Surviving the superbug

At midnight, Ginnie Howard woke up in a hospital bed, drenched in sweat. Gripped by intense fever, she had been drifting in and out of consciousness, but now in this waking moment she looked down at her left side and shuddered.

Her whole arm was swollen to nearly four times its normal size. It no longer resembled an arm, more like a thigh stuck onto her upper body.

Ginnie had been infected with the superbug MRSA and her life was hanging in the balance. And all because of a simple cortisone injection given to her in the outpatients department of a private hospital.

In the week that new figures showed yet another rise in infections, her story is a cautionary tale of the devastating nature of this increasingly commonplace bacterium, showing that it does not discriminate between NHS and private hospitals.

Nor, for those fortunate enough to survive, do its effects end at the hospital door. Rehabilitation and loss of earnings have cost Ginnie thousands of pounds and she is unlikely ever to regain full use of her damaged arm.

A leading interior designer, who runs her own business from Chelsea, 51-year-old Ginnie had been given the cortisone injection after suffering from a recurring injury in both shoulders brought on by moving furniture around as part of her job.

A consultant orthopaedic surgeon suggested she have cortisone injections to reduce the inflammation and an appointment was made at a private hospital in Chelsea, which she doesn't wish to name. After the jab she travelled to Suffolk to stay with friends - and that was when her ordeal began.

"Something was obviously very wrong," she says. "My shoulder began to swell, and I was having trouble lifting my arm. I had a terrible fever and the bedsheets were soaked with sweat. The pain was excruciating. If anyone tried to touch my arm I thought I would faint."

Ginnie, who lives alone in Chelsea, called her London GP. He urged her to come back to London to see him. Her friends organised a car to take her straight there. "I couldn't relax," she says, "I felt panicky and scared. I found it difficult to concentrate on anything." By the time she arrived at her doctor's, she was almost delirious. Without hesitation, he got her straight to hospital - although not the one where she had the cortisone injections.

Ginnie was put in an isolation ward to prevent the infection spreading. Her doctor had told her she had a bacterial infection and that the injection was probably to blame; that the needle had not been sterile. He believed there was no other way the infection could have lodged in her arm.

Meanwhile, the swelling was spreading from her arm down her left side towards her waist. Hospital staff did not mention MRSA, but she was given Vancomycin, the powerful antibiotic normally delivered intravenously to fight the so-called superbug, and morphine for the pain.

For the first week, the nights were interminable. Knocked out by the morphine, Ginnie would doze then wake up at night desperately uncomfortable. She was hooked up to two drips: one morphine and the other Vancomycin.

She recalls: "It felt as if both my arms were tied to the bed. I felt like a prisoner in chains, I couldn't move."

The fluid that had accumulated in her left arm was being drained into a bag attached to her side. This was emptied on a daily basis. Ginnie could see all this happening, but a side-effect of the drugs was that she just didn't care.

She says: "Floating on morphine, I could see the bag filling up with all this repulsive fluid. Rather than being horrified I was just glad it was leaving my body."

The fever gradually subsided. As the infection eased and her arm decreased in size, the doctors lowered the morphine dosage. Every day the nurses used a red marker pen to draw down her left side - from the previous day's line they could tell that the infection was slowly retreating.

After two weeks, the morphine haze evaporated. Her only emotion was profound relief at being alive. At times during that tense first week, when she felt herself sinking under the morphine, the thought often crossed her mind that she might die.

This fear was backed up by her GP, who told her that if she hadn't got treatment when she did the infection would certainly have killed her. Ginnie's friends and brother and sister confessed that they, too, had feared for her life.

The classic symptoms of MRSA are fever, acute pain, boils and wounds that will not heal. Often the superbug is spread through open wounds after surgery - or it affects the more vulnerable seriously ill hospital patients. It can also gain access to the body through contaminated equipment such as drips and needles.

Her case shows that it is not just NHS hospitals that are susceptible to cases of MRSA. Yet as one of the city's most sought-after interior designers with a high income and good health insurance, she says she was luckier than most.

She was able to see the best shoulder consultants and to meet all the extra costs herself. "But what about people less fortunate than me?" she says.

She left hospital after three weeks, yet her ordeal was far from over. The muscle tissue in her arm had deteriorated significantly and she could no longer lift her arm.

For the first year, she had daily sessions of physio, which helped her regain some movement in her arm. But she needed three months off work. Ginnie had been working on a large commission refurbishing the headquarters of Pilkington Glass. Luckily her small team coped without her. Otherwise, she says, she would have lost her consultancy business.

After that first year, she had a clean-up operation to get rid of the dead tissue in her left shoulder. This was followed by another operation six months later.

She needed more time off work: nearly another six months. This was the most difficult time. "Knowing my arm was never going to completely heal made me depressed," she says. "It has been emotionally draining."

Who does she blame? "I'm not sure that I can blame one person. It's the hospital's fault, it should have higher standards of cleanliness; I remember seeing used swab bowls lying around in my room, and there was carpet everywhere instead of lino. I'm sure that encourages bugs to spread."

Ginnie sought legal advice but her lawyer said it would be hard to prove that the hospital was directly responsible because there was no evidence of where the infection had come from. She was advised to take it no further.

Three years later, Ginnie still has weekly physiotherapy. The swelling has gone down but she has been left with a large scar over her left shoulder and an arm that does not work properly. "I can't do up my dresses, as my shoulder won't go that far back. The side-effects have been far-reaching and have cost me thousands: I have had to pay out for drivers, domestic help and private nurses to help me bathe."

She is speaking out now because she feels it is important for people to know that MRSA can strike at any time, anywhere - and is not confined to NHS hospitals.

Like Claire Rayner, who famously caught MRSA after a knee operation, Ginnie tries to deter her friends and family from hospital visits. What if they need an essential operation?

"Then I tell them to take a bottle of Dettol with them. Why do people get infections? It only comes down to cleanliness in hospitals."