post-surgical viral infection???

[Sobes]

Hi Everyone,

Called my doctor today to let him know that my facial paralysis has gotten worse, etc. He had seen me on Monday and didn't want to give any steroids as my paralysis was only a level 2 at the time, but wanted me to call if it got worse and my eye wouldn't close so I called a few hours ago. The nurse just returned my call and said that she spoke with the doctor and he wasn't at all surprised that it had gotten worse along with the other symptoms and prescribed prednisone and valtrex. She said this is related to a viral infection that is very common after this surgery. Does anyone know what this viral infection is??? I feel a bit confused. She says it is very common and not to worry but I forgot to ask her what the infection is called, etc. If anyone could help me understand this I would really appreciate it. Thanks!!

Bren~

[Jim Scott]

Bren ~

I'm really sorry to learn of this post-op complication.  I hope and will pray for your rapid recovery.

Jim

[Cheryl R]

Sobes, You do not have meningitis.      I know there was a Missouri gal who also had this and her Mayo dr called it a form of Bells Palsy.     Post op Bells Palsy, I can't remember.        I did take Valtrex in the hospital for my 2001 surgery and maybe a few days at home but am not sure about the at home bit..     I did not have it with the rest of my surgeries.             I think the Famvir and Valtrex are very similar.           Each dr has their own protocol.           So you will improve in time and just take care of the eye and wait it out.         Not fun to end up with something not too common.                             Cheryl R

[Denise S]

Hey Bren, the viral is for the caution of the virus we can be prone to that runs along that area in a dormant matter.   It is shingles which is a type of herpes virus.  No,  trust me, I researched it too, not as  creepy as it sounds.     Put SHINGLES into search above and you'd get answers.

Even some doctors prescribe a virus med a few days before surgery (like Cheryl from NY got) to help prevent it.

I never got it, and they didn't give me that with the facial paraylsis after I had told them I just had chickenpox testing only a few years  (to prove I never had it yet.....age 38 know).   Sure enough, no signs of it at all, so I got those shots called varicella (which is in a similar category as shingles, etc) at that time when my son got the shots.   SO, my doctor said my chance of getting the viral one should have been super low.

Glad to hear they got you on both because I don't remember that they could tell for sure which  it was.

Good luck! 

[leapyrtwins]

This never happened to me.  I never heard of this or read about it on the Forum before - either it was before my time or I missed those threads.

I did have to shower and shampoo with Dial soap the morning of my surgery, but the hospital I was at requires that of all their surgical patients.  My dad who's had numerous surgeries at various hospitals always has to follow a shower/shampoo routine prior to surgery.

Sorry to hear about this Bren.  Hope things get better soon.

Jan

[Eli]

Bren -


From my understanding, the shingles virus can affect the facial nerve and cause Bell's Palsy like facial weakness. AN - the gift that keeps on giving...

I had a translab on 12.11.09. Immediately post-op and for 8 days I had good facial strength on my surgery side - probably 90% pre-op control. On 12.19.09, post-op facial weakness started. On 12.20.09, I lost complete control. I called the hospital and was prescribed prednisone and valtrex. So, it seems that prednisone and valtrex are protocol for this type of situation.

Hope that is of some reassurance.

Eli.

[Lilan]

Yes, House gives Famvir for a few days for this reason. I have heard of other House patients taking it before surgery, but they had me have it (maybe during/day of? don't remember) and for the days immediately afterward. I didn't have any problems.

[Lilan]

he wasn't at all surprised that it had gotten worse along with the other symptoms and prescribed prednisone and valtrex. She said this is related to a viral infection that is very common after this surgery


Then why aren't they taking steps to prevent it?

Future patients, inquire about this when you talk to your surgeons in advance.

[Kaybo]

I wondered that too Lilan...

K   

[Sobes]

Hi Everyone,

What GREAT info!!! Thank you everyone! I would never have known about the bells palsy issue! It sounds like it must be that. But I must agree with Lilan and K...if they know this then WHY wouldn't they have put me on this stuff sooner or told me about it...grrrr. I told the doc on Monday (when I had my post-op) about the facial weakness starting, etc. He said if it got worse to call. So, I called yesterday and I am SO glad I did. The facial weakness hadn't gotten too bad but my eye wasn't closing good and I sometimes had a bit of difficulty swallowing. When the nurse called me back she said "Ok, the doctor wasn't at all surprised that you called and were having more symptoms. He said this is a common delayed viral reaction from the surgery and we are calling in some prednisone (40mg) and valtrex". I thought the same thing. If it is so common and he knew I would be feeling so crummy, WHY wasn't I put on this medication sooner. I was in agony all week!!! Even my headaches were worse and my neck was/is soooo stiff and sooo painful. I felt/feel like I'm in a strange fog (even stranger than usual lol). Ok, sorry...just ranting now. The frustration builds up sometimes ya know?!

