Infection Club

Had a device swap and lead revision on Jan 2nd (this year). On Jan 29th I had a stress test to see what the new unit was capable of and to see if they moved the atrial lead to a better location then before. Everything worked better than expected and I was on cloud 9 feeling better than ever.

Well, that didn't last long. Two days after the stress test my incision opened in the middle. I thought I popped a sub Q stitch so I used a steri strip to pull the incision together. A day later I noticed the wound dressing was absorbing a clear yellow water like fluid so I cleaned the site with salt water and kept it covered. Over the weekend the site was sore to touch and looked red and continued to drain the same fluid. I called the pacemaker lab at the hospital to arrange a visit asap (booked for Tuesday this week).

Monday I thought I should get an opinion and maybe some tests done so I dropped into a walk-in clinic. The Dr at the walk-in said right away it was an infection and swabbed the incision for a culture test. (***Side note... This young Dr at the walk-in was a resident under one of the EPs at the hospital that did my device install***) He prescribed me a round of Cephalexin 500mg and said it should prevent any further infection. Also, it would take care of the most common pocket infections. He had two sets of blood cultures taken before sending me home.

At this point, I was only feeling slight pain at the incision site. No other infection symptoms like fever, chills, flue-like anything, weight loss, loss of appetite. The incision was still being held together by the sub q stitches except for the small opening in the middle...

On Tuesday this week, I visited my EP team and they were clearly not happy to see an infection. The one Dr massaged the incision to work some of the drainage out of the pocket. They basically said there's nothing they could do while they were waiting for the cultures to cook. I was instructed to keep the site clean and apply pressure during the cleaning to bring out more of the fluid. They agreed with the Dr I visited yesterday about the Cephalexin being the right choice while we wait for results.

This morning I cleaned the site and applied slight pressure starting at the bottom of the pocket. the fluid was now cloudy and looked more like infection residue. Without warning the pocket released a lot of fluid (incision stayed in-tact), and I was kind of surprised for a minute. I irrigated the incision with salt water and covered it up with a new absorbent pad.

My questions for anyone seeing this, am I (or the Dr's) taking the proper steps to remedy a pocket infection?


Should I have asked for them to do any other tests to determine the extent of this?

The EP Dr said if it's bad they'll remove everything and deal with the infection. They'll call when they see the culture results and said to come on Friday if they don't call by then. I'm beyond pissed at this point because the surgery and the stress test result couldn't have been any better. This is a huge setback for me and my progress. I'm afraid to touch the pocket even to clean the area now after seeing what I did earlier today with the cloudy fluid.

Is it better to leave it as it is until I receive further instruction, or should I keep working the junk out of the pocket and keep it clean?

 

UPDATE: Incision swab tested positive for Staphylococcus aureus
I'm scheduled to visit the hospital tomorrow with the EPs to review the situation.

2 Comments

to remove...or not to remove, that is the question

by ROBO Pop - 2018-02-09 10:40:14

I cannot believe the cavalier attitude of so many doctors on this problem. I guarantee I would never want to go through that a second time. I lost 6 months of my life with daily hospital visits having to wear a life vest, a vacuum pump, and an infusion pump. That crap is heavy let me tell you, though it did have a positive aspect, when I went into public areas people thought the black bags with flashing lights hanging on my shoulders were IEDs. People jump when you say to.

If I had it to do over again, I'd demand everything be yanked immediately if not sooner. I spent 2 weeks in hospital oozing poison while the doctors fiddled. Every morning the infectious control doctor came in and told me there washigh risk of the poison moving down the leads and into my heart if they didn't get it out immediately.

If all they do is give you anti-biotics you'll be prone to infections forever with that thing. I'd insist they get it out.

No bueno

by bposter - 2018-02-10 12:18:03

I'm with you man, this sucks. I've recently gone through a very similar situation, check my posts, I'll save everyone the retelling. I feel for ya man.

Get it pulled, get the infection cleared out, it's too life threatening in the long term otherwise. 

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