Beware infections with implants

This is a good case describing how disastrous a ‘simple’ infection can be, when there is foreign/implanted material in they body.

Doing hospital rounds one day I approached an elderly woman’s room and could hear her groaning long before I got to the door. This was a patient that was being treated for a bacterial infection of her artificial heart valve.

When I got in I asked her what was wrong. She said her body was aching her, from her chest to abdomen. Then she quickly said, “I am sorry I am being such a baby!”

I then quickly told her, “you are not being a baby, you have been through quite a lot! Don’t give yourself such a hard time. Try to relax and let us take care of you.” Then I explained to her why she has a right to feel upset every now and then.

Imagine making it beyond 75 years of age, doing well most of your life. One of your heart valves got scarred earlier in life so you needed surgery to replace it. The surgery went well and the valve served you for a good 20 years!

One day you start feeling a bit unwell, just tired and weak. This worsens so your children make you go to the hospital against your will.

There was never any fever but blood cultures were done just in case there turned out to be infection in the blood, since it would be a disaster to miss such a problem in someone with an artificial heart valve.

A CAT scan is done of your head because family said you were a little confused. It showed multiple mini strokes. This can happen if growths on the artificial valve break off and go to the brain. So the next test is a scan to look at your heart valves. The valve appears normal and you breathe a sigh of relief.

You are being prepared to be discharged when lo and behold, the lab calls to say that your blood is infected with Streptococcus! Oh dear…no going home for me yet!

The next thing you know, the Infectious Diseases (ID) specialist is walking into your room. You think, my goodness, I must be dying now!

You hear from the ID specialist, that even though your heart scan did not show infection on your artificial valve, it is probably infected nevertheless (scans can’t see everything sometimes), and you will need antibiotics, not by mouth but via a drip, for 6 long weeks.

But…there is hope. They say you can actually get the medication at home! A nurse can come and show your family members how to hook it up to you. Turns out though, that you are rather weak. So instead, they want you to go to another facility to get some physical therapy along with the antibiotic.

You are waiting for everything to be set up for your transfer but that night, you start feeling funny and nurses come running into your room because your heart has slowed to a dangerously low rate. They fear you are having a heart attack.

You are resuscitated and then rushed to the heart-cath-lab for a special test to see if they need to reopen a blocked heart vessel.

There is no blocked vessel but instead, an infectious growth is seen, not only on your artificial heart valve, but also on one of your other valves!

It is confirmed that you have heart valve infection from that Streptococcus bacteria.

You are urgently transferred to another hospital because it’s felt that you need surgery to replace those infected valves that are threatening to cause your heart to stop beating, and causing multiple mini strokes.

You get to the other hospital. The surgeon evaluates you then concludes that you are too high risk for surgery. Your chance of dying on the operating table is almost 100%!

So…back to the original plan of 6 weeks of an antibiotic drip. You get a pacemaker placed to keep your heart beating properly, and are transferred to a third hospital to finish the antibiotic treatment.

Thankfully, because you actually have a good attitude, even throughout all this drama, you make slow steady progress. There are some bad days in between and you sometimes doubt yourself as to whether you can carry on much longer. You had a good life and are not afraid of the end. But then you think of your family and vow to carry on for a bit longer.

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Who agrees that this lady was far from being a baby? I told her I would be an absolute mess if I were in her shoes! There were so many emotional ups and downs in a 1 week period. That emotional roller coaster alone would set my heart out of wack!