Re: Post op complications hysterectomy

From: mcgdog mcgdog (dogdoc6283@msn.com)
Sat Feb 22 18:59:29 2003


Hi Judy, Thanks for your input. I thought that I would let you know how things are going. Not too well, I'm afraid. I saw my regular (family) physician concerning the skin lesions. She (nor I) had really seen anything like them before. They look like fungal lesions with petecchial hemorrahages. She did two punch biopsies which read out as nonspecific, but looks allergic. I have not changed any of my cleansers, etc. so I know that it is not contact dermatitis. However, my pathologist friend said that she has seen such skin lesions occur with endotoxic reactions (possibly from the Staph aureus infection still present in the hematoma). I made a follow-up appointment with my OB/Gyn (whom is also an infertility endocrinologist). He examined the incision area and said that he did not think that it was still infected. He refused to do an abdominal ultrasound of the area even though there is still a very hard nodular area proximal to the incision and a focal point of pain where he drained the fluid which grew the staph. He told me that the hematoma had resolved and that the thickened area was simply scar tissue where he had to lift the skin from the fascia during surgery. The "scar tissue" is about 2 inches thick!!! I questioned him about the culture of the fluid: whether or not it was MRSA (since he didn't qualify this to me last visit). He reluctantly checked my chart and told me that it was in fact MRSA, but that it was moderately sensitive to tetracycline and very sensitive to vancamycin. I have already taken a full 21 day course of tetracycline along with 4 other rounds of oral ABx's with no resolution. I know that the vancamycin only comes in an IV prep. He also tried to tell me that the staph infection was a normal skin flora, which I rebutted with the fact that it is MRSA and had to be acquired in the hospital. I explained to him that I was not interested in blaming anyone for the infection, but only want to get it treated. He refused to do anything more for me; diagnosticly or otherwise! I am suspicious that his lack of motivation is partly due to the fact that my insurance is not paying for these "post-surgical" visits as they have pointed out that these charges should be included in the charge for the surgery. His office manager said that post-op appointments are only supposed to be for up to 6 weeks post-op. However, I quickly pointed out to her that I have a post-surgical complication and therefore (for once) I believe the insurance company is correct in their decision. I have made an appointment to see a dermatologist in 2 weeks (the soonest that I could get in) by referral from my family MD. Here's another added little bonus: my family MD found an increased Alk Phos on my chem panel, questioned me about gall bladder symptoms and ordered an ultrasound. Yep, you guessed it..the radiologist read out gall stones!!! I am going back to my regular MD Tuesday to discuss my options.which I'm sure will probably lean toward SX as I am having sharp pains and some hepatomegaly associated with the friendly little stones (just my mcgd)! Do you recommend that I ask her to refer me to another surgeon to check out the hysterectomy incision? I'm really disappointed in my doctor (OB/GYN) as he has been my doctor for the past 14 years and has done 4 laparoscopies and 2 laparotomies during that time.

Sincerely, Angie

>----- Original Message -----
From: "Judy Kemp" <jukemp@utmb.edu> To: "Multiple recipients of list ADHESIONS" <adhesions@mail.medispecialty.com> Sent: Monday, February 17, 2003 6:59 PM Subject: Re: Post op complications hysterectomy

