Mandi Leonard’s husband Chris lost his battle with cancer in December 2019 at the age of 58.
During his chemotherapy treatment, he had sepsis twice. If it wasn’t for the hospital staff who made his family aware of the signs of sepsis, and Mandi’s foresight to recognise that her husband’s confusion and high temperature were signs that he was very unwell, he could have had much less time with his loved ones.
Mandi is sharing Chris’ experience to help make others aware of the signs of sepsis – so that they too can act before it’s too late. She said: “If one person goes to the doctors and gets the treatment they need out of me sharing our story, then that would be absolutely brilliant.”
Chris Leonard was 57 when he was diagnosed with Primary Central Nervous System Lymphoma (PCNSL). He had had an MRI scan, but they scanned from his neck down and his tumour was in his head, so it was missed until it was quite severe.
His wife Mandi took him to A&E because she thought he was having a stroke based on the symptoms he was presenting with. However, doctors found a tumour on a CT scan that they thought was cancerous. Describing how she felt upon hearing the C-word, Mandi said: “We were really shocked, but also not surprised because we knew that was something that wasn’t right.”
Chris had to have a brain biopsy to establish the type of cancer, which led to an official diagnosis mid-October 2018. But, the odds were reasonably good at first. Mandi said: “Look, no cancer in your brain is going to be good, right? But, the prognosis was better than some other brain tumours. We were told it was curable in some instances. No promises were ever made, but it wasn’t necessarily the worst kind of brain tumour you could have, so we were reasonably hopeful.”
Chris was referred to haematology at the Royal Surrey County Hospital in Guildford, because PCNSL is a blood cancer. He was told treatment would involve five days of chemotherapy in three batches. Once Chris had the three rounds of intensive chemotherapy, he would have a stem cell transplant at the Royal Marsden in Sutton.
The rounds of chemotherapy took place between November 2018 and February 2019, but it wasn’t all plain sailing. Chris had sepsis twice during this period – and ended up in high dependency on one occasion.
Prior to Chris’ illness, Mandi wasn’t particularly clued up about sepsis. She said: “I’d heard of sepsis, but I didn’t really know too much about it. I think it was one of those things you heard on the news sometimes, but you don’t notice stuff until such a time as it really becomes part of your world.”
Mandi’s understanding of sepsis changed when Chris started chemotherapy treatment, as chemotherapy targets cancer cells but can also kill healthy infection-fighting cells called neutrophils. When someone’s neutrophil levels drop below a certain level, they can have neutropenia or be labelled ‘neutropenic’ – which means they are more susceptible to infections. Mandi said: “We were aware that sepsis was a possibility because the type of chemotherapy that he had really depletes your immune system, so we knew that we had to watch out for the symptoms of sepsis.”
She added: “When we left the Royal Surrey after each round of chemotherapy, they were very mindful of reminding you of things to be looking out for and the additional cleaning you needed to do.”
Despite taking all the recommended precautions, though, Mandi got up for work one Friday morning and Chris was still in bed. Mandi said: “He was just talking absolute nonsense. He was talking rubbish and so I stopped, I took his temperature, and it was over 40 degrees, which I knew was one of the sepsis symptoms along with confusion. So I took him straight to our local A&E. I had my little card to say that he was neutropenic and after a little bit of persuasion that he wasn’t having a heart attack or anything, they started treating him for sepsis.”
Chris’ doctors followed the sepsis protocols, but he became very, very unwell. His blood pressure dropped dramatically over the next 24 hours and they couldn’t get it back up. He spent 24 hours in high dependency, and was in hospital for six days. Mandi said: “My son was a medical student at the time, but also a qualified nurse. He was in the hospital with us seeing all the charts and I could tell by his face it wasn’t good.”
The second time Chris had sepsis, it was caught much earlier. Mandi said: “I think we picked it up earlier this time because we knew what we were looking for. He was just feeling generally unwell, and it was the high temperature that we picked it up with and again took him in. He spent three days in hospital that time and thankfully didn’t need to go to high dependency. But I have to say my local hospital was absolutely brilliant. They really, really were. I had my sepsis card, I had the neutropenic card. And they followed protocol and did exactly what they needed to do.”
After recovering from sepsis and the chemotherapy, Chris went in for his full stem cell transplant in March 2019, which went okay. In July 2019, his family even had the all-clear – and were told there was no sign of cancer.
Unfortunately, though, in September of that year, Chris had a major seizure at home and then doctors found a tumour on the left-hand side of his brain that that became untreatable over the course of time. He passed away in December 2019, age 58.
Now, sharing her and Chris’ story with The UK Sepsis Trust in 2023, Mandi said: “From Chris’s story, I guess my takeout from it is to trust your instincts. He’d been going to the doctor since March and wasn’t diagnosed until September-October time. It’s very difficult sometimes to get those face-to-face doctor’s appointments, but don’t necessarily take no for an answer.”
“That’s the same with sepsis. I had quite a few hot and cold moments when I thought, ‘What if I’d have just thought he was talking rubbish and I had just gone to work that day?’ I don’t know what state I would have found him in by the time I got home that evening and whether he would have been recoverable at that point. Although ultimately, he passed away from the cancer, he didn’t pass away at the beginning of 2019. We did have him for the rest of that year as well, and we could have lost him an awful lot earlier. It’s one thing to have lost him to cancer. It would have been horrible to have thought at that stage that he might have survived the cancer and actually it was sepsis, and perhaps us not being as quick to react to it as we could have been.”