My wife is back in the hospital

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T

traig

Sunday was a big day for us -- we moved out of my in-laws' house and headed back home with a van full of stuff and the twins in tow. However, not long after dinner that night my wife asked me to take her pulse. She was concerned that it felt high.

Now, we're two months out from her AVR and MVR surgery and thanks to 25 mg of torprol a day her heart rate was generally 90-100, and we assume it will continue to come down. When I took her pulse that night she was at 120. Later that night it was higher, and at its worst at 3 am she was at 150. We tried to call her cardio practice but the menu system was fubar and we couldn't get the answering service. She took another 12.5 mg of toprol and was able to sleep a few hours. At 6 am she was at 120 bpm. We finally got her doc at 7 am and he told her to take 100 mg of toprol and if she wasn't down to 100 bpm by 8 am to go to the ER. We went to the ER.

Her doc met us there, did an EKG, and they determined that she didn't have an a-fib or other irregularity, so they gave her an injection of metatorpol (sp?) and she came down to around 100 so he was going to let her go with a new scrip for 100 mg of Toprol XL per day. However... while they were waiting an hour to see where her heart rate would end up, some blood they took showed an elevated white blood cell count (13 ... don't know what that means) and she suddenly had a fever of 101 (she didn't have a fever when she arrived). THey said she needed to be admitted for fear that she might have redeveloped endocarditis (the prosthetic variety) and they needed to hold her for a couple of days while the cultures they took developed. :(

So we were all freaked out and depressed. Infectious disease docs said the likelihood of endocarditis was low, maybe 5%, and that the wbc and fever could be a urinary or other infection, or the result of a virus. Strangely enough, she developed a sore throat and stuffed nose later in the day.

Today they did an echo (the tech said it looked good) and we're waiting for the first culture exam to come back. If it's negative today and tomorrow, she's 96% off the hook for endocarditis. They're going to watch the cultures for another week to see if anything develops late. We'll also know today if anything grew in the urine they took, but they've already almost ruled out UTI.

I guess they're simply being conservative. One doc told us that when mech. valve patients present with fever and elevated wbc they tend to worry about endocarditis and play it on the safe side since the consequences of misdiagnosed endocarditis are so severe ( as we well know ).

By the way, I woke up today with a sore throat, stuffy nose, and a very mild fever, 99.1. What I'm thinking is the move back irritated her heart and on top of that she was starting to be attacked by a rhino or other virus, or a sinus-type infection, so that complicated things. That also led to higher tachycardia. I'm hoping that's all this is and she'll be back home tomorrow.

What a year...
 
I got chills and became overwhelmed by your wife's situation after reading the signature at the bottom of your post! HOLY APCRAY! Double valve replacement two months after giving birth to TWINS! And now you've moved two months after that? (Of course, I understand none of this was avoidable, but it is A LOT.) And she's got at least a cold and fever?

Tell your wife to go home, sit down somewhere comfortable and diaper a baby, feed a baby, read to a baby, diaper a baby, feed a baby, goo and gaa at a baby, diaper a baby, feed a baby, go for a walk with both babies, sleep for every nanosecond they do (this will probably add up to a full minute or two during the course of a day)...repeat. Have a basket of fruit, some whole grain bread, some jerky and a bottle of water within reach at all times (this will come in handy in future years) and eat and drink as much a possible. Even with this handy schedule, I don't see how she could possibly get enough rest to recover from what she's been through!

Man, I hope you and she have a lot of help. I'm guessing you are working during the day. Is someone helping her out with laundry? Cooking dinner? Doing dishes? Is everyone who enters your house washing their hands before and after touching anyone or anything? You need to station a handwashing nazi at the door "STOP! You MUST vash ze hands!"

I'm hopeful that your wife "only" has a cold and she will recover without passing it on to the babies. (Knocking would as I type that.) I really believe that everything you do after you bring a baby home from the hospital has to be re-learned in the context of that baby. You've taken a shower every day since puberty and suddenly you have to figure out how to take one with a baby in the house--two even! Add to that an impressive chest scar and...perhaps others can imagine...I can't even go there. I know it has got to be way easier said than done, but find a way to lighten her load and don't take it all on yourself either.

TAKE CARE. Hugs to you both. (I'll leave the baby hugging to lucky you!) Cheer up! It can only get easier, right? (Knocked wood again. :D )
 
Dadgummit!!!!!!

Sure sounds like a few very nasty coincidences - the move back home and a virus/bug. I certainly hope and pray along with you that it's nothing more serious than that.

I am so empathetic to your wife's circumstances. I was at my worst when I had a baby and toddler at home. Stays in hospitals while others cared for them were awful. It was a very tough time emotionally, as well as physically.

Know that your wife and you are in my prayers. She's been through a huge ordeal and her body will take time to get strength back - but she will.
 
