Incision on chest not healed completely.

[Ron Wyatt]

This is the best I could do. I couldn't find out the url for that photo to save my life. When I copy and paste the url field it just takes me to the front page of my Flickr account, so here it is... maybe you can see it clearly enough. https://www.flickr.com/photos/140882054@N04/

 

[pellicle]

Hi Ron Wyatt

thanks for having a bash ... you're close but not quite there. The page says that Ron hasn't made any photos public yet. Accordingly there are no images which are viewable. So you must have your privacy settings to disallow public viewing.


Click on your personal icon at the top right of the page
Click on Privacy & Permissions
scroll down to Defaults for new Uploads - > observe that and confirm that See: is anyone if not change it

Alternatively, to change the visibility of a single photo, click it to view ...
scroll to the bottom of the page and look at Additional Info what is set for "viewing this photo" select public from the dropdown list

If you wish to keep it private then add me as a friend so that I can perhaps see it.

I personally keep everything public on flickr and only put stuff there that I want others to see ... my security is "if its on the net its not secure" so if its something I want secure its not on the net.

with respect to

I couldn't find out the url for that photo to save my life.

you click the photo to view it
at the bottom in the black surrounding the photo you'll see 4 icons
if you hover over one you'll see its share
a window will pop up and you'll see
Share Embed Email BBCode

Choose BBCode and choose a size from the dropdown (default is perhaps 1024x768... copy that and paste it here ... it may have additional stuff that you don't wish, so you can trim that after you post it here

I usually trim out everything except between [img .... /img] those img tags must be left.


(god help you if you're using a tablet)

 

[Ron Wyatt]

It just wasn't meant to be. My settings say that 'anyone' can view. But my main page tells me I have no public photos. I only have the one photo, and the only way I can see it is to click on my 'buddy icon'. But it doesn't have a black border around it.

I don't understand why they won't just let me upload an attachment to my postings. Now I have a headache... stupid Flickr. I can email it to you if you really want to see it.

 

[pellicle]

It just wasn't meant to be....I don't understand why they won't just let me upload an attachment to my postings.

server space ... can you imagine how many bytes of storage hank would have to provide? Would people resize their images (do they even know how) ... all for free?

Now I have a headache... stupid Flickr. I can email it to you if you really want to see it.

well that was my initial proposal ... but I have no "real want" to see it, I'm just trying to help you.

PM me for email if you wish, don't if you don't ... its simple.

The only benefit from me seeing the wound is to determine if you have a fistula there or not.

The critical point summary of my posts to you is this:

• scabs should be well cleared from the wound by 1 month
• the wound should be well sealed and dry by 1 month
• chronic weeping (comes from chronos = time) is a bad sign and strongly suggests infection
• infections can smoulder for months to years, especially bacteria such as propionibacteria
• such infections are common causes for prostheses to fail and need replacement. While this is most common with prostheses such as hip and knee, the bacteria don't distinguish between makers
• such infections frequently result in the prostheses being replaced ...
• I have had exactly this problem but it stayed beneath the skin till it erupted.
• diagnosis of the bacteria is not straightforward due to culturing difficulties and "noise" from your own skin flora

Best Wishes

 

[Ron Wyatt]

Thanks for trying to help me, I really appreciate it!

 

[pellicle]

Ron Wyatt

Julien has pointed out to me that you managed to make it your ICON photo on Flickr (in space noone can hear me scream)

So does it look like this

if it does and it has looked like this with a small discharge for 5 months then then that looks almost certain you have in infection. I'm suspecting that its on the wires.

That will be a tricky surgery as just pulling the wires risks dragging any infection back behind the sternum (if it hasn't already travelled down the wires yet) where its in real risk of infecting your prosthesis.

 

[Ron Wyatt]

Yep, that's what it looks like scabbed over after a few days. When I shower, it comes off and you can see the little hole.

I might have to look at replacing that icon photo... it looks kind of disgusting.

 

[Ron Wyatt]

I took antibiotics for ten days, but nothing came of it. My GP cauterized it today. If it works, great... if not, I'm past worrying about it. Thanks guys!

 

[pellicle]

Hey Ron

thanks for the update.

Best Wishes and Happy Easter

 

[Superman]

If the infection is slow growing as pellicle suggests, then a 10 day course might not do it. Wouldn't cauterizing it just close the infection in there?

I came down with an infection after my last surgery that traveled along the lymphatic system called Mycobacterium marinum, I got it from cleaning a fish tank and in my immuno-compromised position was more susceptible.

Point is the incubation period of that infection is from 7 - 21 days. Because it has such a long lifecycle - an ordinary course of antibiotics being 10 days may not address the infection. It could miss the incubation period of new bacteria. I believe I was put on a six week (or month?) course which finally took care of it.

Oddly - the doctor (after a three day stay in the hospital and consultation with an infectious disease doctor) who correctly diagnosed and treated it was a dermatologist. I went there on a whim, because I was running out of ideas of where to turn to make it go away. He identified it on sight and new exactly how to treat. He also paraded a bunch of his partners in to look at it since it was so rare.

