The Dr Louise Newson Podcast - 100 – Sepsis, UTIs & quadruple amputation: Kim’s story

Episode Date: September 10, 2026

Kim Smith went on a family holiday to Spain with a UTI and woke up nine weeks later having lost all four limbs to sepsis.Twice missed by Spanish doctors, Kim's kidney pain and uncontrollable shivering escalated so fast she doesn't remember being flown home. She tells Dr Louise Newson what actually happened, from the misdiagnosis to being told all four limbs would need amputating, and how she's rebuilt her life since as a quadruple amputee and sepsis awareness advocate.Louise and Kim discuss the sepsis warning signs so often missed, why kidney pain and sudden shivering are red flags, and how around 30% of sepsis cases start as a urine infection. They also cover why vaginal hormones significantly cut UTI frequency and severity and are safe for almost everyone, including women who've had breast cancer, yet are still rarely prescribed.Kim shares her three take-home tips on sepsis before the episode ends.Follow Kim: @kims2ndchance Let’s connect👉 Track your symptoms andunderstand hormones, download the Balance app: https://bit.ly/4yZty5A👉 More from Dr LouiseNewson: https://linkin.bio/drlouisenewson

So Kim, I'm very excited. I've sort of hoiked you in after seeing you on Instagram. And Instagram's great for connecting with people. And I just read a few lines about you. And I thought, I really want to speak to this lady because you've got a story which is hard, but it's good because look at you, you're here, you look great. But it's not good and it could have been a lot worse. And do you know what? It resonated me for two reasons. One is that you had your new tract infection, which is, and they're so common. And they're almost like a bit belittled. And I've had UTIs that have been a bit come and go. And I've had UTIs where I literally would prefer to die because I've been in so much pain. I've been bleeding blood and just thinking this is terrible. But also you had sepsis, which really makes people think. And my 12, well, when my middle daughter was 12, she had sepsis. And we couldn't.

talk about that. But, you know, those two things, the only tract infection can cause sepsis and can kill people. And it's not spoken about enough. So listening to this story that you're going to tell us is going to make people think differently, I hope, or some people think differently. So just tell me what happened, Kim, if you don't mind. Yeah, so I was in Spain on holiday and started to feel a little bit unwell. I didn't have any UTI symptoms, which some people are quite shocked about. But then I started to get kidney pain in my left side and I thought, maybe I've got a UTI and it's gone to my kidneys. And that was the first inkling that I might have a UTI. I'd got severe breastlessness that I'd put down to my asthma. So I was using my

inhaler. I was shivering uncontrollably. I'd got the central heating on. We were in a villa and the log burner and I'd got thick jumpers on, I'd got blankets around me and I was shivering. And I just thought, it's the weather, I'm just cold. And my husband

kept coming in and going, oh, it's like greenhouse in here. I can't sit in here. It's too hot. But I was so cold I didn't know. I hadn't passed much during that day, but I hadn't really noticed. and I'd got really cold hands and feet and I could not get my hands and feet warm. He'd even done me a hot water bottle and I'd put that under my feet.

It made no difference. I've got several pairs of thick, fluffy socks on and they were still icy cold. But something in my gut told me that I needed to get checked and it would probably be better to go to the hospital. I must have thought I was quite poorly for me to want to go to the hospital. So in my little bit of Spanish, I said to them, Dolora here, which means pain here and pointed to my left side. Stupidly, I didn't say moinfermo, which means very ill. I didn't say infection, because I didn't know the word for kidney or urine, I didn't say infection.

So they apparently x-rayed my back and I say apparently because I don't remember. Because you were so poorly. They, yeah, they x-rayed my back and sent me away saying nothing's broken. The next day, at some point on my phone, I'd done a translate app, and I'd written in there, I think I have a urine infection, and I'd translated it into Spanish and screenshot it. And my husband took me to the doctors. I vaguely remember getting out of the car and trying to shuffle,

I could hardly walk at this point. And I was hanging on to my husband and seeing the doctor. And I don't remember seeing him. I don't remember going into the doctor. But I showed him my phone apparently. And he must have done a urine sample and confirmed I've got a urine infection. And he gave us a prescription to go to the chemist, which we did. But the chemist said we don't have any of those antibiotics in stock come back tomorrow.

