My husband has had three surgeries since October of last year. 1. Temporary antibiotic spacer put in a/c found sack of fluid in the hip area. 2. Was on IV antibiotics at home for 8 weeks. 3. Had hip revision on 12/27 and never stopped bleeding. 4. After 3 trips to ER doctor decided to perform a 3rd surgery. Never found the source of bleeding. 5. Still in the hospital with a drain full of blood. Just found out today possibility of blood all of a sudden not clotting properly. 6. Surgeon has no answers wants to just pull the drain out in 24 hours.
I am sorry that your husband has to go through all this.
It is indeed necessary to see where could be source of bleeding. If the bleeding does not stop, bleeding and clotting parameters should be evaluated.
I believe most of the hospital around the world would check for bleeding and clotting parameters before surgery.
Keep me informed about the disease progress of your husband.
They just told me today that they think his blood is not clotting properly. They have not found the source of bleeding. Surgeon did the last surgery hoping to see something but said saw nothing? The big question is do you think it would be right to just pull the drain when it is still bleeding? It has actually been bleeding since 12/27 but to be fair had the third exploratory surgery 1/3/08? Please help????
I am wondering what would be his general condition. What about his hemodynamic stability like BP, Heart rate etc?
If he is bleeding since 12/27 that suggests that he would have been transfuse with lot of blood till now.
You should not be taking the drain off, when he is still bleeding.
If the drain is taken out, then the blood would get collected internally causing lot of sepsis.
Is he an anti-biotic? Was he febrile after surgery any time?
How is his progress after surgery?
I think first thing first is to see for bleeding and clotting parameters and involve hematologist if available.
Keep me informed if you have any other concern.
I can't answer some of your questions because I don't know. Alot has happened since I wrote the above. The doctors are telling us the fluid has now changed to a combination of blood and serous fluid. He has been losing about 120 cc a day. Some doctors say too much, some say no big deal. His surgeon wants him not to move his leg as when he walks that is when the drainage turns to blood. He had a CT done Friday(yesterday) and the results show a collection of fluid still in his hip area.
The weekend doctor today said the drain should come out. We are uncomfortable with that because most feedback is to leave in until drainage stops. The surgeon says we would run more risk of infection leaving it in. We asked for another opinion from someone who just specializes in hips and they called in a friend of the surgeon who doesn't just specialize in hips and ofcourse he also agreed with our surgeon. There was a hematologist called in and she saw my husband today and when she heard everything that had transpired she just shook her heat and walked away.
We fill like we have no choice but to let the drain come out tomorrow.
Here are some of your answers, When he went into the hospital for this 3rd surgery his blood pressure was low. I suspect because of the blood loss. They gave him a few transfusions prior to the surgery and also ofcourse after. They say now he body is making enough blood to replace the little he is losing now. I am not sure what his heart rate is but as far as I know there are not any problems with his heart. What do you mean is he an anti biotic? Did you mean is he on antibiotics? The answer is yes Vancomiacin twice a day.
I think he might be losing some fluid, but that appears to be minimum as he appears to be haemodynamically stable.
Haemodynamically stable suggests that his blood pressure and heart rate are normal with normal urine output.
You told the haematologists had visited but he didn't say anything and walked off.
I always thought his role at this juncture is important. So does this mean that he does not have any bleeding disorder?
The doctors would be right in suggesting removal of drain as not much fluid is draining per day, he is stable too and yes it can be a potential harbinger of infections.
Vancomycin is a good drug.
Keep me informed if you have any queries.
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