Abdominal Aortic Aneurysm

DawnMc

Hi all,
This is just a plea for advice. My dad had an abdominal aortic aneurysm in Feb which was repaired using a graft. Then, last month, he developed a fistula (bowel attached to graft). This was repaired and he came home a couple of weeks ago.
In the past few says, he had a lot of pain and went to hosp today. They say the graft is completely infected (ulcers etc) and now they're performing surgery on Fri and Tue. First is to put a new graft in bypassing the old one and then on Tues, to remove the old graft.

I know this is very long and complex but if any of you can shed any light on it, please do. I really want to know what the risks are etc
Thanks

snorlax

i read some of your posts on PI, i don't know enough to answer those technical questions above but i hope your dad's doing better Dawn.:)

your probably best to ask your dads consultant cos he probably knows better then anyone whats specifically wrong with you dad.

DawnMc

Thanks Snorlax, I was talking to the consultant today. The surgery is tomorrow so just gotta pray at this stage.

DrIndy

I preface what I say with the fact that I am neither the attending physician nor am trained specifically in vascular surgery.

It is ideal to speak to the team or the surgeon in question who is performing the operation - the risks are individual and they can advise best. Remember also that before any surgery, doctors way up how much benefit there will be if the surgery occurs or does not, surgery only proceeds if the odds are stacked heavily for benefit of the patient.

http://www.nlm.nih.gov/medlineplus/aneurysms.html
This is a general page about aneurysms, look specifically at abdominal aortic aneurysms(AAA). This page provides technical info on how the procedure takes place and background information on how aneurysms occur.

It is a very long and technically demanding operation, but vascular surgeons are highly trained and teams will do such repairs up to 2-3 times per week and thus have plenty of experience.

Have a glance through the webpage and if you would like more info or have any questions, please post them.

Best Wishes for your dad.

DawnMc

Hi DrIndy,
It's not an AAA he's having, he had that in Feb. He then had more surgery less than 3wks ago becuase the graft attached to the bowel. Now the graft is infected with MRSA and they are removing the graft and putting a new one in

DrIndy

DawnMc wrote:

Hi DrIndy,
It's not an AAA he's having, he had that in Feb. He then had more surgery less than 3wks ago becuase the graft attached to the bowel. Now the graft is infected with MRSA and they are removing the graft and putting a new one in

Its a big operation without a doubt, but necessary. Remember that surgeons would not undertake something unless there were clear benefits to the patient greatly outweighing the risks of the procedure.

Removing the graft is very important if there is an infection as bacteria hide in the artificial fibres and the immune system nor antibiotics can kill them off. This can also be a problem with artificial hips which can also get infected.

I wish him the best of luck.

DawnMc

Thanks DrIndy, Just praying for a miracle @ this stage

Kernel

I wish him all the best too Dawn, don't give up, prayer can work too. DrIndy, MRSA infections, more signs of poor quality conditions in Irish hospitals?

DrIndy

Yes and no. Short answer is yes, longer answer is the best place to catch an infection is in a hospital and the longer you remain in one, the more likely you will be to pick up an infection.

Also many people carry MRSA as part of their normal skin bacteria and thus is is very hard to eradicate.

However, MRSA is NOT the superbug it is made out to be and can in fact be treated well with antibiotics - just not the standard penicillin class antibiotics normally used. Vancomycin is used to treat MRSA and teicoplanin can be used too. They can also be sensitive to older antibiotics such as tetracyclines too and are not neccesarily resistant to EVERYTHING.

In fact there has not been a reported case of completely resistant MRSA here in ireland(to the best of my knowledge although less virulent organisms have been reported). Remember too that when you get a Staphylococcal infection, no matter if it is MRSA or the old standard one, it is a serious infection and so when people attribute morbidity to MRSA - in fact part of it is simply the bacteria in question, not the strain that is the trouble.

In grafts, it beds in however and cannot be eradicated at all such as a artificial joint or an arterial graft. This is why they are avoided if possible during treatment. Also grafts can in fact be seeded from a distant cut thumb or scratch which cannot be stopped. The only cure unfortunately is to replace it. It is most unfortunate that people get MRSA, but it is very difficult to prevent this occuring......

DawnMc

I agree with you DrIndy in most of you points. However, to my knowledge, it is NOT possible to treat some cases of MRSA,even with the strongest antibiotics(this info given to me today by consultant) I hope you are right though. My father came through the nine hour operation but just barely.
The next twelve hours are extremely critical.

Many thanks for your helpful advice btw

DrIndy

Not quite, it cannot however be treated in your fathers instance as it has seeded into the graft, this allows it to produce a protective coat and remain protected from the immune system and antibiotic therapy. Ordinarily, it is a tricky infection, but manageable. This is unfortunately why the graft needs replacement.

Kernel

DrIndy wrote:

Yes and no. Short answer is yes, longer answer is the best place to catch an infection is in a hospital and the longer you remain in one, the more likely you will be to pick up an infection.

I think the best place to catch an infection is a filthy and poorly run hospital. Health board said there was about 500 cases of MRSA last year, turns out there were around 8,000. Both my grandparents contracted the infection at seperate times in James'. Bring back the matrons I say!

Dawn, any news on your dad?

DawnMc

Dad is still completely sedated and appears to be in a lot of pain.

N8

I am sorry your dad is unwell. Too often we hear of people heading into hospital only to die not as a result of what they had, but of a mistake or catching something in the hospital.

Dirty hospitals are only an added factor. MRSA is short for multi resistant staph aureus, ie a bacterial organism that is resistant to multiple antibiotics and which feeds upon them. MRSA is one result of an overuse of antibiotics.

We are generally fed much reduced numbers on these things from MRSA, deaths from drugs, complications of vaccinations etc. Small enough to agree with us there is a problem, small enough not to alarm us. Who is in charge of these figures???

Ever felt we are at the end of a product line, fed enough lies to make us afraid, then given enough medication to make our deterioration comnfortable and keep the healthcare industry profitable????

Just take a look at this!! http://www.lef.org/LEFCMS/aspx/Prin...px?CmsID=111570

jazzbandit

"dirty" hospitals are not the only factor in the spread of MRSA. Sick ppl carry MRSA, sick ppl go to hospital, MRSA ends up in hospital. It's very difficult to control, and its not the case that everyone who works in hospital goes round pissing on the floor and just not caring about the spread of disease. We generally are more aware than most of the public regarding the effect cleaner conditions over the years have had on various infectious disease, so it grates a bit when everyone jumps on the high moral ground about this issue. How many other ppl have to wash their hands in smelly gel everytime they even touch somebody???

Dawn, I hope ur dad's op went ok. Graft problems happen from time to time. When I worked in vascular surgery we had to go in and sort them out every so often, with pretty good success rates.