In just reading over the thread - maybe I'm missing some private messages or something, but it doesn't appear that the seriousness of this being an infection is fully appreciated.

 

[pellicle]

Hi

In just reading over the thread - maybe I'm missing some private messages or something, but it doesn't appear that the seriousness of this being an infection is fully appreciated.

certainly not by me, but it appears by the Doctors at least. I expect that Ron is feeling depressed (post surgical commonality) and sorely needs an advocate for his proper treatment.

I have significant fears for his health if this is not treated promptly.

To me this presents as Propioni ... which I think I've already said.

http://www.ncbi.nlm.nih.gov/pubmed/19232190

Note the following points:

• I don't know if Ron has this on his prosthesis yet, but it appears to be infecting the sternal wires. If left untreated it will smoulder and eventually reach the prosthese
• that point in the conclusions exactly my own experience (my underline)
• the times for it to present are long

Propionibacterium acnes prosthetic valve endocarditis (PAPVE).

[h=4]RESULTS:[/h] Seven patients developed PAPVE early and 9 developed it late....
The delay in diagnosis was >3 months in 75%....
The predominant echocardiographic finding was prosthesis dysfunction due to dehiscence of metallic aortic valves (6 out of 7) or stenosis of metallic mitral valves (4 out of 7). In 2 of the 3 biological aortic prostheses, dysfunction was due to leaflet distortion.
Blood cultures and surgical specimens tested positive after a mean of 11.6 and 12.2 days, ....
...
Histology demonstrated the absence of acute inflammatory features. Twelve patients received antibiotic treatment with valve replacement: 7 were cured, 4 experienced early prosthesis dehiscence and 1 relapsed. All 3 patients who were initially treated with antibiotics alone suffered relapses.


CONCLUSIONS:

Generally, PAPVE presents as prosthetic valve dysfunction with few symptoms of infection. Prolonged incubation of cultures is essential for diagnosis. Antibiotic treatment provides clinical control but does not eradicate the infection, and valve replacement is necessary for a cure. The postoperative course can be complicated by prosthesis dehiscence.

you can bet your bottom dollar the treatment with antibiotics was not 10 days.

For a start I was on a PIC of a coctail of vancomycin alternating with penicillin for 10 days followed by a continuation of oral 500mg amocicillin every 8 hours (which I remain on).

Look up that word dehisence ... its not pretty.

 

[pellicle]

Lastly Ron Wyatt I urge you to take this evidence to your Dr, both the article above and this one

http://www.ncbi.nlm.nih.gov/pubmed/19376733

OBJECTIVES:

The aim of this study was to investigate the incidence and predictors of deep sternal wound infection (DSWI) in a contemporary cohort of patients undergoing cardiac surgery. The early and late outcomes of patients with this complication also were analyzed

PARTICIPANTS:

Five thousand seven hundred ninety-eight patients who underwent cardiac surgery between January 1998 and December 2005 including isolated coronary artery bypass graft (CABG) (n = 2,749, 47%), single- or multiple-valve surgery (n = 1,280, 22%), combined valve and CABG procedures (n = 934, 16%), and surgery involving the ascending aorta or the aortic arch (n = 835, 15%).

MEASUREMENTS AND MAIN RESULTS:

The overall incidence of DSWI was 1.8% (n = 106). The highest rate of DSWI occurred after combined valve/CABG surgery (2.4%, n = 22) and aortic procedures (2.4%, n = 19). ...
The mortality rate was 14.2% (n = 15) versus 3.6% (n = 205) in the control group (p < 0.001).
One- and 5-year survival after DSWI were significantly decreased

CONCLUSION:

DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival.

So its rare less than 2% but for those 2% the outcomes were serious Mortality rate of 14%

If you were just projecting this then I would be cautious. But you have the wounds to put your fingers into ... I still can't believe that a Dr cauterised a fistula!

Its ironic that a great many posts here are essentially nerves or anxiety and people refuse to calm down. Here we have a relatively clear case of an infection presenting which is serious in its consequences and the poster seems to be dismissive of the magnitude of the situation.

I appreciate that you feel quite miserable, and I can assure you that when I had my infection I actually asked them to "not wake me up" after my second debridement. So I understand that you may feel like taking what comes ... but if I am correct in my view that this is Propi then I assure you it will be an easier path if you push down it now than wait for later.

Let me know if you need prints of those articles, I will mail them to you in hard copy to present to your medical fools.

From here it feels like you are being treated by amateur veterinarians, perhaps not even that good.

 

[Duffey]

I took antibiotics for ten days, but nothing came of it. My GP cauterized it today. If it works, great... if not, I'm past worrying about it. Thanks guys!

Hey Ron! Let us know how this plays out. You may be beyond worrying about it, but we aren't!

 

[Amy]

I realize this thread is five years old, but rather than starting a new one, I wanted to see what @pellicle and the rest of you guys thought about this.

I’m four weeks post-op and after exercise the past days have noticed a drip of whitish liquid on the edge of one of the scabs on my incision (still one on both the top and bottom of the incision). I also feel a bit of pain in my upper pectoral muscles, where I imagine the sternum wires may be (?) and the skin is a bit itchy.

