Important question re:open heart infections.

I’ve got some worries about my father-in-law’s post open heart surgery progress. About a week and a half ago he underwent surgery to replace his aortic valve and had a triple bypass, too. He had to be opened up two additional times to correct bleeding problems within 24 hours of the initial operation. He was on a ventilator for two days afterward, but eventually they were able to take him off to breathe on his own. Four days ago they let him come home to recover. My wife and I are thinking that this was a big mistake.

My FIL is diabetic (no insulin shots for him yet, thank God) and has had a long history of heart problems since he was in his late 20s. He’s 61 now and extremely stubborn. Anyway, the incision in his leg is leaking a yellowish-green discharge and the skin around the incision area is inflamed and the inflammation appears to be moving upward. This is also in addition to the nickel-sized water blisters that come up on his legs if he’s on his feet for too long. The physician has him on a large dose of Keflex which he is taking three times daily. My wife and I are trying vainly to tell him that the antibiotic may not be effective and that it’s only slowing the progress of the infection. Our concern is that he might have a drug-resistant staph infection and that he should get his ass into the emergency room ASAP. However, he’s totally convinced that since his surgeon performed the operation successfully that he’ll be okay because the surgeon and his nurse said that these are normal reactions. My wife and I aren’t convinced. He’s supposed to have an appointment at the hospital tomorrow, but I think wasting extra hours might be very risky in his situation.

Are there any other Dopers out here that have first-hand knowledge about stuff like this happening after open heart surgery? We were freaked out about the extreme water retention in his legs, and this possible infection is really kicking us into overdrive. We’re worried about him possibly losing his leg – or worse. Are we being alarmist or what?

(Sorry for rambling, but I really like my father-in-law. It’s making me nuts to see him doing something that I think, for lack of a better description, is idiotic.)

Thanks!

I’m not a doctor. I have no personal experience with open-heart surgery, although both my parents and my husband have had it.

What you describe sounds to me, in my non-professional opinion, like a real nasty infection that is not responding to the antibiotics. If it were up to me, I’d have insisted on speaking personally to the doctor and/or demanding to be seen at once. Failing that, a trip to the ER. I have seen gangrene and experienced blood poisoning. Neither one is pretty, and both can be extraordinarily dangerous.

IANAD. This is not professional medical advice.

Thanks for the opinion! A question for you: did your parents or husband experience swelling in their legs which would cause the type of water blistering that I described above? I’m talking large straw-colored blisters that raise at least an eight of an inch or more above the skin surface.

No, they did not. Of course, my mom’s surgery was for a valve, so that did not involve the leg vein harvesting. But neither of the guys had any symptoms that were in any way remotely similar to what you describe. I don’t think you are being alarmist at all.

There are many causes of blisters such as you describe. Swelling and infection are among them. Given the extensive nature of your FIL’s surgery and his debilitated condition a bad infection could be devastating. Wht not let his surgeon have a peek at him?

See, that’s the thing. We’re practically begging him to go to the hospital now and have them call the surgeon in to see what’s going on, but the surgeon’s nurse, whom he talked to over the phone, told him that there’s nothing to worry about and that these symptoms are typical. Like I said before, he’s certain that nothing can go wrong because his doctor and nurse told him so. We’re just trying to get him to get himself checked out just in case.

A lot of the problem is that his mouth is running a mile a minute and it’s difficult to get concise answers out of him. At first we thought it was some sort of reaction to the anesthesia or post-op euphoria of some kind (does that exist?), but now it seems almost manic. He appears to be in good spirits, but getting him to talk without having him go off on a tangent is nearly impossible. I think that this handicaps the medical staff’s ability to assess his condition properly.

He’ll be going in for his appointment in less than three hours now. I guess we’ll see if they’ll admit him and hook him up to some IV antibiotics or something.

I wouldn’t guess anything. If it’s an infection, he’ll get antibiotics. If not, then no antibiotics. The reason for a visit is to make this determination.

I don’t know anything about any of this, but ten years or so when my dad had a quadruple bypass with the leg vein harvesting and all, he didn’t have nothin’ that looked like any of that - and he had problems with his leg incisions that required antibiotics and such. But it was just red and oozy, nothing like that, especially the water blisters. All of that really sounds like trouble to me.

Please let us know what happens at the appointment.

Well, it turns out that my FIL definitely has an infection. Right now they’re waiting on the results of a sensitivity test to see exactly what he has and what would be the best medicine to treat the infection. They’ve switched him from Keflex to a prescription for Levaquin in the meantime. Hopefully we’ll find out more tomorrow.