Bacterial endocartis prevention

[loz]

Hi Nancy and everybody
I am worried. Peter my son had dental procedures with no antibotics not long ago. He is due for more dental procedures in april. They have said they will give the antibiotic in april but i can not understand why they did not give it before. They know he has a st jude valve, I wish we were back in america. I know he would be fine. Sorry i hate our N.H.S here in England Uk. They messed up with my son when he had his first open heart surgery they never told us. I found out, thats why we took him to america to save his life and they did thank you america. we are going back to america in september to Miami Childrens Hospital, we can not wait. Peter past diagnosis was moderate to severe subaortic aortic stenosis, aortic stenosis, mild to moderate aortic regurgitation, pulmonary stenosis, mild pulmonary regurgitation, mild mitral regurgitation, trival tricuspid regurgitation, mildly hypertrophied left ventricle. first open heart surgery jan 2000 here in England Uk for resection of this membrane they messed up. Last open heart surgery july 2002 konno procedure with new aortic valve at Miami Childrens Hospital. I now know Peter should of had this konno procedure and new valve on his first open heart surgery

 

[Nancy]

Gee Loz-

That's such a distressing story. I am so sorry for your young man, to have such misery.

Unfortunately none of us can turn back the clock. What's done is done. All that can be done now is to look to the future and to learn all you can about his condition and to be a real pain in the backside making sure he gets the right treatment. It's unfortunate that it has to be like that, but life is just like that.

Everyone involved with medical care tries very hard not to make mistakes, but they can and do happen. We are all imperfect.

It really is true, however, that you might be able to make your son's care a little smoother by watching every single little thing, knowing what's right for him, and seeking the very best medical people you can find. The more you know, the more mistakes you can catch before they happen.

Make sure that everyone involved with him, knows all of his many conditions. I have a "cheat sheet" for all of my husband's serious medical conditions, and a time line of when he has had surgery or serious hospital admittances. It's as concise as I can make it, and I had to use a smaller font, because I wanted everything to be on one page, for those medical folks who don't have time to read the long version in the chart.

I also have a similar sheet for his current medications with the dosages. I keep both strictly up to date. They go with us to every medical appt. and every ER trip. Some doctors throw them out, but I don't care. I did my job and put him on notice. After a while they realize that this is done to help and not to point fingers at anyone.

Sure it takes lots of time to do this, but it has helped a great deal.

Wishing you and your son all the best for the future.

 

[Georgia]

Hi! I'm so sorry about this. And the reason they did dental work without antibiotics is because someone screwed up. I think perhaps you should contact the US docs and see what they'd recommend after the uncovered dental work.

I was diagnosed with Mitral valve prolapse in 1979 and my dentist has NEVER done any work (including cleaning) without asking if I took my antibiotics. He's obsessed with it, and I'm glad he is.

However, I had surgery for breast cancer (lymph node removal) about 14 years ago, and they forgot to give me antibiotics. Seems to me the surgeon about fell out of his chair when I asked him about it. Fortunately, no problems ensued.

Good luck with your kiddo.

Georgia

 

[pegne]

Twenty five years

Twenty five years

of taking oral antibiotics before ANY dental work. In the last ten years or so they started telling me to take them afterwards also. It has been a part of my regimine so long that I don't remember any different. I have had IVs before stomach tests and such and also before I had a test for nerve damage in my back but that's it. I couldn't imagine having an IV before all dental work.

 

[loz]

I will contact miami childrens tomorrow. Yes i agree I do need to look to the future and not in the past. But it is hard
thank you all for being there. Talk soon
Loz xxx

 

[dano]

Some additional info

Some additional info

I was at the cardiologist office to get my INR checked and to get a Coumadin prescription because my company is changing insurance. While I was there, I asked the nurse about the treatment. From what I could read on the AHA card and at the website, people with prostetic heart valves are considered high risk. But the card has a regimen on the front and a regimen on the back. The front is where the Dental is listed and it states the pill regimen for people 'at risk'. I read that as high, moderate, or low. On the back, there is the regimen for genitourinary/gastrointestinal procedures. It breaks out high versus moderate and the IV is for high risk patients. When I discussed this with the nurse, you understood what I was saying and stated that they erred on the conservative side and recommended the high regimen for all treatments. But, she did discuss with a doctor. He said they were guidelines and each patient had to be assessed individually and that they did favor the regimen for the best coverage. They did say that I could use the pills, if I didn't want to do the IV/shot thing. I think I may delay the next cleaning and discuss with my doctor before the next treatment - just to be sure. The IV is definitely a pain and may get expensive (depending on insurance), but they may be concerned since I had two surgeries in 18 months and don't want to chance a third. It was a first for my dentist though. Oh, as a side note, I got shots instead of the IV and my hip is still pretty sore and that was 10 days ago. So, if you have a choice you might want to do the IV. They say it takes about an hour and a half for that to complete. In my case, I'd have to allow at least a half day, because it takes about an hour for the pharmacy to deliver the medicine, an hour and a half for the IV, some observation time, travel time to the dentist and then 45 minutes or so for the cleaning.

