of easy, class 2 mountain river. I ended up rowing for 10 hours and felt pretty good. Maybe I was on the mend, after all.
Not so. Three days later, I had acute abdominal pain. Yet another visit to the GP pointed to my gallbladder. An ultrasound scan was planned for four days later, as the pain at that stage was manageable.
However, things quickly went pear-shaped. Only 36 hours later, I was rushed into an appointment with a radiologist. The doctor performing the scan gave me a quick look over, and said, “Lie here. I’ll do your scan in a moment, but I’m going to call an ambulance. You’re in a bad way, and you’re going straight to hospital after this.”
I was in no position to argue. I’d gone from ambulatory to ambulance in just a few hours. Blood tests showed why. My CRP was again way up: 328 this time, with a fever of 38.8°C.
After four days in hospital with no positive diagnosis, I was at my wits’ end. This time, I truly felt I was dying (that might sound melodramatic, but septicaemia and the pain I was in can do that to you). Only IV morphine and antibiotics were keeping the septicaemia at bay.
In desperation, I called my GP and asked if there was anyone senior at North Shore Hospital we knew who I could talk to and get an idea of what was really going on. He thought for a moment and said: “There’s Jonathan Koea… he comes up here every month.”
Dr Koea is a general surgeon with a sub-specialist interest in liver, biliary and pancreatic conditions. He’s a “special specialist” – and luckily I knew him from the Rodney Surgical Centre in Warkworth, where he’s a visiting consultant.
With moments of being called by my GP, Koea was at my bedside. Miracles do happen. He said, “What are you doing in here? Let’s look at your notes… You’re seriously unwell. Let me go and talk to the team. I’ll be back in 10 minutes.”
Five minutes later, he was back. “Okay, that latest CT scan shows a change in your gallbladder. We’re sure that’s where the problem is. It also may be the cause of the other problems with your bladder. Here’s the plan: finish your course of IV antibiotics, we’ll send you home with another 10 days’ worth of oral antibiotics and I’ll operate on you then. In the meantime, concentrate on getting better. I’ll check on you tomorrow.”
I’d been thrown a lifeline, and it felt good.
Ten days later, Koea removed my scarred, infected, golf ball-sized gallbladder, with minimal intrusion. That evening, he came to check on me while I was having a hot drink and a club sandwich. “It’s a good job we operated when we did,” he said. “We wouldn’t have wanted it to burst. It’s obviously been like that for more than a year. No wonder you’ve been feeling unwell. I’m also pretty sure that’s been the cause of your problems. So go home, get better and I’ll see you in a week.”
Two weeks later, I was feeling 500 per cent better than I’d felt in the previous four years. There’s still a way to go, but at least now there’s a light at the end of this tunnel. I’m going to come right.
The thought of a river being the cause of this suffering is abhorrent to me. Especially when that river is one of our Great Walks (strange but true), and part of Te Araroa Walkway. It’s a popular tourist destination, an industry I’ve worked on promoting for the past 30 years.
I love that river. I went on my first multi-day kayak adventure there back in the 70s. I’m dismayed to see it becoming the source of health problems such as the one I experienced. What I’ve gone through could have killed a child with a compromised immune system – and lots of kids swim in that river.
Something has to be done about New Zealand’s water quality – and soon. Let’s save our rivers before it’s too late.
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