Infection in tissue expander |
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QH RDR 
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Joined: Jul 21 2008 Location: United States Status: Offline Points: 47 |
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 Topic: Infection in tissue expanderPosted: Aug 14 2008 at 4:34am |
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Just wondering if anyone out there has experienced the h**l I have been going through since Sunday. I have developed a raging infection in the temporary tissue expander, 3 weeks after it was implanted. The symptoms started with jabbing pain in the otherwise numb breast, then this severe nausea started with a vengenance. Unrelenting, severe nausea. Mild temp, hot boob. Horrible taste in my mouth. And I haven't even started chemo yet! The doc has me on two antibiotics, Keflex and Leviquin; a suppository for the nausea, and ibuprofen for the pain. So I am on day 3 of the antibiotics, but this nausea just won't go away. If the doc determines I am not better today, he is going to put me in the hospital for IV antibiotics; if there is not an immediate improvement he is going to do surgery to remove the tissue expander.
Has anyone else had this kind of problem??
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Dx 6/30/08, IDC, node positive, skin-sparing mastectomy 7/21/08, A/C (4 cycles) started 8/29/08
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runawaybunny
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Posted: Aug 14 2008 at 3:55pm |
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Hi,
My heart goes out to you! I've been dealing with the same issue. My left expander became infected around 3 weeks out from surgery. The bump became hard and red.
My surgeon switched me from Keflex to Bactrim and sent me to an infectious disease doctor(just like Dr House on TV). I also developed shingles on my left arm and was put on acyclovir. "Dr House" doubled the bactrim and after the acyclovir finished, the bactrim seemed to be working. But today, Dr. House changed the antibiotic to Zyvox, which is similiar to being on IV antibiotic.
This has delayed my chemo 2 weeks, because they won't begin chemo while I have an infection. My surgeon also said if the infection isn't resolved, she will need to surgically remove the expander. At least the pain and low grade temp are gone, but I didn't have any nausea.
I learned I'm allergic to Leviquin when I was having my chemo port installed. My hand with the IV began to itch and turn red. I could tolerate Keflex and Bactrim
Could your nausea be from all the meds you are on or because of taking them on an empty stomach?
You have my fervent hope and prayer that your infection goes away. All of this is tough enough without these perepheral issues.
Catherine (Runawaybunny)
Invasive ductal carcinoma, TN, 6mm, grade 3
Bilateral mastectomy w/ reconstruction
Chemo: AC X 4 and Taxol X 4
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Galina2
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Posted: Aug 14 2008 at 5:48pm |
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Thank you for letting us know, what can happen with these surgeries! My heart go to you and hope your infection will resolve soon!!!
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Galina2
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Posted: Aug 14 2008 at 6:00pm |
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Edited by Galina2 - Aug 15 2008 at 6:12am |
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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QH RDR
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Joined: Jul 21 2008 Location: United States Status: Offline Points: 47 |
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Posted: Aug 15 2008 at 3:54am |
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Oh hey Catherine thanks for the info, as sick as this sounds, knowing I am not the only person in the world with this particular problem is comforting! My nausea started Sunday morning when I woke up, 14 hours before starting any antibiotic. The doc said it was because the infection was so bad. As of yesterday afternoon the nausea had subsided, and I was able to keep down everything I ate. Now I have a screaming headache, which I know is from the meds, but at least I can take something for that. So I see the plastic surgeon again in the morning (on Saturday, if you can believe that - he gave me and my husband his personal cell phone number!), and so long as I continue to improve hopefully I can get back on schedule.
My best thoughts to you for a speedy recovery!
Sandy
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Dx 6/30/08, IDC, node positive, skin-sparing mastectomy 7/21/08, A/C (4 cycles) started 8/29/08
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runawaybunny
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Posted: Aug 15 2008 at 5:02am |
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Sandy,
Plastic surgeons certainly don't want to remove expanders. Mine said she has never lost an expander and I was not going to be her first. She gave me her number too. She's kind of bossy, but I figure it's in my best interest.
I wanted to tell you that after just two doses of the Zyvox, my redness is almost gone! No other antibiotic worked this fast. Maybe the infection was on the mend, but the change from 12 hours ago is dramatic. I'm on 600 MG twice a day. In fact, I'm a bit mystified that we didn't start with Zyvox.
Maybe it's worth asking your doc about it.
Good luck!
