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Old 04-13-2005, 10:58 PM   #1
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Exclamation Deep ab wall abcess with MRSA...

I have kind of a long history...though it only started last June. I will keep it as short as possible. If you wish to only read my most current issue and question go to the last paragraph please.
I had a c-section last June, it took 5 weeks after before it was found that I had an infection, beyond the ordinary in that it went all the way down to the final fascial layer that covers the organs. I had to have the area opened up, drained, lots of tissue removed and was left open to heal. I had some form of strep and I did heal pretty well. I had no symptoms of infection, no fever or ill feeling, no white count, nothing, so until it got so large that there was a massive abcess it went un-noticed. No one could believe how massive the infection was and that I appeared perfectly well. After I healed I still had a lot of pain and swelling and we worried of lingering infection, but after antibiotic therepy, a few CTs and an MRI it was concluded as massive scarring. Though my temp went from always being low 97, to always in the 99 range. Doc said had to wait at least 6 months to go in and remove the scaring. That came and a month later I had that surgery. On March 3, 2005. I also had a tubal ligation done at this time. The scarring was so severe that I had a mini tummy tuck by time it was done with, so I had drains.

After my last surgery, on March 3 for removal of severe scaring due to my pervious incision being reopened and healed that way all seemed well at first. (I also had a tubal ligation done) Since the scaring was so bad I had a partial tummy tuck in a way. I had drains placed on each side. 1 week following surgery I had concern of infection around one of my drains. A CT was ordered. I had an intra-abdominal abcess instead, which doesnt make much sense after only a tubal. Again no symptoms as with my last post-op infection. It took a week to get in for the CT guided drainage, all went well. Then a couple weeks later I started to get some redness near the left side of incision (same side last infection was worse at) it got worse and became hard as a rock also, I made it through the weekend only to go to ER on Mon the 4th of this month. I had a CT and an abdominal wall abcess was confirmed and I continued with antibiotics that day and the next while they decided how to proceed with the drainage. I had a infectious disease specialists brought in to oversee my case since this is my 3rd major infection in less than a year. Eventually the only option that became clear was to go in surgically again and clean it out and then leave the wound open after. This one did not go as deep as the last at least. Well that surgery was on a Wed, and Friday I was informed that I had MRSA. I knew it was bad, but until I come home and researched I didnt realize how bad it can be. And it really upset me when I found out how bad it can be, and that the nurses at the hospital that cared for me didnt even wash there hands after being in my room, often checking my dressings. (I had a man across the hall with leukemia that was in for fevers!) In any case on to my true questions....

They did testing on my cultures that were said to grow quite wildy well. They did test them and found Vancomycin to be effective, and I am on this via IV at home. They put in a Groshong PICC line, which honestly scares me of it somehow getting infected too. But I had found that the typical standerdized does seems to be at 1gm every 12 hours, my does is all the way up at 1.6gm. Thats signifigantly more in a day, 1.2gm more than most common. I have areas of redness, and now of firmness showing up in other areas close to where my incision is open. What concerns me about this is the fact that I have been on Vanco since late Friday and would think that it would be effective enough by now not to allow anymore spreading/progression of the infection. And this was verified on Tue by my doc that it does appear to be progressing still. What is the likliness that I may have the Intermediate Vanco resistant strain? Esp seeing that im already on a high does of the Vanco? I am getting really concerned as of now about all this. My doc already said that if things dont change I will have to go back to surgery yet again soon. Anyone dealt with MRSA? Especially in a deep wound, not one just more superficial to the surface? I know this is very long, but I feel that all the info is necessary if anyone may had any advice at all for me. Im really worried that this infection isnt clearing for me....

Super Worried Emily

Last edited by emilysgk; 04-13-2005 at 10:59 PM. Reason: forgot to put my name on it

 
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Old 04-16-2005, 05:32 PM   #2
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Re: Deep ab wall abcess with MRSA...

Emily,

I am so sorry. This must be terrible to deal with and with a new baby.

The only thing I would tell you is to get on the phone with that doctor asap and demand that he put you on another abx with the Vancomycin. I heard that Vanco should be used along with Gentamycin and this is in the package insert for Vanco. Read up on Vanco and find out for yourself.

