Infections after Heart surgery
Question:
He immediately answered with some comments about a hyperbaric oxygen treatment that’s sometimes used for wounds that won’t heal.
Here is a NASA study on the use of LED light and hyperbaric oxygen. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&… uids=11776448&dopt=Abstract He should ask his doctor about all these things. Obviously what has been done so far hasn’t worked so it is time to look for some alternative answers!! BL
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Thanks to all those who replied – it has been very useful if not worrying ;-( I now have to pluck up courage to tell him the bad news and help him persuade the doctors to try out some of the solutions you have proposed With best wishes Mark
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– Hide quoted text — Show quoted text – A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him? Thanks
I mentioned your problem to a friend who’s better at remembering some things than I am. He immediately answered with some comments about a hyperbaric oxygen treatment that’s sometimes used for wounds that won’t heal. He also mentioned that you can probably get some benefit (but not as much) by having him put on pure oxygen for half an hour twice a day. It’s now too late tonight for me to start a web search to get an idea of how accurate his answer was, but I thought I’d pass along the idea anyway.
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– Hide quoted text — Show quoted text – A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him? First. *Yowch*. That sucks in a lot of ways. Second: how is his diabetic control in and out of the hospital, and his help at home taking care of his blood sugar and other treatment issues? Third: high blood sugars can slow healing a great deal, so it’s important to handle carefully. I’ve had very poor diabetic treatment when having surgery: my shrieking could be heard throughout the floor at MGH when I finally got off the Demerol, hopped over to my chart, and read my bG’s. I’d been too out of it to monitor it myself and they wouldn’t let me use my own glucometer. (I finally had someone bring it in.)
My post heart surgery period was a bad scene. I wanted to get out so I could deal with diabetes. Their answer was to provide more meds to put me in a sleep walking mode. I finally became a real pain so they sent me home to get rid of me. I did not want to stay until the insurance ran out. It took two months at home to get the neuropathy back to a bearable level. It upset me th think about another session. Only part of the story. Guy
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– Hide quoted text — Show quoted text – A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him?
First. *Yowch*. That sucks in a lot of ways. Second: how is his diabetic control in and out of the hospital, and his help at home taking care of his blood sugar and other treatment issues? Third: high blood sugars can slow healing a great deal, so it’s important to handle carefully. I’ve had very poor diabetic treatment when having surgery: my shrieking could be heard throughout the floor at MGH when I finally got off the Demerol, hopped over to my chart, and read my bG’s. I’d been too out of it to monitor it myself and they wouldn’t let me use my own glucometer. (I finally had someone bring it in.)
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A PICC line must be installed usually in the left arm which will last up to 8 months for home I.V. antibiotic administration, and easy access to blood samples.
This is what is scary, he seems to have a serious infection but he gets sent home without IV.
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/ – Hide quoted text — Show quoted text – A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him?
Have the doctors given the reason for it not healing? e.g. is it an antibiotic resistant bug he has picked up in the hospital or is it becasue his bg’s aren’t in control? If it is the first, it can be a long and trying time, if it is the second what steps are they taking to reduce his bg’s? Insulin therapy might be his best bet. And of course we all know about hospital diabetic diets. My brother had a malignant tumour removed from his groin a while ago and it would’t heal either, took a long time and he is left with a pemanent sinus there. When doctors are treating an infection like that the norm is to test to see what is causing the infection and using appropriate antibiotics. See if you can find out which bug they are fighting.
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In fact he has a gaping hole leading down to his heart!
I would urge him to find a clinic that uses low level laser therapy for wound healing. It has been FDA approved for a few different conditions, but is often used for non healing diabetic wounds in Europe, Asia, etc. BL
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This sounds like he’s heading for a case of infectious endocarditis, which basically happens when infectious bacterium take up residence in the blood stream, and works it’s way into the interior of the heart. It usually winds up settling on the Mitral Valve, and grows into a large mass of "vegetation". This vegetation can and usually does break off into small hard chunks, and goes to the spleen and causes high fever, chills, pain all over, sores, and finally delirium. It is 90% fatal if not checked at this point. The procedure is first a blood culture for strep A positive in the blood, and a Transesophageal Echocardiogram to examine the heart valves. Then a transfer to a big city heart hospital for infectious disease consult, blood transfusions, and I.V. Rocephin Antibiotic. The patient must be kept clean while in bed, and I.V. Morphine administered at 4mg/4 hours for coronary artery dilation and pain management. A full cardiac cath must be performed to check for blockages. At 80% infection control, emergency open heart surgery must performed, the Mitral valve excised, and a mechanical valve of the inert bileaflet type implanted (St. Judes are used). During this procedure the heart is stopped for 6-8 hours, and the patient is placed on a heart-lung machine and a vent. A PICC line must be installed usually in the left arm which will last up to 8 months for home I.V. antibiotic administration, and easy access to blood samples. Coumadin therapy must be started while two subcutaneous injections of low molecular weight heparin (Lovenox) are injected daily until an INR of 2.5-3.5 is reached. The Coumadin is a life long thing, and must be monitored 2x month. Edema must be controlled with Lasix 40mg and Zaroxolyn 5mg with 20meq Klor-Con BID. I just celebrated my 1 year anniversay of this procedure July 18, and I beat the odds. I’m disabled and on SSDI, and suffer from angina, pain, and regular bouts of pluresy, but it’s not that bad. Hardest thing was getting used to the clicking of the valve, which can be blocked with Tylenol #3. So now I have to manage my Coumadin level, and my Type 1 diabetes. Accu-Chek and Life Scan are coming out with coagulation meters in the next year to allow people to self test their PT/INR ratio, and adjust their Coumadin dose. Please have your friend talk to a doctor about Bacterial Endocarditis and get the tests done. It’s a sneaky disease and is a killer, usually picked up from dental procedures or urinary tract infections with folly cath sepsis. Larry – Hide quoted text — Show quoted text – A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him? Thanks
Response:
A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him? Thanks
Response:
– Hide quoted text — Show quoted text -A close personal friend with mild diabetes had major heart surgery some 3 months ago, since then he has been in/out hospital with a wound that will not heal. In fact he has a gaping hole leading down to his heart! In hospital, he is put on heave doeses of antibotics and a very uncomfortable ’sucking’ machine. He gets better and is released, but within days, his temperature rises and he is re-admitted as a semi-emergency. There is some talk of the bone having been infected, but no-one seems to be making any moves to resolving it He is getting very frustrated and worried, but knows that his diabetes is an added complication. Does anyone have any ideas or advice for him? Thanks
One problem with "mild diabetes" is that it usually gets really severe when the patient is subjected to surgery and/or infection and/or the stuff your friend is going through. If the docs aren’t treating his diabetes with the big guns, insulin if necessary, his sugars could be all over the place. High blood sugars hinder healing. There would be nothing odd about him testing his blood 8 -10 times a day, and shooting insulin 8-10 times a day until this is resolved. Well. . .I wouldn’t think it was odd because that is what I did after my hip replacement, and it worked well. A patient in his position can probably do little about his overall care other than measure his blood sugars and make certain that they are being controlled. If they are not being controlled, consider becoming aggressive, obnoxious, obstinate, persistent, and obstreperous with the medical teams. Good luck Old Al