> Hi Angie,
>
> My understanding is that hematomas certainly can happen after
> hysterectomies. And yes, they can become infected. Blood and
> proteinacious fliud kept at body temp is the ideal growing substrate
> for all kinds of infection. I would ask how long the doc he intends to
> wait before draining it. MRSA is not to play with either. I would
> really recommend getting another opinion (your friend MD may be a great
> start) and getting some resolution on these issues and a certain
> direction/game plan that you can follow. Good medicine should have a
> course of action - if X happens do Y, etc. I hope you find your course
> of action and take it step by step to good health very soon! Judy
> On Monday, February 17, 2003, at 12:53 AM, mcgdog mcgdog wrote:
>
> >
> > Hi all,
> > I just wondered if anyone had any complications such as infected
> > hematoma from abdominal hysterectomy? The doc said that the hematoma
> > would resorb on its own but so far, 2 months now, no decrease in size
> > and I am having a possible skin reaction to MRSA (Staph aureus)
> > nosicomial infection. I was told by a pathologist (friend) that these
> > hematomas can sometimes fibrose and have to be surgically
> > debrided....not to mention IV vincomison for the Staph infection.
> > Any thoughts, comments, etc.
> >
> > Thanks,
> > Angie
> >
> >> From: Judy Kemp <jukemp@utmb.edu>
> >> Reply-To: adhesions@adhesions.org
> >> To: Multiple recipients of list ADHESIONS
> >> <adhesions@mail.medispecialty.com>
> >> Subject: Re: surgery in Germany
> >> Date: Sun, 16 Feb 2003 23:07:50 -0600
> >>
> >> Hi April,
> >>
> >> Sorry you are having upper abd problems. At least you've halved the
> >> playing field - now you can concentrate your efforts on the other
> >> half and hopefully get your full life back in the VERY near future!
> >>
> >> I had colitis 1/2 a yr ago after several rounds of antibiotics from
> >> the horrible hysterectomy that also gave me adhesions. I didn't know
> >> what was going on then but started feeling really badly and therefore
> >> monitored my temperature 3 times a day. After a few days it started
> >> shooting up (of course on a Sun.) so I headed to the ER. By the time
> >> I got there it was 104 and when they rehydrated me the diarrhea
> >> kicked in big time. I had a big white cell count and a really
> >> ticked off colon based on the abd. CT.
> >>
> >> But that was then and I am now a much more experienced person. So
> >> when I started feeling flu-like a couple weeks after surgery in
> >> Germany (after having been feeling great), I took my temp more
> >> frequently and when it went up to 100, I headed back to Dr. K. Had a
> >> vaginal infx going on and the colitis deal as well. The vaginal infx
> >> pretty much cleared up and I began Flagyl for the colitis. Dr. K
> >> wanted me to hang around until things were progressing in the right
> >> direction for several days. I felt that was a very good idea too, so
> >> Randy and I bedded down in the same hotel where we had been staying.
> >>
> >> All in all, we were 2 days shy of 4 full weeks in Germany. Of
> >> course, more than half of that we planned on doing anyway given the
> >> first surgery and then waiting a week for the 2nd look, and then
> >> hanging out for 3 - 4 days before heading back. So this additional
> >> deal added another 11 days which was OK with us. It was very
> >> important to be under medical supervision with all of this going on -
> >> and Dr. K was conscientious in making sure I didn't get into problems
> >> (check ups, phone calls, etc.)
> >>
> >> I am so glad to read that your bowel movements are not agonizing
> >> deals for you anymore. That must improve quality of life greatly.
> >> Amazing how these nasty adhesions impact so many areas of living! I
> >> agree with you and Annie that a pastry about now would be wonderful.
> >> While having to hang out in Germany the last week I watched Randy
> >> drink many a fine German brew (not that I particularly even like
> >> beer) but it did make me feel bad that I couldn't have one if I HAD
> >> wanted one....so when the going gets tough, the tough get chocolate.
> >> And on that note I enjoyed many a fine pastry. But there is always
> >> room for more research and I would be a willing partner in your
> >> efforts to find the perfect pastry.
> >>
> >> Take care, Judy
> >>
> >> We went back to the hotel where we had been. I did not have to be
> >> hospitalized again.
> >> On Saturday, February 15, 2003, at 09:26 PM, AprilDe402@aol.com wrote:
> >>
> >>> Hi Judy,
> >>> So good to hear from you. I had a bout with clostridium difficule
> >>> after my
> >>> hysterectomy in 1999, It took me quite some time to gain my
> >>> strength back, it went further with bleeding ulcers and
> >>> hemmorhagic gastristis. It was thought to be caused by antibiotics,
> >>> but we had also been out of the country (St. Lucia)
> >>> so they thought it was also possible to have gotten from bad water
> >>> or food.. I
> >>> lost 30 lbs...........it was bad.
> >>> Sorry I didn't mean to get off into all that.
> >>> So I must ask, did you end up back in the hospital or were they just
> >>> able to treat you? Did you stay in Seliganstadt?
> >>> I've continued to have upper ab problems.......still good relief in
> >>> the pelvis.........
> >>> and bowel movements are no longer agonizing events............I'm
> >>> know my upper pain is not associated with adhesions.........I'm on a
> >>> antispasm that is helping a little.
> >>> Your friend was asking about you and here I gave her a report, of
> >>> course without knowing of your problems.....sorry........she was
> >>> pretty worried about ya.
> >>> I say (ditto) to everything you had to say about germany, the docs,
> >>> the whole
> >>> deal.
> >>> It is a little earlier for me to know exactly where I am, but I'm
> >>> encouraged.
> >>> I emailed Ann, and we agreed that we could use one of those
> >>> pastried about now.
> >>> Keep us posted,
> >>> Your friend,
> >>> April
> >>>
> >

>


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