Catherine
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cg---
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Posted: Aug 15 2008 at 5:18am |
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Because Zyvox is consider "a big gun" in the antibiotic world...doctors try to treat the infection with first, second, third line antibiotics - killing off the infection with the mildest antibiotic to start ....but if the infection proves to be resistant then the gram-negative bacteria is usually eradicated with Zyvox.
A lot of doctors do not mention to avoid foods which are high in tyramin which can raise your blood pressure - aged cheese or meats, sauerkraut, soya sauce, beer on tap, red wine, smoked or air-dried meats, pickled or fermented meats.
Also, to avoid taking this antibiotic with SSRIs (antidepressants) such as Paxil, Celexa, etc.
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runawaybunny
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Posted: Aug 15 2008 at 5:26am |
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The food warnings regarding cheese, wine, beer and chocolate were all over the bottle. The doctor mentioned that antidepressants were out as well.
What about cottage cheese? It's not aged so it should be okay.
Does yogurt count as a fermented food like cheese?
Thanks!
Catherine
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Jessie
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Posted: Aug 15 2008 at 5:50am |
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Sandy and Catherine --- please make sure you are tested right away for MRSA. It's a staph Super Bug and almost epidemic in hospitals now. I was in one of the top hospitals in the country and I got it in my bloodstream after my mastectomy. No reconstruction had been started, but my port had to be removed. They said if expanders had been put in, they would have had to be removed also. Problem is the staph bugs "seed" in the ports and expanders and the antibiotics can't get to them.
Be very direct with your question, "Have you tested me for MRSA?" Don't accept a response like "Well, we don't think that's what it is." BE SURE !!! The mortality rate is about 50% so there isn't time to fool around trying various antibiotics. I went into septic shock, my organs started shutting down. I had a heart attack and pneumonia. MRSA is resistent to all but a couple of antibiotics and they are extremely harsh ones, toxic even. IV Vancomycin saved my life. I had horrible burns on my face from it, but there was no other choice. I hope I'm scaring you so you'll insist on being tested for it. It's so important to catch it quickly.
These infections are serious business. They seem to be sort of swept under the rug documentation wise, but the risk is really quite high after surgeries. It seems to occur frequently after mastectomies maybe because there are so many points of entry, with drains, port-a-cath, other catheters, and large incisions -- lots of opportunity.
I'd say treat any infection after surgery as an emergency and make sure the drs take them seriously. My first sign of infection came 2 weeks after the mastectomy. That surgeon did hospitalize me, with IV Zyvox for a week, said "Oh, this is only a bump in the road for you" --- did NOT test for MRSA, and two weeks later I was back in the hospital fighting for my life. Thank God I had been transferred to oncology and they DID check for MRSA and I didn't hear any more "bump in the road" talk !
Enough of this. I guess scaring fellow BCers is my job now.
 Hugs,
Jessie
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IDC,Stage I,Grade 3,dx 4/06
dbl mast 5/06, systemic MRSA post surgery septic shock, heart attack triple bypass 1/07 no chemo due to infections and heart issues so far NED! |
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Galina2
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Posted: Aug 15 2008 at 6:35am |
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Thank you, Connie, TYRAMIN, I do not think even GP knows!! Now I know, why I like all those smoked meats and old cheeses! I have low blood pressure and it makes me feel GOOOOD! I asked doctors so many times to give me something for low blood pressure and they just say it's better than high!
Well, my son has high blood pressure (because of heart problem) and he need to LOWER blood pressure. Of cause, as he passed by I immediatelly informed him about your post! He wants to know why the tap is bad and beer in glass would be OK,
 . (He just turm 18 )BRRR, about the infections, it's enough to hear about MRSA after mastectomy! I do have now a promissed appointment with the plastic surgeon in two years! I do have some time to think about it!
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Galina2
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Posted: Aug 15 2008 at 7:01am |
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Dear Jessie, BRRR and F$@#*&^!!!! My MOTTO now is TAKE CARE OF YOUR HEALTH!! Nobody will do it for you! You have to be educated, knowledgable, ask questions, ask for ALL your reports and tests! Not to test for MRSA is a case for a lawyer! Trying different antibiotics blindly? They probably needed to get you onto something right away, but it doesn't mean not to take (blood/biopsy) samples for analyses!!! MRSA is resistant to EVRYTHING and so far the last resort is VANCOMYCIN!
It's the ONLY antibiotics which works, otherwise you are gone faster than your cancer can get you!
