Nooooo, My incision is infected!

[ocunurse]

I first had OHS 4/2004 and had a bump free recovery. I'm not trying to scare people because I know a majority are bump free.

However on 12/19, I had another AVR with root replacement. I returned home 12/23. I had a pretty painful Christmas, but I was home with family and grateful for that. Unfortunately on 12/26 my incision started to ooze quite a bit. The next day we went to the ER, were sent home with antibiotics. I was home two hours and the incision started to open. Back to the ER, cultures back, found I have a pseudomonas infection, admitted to the hospital for another four days. Now I'm home with a PICC line giving myself IV antibiotics three times a day. Have to redress my incision a couple times a day due to drainage. The incision looks somewhat better everyday. I've got 6 weeks left of IV antibiotics to give myself. Whooo. Each time it takes a hour to do or so. I'm glad we caught the infection early and it didn't get into the bone, yet.

Other than that, I feel alright. My pain isn't really an issue anymore.

 

[kfay]

I had a similar situation, 5 weeks post op, I noticed redness around the lower part of my incision one morning after a shower. It got bigger as the day went on so by late afternoon, I called my cardio and he told me to come in at 8 the next morning. I was admitted to the hospital by noon and started on antibiotics. By the next day, the redness was already subsiding, so I was sent home on some powerful antibiotics for two weeks. Luckily, I caught mine very early and they felt confident that it was just a superficial infection in the incision. I know the picc line is a pain, but just be thankful they didn't have to go back in to clean out your wound. Hang in there, it will get better.

Kim

 

[Lynlw]

I first had OHS 4/2004 and had a bump free recovery. I'm not trying to scare people because I know a majority are bump free.

However on 12/19, I had another AVR with root replacement. I returned home 12/23. I had a pretty painful Christmas, but I was home with family and grateful for that. Unfortunately on 12/26 my incision started to ooze quite a bit. The next day we went to the ER, were sent home with antibiotics. I was home two hours and the incision started to open. Back to the ER, cultures back, found I have a pseudomonas infection, admitted to the hospital for another four days. Now I'm home with a PICC line giving myself IV antibiotics three times a day. Have to redress my incision a couple times a day due to drainage. The incision looks somewhat better everyday. I've got 6 weeks left of IV antibiotics to give myself. Whooo. Each time it takes a hour to do or so. I'm glad we caught the infection early and it didn't get into the bone, yet.

Other than that, I feel alright. My pain isn't really an issue anymore.

Sorry to hear this, but glad to hear it didnt spread to the bone. What hospital were you admitted to? I'm guessing you went to the ER and not to your surgeon because you traveled relatively far for your surgery? If you went to the local hospital have they been in contact with CCF?
I'm curious since Justin had infections twice, did they clean out your wound when you were admitted?
Hopefully it ws just a small bump and the antibiotics take care of it and you can get on with your healing and back to your normal life

 

[dwhist]

One week after I got home from surgery, the bump on the top of incision had gotten red and warm. Called and was told by surgeon to come in to his office that afternoon. When I got to office he looked at it and said he thought it might be a hematoma. Said this may hurt and squeezed it. Out came a bunch of pus. He deadened the area and opened up the top 2 inches of incision and cleaned it out. Sent some out for a culture and put me on regular antibiotic for awhile. Did a wet/dry bandage for a few weeks and all is better now.

 

[Greg a]

I first had OHS 4/2004 and had a bump free recovery. I'm not trying to scare people because I know a majority are bump free.

However on 12/19, I had another AVR with root replacement. I returned home 12/23. I had a pretty painful Christmas, but I was home with family and grateful for that. Unfortunately on 12/26 my incision started to ooze quite a bit. The next day we went to the ER, were sent home with antibiotics. I was home two hours and the incision started to open. Back to the ER, cultures back, found I have a pseudomonas infection, admitted to the hospital for another four days. Now I'm home with a PICC line giving myself IV antibiotics three times a day. Have to redress my incision a couple times a day due to drainage. The incision looks somewhat better everyday. I've got 6 weeks left of IV antibiotics to give myself. Whooo. Each time it takes a hour to do or so. [B]I'm glad we caught the infection early and it didn't get into the bone, yet. [/B]

Other than that, I feel alright. My pain isn't really an issue anymore.

