Author Topic: post-surgical viral infection???  (Read 17040 times)

lori67

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Re: post-surgical viral infection???
« Reply #15 on: January 09, 2010, 12:20:23 pm »
Even if the incidence of this is 20-30%, it should be mentioned.

My doctor mentioned it, and also mentioned the risk of death, which is much less than 20%, but a risk nonetheless.  All risks should be disclosed so the patient can make an informed decision about their course of action.

Why does this seem to be an issue only for some facilities?  I asked my doctor before my surgery when we were discussing risks how many cases of this he'd seen in his own practice and he hadn't seen any.  (now, this was almost 3 years ago when I had my surgery, so that may be different now).

I just wonder what they are doing differently that seems to increase the chances of developing a viral infection.  Maybe they need to stop disinfecting their surgical instruments in the dishwasher in the cafeteria!  (JUST KIDDING folks, I'm sure they don't really do this!)

Lori
p.s.  Happy ANniversary Catherine and Donnalynn!
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

Cheryl R

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Re: post-surgical viral infection???
« Reply #16 on: January 09, 2010, 12:28:09 pm »
It is interesting how each dr and hospital has their own protocol.       I do know that with many surgeries an antibiotic is given for a bacterial preventive infection and no sooner than 1 hour ahead of surgery.     Sometimes just as surgery is starting.    I have had that done to me and also we did when we worked.        Ancef was the most used.             Now the viral maybe is a different story and I am not sure of the answer for that one.          As I said I took Valtrex in 2001 post op and none since.       I've never had to do anti anti bacterial wash pre op and we didn't where I worked.           
                                                    Cheryl R
Right mid fossa 11-01-01
  left tumor found 5-03,so have NF2
  trans lab for right facial nerve tumor
  with nerve graft 3-23-06
   CSF leak revision surgery 4-07-06
   left mid fossa 4-17-08
   near deaf on left before surgery
   with hearing much improved .
    Univ of Iowa for all care

lori67

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Re: post-surgical viral infection???
« Reply #17 on: January 09, 2010, 12:33:09 pm »
At Baptist Hospital where I had my AN surgery, I didn't have to do the antibacterial wash first either.  The nurse just scrubbed the surgical area with phisohex and what felt like a Brillo pad prior to surgery.  Even the other nurse in the room said "Uh, they'll shave that area later, you don't have to scrub her hair off now!".   :o

But at St. Thomas Hospital, same group of doctors, I had to take a Dial soap shower the night before and the morning of surgery.

Would be nice if everyone was on the same page, wouldn't it?

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

JerseyGirl2

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Re: post-surgical viral infection???
« Reply #18 on: January 09, 2010, 01:22:27 pm »
p.s.  Happy ANniversary Catherine and Donnalynn!

Thank you!

Donnalynn, hope you're reading this and that you're having a good "second anniversary"! As we've posted before, Donnalynn and I never met each other while we were at House, but our husbands and daughters did and I remember mine talking about this really nice Canadian family they had spoken with a few times. While I still have some pretty vivid memories of my two weeks in Los Angeles, a lot of things are beginning to fade. Seeing pictures of the "Hollywood" sign bring back memories of my hospital room. Attending the taping of "Jeopardy" six days after surgery was a highlight of my stay and, even now, every night when we watch that show I still think about being there on the set with my bandaged head.

Catherine (JerseyGirl 2)
Translab surgery and BAHA implant: House Ear Institute, Los Angeles, 1/2008
Drs. J. House, Schwartz, Wilkinson, and Stefan
BAHA Intenso, 6/2008
no facial, balance, or vision problems either before or after surgery ... just hearing loss
Monmouth County, NJ

Jim Scott

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Re: post-surgical viral infection???
« Reply #19 on: January 09, 2010, 01:22:58 pm »
Jan raises a valid question as to why some facilities/doctors offer pre-surgery medications.  I would venture a guess that they do so presumably as a preventive measure.

My very (medically) conservative neurosurgeon didn't prescribed pre-surgery medications and I never really needed any, post-op, other than Bacitracin for a mild incision infection that developed days after my discharge from the hospital and was quickly stopped with a few applications of the topical antibiotic ointment.  Well, that and a few aspirin the first few days following my surgery. 

Apparently, as Cheryl and Lori have noted, every doctor/hospital has their own, unique protocol for surgery patients.  Some choose to take the preventative medicine route, others see no reason to prescribe/administer drugs to a patient without an obvious need to do so.  This would make it a subjective decision, based on the doctor's experience and way of thinking about the issue and makes it clear that there is no 'right' or 'wrong' answer to Jan's question. 