You have been through an ordeal! The good news is it appears that the bug she caught is a run of the mill variety versus a nonrun of the mill endocarditis causing bug. Thank goodness for small favors! :)

It sounds like you both have the grit and stamina to regroup and get back on track after she's discharged from the hospital. You will have a few tough weeks ahead, but I'm sure you will prevail. If you can set your sights on the future, and try to ignore the current bumper crop of difficulties, you will do fine. Please let us know what the culture report states tomorrow. In the meantime, I'll add you all to my prayers.

Mary
 
I also was shocked to see that your wife had surgery and also baby twins!!!! I hope all goes well for all of you, take good care of her... Rose
 
Sorry to hear your wife is back in the hospital but happy to hear her doctors are not taking things lightly. Too many do not really understand the problems of illnesses and artificial valves. I will pray that it is just a cold and stress causing all these problems. I get palpitations just thinking about twins/valve replacement/moving all within a few months.

Please take care and try to know that all the boxes will wait for you. This doesn't have to be done all at once.
 
This is something you will be telling others for years. It will be one of those, "You think you have it bad....." stories. Hopefully things will be getting back to normal now and your family can settle in and enjoy each other.

I hope you start feeling better too. Stress can make you more susceptible to germs and viruses. Let's hope endocarditis is ruled out and it is only a cold. Keep us informed. God Bless you and your family.
 
Thanks for all the support. Rebecca was discharged last night. Early cultures and an echo and x-ray were negative for signs of prosthetic endocarditis so they're letting her be at home until they're 100% sure, which will take a few more days. Until then she's on amoxycillin.

They're thinking like I was that she has a simple viral or bacterial cold/infection and that the wbc count and fever were related. I guess the tachycardia plays in there as well.

Thanks again. We had a scare but it's nearly over and looks good.
 
oh my goodness!! I feel so bad for your wife...I just had my open heart a few weeks ago...got out of the hospital...then had to go back in for a couple days. It is a terrible feeling knowing that you were out then to have to go back. But its ALWAYS better to be safe then sorry. I also know what its like to be away from your babies. I have a 16-month old little boy and it's just killing me to be away from him. I haven't seen him in a week, but since I'm not feeling good right now it would be just to difficult to spend time with him :( Tell your wife that everyone here is thinking about her.
 
Forgot to mention that antibiotics will most likely raise her INR. You may have already been told about this, but you'll want to keep an eye on it. I'm sure they probably tested her while she was in the hospital. Would probably be a good idea to get it done again tomorrow or Friday. Just don't let them do the "hold dose" thing unless it's really high. ;)
 
Yup, they actually did tell us that. They knocked her from 5 mg a day to 3 mg a day, but we thought that might be too little so she and I are going with 3.5 for now. She's due to have a reading tomorrow but that would reflect her Mon-Tue dosing, which was 5 and 4 repectively, and she was on cephtriaxone and vancomycin those days. Now she's on oral amoxycillin, so I don't think we'll get a good reading until Monday or Tuesday next week...
 
Mama2Rylan said:
oh my goodness!! I feel so bad for your wife...I just had my open heart a few weeks ago...got out of the hospital...then had to go back in for a couple days. It is a terrible feeling knowing that you were out then to have to go back. But its ALWAYS better to be safe then sorry. I also know what its like to be away from your babies. I have a 16-month old little boy and it's just killing me to be away from him. I haven't seen him in a week, but since I'm not feeling good right now it would be just to difficult to spend time with him :( Tell your wife that everyone here is thinking about her.

She knows and is happy and thankful. I just need to get her to sign up... and find time to post/read, but the twins have other ideas! So for the moment it's me, the proxy! :p
 
So glad she is home- hope that her recupertion continues and is uneventful.
Best wishes to you both.
 
traig said:
Yup, they actually did tell us that. They knocked her from 5 mg a day to 3 mg a day, but we thought that might be too little so she and I are going with 3.5 for now. She's due to have a reading tomorrow but that would reflect her Mon-Tue dosing, which was 5 and 4 repectively, and she was on cephtriaxone and vancomycin those days. Now she's on oral amoxycillin, so I don't think we'll get a good reading until Monday or Tuesday next week...

Sounds like your bases are covered! She's going to be up and down for a while with the combination of antibiotics, virus/bug, and her body repairing itself. Sounds like you are already getting the hang of "the game" of INR.
 
What's interesting is WINDSURFER posted a message regarding systemic inflammatory response which apparently is common in heart/lung bypass patients. His posting was regarding a rash of serious cases in his city hospital (I think he is Va.),however, what I found interesring was this conditon is very common and usually mild in most OHS patients. My point is the symptoms sound very similar to the ones mentioned by traig. I am not playing doctor at all, but I was struck by 2 things: #1: my doctor never even mentioned this possibility to me and #2: how common this is in OHS patients.
All that aside: Hold on you guys. I can't believe how much you are going thru with both the wonderful new twins and the OHS. Wow, truely, if you hold it together and let all your friends neighbors and loved ones help you, you will really have a story to tell. One with a very happy ending. My most sincere wishes for strong babies and healthy recovery are with you.
Laura
 

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