Christian author Rachel Held Evans in 2018. (Dan Evans)

Many people in the “floxie” community have been sharing the tragic news of the death of Rachel Held Evans.

Rachel Held Evans was a popular Christian author, blogger, and speaker. She lived a significant and impactful life in the 37 years that she was alive. She was a wife to Dan Evans, and the mother of two children. Dan said of Rachel:

“She put others before herself,” her husband, Dan Evans, said in an email on Saturday. “She shared her platform. She always remembered how others had helped her. She enjoyed seeing other people in contexts where they thrived. She didn’t hold grudges, would forget as well as forgive. She had little time for pettiness and a big heart for people. And these are all things I wish I had told her more while I still had the privilege to keep her company.” (source)

There are lovely obituaries and tributes to Rachel Held Evans in many publications. Here are a couple:

Rachel Held Evans experienced an adverse reaction to an antibiotic before her death, and that adverse reaction, along with UTI and flu symptoms, are what led her to check into the hospital on April 14, 2019. On May 4, 2019, she had passed after experiencing brain-swelling, seizures, and a medically-induced coma.

Many people have asked if the antibiotic that Rachel Held Evans had a “severe allergic reaction” to was a fluoroquinolone. It is reasonable to think that the antibiotic she reacted to may have been a fluoroquinolone – fluoroquinolones are often used to treat UTIs. However, I have not seen any confirmation that Held Evans was given a fluoroquinolone. It’s possible that she was “floxed,” but it’s also possible that she reacted horribly to another antibiotic. We don’t know at this time. Perhaps her family will update her story with information about what antibiotic she reacted badly to at some time in the future. At this point, the health updates from Dan Evans don’t give specific information about the antibiotic that contributed to her illness.

What is known about Held Evans’ illness and death is summarized well in the Washington Post article, “What we know about the death of popular Christian writer Rachel Held Evans.”

We don’t know what caused her health to decline so rapidly, or what kind of antibiotic she reacted badly to. We don’t know what caused her seizures, or what happened in the hospital. We don’t know what genetic (or other) predispositions she had toward adverse drug reactions, seizures, or anything else. We don’t really know why a 37 year old woman who was healthy less than a month ago is now dead.

We do know that when she entered the hospital she was well enough to tweet and to express concern about missing the newest episode of Game of Thrones (GOT), and that while in the hospital she started to experience seizures and brain swelling. We know that the seizures and brain-swelling led to her death.

We also know that fluoroquinolones can trigger seizures. Per the FDA warning label for CIPRO:

“CIPRO, like other fluoroquinolones, is known to trigger seizures or lower the seizure threshold. As with all fluoroquinolones, use CIPRO with caution in epileptic patients and patients with known or suspected CNS disorders that may predispose to seizures or lower the seizure threshold (for example, severe cerebral arteriosclerosis, previous history of convulsion, reduced cerebral blood flow, altered brain structure, or stroke), or in the presence of other risk factors that may predispose to seizures or lower the seizure threshold (for example, certain drug therapy, renal dysfunction). Use CIPRO when the benefits of treatment exceed the risks, since these patients are endangered because of possible undesirable CNS side effects. Cases of status epilepticus have been reported. If seizures occur, discontinue CIPRO.” (source)

But, again, we don’t know whether Rachel Held Evans took Cipro, or any other fluoroquinolone antibiotics. And we certainly don’t know whether or not fluoroquinolones caused her seizures.

We do know that the death of Rachel Held Evans is tragic, and that she will be missed by thousands (possibly millions) of people whose lives she touched. Hearts around the world are aching for her husband, children, and all others who loved her.

Considering her decline while in the hospital, I think it’s also reasonable to assume that her death was iatrogenic (caused by a medication or medical treatment). If this assumption, and questions around it, give the loved-ones of Rachel Held Evans some peace and closure, I hope that they get both answers and some form of justice.

It is clear that Rachel Held Evans was an amazing person who lived a generous, thoughtful, connected, beautiful life. It is a heartbreaking shame that she died so young and under such shocking and difficult circumstances.

My sincere condolences to her family and loved-ones.

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