Eli, my facial weakness began about 2 1//2 weeks post-op too I am grateful that it isn't worse than it is, but as most of you know, it makes so many things more difficult.

Question: Is Bells Palsy a virus then? This confuses me 

[Kaybo]

Brenda~
If you are not shutting your eye all the way, are you taking all the precautionary measures to keep it protected?  Do you need any help with that?

K

[Eli]

Sobes - I don't recall anyone warning me about the facial weakness issues when I was checking out of the hospital either. IIRC, it occurs in about 20% to 30% of the patients.  Maybe the thinking is - since the odds are against it there's no point in adding one more thing to our list of stuff to worry about...

And, Kaybo is right. Take good care of your eye... I think she was the one who recommended Refresh PM to me. I use it about every other night at bedtime in both eyes. I wake up with the eyes feeling good but it takes a while to get the blurriness cleared out. My eye closes but not very tightly.

I think an interesting point has been raised here...

Obviously, some doctors are being proactive and prescribing the anti-viral before and immediately post-op, while some are waiting until an issue arises.

Off the cuff, I'm thinking that the "wait until there's an issue" group hasn't seen any benefit in adding additional medications until there is definitely a need and perhaps the "proactive" group is just covering all the bases "just in case."

I'm now wondering if there have been any studies regarding this... Or maybe the question is, where are the studies and what was the overcome.

Personally, I fall into the "don't prescribe it unless/until I need it or it's going to be of proven benefit" camp. I had an uncle with incredibly crippling arthritis. Ultimately, it was liver cancer from all the pain meds that proved fatal. Considering I'm only given one liver per life time, I like to care for mine as much as possible.

[Sobes]

Hi Eli,

Very good points you make!!! Thank you As far as the eye goes (Eli and K) ...not entirely sure what to do. I put some of the goop in at night but that's about it. It closes a bit but not really...pretty much stays open but hubby says it seems a bit better since the meds started...I cannot tell myself. Not sure if it should be taped shut at night or if maybe an eye patch would be good???!!! My therapist gave me a few...she is AWESOME  and so are ALL of you! Thank you for "walking" and "talking" me through this.   

<3 Bren

[leapyrtwins]

It seems like I'm always the one on the Forum asking the hard questions, but I can't let this pass - and I love playing Devil's Advocate  

Why is this whole idea of giving patients preventative meds prior to their surgery something that House does?  Do they have a need for this because their patients have a higher incidence of this infection?  I know they have a boat load of AN patients, but I don't think the incidence of viral infection post op is THAT great.

Do places other than House follow this protocol?  Or are they unique in this?  And if so, why?

I'm with Eli - don't give me something unless you find out I need it.  It's like the vicodin the docs tried to pass off on me after I had my twins.  It was just like "here, take this".  I had no need for it, I didn't take it - I had a tylenol and in reality didn't even need that.  This has happened to me in other situations also - docs trying to push meds I didn't need.

I remember asking my neurotologist if I should take some kind of antibiotic prior to my BAHA surgery.  He was puzzled by the question and asked why I felt I needed it.  I cited infection - shouldn't we be preventing it??  His response was, if you get an infection, I'll prescribe an antiobiotic.  It turned out to be a great answer - I never got an infection; I never had to take the meds unnecessarily.  Definitely my kind of doctor!

Just my thoughts on this subject,

Jan

[JerseyGirl2]

I'm a House "alum" (Donnalyn's and my 2-year surgery anniversary is today, in fact) and I certainly remember taking the Famvir for a number of days prior to surgery and washing my hair (and they said to include the neck and shoulders as well) with pHisohex (spelling?) for a number of days prior to, and early morning of, surgery. Didn't really think too much about it and I assumed it was standard procedure. For what it's worth, I had absolutely no infection or any other problem after surgery, and two years post-surgery I don't even think much about it anymore, except for SSD.

Catherine (JerseyGirl 2)