The one thing I have learned from dealing with my own bone infection is this: At the end of the day, no one cares about your health more than you and you are the one who must live with you health not the doctor; therefore, you should have a say in everything and you have the right to question everything. Do it and hopefully the doctor will get you on something else quickly. Perhaps you should go to the ER NOW!!!

One more thing, I am wondering why you are at home dealing with this infection. It seems like you should be hospitalized, but then again we have to wonder about the cleaniless of the hospital as obviously you got this infection there. I am wondering whether or not you were given antibiotics after your C section. I had a friend who got an infection after she gave birth to her daughter. She had an episotomy and it got infected. She still had a lot of pain at 6 weeks after her delivery and didn't realize she was walking around with an infection. Thankfully it was cured with a week or two of antibiotics. So, I know this stuff does happen.

Susan
Let me know how you do.

Last edited by susanl95; 04-16-2005 at 08:01 PM.

 
Old 04-16-2005, 08:23 PM   #3
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Re: Deep ab wall abcess with MRSA...

Dear emilysgk: Susan is right - unfortunately, we live a time when patient's have to have as much knowledge about there disease as they possibly can. I always suggest that you find some friends who have medical experience who can advocate for you in the language of the health care environment when you are unable.
I work in a hospital and I know that there are infections raging everywhere. Some of this is due to the over-use of antibiotics. But much of is due to crappy technique.
You might want to ask the doctor about wound pump which actually cleans the wound while allowing the tissue to be built up around it (I can't, for the life of me remember the name of the pump but I will find out when I get back to work on Monday).
I have to have major surgery within the next two-three weeks and I'm freaked out by precisely becuase of the issue of infections. I plan on having a private room, even if I have to pay for it, and I plan on having fungicidal hand washing available. No one will come near me unless the first use the lotions, not even family. Also, I've already spoken with an infectious disease physician about being in on my case from the very start as a consultant. After all, we are talking about my life here.
Anyway, ask about the wound pump. Good luck, chris

 
Old 04-20-2005, 09:17 PM   #4
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Unhappy Re: Deep ab wall abcess with MRSA...

Unfortunately the wound pump isnt an option for me. We looked into it last time and were told its more for wounds that are shallower and more flat in nature. Where mine a surgical incision thats simply left open. We also looked into other types of therepies some that included different whirlpools and such with different treatment in the water, and again my area are too deep for the options out there.

On tuesday I met with my doctor and he oredered a CT because of the questionable areas are still present after another week on the antibiotics. Today I met with the infectious disease doctor and he gave me a much better impression than I had from him in the hospital, I really do like him. I had been told by other patients that he is a good doc and I think I may agree now will see with time. He looked at my belly and did agree with my other on the fact that there seems to be something going on. He called and managed to get my CT report and its not clear as we all would have hoped. Instead I have on area that is quite small that has some collection, then another that is larger, its not big around, but is pretty long, about 5in in length. There is also evidence of problems in some tissue in the areas too, as he was reading it to himself I heard him say things about dirty tissue and air bubbles, so thats not too good either. Last time around my doctor had to remove a large amount of unhealthy tissue, this time he didnt. Now the unhealthy tissue is showing up in these other areas. He said he is going to leave it up to the other on what they are going to do. The options are stay on the antibiotics for another 3 weeks or so, then repeath the CT and see if things have gotton any better, or go ahead and go in and clean it up right from the start. I am quite sure that my doctor will decide on the surgery from the start with my history. Antibiotics dont usually do much for me, which in this case isnt so good being that im dealing with MRSA which is difficult to rid of for normal people, let alone someone with my issues. I dont know what to think anymore. I just want all this to go away and to get well again, its been nearly a year now since all these problems started and its not over yet. I also had to have my Vanco dose brought down a bit, as I was showing levels that were too high and it would soon start being toxic to me. He didnt drop it much though, from 1.6 down to 1.3.

I have yet to find anyone who has had problems to the degree that I have and I just keep looking....though it dont look promising that I will. You would think that with the amount of people on the net that eventually I could find someone simular....but then again, maybe not.
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Old 04-20-2005, 11:09 PM   #5
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Re: Deep ab wall abcess with MRSA...

