Update: plueral effusion and incision infection

[Mb]

Hello!

It has been 2-1/2 days since making the trip to Boston, and I thought I would post an update, hopefully to help anyone in the future with the same issues.

First the effusion......He got checked this morning by the nurse, and the lungs are still compromised as much as on Saturday. (I marked his back to indicate the level of the absence of breath sounds.) He spoke with the surgeon this evening, who said they will aspirate on Thursday, if the INR can get to 2.0-2.5 - This would be great, since he is short of breath, and certainly cannot walk or talk any length of time at all. This is the same complication that Bill Clinton had post by-pass. Funny....my husband also shares his birth date.

Infection - Three days on the antibiotic, and the red, swollen area remains about the same.....maybe, just maybe, a wee wee bit better looking. I am praying this does not go to the pericardium.

In general, it will be three weeks this Wednesday since his surgery (second surgery, tricuspid annuloplasty). He is quite tired, pale, and his HR remains around 100 at rest. He is, however, in good spirits.

Marybeth

 

[Phyllis]

Thanks for the update, Marybeth. I wish it were better news, but I'm glad he is in the hospital getting the care and attention he needs and that he has not allowed this to get him down. Prayers and best wishes speeding your way.
Phyllis

 

[Pegasus]

Sorry to hear that your husband has such a rough time!

I assume they took a swab from the incision to make sure he is on the right antibiotics?

Best wishes
Astrid

 

[Nancy]

Keeping you both in my prayers.

 

[WayneGM]

I'm sorry to hear the road is still pretty rough, but glad to hear he's still in good spirits. My best wishes continue.

 

[Mb]

Hmmm....

No, they didn't swab the incision. Actually, it is not draining. It is swollen, and LOOKS like to should be oozing/draining......but it hasn't yet. I wish the surgeon had just cleaned it out, myself. My husband is more worried about his lung, and I am worried about the infection. At least we are evenly distributing the worrying.....although we are both more optimistic now.

Marybeth

 

[Ross]

Hmmm....

No, they didn't swab the incision. Actually, it is not draining. It is swollen, and LOOKS like to should be oozing/draining......but it hasn't yet. I wish the surgeon had just cleaned it out, myself. My husband is more worried about his lung, and I am worried about the infection. At least we are evenly distributing the worrying.....although we are both more optimistic now.

Marybeth

Worry about both! They need to stop screwing around and get to it.

 

[Nancy]

Did they at least do some blood cultures?

 

[Susan BAV]

Could the two things be related? A blood culture would show what kind of antibiotic they need to give him, right? I'm glad you two are optimistic and I hope it turns better for your husband soon, Marybeth.

 

[Nancy]

Exactly what I was thinking, Susan. Pneumonia can creep up pretty unexpectedly. It should be checked out.

 

[Nan]

Hi Marybeth,

Glad that your husband is in the hospital where he can get appropriate care. So sorry that he (and you) is having such a hard time. I hope that they can help with the pleural effusion soon and that the antibiotic kicks in for the infected incision.

You have certainly gotten some good suggestions from the other responses....pnemonia should be considered and blood cultures should be done.

Good that you can be there to be his advocate.

I think every patient who goes into a hospital needs an advocate to help coordinate care and make suggestions to the docs.

Best to you both.

 

[Mb]

Hello!

Thank you everyone for your comments.

The surgeon is waiting till Thursday to drain the lung, for his INR to be between 2.0 and 2.5.

Truthfully I am not sure that they did blood cultures. They did draw blood, and I know checked his INR, hematocrit, etc., but I don't believe they did cultures. I will certainly find out on Thursday. His WBC was at the high end of normal last Thursday (before I called his Dr. on Friday). He is NOT running a high fever, which I take as a very good sign. What I am concerned about of course, is endocarditis, should the infection spread to the pericardium, which is SO very close to this site. About half is located at the bottom of the sternum, and the other half below that bone. I had read somehwere that transfusions are often related to infection post surgery. He did get blood products during the surgery, and then he got a full product transfusion a weak later, as his hematocrit was too low.

Believe me, if he spikes a fever at all, or if it looks even a wee bit worse, I will call them.....and back we will go.

I am hoping aspirating the fluid will be all that needs to be done for his lung.

Marybeth