I finally finally got a nurse at C.C. to do something other than just say, “if you’re concerned, go to your local ER” - I’ve been prescribed two weeks of Cipro, without anyone having so much as looked at it, though I offered again and again to send a photo.

Of course I’ll take it, though the side effects look fricking scary, not to mention the effect on INR. But, with no one having looked at it, I do wonder if Im perhaps jumping the gun and seeing pathology in a normal healing process...

So...... someone please tell me about your similar experience!... I mean, is the four-week post-op mark too soon to be expecting the incision to not make a single drop of fluid with exercise? Or is the pec pain maybe related and to be taken seriously?

Any thoughts..... please.. Thank you.

 

[pellicle]

Any thoughts..... please.. Thank you.

• watch your INR on Ciprofloxacin
• did you do the betadine painting as I described to you previously?
• to be clear you wrote " (still one on both the top and bottom of the incision) " while previously you'd spoken of the drain

 

[Chuck C]

I realize this thread is five years old, but rather than starting a new one, I wanted to see what @pellicle and the rest of you guys thought about this.

I’m four weeks post-op and after exercise the past days have noticed a drip of whitish liquid on the edge of one of the scabs on my incision (still one on both the top and bottom of the incision). I also feel a bit of pain in my upper pectoral muscles, where I imagine the sternum wires may be (?) and the skin is a bit itchy.

I finally finally got a nurse at C.C. to do something other than just say, “if you’re concerned, go to your local ER” - I’ve been prescribed two weeks of Cipro, without anyone having so much as looked at it, though I offered again and again to send a photo.

Of course I’ll take it, though the side effects look fricking scary, not to mention the effect on INR. But, with no one having looked at it, I do wonder if Im perhaps jumping the gun and seeing pathology in a normal healing process...

So...... someone please tell me about your similar experience!... I mean, is the four-week post-op mark too soon to be expecting the incision to not make a single drop of fluid with exercise? Or is the pec pain maybe related and to be taken seriously?

Any thoughts..... please.. Thank you.

Hi Amy.
I am 5 1/2 weeks out and do not have any oozing, so I can't speak to that. But, I wanted to let you know that I am also on Cipro right now- I'm on day 3. I have what appears to be some prostate irritation and so am on Cipro as I wait for the urology appointment Monday to assess what is going on, just in case it turns out to be prostatitis.
So far it has not had any impact on my INR but am watching it very closely and testing daily as it is known to raise INR.
Hopefully if it does turn out to be an infection the Cipro clears it up for you.

 

[Lynn]

Amy, I am also 4 weeks post surgery and have not had any discharge from my incision since leaving the hospital. It looks very “healed”. I do have odd pains in my muscles, ribs and sternum, but nothing that lasts. While I am new to this and can’t add much other than my own experience, I will say that when I had a low grade fever and was feeling unwell 10 days ago, the local urgent care department did a full scope of tests; xrays, ECG, full spectrum of blood work including a series of blood cultures to check for any brewing infection anywhere in the body. All tests were fine, and I am feeling better. I had had a sinus infection and a covid shot since surgery, so it was likely the lingering affects of one of those. But if you are worried, a series of blood cultures checking for infection and the type of infection may put you more at ease. It did for me. Wishing you the best

 

[Amy]

• did you do the betadine painting as I described to you previously?
• to be clear you wrote " (still one on both the top and bottom of the incision) " while previously you'd spoken of the drain

Thank you, pellicle. I did the betadine painting for a week or so on the chest tube incision site, which is very slowly healing, I think. Part of the scabs have fallen off twice. I don’t know if that’s good or not.

This time I’m concerned about the sternotomy incision... It has a burnt match-looking scab on the top, and another scab on the bottom, and these haven’t really changed much since shortly after the surgery; except that the bottom one had a drop or two of whitish fluid come out after coming back from walks on three occasions, and a little tiny bit of blood after that. I just don’t know if this is normal, or if this kind of thing is a sign of infection.

I also have new pectoral pain on my right side now, (and continuing pec pain on the left) which I never had before... but then the whole last four weeks have been a continuous series of new aches every day.., so maybe I should not imagine bacteria-covered sternum wires... Well, probably not good to imagine that either way.

 

[Amy]

But if you are worried, a series of blood cultures checking for infection and the type of infection may put you more at ease. It did for me.

Lynn, thank you so much. That’s a good idea. I’d possibly have to walk around outside in the heat for 10-15 minutes to make a drop come out so there’s be something to culture. Ugh, I hate this. But thank you so much for your advice.

 

[Amy]

Hey Chuck,

Yes, I had a feeling it could interfere with the warfarin, despite the nurse who called (telling me she’d call in the prescription) assuring me it would not. Amateurs. ; ) isn’t it a funny thing how much more careful you are to double-check the correct answer when it’s about your own body?

I’m sorry you’re on Cipro, but confess I also feel less alone knowing I’m not the only one who hit a bump on the road to recovery - ha! It is weird how it seems to go two steps forward, one step back.

Thank you for your thoughts, and get well soon!!