I was many times going through the roof, but how you can tell to those highly payed, educated, snobby, bossy, assertive Doc's THEY DO IT WRONG?!!!
What worked for me was patience: I suggested something every time I say Him and in a month he came back with my idea!!! Edited by Galina2 - Aug 15 2008 at 7:04am |
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Jessie
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Posted: Aug 15 2008 at 7:42am |
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You are sooooo right Galina !!
I had never heard of MRSA before I was struck with it. In years past I'd had several kidney surgeries -- and NEVER an infection afterwards. I know the possibility is on the consent form we sign, but the idea that I might have an infection that couldn't be taken care of by a simple injection of most any antibiotic wasn't even on my worry list.
Now I know there are several deadly infections that are not UNcommon after a hospital experience. Many states have pending legislation to force hospitals to make available the numbers and kinds of infections experienced by their patients. Of course this is being fought very hard by the medical community. The fact that I had MRSA is in my medical history, but it isn't easy to spot, sort of hidden by other words like bacterium, sepsis, etc. A search for the word "MRSA" might not be successful. A patient who dies from a MRSA infection would most likely be said to have died by "complications after surgery".
I've wondered how many times hospitals have been sued due to MRSA related deaths. In my case the diagnose, concern and treatment was sooo different between the surgical and oncology disciplines. It was very apparent that Oncology had little respect for the actions taken by the surgical drs in the handling of the initial infection symptoms two weeks earlier.
I was so sick and unaware of all the details at the time. I didn't know that when my husband was not in my room, he was on the phone with our children (all grown) discussing possible funeral plans. I wasn't told til weeks later the things the drs were telling my husband. Bless his heart.
I'm with you Galina --- we can't afford to just go blindly along with our docs. A good doc will answer our questions, discuss info we've gotten from our own research, go over the pros and cons of our options --- and give us respect for our suggestions !
 Coming back with YOUR suggestion as HIS idea a month later --- GRRRRR
Okay, I'm worked up !
Hugs,
Jessie
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IDC,Stage I,Grade 3,dx 4/06
dbl mast 5/06, systemic MRSA post surgery septic shock, heart attack triple bypass 1/07 no chemo due to infections and heart issues so far NED! |
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Galina2
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Posted: Aug 15 2008 at 9:38am |
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That's the problem: they want you back when you "got clinical signs". By that time we are too sick to complain, to check, to ask!!! We need somebody by our side who is assertive and knowledgable!
Maybe that's next quest: to find somebody who would fight for you next time something happens...
 I used to work on the operating room for a year. I have never heard about infections after other surgeries SO MUCH as after mastectomies!! But I SAW, how they can butcher a woman! Maybe they think, if they do not go into the abdomen, it's "just" a surface wound, they can be really harsh. It really depends on the surgeon, how they cut, how they scrape the breast tissue, how many nerves they damage, how they do stiches, how much skin they leave, so one can move and breath afterwards!
They told ME to remove the tape, which was holding the scars in 24h and shower... well, I did not touch it until 14 days later, when a nurse was removing drains. Why to touch something sterile and healing? They were surprised how well I healed....after that I was putting on antibiotics!
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Nancy
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Posted: Aug 15 2008 at 9:47am |
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Hey Galina
I have a friend whose husband had open heart sugery. The surgeon told him to not let anyone touch the dressings until he saw him again. When the nurses came in his hospital room and wanted to change the dressings, Bill said NO. When the visiting home nurse came to his house, they wanted to change the dressings. Bill said NO. He never got an infection, and the dressing was not removed until the doctor saw him.
Lori worked as a operating room nurse also. She could tell you some stories. Nightmares for those who had the surgery............$$$$$$ for the surgeons who didn't give a crap!!!
Nancy
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Jessie
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Posted: Aug 15 2008 at 10:25am |
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How interesting about the dressings. I think in both cases, my mastectomy and bypass, the dressings were removed after about 5 days. I've thought the MRSA infection entered my bloodstream thru a catheter, drain, or the port-a-cath. But could have been thru one of the incisions. Sure makes sense the dressing should stay on til there's NO avenue for entry -- and those "steri-strips" don't do it !
I've also read that staph bacteria can be airborne too --- anybody else heard that?
