Mechanical/Tissue Valve - Redo Surgery on Sept 21st

[Agian]

Agian - I had a pre-existing heart murmur but my dentist never asked and I didn't know it was pertinent. Even so, the protocols currently in place do not advise antibiotic prophylaxis for people with heart murmurs. They say that the risk of antibiotic use is greater than the risk of getting endocarditis. Yea right. I'll also mention that on that particular dentist visit the hygienist tried out a new cleaning method in lieu of flossing. I called it sand blasting. It stung quite a bit and left me sore and bleeding. Between the lack of prophylaxis and the sand blasting I guess it was an open invitation for Mr. Endo.

Thanks for responding Quincy. I always knew there was a reason to be scared of dentists. I've found this thread educational. I'm just not sure we answered the original poster's question.

 

[Agian]

agreed ... I've yet to see any argument against prophylactic use of antibiotics aside from the nebulous "it reduces the span of time that antibiotics will be useful to humanity" argument. Which considering there are literally tons of antibiotics used in animal feed in parts of the world and the same bacteria can infect both humans and stock animals that argument holds little water.

I'm "lucky" that I'm on antibiotics full time...

I still don't understand why people debate this. Anyone would think taking Amoxyl was a big deal.

 

[pellicle]

I still don't understand why people debate this. Anyone would think taking Amoxyl was a big deal.

Same reason people jam everything in your face.
They are wankers.

 

[Paleowoman]

Do we have to worry about endocarditis from bacteria from injuries such as cuts, grazes, splinters ? Or is it specifically teeth/gums that cause entry of that type of bacteria ?

 

[Agian]

Do we have to worry about endocarditis from bacteria from injuries such as cuts, grazes, splinters ? Or is it specifically teeth/gums that cause entry of that type of bacteria ?

I'll tell you what I'm starting to think. A cut, a graze or a splinter would have to be infected to cause a potential problem. Cuts heal pretty quickly and don't often get infected. A festering splinter may be more of an issue. A break in a mucosal surface leading to bacteria entering the blood stream seems more of a biggie: Colonoscopy, bronchoscopy etc. when we have poor dental hygiene it's like our gums are infected. Breach the gums and it risks the bugs getting straight into the blood stream. If there's blood when you brush, then your gums aren't as healthy as they can be.

Some guy I knew injured his foot on a boat and got some sort of 'marine infection'. He got endo from this. I can imagine animal bites might be a risk too.

Post op, people can get it from all the invasive stuff; even a drip being in too long. I wanted everything out ASAP in hospital.

It seems oral bugs causing endo is a recurring theme. They tell us to get an industrial clean every six months.
Pel gave me a gold star for brushing and flossing twice a day.

I'm going to ignore the dental hygienist and start using mouthwash, like I used to. I bought some green, minty Cepacol. This will probably stain my teeth and I'll cop a lecture, during my next visit.

 

[Paleowoman]

Thanks for your response Aglan.

I got urinary tract infection post op in hospital - I had a fever and they kept telling me that's normal post-surgically, then about day 4 they decided to do some tests and found the urinary tract infection, would have been got from the catheter. They did all sorts of tests after that and gave me antibiotics.

I developed allergy to penicillin after several courses of amoxicillin last year (due to a dental problem) so now I have azythromycin on my repeat for antibiotic prophylaxis.

I actually just got an insect sting in my thumb this afternoon, probably from a dead bee in a watering can, there was just the sting and no insect, but the can had been sitting there for several months so must be pretty dirty in it. The 'sting' bled freely but that got me thinking of other causes of endocarditis. I immediately put the thumb in hydrogen peroxide to disinfect it as best I can !

 

[Agian]

My thoughts are just a guess based on what I've read really. I do a lot of stuff around the house and I'm always cutting and scratching myself; I haven't gotten back into it post-op.
I think I mentioned that the anaesthetist who assisted my surgeon told me they see more endo in people with damaged native valves, than those with valve replacements. That's why I was being nosey on the thread. Pannus, clots, bleeds I can get my head around. This one confuses me a bit. I would have thought if they isolated the bug they grew they could identify the likely cause.

I still don't get how someone with a perfectly healthy valve can get this. I don't know why I'm so curious about it. I never had a normal valve, so it doesn't apply to me personally. Is it that bizarre to suggest everyone take antibiotic before a clean?

.... or, how they tell people they have no idea how they got it. It could be that sometimes nothing grows on the blood culture. Surely, they can look at the vegetation on the valve they take out.

 

[Paleowoman]

I suppose it’s like any type of infection - why do some people come down with an infection but not others ? Is it do do with immunity ? Initial immunity that is, fighting the bacteria before they get to parts of the body which cause serious harm. Currently in the UK there is a lot of publicity to get young adults to have meningitis jabs - the bacteria that cause meningitis live harmlessly in most peoples’ noses (I believe) so why do a few people suddenly get meningitis ?

Did you ever watch ‘House MD’ ? Dr House often diagnosed several obscure infections,, not just bacterial, but also viral and fungal - very rare ones or it wouldn’t have made a good story ! (Maybe I should watch them again ? Wouldn’t be so exciting second time around.)