Whew ...I was holding my breath till I read the bone line as that is what happened to me

 

[sarahsunshine]

Sorry to hear you are dealing with infection. Skyler is just finishing week 3 of his IV antibiotics. Half way through.

Are you covered for home nursing care under your insurance? You should find out what is actually covered and what your area can provide. Skyler has an automatic pump that has to have the bag changed regularly. a home care nurse is on all, but she comes to change the bag, flush the lines, and check on things 3 time a week.

There are advantages to doing it yourself, however, if you don't have to be at work or anything. First, Skyler is attached to a pump 24/7. We have come to an agreement with the home care nurse that 30 minutes before she comes we unhook him so he can have 30 minutes of "pump-free" time (in the shower!). On the other hand, we don't have to worry about timing anything to be sure that the doses are done on time. We just have to change batteries and antibiotic bag once a day before 4pm.

I am glad that you are feeling better.

I am surprised that they didn't open you up again and clean out the infection. Hope your healing continues smoothly.

 

[Bill B]

It may be obvious, but you got this in the hospital. Pseudomonas is second only to Staph as a cause of hospital-acquired infection. Jeez, and you were only there 4 days. I'm so glad it was diagnosed and treated so quickly and is getting better. The hospital where your surgery was done needs to be made aware of this if they haven't been already. There are strict guidelines and tracking of such infections done by Infection Control staff at each hospital in a concerted effort to prevent such events, which is a major problem facing all hospitalized patients.

 

[Ovie]

Whoa! Glad to hear those of you who have had infections caught them and are treating them or have them fixed!

Are infections common? I've always thought of them
Happening maybe first week or 2 but 5 weeks post op?! At what point do you not have to worry?!

 

[Greg a]

Whoa! Glad to hear those of you who have had infections caught them and are treating them or have them fixed!

Are infections common? I've always thought of them
Happening maybe first week or 2 but 5 weeks post op?! At what point do you not have to worry?!

I collapsed at twelve weeks post op

 

[ocunurse]

Sorry to hear this, but glad to hear it didnt spread to the bone. What hospital were you admitted to? I'm guessing you went to the ER and not to your surgeon because you traveled relatively far for your surgery? If you went to the local hospital have they been in contact with CCF?
I'm curious since Justin had infections twice, did they clean out your wound when you were admitted?
Hopefully it ws just a small bump and the antibiotics take care of it and you can get on with your healing and back to your normal life

Hi Lyn,

I'm not going back to CCF for a variety of reasons, distance and cost, plus a hint of bitterness towards this whole thing developing. The care I received in the ICU was reckless, dangerous, and not up to standard. I had two fresh out of school nurses, because the charge nurse deemed me as "an easy case." Hand washing was infrequent, when I told them I wanted to refuse my bed bath, they ignored me, flipped me on the side of one of my chest tubes that had an air leak, causing me the most excruciating pain in my life, and pain control, what a joke, they did nothing in the ICU. They just told me to wait until the next morning. The floor nurses were much more receptive, knowledgeable, compassionate, caring, and competent. I'm just so bitter right now because the day and a half I was in the ICU, I was told probably ten times how easy of a case I was, yet they could not take care of me. I went to my local hospital and have been consulted with a cardiac surgeon and an infectious disease physician. I'm quite comfortable with the infectious disease physicians as I deal with them here and there in my job. I have a lot of respect for them and believe in their treatment plan. I'm not certain if they contacted CCF. I gave them a copy of my discharge paperwork. They did a CT scan of my chest and said everything looks good except for the skin layer. They never cleaned out my wound. While I was in the hospital, it was mostly closed with oozing. Over the past few days five-six holes developed on my incision line and now my skin and whatever dissolvable suture is ripping the incision open, quite painful today. I went to the cardio surgeon today, and he said to wash it out with water twice a day and keep it covered.