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Denise S

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Re: post-surgical viral infection???
« Reply #20 on: January 09, 2010, 01:34:49 pm »
O.K., don't want to sound rude or anything, but for starters:  Jan, I'm so surprised for as long as you've been on the site you hadn't heard of this before that I posted (almost seems like you mentioned that on one of my other posts, not sure)  

Anyways, for anyone......USE the SEARCH area above.   Put in VIRUS, try SHINGLES, try HERPES, whatever.  There is plenty on this forum and even plenty if google the virus after AN surgery.

ELI, you asked if there are studies.  YES, trust me I went through all the same stuff Bren is only weeks ago.......I'm a big research, computer person.   After I asked my doctor after my delayed paralysis started "WHY didn't you just prescribe like some doctors do????"   He told me of the studies where adding some of these drugs post surgery has shown an INCREASE in those who have had CSF leak and bacterial meningitis.   Of course I HAD to research it when I got home because I was so upset that all docs don't just do the same.  

SURE enough, I found the study.  But, it was an increased risk of 5%.   Studies were 20% of people without drugs, 25% with.   I may have put more details on my blog, can't remember.    Just know for a FACT there have been studies.  Does hurt feelings some when others say things like never heard of whatever I might post, whatever, but I'm not posting my own opinions, fyi.

As for looking up things, like i say search here, but true facts (instead of just forum members thoughts) it's better to do a search on google or Mayo.com

Bren, please be sure to ask your doctors thoughts with follow up and post to us.  Take care and hopefully you got my FB/email.
  
« Last Edit: January 09, 2010, 02:00:14 pm by Denise S »
W&W 2 yrs. (due to watching other brain tumor: it's stable)
Left AN:  1.2 cm (kept growing during 2 yr.)MIDDLE FOSSA  11/9/09;  Michigan Ear Institute Dr. Zappia & Pieper
SSD, mild tinnitus, delayed onset of facial paralysis lasting 3-4 weeks, no tears AN side
BAHA surgery 10/2/12 Dr Daniels G.R.,MI

Lilan

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Re: post-surgical viral infection???
« Reply #21 on: January 09, 2010, 02:31:06 pm »
House is progressive and does a lot of studies, so they are often out front on things. So why not learn something from them? In fact, Dr. Brackmann authored the one quoted above, which concludes that they will continue to use Famvir and recommend others do the same. 5% is considered a statistically significant difference, and it showed greater reduction in patients receiving translab.

Personally, I didn't say everyone should demand it, but there is clearly enough info out there IMO to warrant asking about it. I had read enough about it pre-surgery that I asked in advance. The patient's previous viral infections or susceptibility, surgical approach and doctor's preference may all presumably play into what they recommend if they don't have a blanket policy.

Facial nerve hemangioma. Probable dx 7/2008 confirmed 4/2009. Combo middle fossa and translab to remove the blood vessel malformation and snip ruined hearing and balance nerves by Drs. House and Brackmann @ House 6/2009. Doing great!

leapyrtwins

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Re: post-surgical viral infection???
« Reply #22 on: January 09, 2010, 03:49:41 pm »
O.K., don't want to sound rude or anything, but for starters:  Jan, I'm so surprised for as long as you've been on the site you hadn't heard of this before that I posted   

Denise S -

no offense taken.

I don't think you're rude - or anything - but just because I'm a forum "old-timer" doesn't mean I've read every post ever written.  There are numerous posts here, especially those that relate to things I haven't experienced - like shingles - that I have never read.  I do have a day job and parent two teenagers single-handedly in my "spare" time  :D

This is a topic that piqued my curiosity - especially since I did nothing but shower & shampoo with Dial soap the morning of my AN surgery and I didn't encounter anything even close to a viral infection.  The morning of my BAHA implant I shampooed and showered with my "normal" products; no infection there either.

I don't think this lack of anti-viral meds - or my subsequent lack of infection - had anything to do with my docs not being progressive.  I think it's just a matter of doctor's having preferences and knowing what works for them and their patients.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

lori67

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Re: post-surgical viral infection???
« Reply #23 on: January 09, 2010, 04:46:45 pm »
Jan,

Your kids told me that in your spare time you sit around with your feet up eating bon bons.  It's no wonder you have no time to read all the posts!   :P

Sobes,  true Bell's Palsy is caused by a virus.  So the mechanical damage caused by the surgery which causes the facial nerve to not function properly is not really Bell's Palsy, although it looks the same.