I now believe it was too late for. oral antibiotics at that stage. I now know I needed IV antibiotics and fluids at hospital. So the hospital missed it and then the doctor missed it. I don't think he took my blood pressure or temperature and just sent me away. And I went home. I was so unwell and it's not like me to take myself to bed. I just don't do that unless I'm obviously really ill.

And I did. I took myself to bed. and I woke at 4 in the morning and I said to my husband, I'm dying, I need to go to hospital. I'm going to die. Close. And I don't even remember getting to the hospital any part of that at all. And I woke up nine plus weeks later in Milton Keynes Hospital back in the UK because finally my travel insurance after six weeks decided they would fly me back. Oh, my goodness.

and being told that all four limbs had to be amputated. And I said to the doctor, yeah, that's fine. How soon can you do it? Because I couldn't even lift them off the bed. It was like somebody had supergloved them down. They were so, so heavy. I couldn't lift them. And obviously my muscles had stopped working as well and everything,

because they had been just laid there for nine weeks, I guess. And then it was just a matter of then being shipped to another hospital for the amputations because my hospital doesn't do amputations. And I spent three months there before going for rehab in London at the Queen Mary Hospital in Roehampton. And I had to literally learn how to walk on my bottom. Yeah, it was quite a traumatic time when I came out of hospital as well because, you know, you used to having nurses kind of just do everything for you.

And then all of a sudden you're at home and you've got to keep asking family. And it's okay to ask a nurse because they're there to do it. When you've got to then start asking family, I was a very independent woman and would be the one running around after everybody else. Not asking people to do things for me. So I found it really, really hard. But I've come a long way since. I've learned how to blow dry my own hair. how to do my own makeup and even without hands, I can do it.

And I do a lot of things now, but my big thing is raising awareness of sepsis and making sure that people understand that any infection is serious and that UTIs are extremely serious for women because so many people just think, oh, it's just a UTI. Yeah. And there's a big difference. So, you know, urinary tract infection, the whole urinary tract is a long system and it's starts with the kidneys and ends in the Erespa that we're we out of. So some people get a bit of cystitis, it burns a bit and stinks and they feel absolutely fine. But you had kidney pain.

That is a red flag, actually. Kidney pain and people could be stones, but if someone then develops feeling cold shivery, that means you need to go to hospital. It doesn't always mean this, but it means you've got possibly pyloanopritis, which means infection in the kidney, which you probably had brewing then and that time. But it's very scary. It must have been very scary for your husband as well. Exactly, yeah. I mean, he was made to wait in a waiting room.

And I think they came out to him a couple of hours later and said she's got hours to live. She won't be needing these and gave him a bag of my clothes. I've gone in my pyjamas and my dressing gown and my jewellery. And they just gave it to him and said, she could die. She's got two hours to live. I was like, oh, wow, he doesn't speak a word of Spanish. They spoke a little bit of English. And so he must have been absolutely petrified.

And then he had to go home and phone the family. And then they all got flights out. Goodness. Yeah. I mean, urinary tract infections are very common. In fact, most women have them at some stage of their lives. I don't know the figures, perhaps you do, but I would have thought it's way over 70% of women have a urinary tract infection.

I mean, I don't know. I read that it can be 95% women and 5% men. Yeah. So I know it's a higher percentage with women. Absolutely. Yeah. Yeah. It's, and, you know, it's very interesting because there's a big move to not give antibiotics

for every episode of cystitis. Wow. But it's really difficult. As a doctor, I've seen 100,000 of women with urinary tract infections. How do I decide who doesn't need an antibiotic? And actually we also know that it's not always in the urine test because sometimes you can come back with a negative test, but people still have an infection, which I'm sure you've heard of. I've had negative tests and I know I've still gotten infected. Yeah.