 

[loz]

Hi Nancy and everybody
Loz here! Spoke to Peters new cardiologist about antibiotic cover for dental procedures,he wrote a letter to us saying that he requires antibiotic cover for potentially septic procedures such as dental extraction ,I hope that this is right, he also informed Peters INR clinic that his INR should be maintained between 3 and 4,they had got Peter down as between 2 and 3.
I did tell them when we returned from America in August last year,that it should be between 3 and 4,but they didnt listen.It has took them 7 months for them to sort this out and im quite sure that our sons had a mini stroke in the last 4 months and the cardiologist suspected this aswell.Peters speach went slurry and he started to dribble and started to flinch and twitch a lot too,that has now passed,lets hope that he doesnt have this again!
Im going to be watching everything that goes on when Peter goes for future appointments as I cant afford to let them make any more mistakes.

Look forward to hearing from you all soon!!!
Loz.

 

[Ross]

They should be giving him 4 500mg (2000mg total) capsules of amoxicillin or trimox one hour before any dental appointment. St. Jude recommends an INR of 2.5 to 3.5 for a mechanical valve. I prefer to keep mine as close to 3.5 as possible. Much rather be higher then lower!

 

[ccrawford]

Affect on INR

Affect on INR

Hi Ross - Does amoxicillan or trimox alter your INR because of affecting the bacteria in your digestive system ? Have you tried yogurt as a way to replace the bacteria more quickly ? Chris

 

[Granbonny]

Trimox

Trimox

Have taken 2,000 mg....3 different times. Never bothered my INR. I guess someone would have to test 3 days later to see if it altered INR. Cannot remember when I tested. Can I borrow that book Bonnie

 

[Ross]

I just got done doing a full ten day run on amoxicillin and it didn't do a thing to my INR. Now I can't say everyone would have the same result, but it didn't affect mine.

 

[loz]

Hi Ross
Peters INR was 3.5 is now 2.5 going back to INR clinic 17 of April
Bit worried about this dental thing he had 4 fillings not long ago without antibiotic cover. He is due for more fillings on the 26 of April. Not to happy now with this letter we have had from his Cardiologist saying that he only needs antibiotic when he has dental extractions, I think i need to talk with him again
Regard,s Loz

 

[Georgia]

Say cheese!

Say cheese!

Loz - I've had to use antibiotic cover since 1979 - here's the scoop. I think (as does my dentist) that it's prudent to be covered every time we walk in the dentist's office. However, the SAFEST you are is having fillings done - as long as the gums aren't nicked, it's OK.

But I think everyone is happier when you're covered for all dental work. I know that my dentist would not do any work without my taking the 2,000 mg of amoxicillin. He'd rather lose the business.

Why not have Peter's dentist prescribe the antibiotic? That's what I've done for ever. That way the opinion of the physician is moot.

 

[Ross]

Not to happy now with this letter we have had from his Cardiologist saying that he only needs antibiotic when he has dental extractions, I think i need to talk with him again

And you shouldn't be happy either! Even for fillings, cleanings, whatever, take the antibiotics. Even a shot to numb you is breaking the skin and introducing bacteria into the blood stream. This is something that cannot be overlooked. It would be very risky to do anything without premedication.

Could you sue your cardiologist if anything became of the patient because of his poor advice?

 

[Enudely]

Like I said before... anyone interested in replacing the good bacteria in their intestines (after high dose of anitbiotics kills them) should take Acidophilus. Yogurt contains acidophilus, but because it is difficult to digest, the cultures are not as easilly absorbed. Taking a capsule form of acidophilus is a much superior method...

 

[pegne]

My dentist's office called

My dentist's office called

I have an appointment in June to see the dentist for a cleaning exam. They called just last night to see if I wanted to come in today. I couldn't because I wouldn't have had the antibiotic. The pharmacy closed at 9:00pm and they called at 8:30pm. They wanted me to go in at 9:00 this morning. When they found out I didn't have any antibiotic we both knew I wouldn't be keeping that appt. No ifs, ands, or buts about it. You need to be premedicated before ANY and All dental work. If anybody is telling you otherwise DO NOT know what they are talking about. I, like Georgia have had to follow this rule for a very long time and every dentist I have been to has insisted on it.

 

[Georgia]

Hey, Peggie - SMILE

Hey, Peggie - SMILE

My dentist started giving me a prescription of 12 tabs instead of just the amount I need for each visit (unfortunately, it DOES say a lot about the amount of work my mouth requires ). I just make sure I always have 4 of them on hand in case of emergency. I've been in the same position you were and it really irritated me. This is simple and works for me!

 

[pegne]

Thanks Georgia

Thanks Georgia

I usually have a standing prescription. This time it was just too late to get it filled. Oh well I usually need a few days to psyche myself up for anything dental. It's funny I went through 4 heart surgeries, a lung surgery, and a hysterectomy and I'm afraid of the dentist

 

[Georgia]

Go figure

Go figure

Well, Peg - we all have our neuroses. I've been through chemotherapy and this latest mess and have to lie down to get a shot or blood drawn. But the dentist has NEVER bothered me and I've had a lot of extensive work done. There's just no rhyme nor reason to what bothers whom.

 

[Granbonny]

Amoxicillin 500 mg

Amoxicillin 500 mg

When I last saw my Dentist. she gave me a script for 40 pills to expire next Jan. 1, 2004....Next appointment. June 25th for simple cleaning.(Saw her March 13th..simple cleaning) Anyone need Trimox? Got a bottle full Bonnie