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Dr. A or Dr. Ed.....please advise

Posted by CindyF on 8/31/01 at 01:58 (058550)

I have previously posted on here that I have an infection to the incision site...present almost 2 weeks now....I am 5 weeks post op TTS..
I was seen by my Ortho again Wed.....and all he did was have me continue the Augmentin 875mg twice daily for 15 more days, prescribed me more Lortabs(which I hate taking...but they do take the edge off the pain) and prescribed me to take Neurontin 300mg twice daily PRN....and to return in a week.
I was also diagnosed as a diabetic last week...but since that day my bloodsugar has been normal...I check it 4 times a day and take Glucophage XR once daily...
My Ortho stated he thinks I might just heal poorly...or that maybe when my bloodsugar was up ...(which only got to around 150)...that it could have caused the infection to form.
Well..I feel that even today this infection is getting worse by the day...
I am still applying panafil everyday....And when I do my wound care and apply the panafil...I get the worst pain...that last for hours....
I can't even get it to settle down with 2 Lortab 7.5mg taken at once.
I have very little pain before doing the wound care....but about 20 minutes after applying the panafil...the pain gets so great that I feel like I want to just cut off the foot.
The Ortho doesn't feel like it is the panafil...and he wants me to continue using it...which I am.
Here it is...1:45 in the morning, and I did my wound care around 8pm and the pain is just now starting to subside to a bearable pain. I do it in the evening so my day won't be full of pain.
I am a nurse...so I know I am doing the wound care properly.
I have also previously posted that I had an infection in this exact same site in 1996...that was a peptostreptococcus bacteria.
I was wondering if this infection could be the same as then. He hasn't taken a culture of it as of yet, and there isn't really any drainage right now, but the tissue is being debreided by the panafil and is getting larger by the day.
I have searched extensively on the net to see what I could do to get this infection under control, and found several sites on anaerobic bacterias.
My question to you is this....
Should I suggest to my Ortho if I could take Hyperbaric chamber treatments, or be given doeses of IV pennicillin or do you think these might not help me?
Do you think I could be allergic to the panafil....and has any of your patients complained of this pain after appling the panafil?
I went through so much in 1996 when I had that infection, and I told him this prior to the surgery.
I have the insurance that has so far paid 100% of this....so I'm thinking it might cover other treatments as well.
Please give whatever advise you think I should ask him...because I really want to get this wound healed so I can start my PT and at least get to walking again.
I just need to get this resolved.
Thanks
CindyF

Re: Sorry...previous message was for Dr. Z and Dr. Ed...not Dr. A.....(typo)*LOL*

CindyF on 8/31/01 at 02:00 (058551)

Sorry...previous message was for Dr. Z and Dr. Ed...not Dr. A.....(typo)*LOL*

Re: Dr. A or Dr. Ed.....please advise

Ed Davis, DPM on 8/31/01 at 14:33 (058597)

Wound cultures MUST be done. Prolonged infection will lead to scar tissue which can compromise the surgical results.

There is really little guess work when it comes to treating infections and, based on what you are stating, it does not sound like you are getting care wtihin accepted standards. Again, I cannot give you a second opinion over the net but I am offering you an interpretation of the information you have provided. Consider seeing a wound care specialist or infectuous disease specialist ASAP.
Ed

Re: Dr. Ed

CindyF on 9/02/01 at 23:19 (058875)

Dr. Ed...
Thanks for your help....I didn't think of asking to see a wound specialist...
I haven't really had any drainage other than the clear drainage...but I'm going to request for a culture on my next visit which is wednesday...
The lack of drainage is what confuses me...
When I had the infection in 1996...the drainage was really horrible...heavy amt. with an odor...
This time all I have is the necrotic tissue....which I guess is why he thinks it could just be from the diabetes...
I also had lot's of edema in the foot...but being alone here at home...it is hard to keep it elevated like it should be...so it swells when I let my foot down...
I have really tried this last week to keep it up as much as possible...
I feel like I have to have some trust in my Ortho.....Or else I shouldn't be seeing him.....Do you agree?
I'm also going to see my medical Dr. on Tuesday...and I'm going to get his oppinion also...he is the one who reccommended this Ortho...
He has really taken time out to answer my questions...and he listens to me......
I guess I just wanted to get your oppinion...Oh...and on the panafil...to see if you know of any patients that could be allergic...or complained of pain after application..
I will suggest the wound specialist when I see him....
Thanks again for your help..
CindyF

Re: Sorry...previous message was for Dr. Z and Dr. Ed...not Dr. A.....(typo)*LOL*

CindyF on 8/31/01 at 02:00 (058551)

Sorry...previous message was for Dr. Z and Dr. Ed...not Dr. A.....(typo)*LOL*

Re: Dr. A or Dr. Ed.....please advise

Ed Davis, DPM on 8/31/01 at 14:33 (058597)

Wound cultures MUST be done. Prolonged infection will lead to scar tissue which can compromise the surgical results.

There is really little guess work when it comes to treating infections and, based on what you are stating, it does not sound like you are getting care wtihin accepted standards. Again, I cannot give you a second opinion over the net but I am offering you an interpretation of the information you have provided. Consider seeing a wound care specialist or infectuous disease specialist ASAP.
Ed

Re: Dr. Ed

CindyF on 9/02/01 at 23:19 (058875)

Dr. Ed...
Thanks for your help....I didn't think of asking to see a wound specialist...
I haven't really had any drainage other than the clear drainage...but I'm going to request for a culture on my next visit which is wednesday...
The lack of drainage is what confuses me...
When I had the infection in 1996...the drainage was really horrible...heavy amt. with an odor...
This time all I have is the necrotic tissue....which I guess is why he thinks it could just be from the diabetes...
I also had lot's of edema in the foot...but being alone here at home...it is hard to keep it elevated like it should be...so it swells when I let my foot down...
I have really tried this last week to keep it up as much as possible...
I feel like I have to have some trust in my Ortho.....Or else I shouldn't be seeing him.....Do you agree?
I'm also going to see my medical Dr. on Tuesday...and I'm going to get his oppinion also...he is the one who reccommended this Ortho...
He has really taken time out to answer my questions...and he listens to me......
I guess I just wanted to get your oppinion...Oh...and on the panafil...to see if you know of any patients that could be allergic...or complained of pain after application..
I will suggest the wound specialist when I see him....
Thanks again for your help..
CindyF