So, but also as a GP, it can take two or three days or longer if it's over the weekend for a result. So then what do I do as a GP, do I wait for the result or do I treat the woman? And so it can be very difficult. And my sister had a kidney problem and she had to have an operation when she was young and she's very prone to urinary tract infections. And she knows very early on whether she's got an infection or not. But so many times she's been told you can't have antibiotics because we haven't got the urine test result back. But she knows if she has a short course and gets on top of it, it's a lot better. So it can be very difficult to know because guys.

sidelines will say different things, different doctors things. But actually, like I was saying to before we started recording, my job as a doctor is to listen to patients. And often women know if it's an infection or not. And if they think it is, then they often need antibiotics. Kidney pain, fever, really can take a hold as it did for you very quickly. Something like, and you probably know the steps, it's about 30% I think, of sepsis is due to Euro-sepsis.

So, it's one of the highest causes. Yeah. Yeah. And it's, you know, it's more common as we age. It's more common in women. Yeah. Lots of women, when I used to look after women in nursing homes, they would be very confused, delirious.

We wouldn't know what was going on and then we realized that it was a urine infection. So you don't even have to have classical symptoms. And, you know, sepsis means different things to different people. people, doesn't it? I think there's still some confusion. I think fine was extremely, extremely drastic, you know, to lose my limbs from it. I mean, I'm lucky. I didn't die because so many do die. And I find I'm lucky. I mean, people say, oh, poor you. And I'm like, I don't need a pity. I don't need pity. You know, I'm, I want you to learn about sepsis is what I want. I don't need pity. I'm doing great. I've got a good life. I'm happy. And, you know, I'm raising awareness of sepsis. I'm doing something really healthy, really good. You know, it's, I had a message just a couple of nights ago about I'd save this lady's life because, because of my posts and my videos, she'd gone to the hospital and got treatment and she had got sepsis from what I'd said in my videos. So I won't stop. I will never stop.

It's so important. But how would you, if someone stop you in the street and said, what is sepest, What do you say? What's your answer? I just tell them, sepsis is an extreme reaction by your immune system to an infection. And anyone can get it at any time. It doesn't matter if you're fit and healthy because I was fit and healthy. And to seek medical advice, usually I tell them to go to A&E because you need IV antibiotics and fluids. And going to your doctor isn't really going to give you IV antibiotics. If you can't get to hospital, 999 because most of the paramedics are very well trained. They certainly are in the south anyway. And get treatment because sepsis can kill so fast. I mean, I've known if people die within 24 hours. It's the speed, I think, is really important. And I do think as patients, we have to advocate for ourselves or our relatives.

But I think if we say that word, I think it could be sepsis. could they, you know, what about giving intravenous antibiotics? No one is going to tell me off as a doctor for giving intravenous antibiotics if someone can have sepsis. But it could go wrong the other way. And it is about the language, I think, is really important. A lot of people now are aware, thankfully, of sepsis. But when my daughter had it, I knew she was ill and she had a lot of pain in her hip, actually.

But hip is a really unusual place to get an infection. and she had this awful pain with getting worse. It woke her up twice in the night. And the second time I said to my husband, something's not right. I can't carry her. She was too big then for me to carry her down the stairs. So we had to call an ambulance. And they gave her heavy-duty pain killers.

And even then she was in pain. And going to the hospital, the x-ray was normal. So the doctor said, she can go home and have some physiotherapy. And I said, but she started to vomit. Like, there's something going on. she's not right. But even then as a doctor, sepstis wasn't on my radar. The next day she got worse.

They did another ultrasound scan. That was normal. I said she needs an MRI scan. Something's not right. And they went, oh, you're very anxious. I think we'll wait tomorrow. And I say, look, I'm really anxious because she's really ill, actually. And I'm really concerned.

And then she became very unwell and the MRI showed this fluorid infection. But actually what they did was they said she's got osteomyelitis, which means infection of the bone. bone, yeah. And was very ill and went to the ward. And it was only a few days later. I said, I said, well, actually, she's got sexis, but they never used that word. So the physiotherapist used to come and make her walk. And I said, no, she's still really ill. She's still getting fevers. She's not right. Wow. And it made me realize in medicine, the language of what you use is really important. When I told the school, oh, she's off because she's got an infection of her hip, they were like,

oh, that's a shame. But once I started to say she's had sepsis, it. was like, oh my gosh, is there anything I can do? Are you all right? And I thought, actually, isn't that interesting? Because for me as a doctor, I'm quite old now. So I wasn't trained in sepsis. I was changed in infection. So like you had pylonephritis, but it did develop to sepsis.

