Incision infection & plueral effusion

[Mb]

Hello everyone:

Update: My husband has been battling fluid in his lungs since coming home. I had previously posted that they had increased the lasix, and he seems no better. Yesterday, I noticed that the tissue around his incision seemed to have changed, and today he is sporting a 2-1/2" x 4" red area, close to the bottom of the incision. I spoke with the cardiologist, and we are back to have the surgical staff look at him at the hospital tomorrow. Will post when I know more. If anyone has any input, I would sure like to hear it. He is 2-1/2 weeks out from surgery. - Marybeth

 

[Nan]

H, I don't really have any input, but sure am glad that you are having the surgical folks take a look at him! Seems indicated.

Hope he feels better soon. (and you too!)

 

[Mb]

Well....

we left at 6:30AM Saturday morning for Mass General. I have to say, I continue to be so impressed with the doctors and staff taking care of my husband. When we arrived, at the cardiac surgical floor, they were expecting us, and had orders to get things done.

First, the looked at the incision, and there is definitely something going on there. When the surgeon looked at it later, he thought it was one of three things....strep infection, reaction to the steri-strips, or ?????. They marked the edges of the infection, and have given us a presciption for an antibiotic, the name of which totally alludes me as I write. They said if it got worse, to call. He did not want to open the wound, as he could feel no "pocket" of stuff in there. It actually has extended beyond the marks, but he just got the first pill into him about an hour a go, so I will take another peak in a couple of hours.

The chest xray showed that the fluid has INCREASED, from one third to one half of the right lung. The surgeon increased his lasix, with firm instructions that if the breathing got worse, to return asap to the hospital, and they would drain it. He really doesn't want to do that right now, for fear of introducing add'l bacteria to the chest area, and his INR is at 3.9 right now. (Blood work done asap, when we arrived). We are instructed to hold the coumaden for the day, and decrease tomorrow to 5mg. (He has been on either 15 or 10 daily for the past ten days.) INR to be checked tomorrow and Monday, with instructions to call. He asked us to call on Monday, for a report, and we already have an appt. to see him on Thursday morning.

Even with his local PCP, nurse, and visiting nurses, frankly I am the one who "knew" it was infected, and that his breathing was worse than mid week. No one knows the patient, like either the patient themselves, or the spouse/SO.

If ANYONE has any suggestions, please please write. I am concerned.

Marybeth

 

[Mary]

I have no suggestions Marybeth; it sounds as though they are taking a cautious, conservative course of action. As we all know, it is easy to introduce more pathogens with another procedure, so I understand their wait and see approach with the chest tube.
How long does it take for you to reach the hospital? I am uncertain how you can accurately gauge Wayne's shortness of breath, since it is somewhat subjective, but if you have a very long drive, I would move quickly if the need arises for another trip back.
I hope this resolves soon.

 

[Mb]

Dear Mary:

You are right....they are taking a cautious approach. The hospital is an hour and a half drive away. Believe me, I am on my toes right now.

Thank you for your comments. I sincerely appreciate it.

Marybeth

 

[WayneGM]

Sorry to hear Wayne's travelling a bumpy road. I can't offer any more suggestions or advice, but it sounds like all the right steps are being taken. I hope things turn around soon. Take care.

 

[Debster]

Hi Marybeth! You are so right-no one knows the patient better than himself and you! My mom had the same scar infection after her surgery-she ended up with vancomycin in a pic line for several weeks. Not fun but it did the job-her infection I think was farther along-she had that pocket of stuff in hers. I am glad the drs are being of help and I wish you both the best to a speedy recovery! Deb