what is wrong

[Gemma]

April,
A smelly discharge isn't a good thing. Jim was given oral antibiotics when his incision failed to heal near the bottom, but these didn't do much - he was then given a topical antibiotic cream when a staph infection was finally diagnosed (Fucidic acid if I remember rightly, although you may get something different in the USA) which cleared the infection up in a few days. If you do get prescribed a cream - keep using it for a while after the infection clears up - Jim's seemed OK but oozed a bit again after he stopped using it the first time.
Gemma.

 

[Nancy]

April-

That infection is really scaring me. I think you should go to the ER and have someone look at it. They have to treat you there, I hope. I would hate to think that this was escaping into your bloodstream big time. You don't want anymore of your surgical sites to become infected as a result, especially the valve areas. Please go and don't wait another day. It's too dangerous.

 

[Guest]

April,

Your low INR is pretty typical for someone who is recovering from heart surgery. Your increased activity and appetite will account for this. If the doctor did not know this, there is a good chance that it was a physician-in-training and this being July quite likely that it was the first month in training. This is one of the bad things about going to hospitals where they charge reduced fees for those with no insurance. They have a preceptor physician but things get changed in relaying them from one person to another. The preceptor may have said, "Check if she is taking the warfarin." "The new young, scared doctor says, "How many doses of warfarin did you miss?" You hear, he is accusing me of not taking warfarin. You remember the game about passing around secrets and how they get messed up!

The type of doctor you have is not as important as their familiarity with warfarin.

 

[atydev]

I got some attention today. I had to my primary doctor today and I showed him the infection and of course his first reaction was to mash it and drain it again....what is it with doctors do they like inducing the pain or just watching the thing drain....which is not pleasing. He gave me Cephalexin 500mg 4x's a day and he said put antibiotic cream on it. My surgeon said just peroxide and definaly no antibiotic cream. I am so glad I got something. It split open even more sometime during the night. I have 2 holes in my incision that are almost as big as dimes...I think I am on my way to recovery...I now have to tell them on friday that I am taking them so they won't increase my coumidin again.

 

[Nancy]

Tell your Coumadin doctor about the antibiotics. They will, no doubt, have to adjust your Coumadin for this new medication, and then readjust again after you are no longer on it. That is just the way Coumadin is. Telling him about it doesn't mean that they won't do an adjustment. Your Coumadin has to be at a certain level, and your doctor will make the necessary dosage adjustments to keep it there.

So expect to have an adjustment.

I am so glad you finally got an antibiotic.

 

[ALCapshaw2]

April,

I think it would be a good idea to call your Surgeon's office and advise them of what has been happening in regard to 1 - your incision / holes / infection / treatment, 2 - the lack of patient information / education about what to do and NOT do, as well as the lack of information about living with Coumadin.

Hopefully, he has an interest in your welfare and survival since HE is untimately responsible and your survival reflects on HIS numbers. Since you were told NOT to use anti-biotic cream, it might be good for your surgeon and your PCP to talk this over and come to an agreement.

When you feel up to it, you may also want to start looking for a Coumadin Clinic, or at least a Doctor, with EXPERIENCE overseeing patients on Coumadin.

Best wishes for your improvement.

'AL'

 

[atydev]

Thanks

Thanks

Ya know I have never heard of a coumidin clinic except on here. I will look for one and see what I can do. My surgeon is just as guilty as all the others she is the one I saw on friday and accused me of not taking my coumidin she is the one who said not antibiotics or creams just peroxide. She is the one that roto ruttered it out (cleaned it) she was in the room and out so quick on friday I had no chance to catch my breath before she left. She threw me in shock with the cleaning thing and told me to up my dose to 7.5mg and left. We will see how far I get on this friday.

 

[Ross]

April they should test your INR in 5 days while your on the Cephalexin. You should get a rise while on it.

 

[Mary]

April,
Why don't you type in Louisiana"s state board of health site and look to see if any complaints have been lodged against your surgeon? You can lodge one yourself if you believe your treatment has been substandard.
I realize you're in a quandry since you're not covered by a company or individual health insurance. You don't have an advocate without a case manager following your treatment.
Bad medical care is perpetuated when we ignore it. You should be receiving the best care there is regardless of your financial circumstances. Doctors take an oath, and they are bound by it.
Yes, I'm on a soapbox.
Would you like me to come down there and take care of this?
Mary

 

[Sherry]

I'm with you, Mary!

I'm with you, Mary!

Mary, can you say ROADTRIP?? I'll meet you in Southern Illinois and go down with you. Her case is ticking me off in the worst way

 

[Mary]

Sherry,
When I saw your title, I thought, Roadtrip! Yes, we'll take care of this ourselves!
Leave it to teachers!
Mary

 

[atydev]

Sure

Sure

I will leave a light on........