But it's that language, I think, is so important. But it's also important for us when we're with a patient or we are a patient to use that language properly. So if you had known the Spanish for sepsis, that would have been, you know, I didn't, but I didn't even know what sepsis was back then. I had no idea what sepsis was. I didn't know the word for urine or kidney, as we even say. So I didn't say infection. Yeah. You know, if I'd have said infection, would they have checked me more? I don't know. It's impossible to know, isn't it? If I'd gone to Milton Keynes Hospital, would they have done any different? I don't know. You know, I don't know if it had been any different in the UK.

I probably would have got to the doctors, first of all, and I probably would have asked for antibiotics because I thought I had a urine infection. If I still hadn't had been well, I'd have probably gone to the hospital then. But it's hard to know because it happens in this country as well as abroad. So it happens all over the world, unfortunately. Because it does. Because it does. So awareness is really important.

intravenous antibiotics really important and admission to hospital and you know we've got Martha's law that's come in now where people can ask for second opinions and actually when it stopped my husband's adopted but when he read about it he couldn't even read he gets very traumatized thinking about what if you know it happened to my daughter you can't because you don't know but I can guess what happened if she'd been sent home because she was so poorly but it's so important You know, yes, I was labelled as an anxious mother. I can get over that. A lot of people aren't so gloving.

I've had that as a mother being told I was an anxious mother when my daughter was a baby and she was vomiting and had diarrhea and losing weight. And they told me I was just a neurotic mother, was what they said. And I said, no, there's something wrong. Every time she's eating, she's then vomiting and she's got diarrhea. So what is going on? It turned out that she'd be in hospital. They'd give her, I rely on all kinds of treatment.

She'd be fine. They'd send her home. But what I didn't know, because I had another child at home that I had to be at home for, I was going home overnight, coming back of the morning. They were giving her Farley's Russ a day before she was leaving hospital. And she was supposed to be non-cow's milk. She was, they thought, allergic to cows milk and lactose and sugar. They're giving her farley's rust that's full of lactose and sugar.

She was then back 48 hours later. So I think they thought I was taking her home and eating her something she shouldn't be having, which I was only given her vegetables and doing what they told me. And then I'm back again. So, yeah, I sorted it out on my own at home in the end. So, but listening is the most important thing. Yeah, definitely. Me as a doctor, but for people as patients, they have to be listening to.

Yeah. The other thing is, I know you told me before, if you don't mind me saying, that you're using vaginal hormones. And that's really important because we know one of the reasons that women are more likely to get infections is because hormonal changes. And we've known actually since the 1980s that vaginal hormones will reduce frequency and severity of urinary tract infections. Wow. Yet only the minority of menopausal women are given vaginal hormones, which are very safe. They don't get absorbed in the body.

Anyone, you know, including women who've had breast cancer, can usually very safely use them. Yeah. So anyone that's had any urinary tract infection, certainly recurrent urinary tract infection, should be prescribed vaginal hormones. Yet a lot of times that's not even spoken about or considered. So many women don't know. You know, when they see my videos talking about, you know, getting vaginal estrogen, they're like, oh, I didn't know that.

I didn't know I could get that. And, you know, and how can you have it? And I said, well, it's either a pestle or a gel, I believe. But maybe there's cream as well. I'm not sure. I'm not a doctor. I don't know. But, you know, I tell them to speak to your doctor.

It's so important because some of my patients say to me, my doctor says I don't need vaginal hormones because I'm not sexually active. And it's like, hang on, it's not just for the vagina. It goes through into the bladder and it makes a massive difference. And, you know, because Eurosepsis, as you say, is common and it's still up there. It's not reducing. And partly because women are living longer, they're menopausal phenomenon. They've got low hormones for longer and they're not being given any vaginal hormones.

The doctor I saw at the Portland Hospital about my constant UTIs actually said that pregnant women really need it and breastfeeding mothers need it. And they're not told. They're not told. No, of course not. No one's told anything but also people on contraceptives that can often, because it's synthetic hormones, often can often can increase. often can increase someone's incidence and risk of having your own retract infection. So anybody of any age actually can use vaginal hormones. And once you start using them, it should really continue as well.

