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Patient Success Story – Muawiyah Atiyah

Let’s begin by telling you about Muawiyah Atiyah, a 37-year-old Dentist who was given a second chance at life thanks to our outstanding team. It is not often that patients who have been declared dead return to life but this was the case with Muawiyah. Muawiyah visited our Emergency Department on the 20th October 2020 where he was very unwell. He had a very high fever and by mid-morning that day, his blood pressure started to drop and his breathing became more laborious. Initially it was thought that he may have COVID 19, however he had already done a swab in an outside facility which was negative. Gradually Muawiyah went into shock and being customary in that situation, a focused echo scan was performed by Dr Tarik Al-Janabi, Head of Emergency Department and Consultant Emergency Medicine. Dr Tarik noted that Muawiyah’s heart function was very bad and in effect, he was in heart failure. A deep line (a central venous line) was inserted and blood pressure medication support was initiated. At this point, it was clear that the team were racing with time in terms of reaching the diagnosis and treating it promptly before Muawiyah went into multiple organ failure. There were some odds that were on his side, given his age and physical built, yet nevertheless it was clear that if action wasn’t quick, those odds would not aid his survival.

After admitting Muawiyah to ICU and having a thorough history and examination, it was mentioned that he was recently complaining of pain in his gluteal region. After a clinical examination, a bed side ultrasound revealed the presence of abnormal tissue and fluid collection. Dr Ali Eghtedari, Consultant General Surgeon confirmed the problem whereby Muawiyah was instantly taken into theatre. After opening the wound, it was clear that Muawiah had a ruptured gluteal abscess, necrosis (dead muscle) and pus. Muawiyah tolerated the surgery and general anaesthesia, however he immediately went into sepsis and septic shock. The next day he became very sick and was barely conscious, his breathing was severely compromised and his kidneys started to shut down.

Muawiyah was sedated, intubated and ventilated and at that point, in effect, he had multiple organ failure syndrome which is associated with a very high mortality. After offering organ support and multidisciplinary input in the form of a microbiological consultation with Dr Wael Faroug Mohamed Elamin, a Nephrology consultation from Dr Adil Obeid, Cardiology consultation from Dr Omar Hallak and Dr Tamkeen Kinah, input from Lead Dietician, Edel Warke, Pharmacists, Physiotherapists, Tissue Viability Nurse and the care of our wonderful ICU Nurses, Muawiyah steadily improved. However, at one stage Muawiyah almost reached a point of irreversible shock. Luckily, the team managed to get Muawiyah off the ventilator and he was extubated. There was hope that things from there could only get better, however he unfortunately developed another episode of sepsis and became very unwell. He also developed some minor bleeding in his stomach due to what is called stress ulcers. Dr Regina Will, Consultant Gastroenterologist was consulted but fortunately Muawiyah didn’t require an endoscopy. However, he continued to worsen from a sepsis point of view and required to be re-intubated and was put back on the ventilator. This was extremely difficult for the team feeling they had gone back to square one.

Due the phenomenal efforts of our team including the remarkable Dr Mohammed Abdulraheem, Consultant Anaesthetist and Lead Intensivist, Dr Desh Deepak, Specialist Critical Care Medicine and our ICU Nurses, their tremendous hard work paid off. Not to mention the input from the various members of the multidisciplinary team, they were able to extubate Muawiyah again, successfully on the 1st November. Since then, he has made a steady and stable recovery and was discharged to the ward on the 9th of November after 21 days on ICU. He spent a few days on the ward and was discharged home on 12th of November.

Dr Mohammed Abdulraheem told us ~ Sepsis and septic shock are challenging conditions and can affect all age groups and even in the healthiest of people it can have devastating consequences. Fortunately for Muawiyah, with the guidance from God and the efforts of our multidisciplinary team here at King’s, he had a favorable outcome which might not be in the case even if he was in a facility abroad. Therefore, I am very proud of my team especially our nursing staff whom without their dedication and perseverance, I am sure he would not have survived. Muawiyah visited the team from Abu Dhabi today to extend his appreciation, particularly Dr Mohammed who he created a special bond with. He told us “Dr Mohammed and all the team gave me a second chance at life and I am eternally grateful. My Father who lives in Libya would even like to come and meet the people that saved my life. The clinical care I have received is outstanding and I cannot thank King’s enough”.