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

Sobes

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Re: post-surgical viral infection???
« Reply #24 on: January 09, 2010, 06:13:03 pm »
Wow, lots of input and great information here!! It is ALL helpful to me and hopefully to others too :) The only thing I know for SURE is that I am definitely going to find out from my doctor exactly what kind of "viral infection" this is (I need to know for certain...shingles, meningitis, Bells Palsy, etc.). Whatever it is it has kicked my butt a bit  :( My neck got SO sore and stiff and I was feeling just AWFUL within a few days. It was so strange as it was unexpected to me. I will most definitely pass along all the info from my doctor and will also ask him what he thinks of the "before surgery meds" as opposed to the "post-op meds" debacle...should be interesting. I believe the same as many of you that it is simply a "doctor's choice" and what they deem necessary and what they like to use as protocol according to their own experiences. I would sure have loved to know this info though...as he sure seemed to be expectant of it :( ya know?! :(

Lori...you cracked me up...haaaaaaaaa.."Maybe they need to stop disinfecting their surgical instruments in the dishwasher in the cafeteria!" bahahaha... wow...what a great laugh  ;D

What would I do without all of my amazing family here!!!!!!!!!!!!!!!!??????????!!!!!!!!!!!!! You are ALL my survival...THANK YOU! Again, wish I could be better responding to you all for your wonderful posts but just don't quite have the eye power yet :( Soon, dear friends...I am confident  :D

Want you all to know that I love you...ok, I know that is REALLY corny, but it is how I feel and so I am going to say it!!! I wear my heart on my sleeve, what can I say?!  :D
Small AN, left side, Oct. 22 2009
Surgery Dec. 22 @ UW Madison (wonderful doctors)
SSD (left side)

Kaybo

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Re: post-surgical viral infection???
« Reply #25 on: January 09, 2010, 06:56:24 pm »
I love you too, man...

K   ;D
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

Lilan

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Re: post-surgical viral infection???
« Reply #26 on: January 10, 2010, 08:38:52 am »
Part of the reason the online forum is so valuable is that the advice is constantly renewing itself. To get advice only from people who had surgery 2, 5, or 10 years ago would probably not include all that is done in surgery *today.* Posters should feel free to weigh in on current research (such as the above study, 1/2009) without being criticized.



Facial nerve hemangioma. Probable dx 7/2008 confirmed 4/2009. Combo middle fossa and translab to remove the blood vessel malformation and snip ruined hearing and balance nerves by Drs. House and Brackmann @ House 6/2009. Doing great!

ppearl214

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Re: post-surgical viral infection???
« Reply #27 on: January 10, 2010, 08:55:11 am »
As previously noted...... facilities all have their own protocols, so there is no right or wrong answer to this.... regardless of what HEI or other facilties suggest, it is up to us to follow up properly, pre-treatment, with our treatment teams to find out what their protocols are.  As we know, no facility can fully prevent what occurs in their facillities and we do what we can to protect ourselves as best as possible.  CrazyCat (Paul) developed MRSA during his AN hospital stay.... heck, my dad is required to take penicillin prior to dental work.

Do what you can to protect yourselves as best as possible.... yet, be realistic that not all infections can be prevented.

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

leapyrtwins

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Re: post-surgical viral infection???
« Reply #28 on: January 10, 2010, 11:47:30 am »
Part of the reason the online forum is so valuable is that the advice is constantly renewing itself. To get advice only from people who had surgery 2, 5, or 10 years ago would probably not include all that is done in surgery *today.* Posters should feel free to weigh in on current research (such as the above study, 1/2009) without being criticized.

Another part of the reason this forum is so valuable is that many, many old-timers take the time to share their experiences with newbies - which in itself is extremely valuable.  Without it, odds are great that I wouldn't be sporting a BAHA in my skull, which IMO would be a damn shame.  And just because we may be oldies, doesn't mean we are clueless when it comes to how surgery is done "today" or the studies out there on the internet.

As far as anyone "being criticized" I just don't see it.  Just because we have different opinions and care to express them, does not mean we are criticizing anyone.

Bren -

it's completely possible that your stiff, sore neck is just a result of the position you were in (literally) during your surgery.  The docs position you - tilt your body and neck - so that they can get the best view of what's inside your head (in our cases an AN).  My surgery was 7 1/2 hours and my neck was stiff and sore for quite a while. 

Hope things get better,

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

pjb

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Re: post-surgical viral infection???
« Reply #29 on: January 10, 2010, 06:15:44 pm »
Just reading about the prevention before surgery I have to take antibiotics before any dental procedures. I had surgery for 3 lipomas removed from my arm and now remembering I had to shower the night before and the morning of surgery with something the hospital gave me forgot the name.  Now I had major brain surgery from a different hospital and was not anything to take or bath before ??? definitely every hospital is different.

Pat
Diagnosed with a 1 cm. AN had Retrosigmoid
Approach surgery July of 2009, several problems after surgery.