cuts on warfarin

[ATHENS1964]

I always have a mot with me especially if I travel a few doses of amoxicillin, in case I cut deep ΄ or the injury is wide I will contact my doctor or I will find someone where I am and what they tell me I will do, if I am somewhere far away or not far away first aid station I will definitely take 1 dose on my own or which covers me for 8 hours in this time I will have found a doctor.
I always have with me in my backpack that I keep every day, even in the city, a small pharmacy with a little oxygenated gauze stitches and basic medicines. All this took up minimal space and 2-3 times seemed useful not to me but I helped others.
Once he had beaten a child on vacation on a remote beach, fortunately there was a doctor who had nothing but his swimsuit,
but I had my portable small pharmacy with me, I gladly gave it to the doctor and he did what he had to do, the doctor congratulated me because he did not expect that I would even have surgical sutures in addition to the stickers.
Do you have a pharmacy with you on the trips with the essentials?

 

[Chuck C]

Do you have a pharmacy with you on the trips with the essentials?

Not currently, but you've inspired me to do so going forward.

 

[Amy]

my surgeon recommends no dental procedures for 6 months following surgery

My surgeon didn’t say anything about this but I read somewhere *three* months... that may have been the recommendation for a more general heart surgery like CABG rather than a valve replacement, though. I’m glad I heard this from you, Chuck! Thank you. Think it really makes sense to hold off on the dental work I had planned.

(Plus, (between post-op pains, concerns &) with all the flossing I’ve been doing since surgery, the tooth pain I’d been having is practically gone. Hooray! Something to be grateful for. )

 

[pellicle]

e especially if I travel a few doses of amoxicillin,

surprisingly hard to do if you are not (or not friends with) a pharmacist. Then there is the "use by date" issue.

I've of course always got a few dozen at minimum (because of the past issue)

 

[ATHENS1964]

surprisingly hard to do if you are not (or not friends with) a pharmacist. Then there is the "use by date" issue.

I've of course always got a few dozen at minimum (because of the past issue)

Fortunately, my dentist and cardiologist know that I am a prudent and informed person and that I would never take an antibiotic without their reason or instructions. So once in 2 years I make sure to replace the old antibiotic with a new one with their prescription.
Alternatively, if someone you know has taken antibiotics, it is unlikely that the whole box has run out, so 2-3 doses can be found from there.

 

[Chuck C]

Fortunately, my dentist and cardiologist know that I am a prudent and informed person and that I would never take an antibiotic without their reason or instructions. So once in 2 years I make sure to replace the old antibiotic with a new one with their prescription.
Alternatively, if someone you know has taken antibiotics, it is unlikely that the whole box has run out, so 2-3 doses can be found from there.

Personally, I think it will be easy to always have some amoxycillin around. My cardiologist will likely write me a renewable prescription for dental appointments and I can double up a little bit, as my dentist also has readily available amoxycillin on hand for folks like us with prosthetic valves.

 

[slipkid]

endo is very uncommon for a start, and requires a bacteria which is comfortable in living in and on you and is able to live both with and without oxygen. These are very uncommon in the sorts of cuts you get gardening.

Although I agree that endocartitis from a cut in the garden is probably rare, it is untrue that anaerobic bacteria (those which can live without oxygen, some of which can only exist for limited times exposed to O2) are not common in your garden. They are VERY common in dirt/soil (EG: one of the species of genus clostridium that causes tetanus). Don't be rubbing dirt into your cuts folks!

Although you are more likely to get something like a localized infection or even tetanus than endocarditis if you get a cut in a garden make sure you clean it out well. But bacteria of all types are everywhere. On and in you right now. Your intestines are obviously a big happy place for bacteria to hang out.

I don't know the reasons why dental cleaning/bleeding is considered a big source of endocarditis other than perhaps because our mouths have a lot of germs in them and the bleeding from the gums gives those germs a direct entry point into our circulatory system making it easy to get to our hearts (??), as opposed to a skin cut which perhaps gets sealed off more quicker and the germs have to travel farther evading our immune system to get to the heart (???). Again I don't know, am not a Dr and do not play one on TV!

 

[Chuck C]

I don't know the reasons why dental cleaning/bleeding is considered a big source of endocarditis other than perhaps because our mouths have a lot of germs in them and the bleeding from the gums gives those germs a direct entry point into our circulatory system making it easy to get to our hearts (??

According to my dentist, it is also the fact that the mouth often contains the same type of bacteria that causes endocarditis. So, couple the fact that you have a moist bacteria rich environment, with the right type of bacteria and a place with frequent cuts and lesions and it makes for a potential endocarditis infection.
The past 20 years I've been very good about dental hygiene. Since my surgery I've upped my hygiene routine even more. It just takes a few extra minutes per day to really take good care of our teeth and gums and the benefits could be life saving. At the very least we will have fewer cavities and healthier gums from being diligent in this area, not to mention better breath, which our spouses will be happy about.