Emily,
When I start writing, this might be long too, but this is what happened to me. On 10/5/04, I went in for a L5-SI discetomy. I had a ruptured disc. They cleaned the broken fragments out-it was even done as out-pt. surgery.
On 10/23, my incision site started draining, and basically wouldn't stop. The hospital where I had it done turned me away twice for treatment, I won't even go into details on that one, its a long story too. Thank God I work at
a local hospital, received treatment from them twice that weekend.
So on 10/25,I was told to come to a bigger hospital, where I should have went to in the first place. They did an I & D washing of my spine-cleaned all the fragments out again, due to the breakage of the disc's. Same doctor, mind you. I was placed in isolation when I come out of surgery due to finding out I have MRSA! They start me on Vanco, then by the end of the week, I can hardly walk, then pneumonia sets in both lungs. I almost died from both, it was that severe. I was in the hospital for for 10 days and when I left, I have to go home on IV therapy with a picc line in left arm.
I am most certain the MRSA came from the first surgery, but I can't blame them because, my infectious disease dr. said you have 3 strikes against you-
1-you are a healthcare worker(I was a CNA) 2-I'm a diabetic and 3- I have psoriasis. Hello-this infection was in my spine-how could I have already have it or been a carrier like he said might have happened. I wasn't sick before I went in-only my back and now I nearly died. Thank God I didn't!!!
In closing, before leaving the hospital from this 2nd surgery- the same doctor said since everything was still breaking off inside, I would probably have to have a fusion.My husband was fit to be tied. His theory was why didn't you do that in the first place. My hubby wanted me to go to Mayo's for a second opinion, asked this dr. for a referral-he said NO, I can do just a good a job if not better, right here. My hubby was ready to thump him. So,
guess what I went in for a TLIF(fusion with bone graft from left hip) on Nov. 22. I was on Vanco for a month or so, until I had a reaction then they put me on Daptomyocin, until Jan.3,2005. My picc line came out on Jan. 6-that was a relief. I was on doxicycline for a month. I had to have to 2 nasal cultures done and blood work done before I could come back to work. Those, Thank God once again, was clear. By the way, I live at my parents house from 11/5-Jan. 1st or so. 2 months I depended on my parents to bathe, dress, help me with my IV's and to get to my dr's appt. too. This took a toll on my husband and daughter, since they both had work and school and my parent's were retired.
I finally went back to work on March 1st with a permanent weight restriction and now I work in a different dept.and shift. My employer was very understanding thru the whole process. Because, as you see, this went on for several months. I had originally hurt my back at the grocery store-it went out on July 2,2004 and this is what all I went thru. I don't mean to scare anyone, that is not my intentions-this is reality. I made it through everything with God's help.
I have been hurting some with pain-not sure what's going on there-I guess I will always have problems now, probably with arthritis and such. I just hope the fusion is fusing and I don't have more problems with anything above my spine and my other vertabraes. Will write more later......

Good Luck and God Bless Everyone..............
CNA02

Last edited by cna02; 04-20-2005 at 11:30 PM.

 
Old 04-29-2005, 06:43 AM   #6
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Re: Deep ab wall abcess with MRSA...

My mother just recently passed away from MRSA. She had huge wounds inside and out. The wound vac (not pump) did wonders on her wounds, but in all honesty, go to an Infectious Disease Unit! Had my mother gone there she would be alive today. They have alot of medical options, including using the hyberbaric chambers which along side vanco treatments, cutting away infected tissues and using the chambers to promote tissue healing it's the only way to go. Unfortunately AFTER my mothers MRSA spread to all her internal organs did her doctor even move her there, by then her abdoman inside and out was infested with MRSA, which had spread to her internal organs and eventually to her blood stream. She died four days later. Had she gone there in the first place she would be alive today.

My daughter contracted hospital aquired MRSA the day before my mother passed away from the same thing. (My mother lived in Florida and my daughter had surgery in Georgia so it seems to be everywhere). Now my daughter has to be checked for it again though her wounds healed after three months, after reading your story her reoccuring pain seems very simular and is being chalked up to scar tissue but she's got terrible pain and a deep hardening three inches away from her incision, so it can't be blamed on scar tissue and it's really got me worried. She will be taken to the Infectious Disease Center this time. Hopefully you will do the same. Good luck and we'll keep you in our prayers.

 
Old 04-29-2005, 03:47 PM   #7
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Thumbs down Re: Deep ab wall abcess with MRSA...

