Monday, August 12, 2013

Soap and Floss Can Save An Aorta or Your Life

Things we take for granted, like personal hygiene, can literally save your heart and aorta from inflammation, dissection and help you avoid an Infective Endocarditis (IE) incident such as the one I ended up with.
Personal Hygiene and Marfan Syndrome - very important for heart health
Inflammation can cause vascular damage in anyone, but especially in those of us with connective tissue disorders like Marfan Syndrome.

Skin infections can quickly reach the heart through a cut or scrape.  Once the cardiovascular system becomes infected and inflamed, this condition can produce deadly results.

Infective endocarditis is especially dangerous for those with prosthetic heart devices such as the mechanical aortic valve in my heart and the Dacron graft across my ascending aorta.

One of the first things I remember after waking up from my first open heart surgery was throwing up all over my freshly sutured and sealed chest incisions.  Barfing never felt so good I thought as I lay in the hospital cardiac ICU bed.  Volumes of fluid erupted out of my mouth and across my chest and I did not care.  It felt so good to empty my stomach of all the slosh.

I vaguely remember Judy shouting to the ICU nurses who practically ignored her calls for help.  She ended up cleaning the vomit herself for the most part.  My vision whirled for a second then I passed back into the land of post-operative deep sleep.

Ten days or so later I made it home (to our now Palm Coast home) with my new bionic heart parts and met our home health care nurse, Ted Rhodes, RN who always says RN stands for 'writes notes'.

Within a matter of days Ted worriedly sent Judy and I back to doctor's office in Jacksonville.  My chest was turning a bright red above the heart incision.  The nurse practitioner pressed hard down on my chest sore now swelling in size, prescribed an oral antibiotic and sent me home with instructions to come back if the boo boo worsened.

Have you ever had a Physician's Assistant take a scalpel to your chest without painkiller?  It hurts!  But the PA felt like he had to get the infection out immediately.  So he pushed me back on the table and cut.  Judy was gasping in the corner of the room at the site of her husband (me) being manhandled on the exam table, cut and sliced without anesthesia.  Puss and blood of course was everywhere.

To make a long story short, the entire episode of madness lasted for over four months from a reopening of my sternum, pressure washing the green goop from around my heart and Dacron graft, installation of a picc line for daily IV treatment with some of the nastiest antifungal and antibacterial drugs I've ever had.  There were wound vacs taped to my chest and heparin hypos everywhere. I still worry each time I run a slight temperature.

Bless Judy for the many times she was sprayed with the stuff trying to purge a line or add a bag of solution at one am.  I believe she still suffers collateral damage even today from exposure to the IV liquids.

An array of doctors and lab techs poked, pulled, prodded and took so many samples but they never figured out what the green slime around my heart was.  Everything was negative with respect to bacteria.  Infectious disease doctors finally blamed an unknown fungus. 

I know what it was.  It was an infection and it was trying to eat me.

So I am here to say, pay attention to personal hygiene, use lots of soap and floss.

Even the American Heart Association and other health groups have been emphasizing personal skin and mouth care lately.  As the use of antibiotics has been backed away from as a favorite for many procedures, to the contrary cleanliness has remained at the top of every list for preventing IE.

In fact some medical literature says personal hygiene is very, very important.

Legs, ankles and feet are more difficult to reach and scrub during a shower.  But pay attention to all the appendages.  Clean between toes and under nails.  Use a back scrubber and reach behind those ears.

Our bodies usually have staph and strepto populations growing across our skin.  But a cut or scrape can allow those germs to enter our bloodstream and reach our heart.  The bad guys are especially attracted to prosthetic implanted devices like mechanical valves or Dacron grafts.

Let me tell you from experience, you do not want infective endocarditis.  Besides the high mortality rates associated with IE, recovery will take a year or so out of your life.

An aorta free from inflammation caused by infection may also be less prone to dissect or develop an aneurysm.

So grab the soap and scrub and scrub and scrub.

No more going to bed at the end of a long, hard day without a shower and scrub. Never again.  Brush and floss too.

Your heart and your partner will thank you.

1 comment:

FitOldDog said...

Hi Kevin, nice blog, and I'm glad you're doing this. People really need guidance on these issues, but at the end of the day they must learn to take responsibility for themselves - no easy lesson. Kind Regards, Kevin