 

[ocunurse]

Sorry to hear you are dealing with infection. Skyler is just finishing week 3 of his IV antibiotics. Half way through.

Are you covered for home nursing care under your insurance? You should find out what is actually covered and what your area can provide. Skyler has an automatic pump that has to have the bag changed regularly. a home care nurse is on all, but she comes to change the bag, flush the lines, and check on things 3 time a week.

There are advantages to doing it yourself, however, if you don't have to be at work or anything. First, Skyler is attached to a pump 24/7. We have come to an agreement with the home care nurse that 30 minutes before she comes we unhook him so he can have 30 minutes of "pump-free" time (in the shower!). On the other hand, we don't have to worry about timing anything to be sure that the doses are done on time. We just have to change batteries and antibiotic bag once a day before 4pm.

I am glad that you are feeling better.

I am surprised that they didn't open you up again and clean out the infection. Hope your healing continues smoothly.

My insurance is okay, just has a high deductible and high out-of pocket maximum. Wow IV 24/7??? Are they monitoring kidney/liver function? My home nurse only comes once a week. I'm going to ask how much it would cost for a pump, because I've been warned that if I give it to myself too fast then it create a number of problems. I hope skyler feels better. Is his incision open or oozing or anything?

 

[Bill B]

Hi Lyn,

I'm not going back to CCF for a variety of reasons, distance and cost, plus a hint of bitterness towards this whole thing developing. The care I received in the ICU was reckless, dangerous, and not up to standard. I had two fresh out of school nurses, because the charge nurse deemed me as "an easy case." Hand washing was infrequent, when I told them I wanted to refuse my bed bath, they ignored me, flipped me on the side of one of my chest tubes that had an air leak, causing me the most excruciating pain in my life, and pain control, what a joke, they did nothing in the ICU. They just told me to wait until the next morning. The floor nurses were much more receptive, knowledgeable, compassionate, caring, and competent. I'm just so bitter right now because the day and a half I was in the ICU, I was told probably ten times how easy of a case I was, yet they could not take care of me. I went to my local hospital and have been consulted with a cardiac surgeon and an infectious disease physician. I'm quite comfortable with the infectious disease physicians as I deal with them here and there in my job. I have a lot of respect for them and believe in their treatment plan. I'm not certain if they contacted CCF. I gave them a copy of my discharge paperwork. They did a CT scan of my chest and said everything looks good except for the skin layer. They never cleaned out my wound. While I was in the hospital, it was mostly closed with oozing. Over the past few days five-six holes developed on my incision line and now my skin and whatever dissolvable suture is ripping the incision open, quite painful today. I went to the cardio surgeon today, and he said to wash it out with water twice a day and keep it covered.

That is a telling tale. I somehow missed that you are a nurse! You would think you would get special care, but it appears just the opposite occured. I didn't want to get too pointed, but a wound infection like this is evidence of a major breakdown in care, as you understand, so I wouldn't blame you at all if you were very upset. A place like the Cleveland Clinic has an active infection control program, but it failed you. You know proper antibiotics and wound care should resolve this, but it shouldn't have happened in the first place. I do not understand the use of first year nurses in the ICU. I would expect only very seasoned, highly trained nurses to be charged with this level of care, no matter how "easy" they think your case is. Any new nurses should be closely supervised by senior staff in this setting. You're in the ICU for a reason - you just had OHS and require close, skilled monitoring in the first 24 hours at least. Part of me thinks you should pursue some form of complaint to see that this doesn't happen to the next "easy case". The other part would just want to move on with life if your course is benign from here on out. Hoping it all goes well.

 

[Lynlw]

My insurance is okay, just has a high deductible and high out-of pocket maximum. Wow IV 24/7??? Are they monitoring kidney/liver function? My home nurse only comes once a week. I'm going to ask how much it would cost for a pump, because I've been warned that if I give it to myself too fast then it create a number of problems. I hope skyler feels better. Is his incision open or oozing or anything?