 

[atydev]

Grrrrrrr

Grrrrrrr

My mother just told me after she see's my incision she maybe taking me back to shreveport. When I woke up this morning my chest was hurting like it had split open more. So I got up to clean it and check it out and this morning my shirt was bloody and my hole is now the size of a quarter instead of a dime. Dont seem to see as much pus as yesterday. Maybe the antibiotic is working but was upset about the hole getting larger. I hope they will sew it up again. If not it will be an ugly scar.The reason I don't want to go back today my baby will be 9 tomorrow. I cant miss his birthday. If she insist I will go after his party tomorrow. I know she said the same thing the party can wait.....It is my children that are the only thing that seems to make me happy lately. They are what keeps me going.

 

[Nancy]

I'm with you on that trip in spirit. I believe this represents the worst kind of neglectful medical care. It's a nightmare for this young woman. Very substandard in many ways!

 

[ALCapshaw2]

April,

Your children need their Mother!
The best present you can give them is to be around to raise them. Go get FIXED!

You may want to call your PCP, tell him about the bigger hole, and see what he says. You will probably need to go back to your original surgeon because no one else will want to be responsible.

It would be interesting to check up on your surgeon.
Is she Board Certified?
Or is she a resident, just learning the trade?

The hospital will probably send you a patient evaluation questionaire. Be sure to list everything that has gone wrong or NOT done, such as patient education and Coumadin instruction.

Keep copies of all reports and complaints.
You may need this later.

'AL'

 

[atydev]

I know

I know

Al

I know I should go right now I just listen everyday about how excited my baby is about tomorrow. I hope one day will be ok. My surgeon is board certified, I have checked her out. She does all the heart transplants actually she does all heart surgery's at that hospital and has done so for 25 years I have confidence in her as a surgeon just not sure about the rest. She comes across to me as I do the surgery and the rest is up to the residents....So I was shocked when I saw her on friday instead of Dr. Wolfport the resident. Although my appointment was at noon and it was 2:30 before I saw her. She was hurried and after she got thru with me I was hurting. I will get some answers on friday or tomorrow depending on my mother's persistence. My mother seems to think that the infection was from me doing to much and moving my arms. My doctor accused me of not cleaning it. Which I know that is not true. So do you think is is possible to it infected by doing to much I think it was from my under clothes rubbing it. What is your professional opinion......

 

[Mary]

April,
Another thought after reading Al's last post. If you have access to a camera, have someone take a picture today of the incision and date it.
Keep it with your paperwork.
Document, document, document.
Mary

 

[ALCapshaw2]

Responses inserted in Quote Box

Al

My surgeon is board certified, I have checked her out. She does all the heart transplants actually she does all heart surgery's at that hospital and has done so for 25 years I have confidence in her as a surgeon just not sure about the rest. She comes across to me as I do the surgery and the rest is up to the residents....

That seems to be 'The Way It Is' at a lot of
Teaching Hospitals...

So I was shocked when I saw her on friday instead of Dr. Wolfport the resident. Although my appointment was at noon and it was 2:30 before I saw her. She was hurried and after she got thru with me I was hurting. I will get some answers on friday or tomorrow depending on my mother's persistence.

Nothing new about having to wait to see Surgeons!

My mother seems to think that the infection was from me doing to much and moving my arms. My doctor accused me of not cleaning it. Which I know that is not true.

All you can do is tell them the facts.

So do you think is is possible to it infected by doing to much I think it was from my under clothes rubbing it.

Well, ah, I don't have much experience WEARING lady's underwear, but some of the other ladies on VR.com have commented on buying larger sized or sports or sleeping bras which seemed to help them be more comfortable. I CAN say that 'doing too much' is generally Not Good!

What is your professional opinion......

(Disclaimer) I am not a Doctor, or Nurse,
or medically trained professional;
only a Long Time Heart Patient
who has experienced MANY
medical procedures!
- 'AL Capshaw' -

 

[Nancy]

April-

I'll offer my own non-professional opinion.

You have an infection because some type of microscopic organism saw an opportunity to get into your newly operated on site. It started growing and is continuing to grow because you did not get adequate treatment when this first showed up. And if it continues to get any worse, in spite of antibiotics you really MUST get immediate treatment. It sounds as if the soft tissues and the bone are both infected.

People who have had recent surgery have lowered immune systems sometimes and things can get started and take hold much easier than they would ordinarily.

When you have had time to heal, all this will will correct itself, but right now you have something that's is running rampant and has to be stopped.

Take your temp religiously every couple of hours and write down EVERYTHING. If your temperature is rising, head to the ER. I agree that you should take some pictures. AND keep a journal of everything that is done or not done.

Your immediate health is much more important than anything else in your life. I know that birthdays are so important, but if you have an extended stay in the hospital because of this thing, you will be most unhappy and so will your family. Plus your healing will get quite a setback.

This is really not a good thing. And from many of the problems that have happened to Joe, I know for a fact that things can change very, very rapidly. Please take good care of yourself.

 

[Guest]

I think that your biggest risk is that the infection could get into your breast bone. If this happens and it is methicillin-resistant staph aureus, you are looking at months of IV antibiotics. These can also require your warfarin dose to be 3 to 5 times higher than you were taking when the infection got started. This could turn out to be life threatening. You probably need an infectious disease specialist, not the surgeon any more.