But also systemic hormones can really prime our immune system. So the hormones help our immune system to work effectively. Because there's one thing avoiding an infection. But if you have one, you want to make sure that your body is really fit to fight it. so it doesn't take a halt and develop in the sipsis. So we've known that for many years that the hormones can really improve the way our immune system works as well. So a lot of people we see who have had urinary tract infections, we give systemic HRT and testosterone

if they need it as well as vaginal hormones. And there are different preparations as well. So you can't have both. You can have both. Yeah, absolutely. Yeah. And a lot of people need both. So there's quite a lot of people who.

were on HRT and then their hormones drop and then they need vaginal hormones as well. So, I mean, I'm 55. I've been on HRT for about 10 years and I just had HRT and testosterone and then I had a hysterectomy and I got urine tract infection after UTI, UTI all the time. And I had them and I was younger as well, but they were really severe. And so using vaginal hormones has transformed literally my life. It's amazing. Yeah. So a lot of people say, well, it can't be hormonal because I'm on HRT, but you can just get it differently and different amounts.

And so there are the vaginal, like you say, there's the vaginal estrogen pezzary, the little tablet, there's a cream, there's a gel. There's a ring, actually, that's a silicon rig that's slow release to estrogen for about three months. And then there's something called intaroza or prasterone, which is a daily pezzary of DHA, so it converts to estrogen. and testosterone, and that's more effective at reducing urinary tract infections than just vaginal estrogen.

Wow. I think I need that then. Yeah. I mean, honestly, anything that's going to help reduce urinary tract infections is really, really important. Absolutely, because I'm currently waiting for a double hand transplant too. Wow. And when that does happen, I will then be on immune suppressants for the rest of my life. So then that's going to make me even more at risk.

So you want your immune system to be as strong as possible. Yeah, absolutely. Absolutely. And it's very important. I've got a pathology degree as well as a medicine degree. So I spent a lot of time my pathology degree learning about the immune system and what makes it as healthy as possible. And we know that hormones do as well as lots of other things.

So really important. But the work you're doing, Kim, is incredible. And like you say, people, especially women, share stories. They share experiences. They talk. They learn from each other. And you are living proof, not just how sepsis doesn't always kill. But also your positivity just shines through here today, but also on your Instagram.

And, you know, that's so commendable. It really is. Everyone says that. I'm just me. I've just always been the same. But, yeah. It's great. So I'm really grateful for you coming on just talking about this.

I always end my podcast with three take-home tips. So you can't be excluded. So three things that everyone needs to know about sepsis. Everyone needs to know the symptoms. So the symptoms are slow speech and confusion, extreme shivering and muscle pain, passing little or no urine in a day, severe breathlessness,

it feels like you're going to die, skin mottled or discolored. You can also have cold limbs, cold skin to touch or cold hands and feet. You can also have extreme. high or low blood pressure and temperature. And if you've got any of these, they are big red flags. So that's about sepsis. Two other things that we need to know about sepsis. So those are the symptoms. What people do if they think that they've got sepsis or someone that they know

might have sepsis? I always tell people, if you think you've got sepsis, get to hospital immediately. Tell them you've got an infection and you suspect you have sepsis. You have the symptoms. If you get fobbed off, which often patients do, ask for a second opinion or tell them, no, I'm really not well, and I need you to listen to me. And then ask for a second opinion if they won't listen to you, because I tell people, don't get fobbed off. Don't let them fob you off. If you think it's something wrong, trust your gut and tell them nicely that you need them to listen to you and that you need them to check you because you know something isn't right. Yeah, so important. And then the third thing, I think really, if you agree, would be just other people need to learn and help that person.

Absolutely. Everybody needs to learn what sepsis is to keep everybody else alive. You know, it might not be you, but it might be your family member. It might be a friend down the road. It might be a neighbour and they might not know what sepsis is. But by telling them about sepsis and making everybody aware, we are going to save lives. and that's what I bang on about all the time so that people understand everybody needs to know what it is because it can be anybody at any time. Absolutely. So keep banging the drum. Yes. And using your vagina hormones, that's for sure. Yes, I will.

And I think I'm going to wait for your email and I'm going to be contacting my GP about getting HRD again. Absolutely. So thank you. Oh, thanks, Kim. It's been great. Thank you. Thank you very much.