Hello Chinisup, sorry to here about your mother. I do worry a little bit about my situation. Though my primamry doc that im seeing is worried about my immune system, the infectious disease doc hasnt even talked about it or ran any tests at all. As far as we can tell, my body does nothing to combat an infection, lets it sit there and do its thing. And that is the reasoning behind it takeing 4-5 weeks before anything surfaces, it goes unnoticed until the abcess is so large that its obvious and becomes painful. Also I believe that is why antibiotics have always been minimally effective on me and seem the same now, they are pretty much working alone instead of with my body.

After my last post things have changed. It turns out that my first CT is actually considered inconclusive because they left the packing in my belly, and as far as they can tell most, if not all of what they seen was that, and not collections. But I went to my doctor this past tuesday and as I had suspected the area has gotton larger, and it is more painful. It was just along the top edge of the wound, where now it goes above it and to the side. So I am having another CT done this coming tuesday, without the packing and going to the doc strait after it and will get the result immediatly. I will update then. My wound is healing up great, and is getting quite small, wont be long and it wont need packing anymore. I heal extremely fast, I guess thats the only good thing in it all. Much faster than anyone expects and more than whats normal. I have had so many CT in the past year its rediculous, im waiting for the day they find a growth in there or something from so much exposure, there all of entire ab and pelvis each time, cant be good. Anyways....things are not looking better infection wise, but I am healing. Though I was feeling better a number of days ago than I do now, even though the wound is getting so small. Its the infection growing I know it is.

One last thing. My doctor (surgeon too) said that if ther is fluid he has to drain it and clean it up, thats obvious. But if its just infected tissue he cant do anything. Now im thinking that infection is infection either way isnt it? I understand that he dont want to go in and remove a good bunch of tissue and cause a lot of troubles from that stand point. But will it ever go away any other way?

I talk to much....I know that. Sorry.
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Old 11-08-2005, 05:47 AM   #8
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Re: Deep ab wall abcess with MRSA...

Hi EmilySGK! I'm responding to a post that you left way back in April of this year so I'm not sure you are even still reading this board. But perhaps others with the same situation will be. If you are reading it, I'd be so interested in hearing how your MRSA resolved or didnt resolve. I am living a similar scenario right now and could use some advice:

I've known that I'm a carrier of MRSA for several years. I can't remember how it was discovered but at one of my many hospitalizations for back surgery, I was told. I wasn't put on any antibiotic but I was placed in a private room with some restrictions for nurses and visitors about wearing disposible gowns and masks.

In late May of this year I broke my hip. I should tell you that I have severe osteoporosis and my bones break spontaneously. I don't know how I broke my hip but after walking on it for several weeks I decided that the pain was way over the top and that I better go see someone in the ER. I was admitted and in early June I got a new hip. I was placed on Vancomycin before surgery and during my recovery. After I was home about 2 weeks, the femur on the same side as my broken hip also broke. This made the whole hip replacement fail and I went back for another hip in July.

I got another hip in July and the surgeon wired my femur. For some reason he was concerned about the MRSA so he sent me home this time with a Groshong catheter and 5 weeks of at-home Vancomycon.

2 weeks after I stopped the course of Vancomycon the MRSA took over my body. It seemed to be everywhere: my blood, my organs, and of course, my hip. So the surgeon put me in ICU and removed the hip, cleaned out the wound and I stayed in the hospital isolation for the entire month of August.

Sorry this is so long.... On September 3 of this year I was finally sent home without a hip and on another course of Vancomycon. This time I took the medicine for a combined course in and out of hospital of 10 weeks. I stopped taking it a few weeks back.

My surgeon wanted to aspirate my hip last week to make sure that there was no MRSA left in the hip space. The lab report came back saying that the fluid contained VRE. After a little research I see that VRE is a Vancomycon resistant anti-biotic!! Well, I'm going next week to have another one done (aspiration) to make sure it isn't a lab contamination error. I just don't know what I'll do if it really is VRE!! As it was, my surgeon wasn't going to give me a new hip until March 06 and that was conditioned on the hip space being absolutely CLEAN!

Do you or anybody reading this know how they treat this? I feel like I'll be infected with something my whole life. I should say that I do have auto-immune disease and am on prednisone. So I am more prone to getting infections.

Your thoughts please. Thanks and sorry this has been so long.

Last edited by Administrator; 05-24-2009 at 09:39 PM.

 
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