Tuesday, February 24, 2009

Pseudomonas & Enterecocci Infection

Yesterday, we had an oncology appointment, which lasted for more than 3 hours. Lots of waiting and then lots of information given to us regarding chemotherapy and the other clinical studies they're doing for new medication for pre-menopausal women.  So, we have a lot of reading to do and we have to make a decision on what treatment option to take. It's alot to process in one sitting.  I showed Dr. Robinson the area in the reconstruction where the blister had popped and there seemed to be an infection. I had called the nurse from plastic surgery last week and she didn't think it was a big deal and told me to wash it daily and apply bacitracin. Ok, so we did that and Frendell said it's getting worse.  So, Dr. Robinson looked at it and put me on antibiotics (cephlexin... i don't remember the name of it); she also took a swab to rule out MRSA.  After the oncology appointment, she told us to go to the Coleman Foundation Self-Awareness Department. So we went there and stayed another hour. The lady there helped me find supportive undergarment that I can use while I'm healing. She was a little upset that I hadn't gone there prior to surgery. They actually have a camisole they give you that has pockets, where you can put your ballz/ornaments after surgery!!  Imagine that!! Oh well.. even it it's too late for that, at least I have support now 
:-)  :-)  When we got home, i was exhausted. So we ate an early dinner and then I went to sleep... and of course woke up around 11 p.m. and then couldn't sleep until 4 a.m.

Today, Dr. Robinson called me back to confirm some of the initial findings of the test. Pseudomonas...and some enterecocci infection. So, I'm taking the wrong antibiotics... so, she is changing the prescription. If this is not working, the Infection Control Dept wants to see me.  When will it stop?  Anyways, she will call the plastic surgeon, Dr. Vandevender, to update him on what's going on. He will not be happy. I hope the nurse doesn't get in trouble when he finds out I called last week to report about it and she told me she "didn't think it was a big deal, probably nothing.. I think you should put bacitracin and it should be fine". I even offered to move up my appointment date so the dr can check it out, but she didn't think it was necessary. Oh well. I called her this morning (before the doctor called me) and told her that the oncologist had swabbed it and put me on antibiotics.  We'll have to see what Dr. V will say when I see him later on this week.

so, that's the latest update... also a small infection on the incision part in my belly.... the belly-button one is drying up though...  I hope that antibiotics work.. sometimes this bacteria is nocomial and medicine-resistant... I don't need this.. I told Frendell I'm so tired of taking meds.. and I will have to take more daily for 5 years... help

3 comments:

  1. I thought of you again today. I saw this and GLADY came to my mind immediately. We are beside you all the way to watch you kick cancer's ass!!

    http://www.youtube.com/watch?v=sEImOOA2rh4

    ReplyDelete
  2. Reading your post today, I can’t help but share my 1 cent worth of medical opinion just to allay some of your fears.So here goes:

    1.Unfortunately, wound cultures often are not diagnostic and can be misleading, because non infected wounds frequently have bacterial colonization.
    Therefore, microbial growth may represent merely wound colonization and not true wound infection.
    2.Clinical evaluation of the wound helps in differentiating true infection from
    colonization.
    A. Visual inspection-if there is large area of erythema(redness) and copious discharge then infection is likely but not diagnostic of specific organism.
    B. Smell-
    Putrid odor=anaerobic organism
    Malodorous=Enterococci
    Grapelike= Pseudomonas
    C. Crepitance( you can palpate this like air in and around the wound)=Anaerobes
    D. Gram Stain= look for numerous PMN’s and the dominant stain of the organism.
    3.The type of surgery may provide a clue to the causative organism:

    Clean surgery- Staph and Strep
    Clean surgery plus foreign body-Staph
    Bowel surgery-enterococci, anaerobes

    In short, the pseudomonas and eneterocci isolated from your culture may still be colonizers and not true infection. But if it turns out to be true infection, these bugs can be treated with wide spectrum penicillin or third generation cephalosporins. If youre taking antibiotics for a long period of time, you may opt to take some form of probiotic as to maintain the normal flora of your intestine. Here in the Philippines, we just let our patients drink one bottle of yakult per day if they are not diabetic.

    We continue to pray for you Glady.

    ReplyDelete
  3. Faith, I really enjoyed that vdo clip.. I will survive!!

    Ariel, thanks for sharing your knowledge. It's an infection, but getting better. When it first started, it had all the symptoms of infection.. redness, copious discharge and smell. I've been on antibiotics 3 days now, and it's starting to get better.. drier in most areas, but it continues to have discharge. the surgeon was very reassuring that it will heal fine. I'm to take the meds for a week and apply a different antibiotic cream.. he said in the long run, it will be heal well.. so I'm very relieved about that. i appreciate you sharing what you knew.. he also said the same thing to us today about infection vs colonization.. so I knew what he was talking about since you'd already written about it :-) thanks, I really appreciate it

    ReplyDelete