 

[JulienDu]

I have had BAV since I was born, a repair at 9. I never took care of my teeths, I did cut myself hundreds of time, I have had dozens of infected cut untreated, dozens and dozens of fever without antibiotic and never contracted Endocarditis.

With this last operation, I took that problem very seriously and I take care of my teeths but I still cut myself very often because of my job and I was also wondering like Paleo how dangerous it would be to contract Endocarditis...

Anyway...interesting thread.

 

[pellicle]

I took that problem very seriously and I take care of my teeths but I still cut myself very often because of my job and I was also wondering like Paleo how dangerous it would be to contract Endocarditis...

my view is this:

• the gums are a much more potent source of infection than the skin, due to blood supply, and constant exposure to bacteria
• people who have "bleeding gums" are typically suffering from irritation (gingivitus) which implies a constant infection
• infections do not clear up while there is a source of a body that will harbour the bacteria - in this case plaque
• cuts that are not infected for months at a time (unlike peoples mouths which are often infected for years at a time) will be a remarkably lower risk
• mouth infections are much nearer the heart than hands or feet, thus to my thinking leucocyte cells will have far less time to target and kill them

just my 2c

 

[briacunn]

My wife had her heart cath today and everything went well. Her Cardiologist which we both really like and respect gave us his unsolicited opinion about tissue/mechanical valve. He said that most valves that are being used in younger people are tissue valves and that if/when it fails a new one can be entered through the groin and inserted into the old one. He recommended this, but did say that it was a hard decision. My wife seemed to perk up when she heard this because she would love to be off of the blood thinners.

I am glad I found this forum as I come back and read each comment every evening. I hope that this upcoming surgery goes well and that endocarditis never rears it's ugly head again. Have gone crazy trying to figure out how she developed it, but do know that extra caution needs to be taken when cleaning teeth and need to be on ball with any symptoms.

I appreciate all of the comments even if it did get off topic a little as I am learning something new every day.

 

[Agian]

I'm glad you and your wife are feeling better briacunn.

Pellicle, I never thought of it that way: Gingivitis as a chronic, festering infection, lasting years.... then along comes the dentist with his power tools. Like someone using a dirty needle, I guess.

 

[pellicle]

Then along comes the dentist with his power tools. Like someone using a dirty needle, I guess.

The plaque attached to your teeth under the gum line is where they all live.
Scraping the plaque also stirs up the area (gums) and breaks up the bacteria home like stirring up an ant nest

 

[briacunn]

This is first time I have logged on here since my wife had her heart cath. Actually her heart cath did go well that Friday afternoon, but it was that Friday evening she had chills. The next day she had chills, low grade fever. I took her to ER on Sunday as she still had fever and her face was swollen. She was admitted to CTICU. The surgeon came in to talk to me on Tuesday, August 30th and said he wanted to replace her heart valve tomorrow. He asked me what I thought. I said, "you're the expert and do you think she is well enough to endure that surgery". He said there will be no perfect window. So, she had her surgery on my birthday, Aug 31 and lasted about 5 1/2 hours. He said the mechanical valve was just sitting there not really attached. The surgery went well, but she is still recovering in the CTICU. She walked around the unit today which was the farthest she has walked since being out of surgery. She is still weak, but progressing very slowly. And she had to have a temporary pacemaker put in. They will be putting a permanent one in once the white blood cell count comes down.

 

[pellicle]

This is first time I have logged on here since my wife had her heart cath. ... The surgery went well, but she is still recovering in the CTICU. She walked around the unit today which was the farthest she has walked since being out of surgery. She is still weak, but progressing very slowly. And she had to have a temporary pacemaker put in. They will be putting a permanent one in once the white blood cell count comes down.

That's a rocky road to be sure.
I'm glad you still have her.
Best Wishes

 

[honeybunny]

I read your post and said "whaaaattt???" So glad she made it through. She's lucky to have you by her side. Was the replacement valve mechanical or tissue? Keep us posted on her recovery.

 

[Agian]

Take care.

 

[briacunn]

About eight weeks since the surgery. The surgery was actually a piece of cake compared to other issues my wife was dealing with. She had severe allergic reaction to a medication. Steven Johnson syndrome. They were going to send her to a burn unit. Skin was blistered. Constantly freezing. Also mouth was hurting and could not eat. They tried tube feeding, but that didn't go well so they did TPN. Discharged home with a central line in chest. Was not being used....ended up getting infected....took her to ER....was in for two more nights....this extended her oral antibiotics for two more weeks. She was getting nauseous and vomiting almost daily, but since the antibiotics are done her GI system seems to be settling down. She said food tastes different, but is starting to come around. He heart rate is always over 100 and that is only thing that concerns me right now. Rough year.

 

[pellicle]

Hi

...heart rate is always over 100 and that is only thing that concerns me right now. Rough year.

for what its worth mine was high for a good few months after sugery. I believe that it was just getting out and exersizing and some breathing exersizes that I did which brought it down. My breathing exersize was simply to sit straight (or stand) and breath in as deeply as I could possibly do and just hold. The HR would fall in a few seconds (one could feel it). After a while I was holding my breath for a minute with no problem and somehow that seemed to help "train" my heart that it didn't need to beat as fast as it had been.

I know when I'm more serious on exersize my HR is down after a day or so (but up all that day after).

Best Wishes