I dont know what Antibioitcs you are on IV, but i wouldn't worry about giving them too fast or causing probles, I would think it would be much more comfortable just to be hooked up to the pump a couple times a day then have it on 24/7, but i could be wrong. Justin had vanco and gento thru his picline 3 times a day when he was 11 and even tho I usually hung it, Justin was trained to do everything before he was discharged and liked to do his own time to time, so i think if he could do it at 11, you should be more thn fine especially since your a ONC nurse. He did have a home nurse come out a couple times a week to check things out & change dressing etc. I'm just saying this to say that is one thing i wouldnt worry about if i were you.. with THAT said...

What you describe really doesn't sound that good to me,especially since it is reopening and oozing more, even tho youve been on antibiotics over a week.
but I'm not a doctor, just going by our experiences with post op infections. Justin had a pretty deep infection when he was 19 as well as Sterile suture abscesses almost the length of his incision, a few weeks after his first OHS at 10 days old, from not dissolving disolving sutures that had to be lanced open and we did wet to dry dressing with saline and gauze twice a day until it was pretty healed.
With his infection at 19, the first night it looked like a small pimple like when he has a suture problem but the next moring it was oozing a little, he was admitted, did did XRAY echo and CT scan as well as cultures, they did ER surgery the next day and found there was also infection in his sternum so removed the bad sections, and plastic surgery did a right pec muscle flap..we were told they thought they got all of the infection and area around it, but chances are he might have to go back to the OR one or more times to get it cleaned out..luckily between the surgery and antibiotics he didnt have any other problems. even with all that once it was cleaned out he didnt have any oozing and no more spots opened, the incision looked and acted like all his other heart surgeries and he has a thin scar. (the scar they lanced has always bean wide since it healed inside out pretty much.

You arent the first person i've heard with similar complaints about CCF, but you probably can find people who've had bad experiences at any hospital big or small.

Its good you have an infection control specialist, have you discussed getting the opinions of a wound specialist?

 

[Lynlw]

I dont know what Antibioitcs you are on IV, but i wouldn't worry about giving them too fast or causing probles, I would hink it would be much more comfortable just to be hooked up to the pump a couple times a day then have it on 24/7, but i could be wrong. Justin had vanco and gento thru his picline 3 times a day when he was 11 and even tho I usually hung it, Justin was trained to do everything before he was discharged and liked to do his own time to time, so i think if he could do it at 11, you should be more thn fine especially since your a ONC nurse. He did have a hom nurse com out a couple times a week to check things out & change dressing etc. I'm just saying this to say that is one thing i wouldnt worry about if i were you.. with THAT said...

What you describe really doesn't sound that good to me,especially since it is reopening and oozing more.even tho youve been on antibiotics over a week.
but I'm not a doctor, just going by our experiences with post op infections. Justin had a pretty deep infection whn he was 19 as well as a Sterile suture abscesses a few weeks after his first OHS at 10 days old, from not dissolving disolving sutures hat had to be lanced open and we did wet to dry dressing with saline and gauze twice a day until it was pretty healed.
With his infection at 19, the first night it looked like a small pimple like when he has a suture problem but the next moring it was oozing a little, he was admitted, did did XRAY echo and CT scan as well as cultures, they did ER surgery the next day and found the re was also infection in his sternum so removed the bad sections, and plastic surgery did a right pec muscle flap..we were told they thought they got all of the infection and area around it, but chances are he might have to go back to the or one or more times to get it cleaned out..luckily between the surgery and antibiotics he didnt have any other problems. even with all that once it was cleand out he didnt have any oozing and no more spots opened, the incision looked and acted like all his other heart surgeries and he has a thin scar. (the scar they lanced has always ben wide since it healed inside out pretty much.

You arent the first person i've heard with similar complaints about CCF, but you probably can find people who've had bad experiences at any hospital big or small.

Its good you have an infection control specialist, have you discussed getting the opinions of a wound specialist?