 

[pellicle]

Hi
You sort of answer your own question

I don't know the reasons why dental cleaning/bleeding is considered a big source of endocarditis other than perhaps because our mouths have a lot of germs in them and the bleeding from the gums gives those germs a direct entry point into our circulatory system making it easy to get to our hearts (??), as opposed to a skin cut which perhaps gets sealed off more quicker and the germs have to travel farther evading our

As well

There is a huge difference between a mouth filled with a plethora of opportunistic pathogens very close to main blood supply routes and extremities like lower legs

So both proximity to central flows and the skin type.

both with and without oxygen. These are very uncommon in the sorts of cuts you get gardening.

Called facultative anerobes.

And last but not least, species that are already adapted to life in us, a different environment (for now) and concentration.

According to my dentist, it is also the fact that the mouth often contains the same type of bacteria that causes endocarditis.

HTH

 

[ATHENS1964]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491369/

 

[pellicle]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491369/

Interesting article and raises the issue which I've seen here of some countries not wishing to prescribe antibiotics for hasty patients

It is estimated that antibiotics use in dentistry may represent up to 10% of total antibiotics use, and the risk of developing bacterial resistance should be taken into account.

Myself I disagree.
Actually this would be a great opportunity for some comment from a more "fresh" microbiologist @Critter (hopefully this will generate a notification). My question is has any research been done on the actual outcomes of single high dose of (say) amoxicillin in promoting antibiotic resistance? My personal take on the mechanism and statistics would suggest its not an issue, but I'd be interested to read anything you know of.

 

[Critter]

Not recommended to start taking antibiotics for a cut. Doing basic first aid by cleansing coupiously the wound and then dressing it with perhaps bactoban. Oral antibiotics are not indicated . I knew an old trauma surgeon that once said: “ The solution to pollution is dilution”. The resistance that is going on in antibiotics stems quite a bit from overusage in veterinary as well as other industries that routinely use them. Only reason to use them prophylactically is with dental procedure. They have found strep viridans inside of coronary arteries on autopsy specimens. Organism that lives in your mouth typically. If you start taking an antibiotic every time you break your skin there is the potential for reducing their benefit. Keep the bullet in your back pocket. Because if you take antibiotics ”prophylactically” You will be selecting for organisms that are resistant to it. Then if you do get an infection it will probably be resistant to the antibiotic which will make it a meaner bug to eradicate.

 

[mecretired]

I have had endocarditis twice—summer of 2019 and summer of 2021. My ID was positive that it came from my mouth as it was strep both times—but 2 different strains of strep. But I now use a water pic—no flossing. I also use mouthwash before brushing. I am on long term antibiotics—-Keflex.

 

[skeptic49]

I have had endocarditis twice—summer of 2019 and summer of 2021. My ID was positive that it came from my mouth as it was strep both times—but 2 different strains of strep. But I now use a water pic—no flossing. I also use mouthwash before brushing. I am on long term antibiotics—-Keflex.

Wow. What happened with your valve during the infections?

 

[cldlhd]

Not recommended to start taking antibiotics for a cut. Doing basic first aid by cleansing coupiously the wound and then dressing it with perhaps bactoban. Oral antibiotics are not indicated . I knew an old trauma surgeon that once said: “ The solution to pollution is dilution”. The resistance that is going on in antibiotics stems quite a bit from overusage in veterinary as well as other industries that routinely use them. Only reason to use them prophylactically is with dental procedure. They have found strep viridans inside of coronary arteries on autopsy specimens. Organism that lives in your mouth typically. If you start taking an antibiotic every time you break your skin there is the potential for reducing their benefit. Keep the bullet in your back pocket. Because if you take antibiotics ”prophylactically” You will be selecting for organisms that are resistant to it. Then if you do get an infection it will probably be resistant to the antibiotic which will make it a meaner bug to eradicate.

I know a guy who worked In the water and sewer industry who also regularly said " the solution to pollution is dilution"

 

[slipkid]

I know a guy who worked In the water and sewer industry who also regularly said " the solution to pollution is dilution"

Was it Ed Norton?

And of course...

 

[user 16827]

Changing the bikes bottom bracket bearing and slipped with the knife I was using to remove the dust cover.

I'm happy to report I didn't bleed to death .

 

[pellicle]

Changing the bikes bottom bracket bearing and slipped with the knife I was using to remove the dust cover.

Stitches?

 

[user 16827]

Mrs Leadville put on some butterfly strips Pell

The BB is running sweet now, schoolboy error but I survived the bleeding to death

 

[pellicle]

I myself find this is usually the case

I think its fair to say its only the case on subjects I speak up on. I prefer to remain silent or offer a "I looked this up and this seems to be the answer" response.

This fellow has a pretty good summary of my position