Jessie
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IDC,Stage I,Grade 3,dx 4/06
dbl mast 5/06, systemic MRSA post surgery septic shock, heart attack triple bypass 1/07 no chemo due to infections and heart issues so far NED! |
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QH RDR
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Joined: Jul 21 2008 Location: United States Status: Offline Points: 47 |
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Posted: Aug 19 2008 at 5:23am |
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Well girls since I started this topic I thought I should bring you up to speed. I saw the plastic surgeon yesterday (yesterday was also my last day on Keflex and Leviquin). He did do a culture, it came back completely negative. Yes he tested for MRSA, he said he tested for any and everything. Nothing. He is not convinced I had an infection, in fact he was quite honest in telling me he did not know what my problem was. My symptoms started with severe, unrelenting nausea, major fatigue, hot redness at the mastectomy site, and severe, knife like shooting pains through the otherwise numb breast. I never had a temp. Today I feel fine (ha, relatively speaking). The general surgeon won't touch me for the port install until 8/26; because they are not sure what my problem is/was he wants me to have several days off the antibiotic to ensure my symptoms don't return. Although the oncologist wants to start chemo yesterday, but now it looks like I won't start until 9/2 (my hubby's birthday, yippee). I guess they like to wait a week after port installation before they start pushing the drugs in there.
So here I sit, hoping any flipping cancer cells floating around in my system aren't setting up shop somewhere! AAARRRGGGHHH! Frustrating doesn't even begin to describe........
Sandy
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Dx 6/30/08, IDC, node positive, skin-sparing mastectomy 7/21/08, A/C (4 cycles) started 8/29/08
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Jessie
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Posted: Aug 19 2008 at 6:04am |
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Bless your heart, Sandy.
It has to be maddening to have issues that are obviously SOMETHING, but can't be explained. The educated guesswork involved in cancer treatment and issues that come up during that time is soooo agonizing.
Only cancer patients and their caretakers know the extent of the frustration that seems to be such a big part of this desease. It does sound like you have a doctor who is thorough, cautious, and deals honestly with you and I'm sure you're glad for that. You're in a phase now where the dust is swirling so fast all around you, it's impossible to see how it can possibly clear. But it will and you'll come out the other side -- a stronger person.
Try to acknowledge those things that you have no control over and focus on things you do. Be kind to yourself and extra kind to hubby and those who spend a large amount of time with you. Their lives have been changed also and they share your frustration. My husband and I call 2006 our year from hell. Sometimes I think it might have been even harder on my husband -- he's used to controlling and resolving our problems and this one, he had to admit, was beyond him. I'm a southern girl and trained from birth in dealing with the male ego.
 Not being able to rescue you is an ego killer for him. Maybe knowing there will come a time when not every minute, every day, will be dominated by this thing that has grabbed your lives -- maybe that can help.
Hugs,
Jessie
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IDC,Stage I,Grade 3,dx 4/06
dbl mast 5/06, systemic MRSA post surgery septic shock, heart attack triple bypass 1/07 no chemo due to infections and heart issues so far NED! |
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Galina2
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Posted: Aug 19 2008 at 2:26pm |
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They did not find the infection, because: they did not sample right, bac/virus/funge died, did not process properly (wrong sampling, too late/after administration of antibiotics, wrong incubation/ wrong media, etc.) Many things can go wrong, science is not exact! There are instances, where a tech forgets culture plates in the incubator and "something grows". We also do not know all the bacteria! Bac. have different properties and change properties constantly. We can call something "strep" or Escherichia coli and still have hundreds of subspiecies. Well, do not take "we do not know" for the answer! Get treated until your problem/pain/swelling goes away!!
Any of these symptoms (even if they occur without a fever), they all indicate an infection even if a fever is not present. See at:
I do not know how to change font, sorry!
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Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Nancy
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Posted: Aug 19 2008 at 4:40pm |
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Galina,
Font looks ok to me, much easier to read...don't have to squint....can even take off my glasses...jumps right out at you..... wish everyone would choose that font.......but then I'm old
I love it when someone else has a problem with posts!! Hugs,
Nancy
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runawaybunny
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Posted: Aug 23 2008 at 10:42am |
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How did he do a culture?
I just saw my "Dr. House" on Thursday. He told me that 50% of staph infections in the US are MRSA and most Doctors assume they are fighting MRSA. He said a blood test can't test for MRSA in my case and there's no opening or puss to culture.
Also, I had to start my first AC yesterday while still on Zyvox. My left bump is still a little red and the Zyvox lowers the white count just like adriamycin, but I will get 7 nupogen shots, 1 a day beginning tomorrow and Dr. House says that will help.
Not out of the woods yet.
Hugs!
Catherine
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