BTW you might want to write a letter complaining about your care at CCF. I've done that before and got alot of responses. I sent it to pretty much everyone, head nurse, surgeon, president or CEO of hospital.(it wasn't anything terrible and he did great, just things happened that should not have) they actually told me things/procedures that were changed so that wouldnt happen again.
When Justin went there a couple years later, one of the head nurses came to introduce herself and gave me her contact info and asked me to page her if i had any problems..she had a copy of my letter.. She also stopped by when he was in CICU and on the floor to make sure things were ok since they impoved those areas

 

[ocunurse]

I'm still contemplating how I will handle CCF. One of their schedulers called me, and I told them I was never coming back and was an inpatient at another hospital. LOL. Here is a pic of my incision line:

edit- I need to find another place besides facebook to host the picture.

 

[sarahsunshine]

No opening or oozing for Skyler, but they openned him up and cleaned everything out so that's not surprising. If you are still oozing, that sounds completely wrong. In fact, they gave him 6 weeks of IV antibiotics because they wanted to make sure that the infection didn't turn into endocarditis or get in the sternum. I would be concerned about the seeming "lack" of concern about those things. He's on Cefazolan (IV) not vancomycin or gentimicin. He got off the Vanco 4 days post-cleaning, and gent after 2 weeks in the hospital. He's also on Rifampin (oral) for the 6 weeks.

They aren't currently monitoring kidney function either, but he was in the hospital for 2 weeks post-op so I assume they were doing it then.

Hope your healing keeps up!

 

[ocunurse]

So most of my scar completely opened up and became very painful. I'm back in the hospital and after a 24 hour pissing contest, my infectious disease doc told me the other docs/surgeons on my team are unwilling to help me. My ID doc is going to try to consult other docs, but if that doesn't work she wants to ship me to Cleveland and Dr. Pettersson. Another fun fact, I've had a picc line for 10 days, used it for 9. The docs never verified placement until last night when I was in the ER a chest xray was done. The results: its out of place and has always been out of place since they never did a verification chest xray.

 

[kfay]

I'm so sorry to hear about this turn of events for you. Just curious, what reason did they give you for not wanting to treat you? It would have been nice for them to let you know that 10 days ago. I had a similar situation in that I traveled to the Mayo for my surgery and got an infection too. I was lucky that it turned out to not be a big deal, however, my team at home was more than happy to treat me. My thoughts were if I had needed to be opened back up, I was going to get on the next plane to Mayo and have my surgeon do it there. But it sounds like my experience was a little bit better than yours.

I think it is important for all of us to recognize that getting an infection in the hospital is a very real possibility, whether it is your local hospital down the street or one of the best hospitals in the world. How it is handled after the fact is what makes or breaks a facility and team of Dr's for me.


Kim

 

[esvaja]

I am SO sorry for you & I can empathize, no one wants to touch me here @ the U either because i had surgery @ CCF. I did realize that when I chose to go to CCF there might be some noses out of joint, but I had some very good reasons to go to CCF. I just can't believe that the local Drs won't take responsibility for aftercare. I will say a prayer for you & your Drs to get this thing taken care of promptly & correctly.
Maybe they think because you are a nurse that you can take care of yourself????? Treat yourself? Holy Moley..........
esvaja

 

[Bill B]

ARGH! Good thing you have a very proactive ID doc on your side. I had a similar experience with my dad. I remember having to yell at my dad's primary doc to get him to admit my dad one time when his Hgb was 6. My dad had a terminal disease but he wasn't in the final stages. His primary doc had rather given up and just wanted my dad to fade away. My dad was an inconvenience to him, getting sick on a holiday weekend. It struck me that he was concerned that he needed to avoid admitting my dad to try to save cost. Once my dad was admitted, the ID guy at the hospital and I talked about what was going on or rather not going on and he jumped in and got things rolling so my dad was given proper treatment, was discharged from the hospital in better shape and lived his last 6 months at home.

You have a potentially serious wound infection. Your local docs are following some very twisted thinking if they are choosing not to treat you more actively because your surgery was done elsewhere. Very risky and narrow-minded. Even more shocking that they would treat a fellow healthcare worker this way. Keep pushing with the help of you ID ally.