Since Slim continues to have complications from his heart attack and bypass surgery we have decided to reinstate the blog.
Slim entered the hospital for the 3rd time since his heart attack on Jan 16th. The last two admits have been as a result of complications from getting an infection. The most recent readmission (Wed. Feb. 9th) was also due to some early stage kidney failure.
The first sign of an infection came while he was home recovering two weeks ago. Mom and I began to notice some increased swelling and redness to his left leg. It was located at the incision site of where they took the vein used to make the grafts for his bypass. He was admitted for five days and in the end they drained out one pocket of infection and put a wound vac on the incision site. Slim probably should have stayed in the hospital at least another day so they could monitor his infection and other lab tests better. However, he was pretty anxious to get out and be home where he felt more comfortable. The hospital set him up with out-patient infusion therapy going morning and evenings to get the needed antibiotics. A day and a half later he was again re admitted. The White Blood Count (WBC) score had gone up again to 21,000, which indicated that the infection was getting worse. The lab work also indicated that his kidneys were not doing well. He also continues to have fluid around and or in his left lung area.
As they were in the process of admitting him into the hospital they were assessing his dressing on his chest and noticed some infectious fluid coming out of his chest incision site. They had the physical therapist that works with wounds come in and set up a wound vac on this site as well. They also reexamined his leg and noticed some tunneling had occurred. Tunneling occurs when the infection and necrotic (dead) tissue starts to work its way deeper into the body. As they followed the tunneling, they found 2 more masses of infection in his leg. They cleaned them out and kept the wound vac on to help suck out any additional fluid and to promote wound healing.
Lab Results as of Wed;
*INR was over 5. This means his blood is too thin. Normal should be around 1.0
*WBC 21,000 Normal white blood cell count is 5,000-7,000
*Kidney function score was a 2.0, which indicates that the kidneys are not working as they should.
*They did an echo cardiogram and found excessive fluid around his heart.
*CT Scan- showed that the infection appeared to only be superficial in his chest.
They have done various tests to assess what type of infection he has…. Since he has been on antibiotics since his surgery, the cultures are not able to identify exactly what type of infection he has. Because of this, they are using the strongest antibiotics they have…. Assuming the worst of infections and trying to treat it as if that is what he has. It is likely a staph infection
Over the last few days the lab tests showed that the infection was getting better. He was down to 13,000 on his WBC on Sat. His INR was still at around 2.4… The challenge is that they are trying to balance giving him as much antibiotic as they can give him, without pushing the kidneys into further failure. They have also been giving him vitamin K to try to help boost his blood into thickening up more. This has not improved as fast as they would like.
Slim has had a hard time sleeping in the hospital bed. We received permission to take over his favorite recliner and put it in his room. He spends most of his time in this chair. He has to sit mostly upright because if he lays down he begins to cough and this irritates his chest incision. He doesn’t have much of an appetite and has difficulty talking much. He can talk for maybe 1-2 sentences and then starts coughing. This is why we have discouraged visitors…. He just can’t carry on any kind of a conversation. It also drains him and he really needs to conserve his energy.
Sunday: The labs came back and showed that his WBC had actually gone up to 14,500. This is not good considering how much antibiotics they are giving him. They would like to have taken him into surgery today, but his INR is still too high. In simple terms, this means that he could bleed out while in surgery.
The Tentative Plan for Monday- They hope to take him in for surgery Monday afternoon around 4 pm. The plan is to put a chest tube into his left lung to assist in draining out the excess fluid. They also hope to explore his chest incision site and even look down towards the heart and surrounding tissues, looking for excessive fluid or signs of infection. This could also mean doing some debridement of necrotic (dead) tissue. Following the surgery, he may need to go to the ICU unit.
We are not sure how long he will be in surgery tomorrow, as they don’t know just what all they will find once they are able to get inside his chest. I will post again tomorrow night when we know more about how the surgery went.
Thanks for all your prayers and support
Jaren
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