Sepsis bacteria after cancer operation on the stomach
My dad at 75 has had surgery 5 weeks ago for stomach cancer, they removed 3/4 of his stomach and part of the bowel, everything went very well with the operation and due to the fact he has emphecema, but 15 days on food wasn't getting through due to a blockage which was making him sick. The surgeons then tried to stretch. The hole bigger a couple of times but failed. Then they tried a stent but couldn't do this either so decided to operate again to correct the opening so food would pass through. Went through the operation very well again and think they had sorted the problem, then on day two he started with severe pain in his stomach has to go to surgery again doctor thinking his bowel had a slight leak. Cleaned all the area out then he was put on a high dependency ward when dad came round from surgery he was very confused and thought everyone was trying to hurt him and trying to pull tubes and oxygen mask off, he now also has a chest infection. The doctors came round in the morning and they were happy with dad even though the nurse had mentioned the colour of the contents in the drain tube bag. Mum thought it looked strange a different doctor came round later that night and wasn't happy with the colour in the drain bag and told us he was taking him straight back down to surgery he thought there may be a leak which they had missed. Dads temperature was going up. So this is four time he has has surgery came though again ok and the surgeon didn't find a leak just cleaned the area out again, dad now on a ventilator three different. Antibiotic but still didn't know what bacteria was causing this. His temperature last night had come down, blood pressure had gone up to normal, and now was passing the right amount of urine through a catheter. So left him last night feeling more confident. Rang this morning and his temperature had gone up again. He is now in intensive care. Bloods came back this morning and they have found which bacteria it is so should able to treat with the right antibioctic.
Do people recover from sepsis?
They have told us he is a very poorly man, but before the operation he was such a strong man and people couldn't believe how fit he was before the surgery and how quickly he recovered after the very first operation.
How long will his recovery be with the right antibiotics x
You have my sympathies. These infections are tricky, and there are many new drug resistant varieties of bacteria that have shown up. Just keep on top of things and insure he has had a consult with an infectious disease specialist and that the bacteria have been cultured. Surprisingly they don't always do this. The chances are he didn't have a bowel obstruction, but was being provided an opiate for pain, which caused peristalsis in the bowel to stop. It's very common. There is not much you can do except pray. Make sure you have authorization to interface with the treating physician. They only like one member of the family to do so. Some "last ditch" medications are very expensive, and if you agree to pay for those, even if not covered by insurance, it would widen the treatment options. Unfortunately, expensive drug selection is a consideration in the treatment of patients. Yes, people do recover from sepsis. One of the problems with systemic bacterial infections is that when the bacteria are destroyed, toxic substances are released in the bloodstream. Visit him often, and ask a lot of polite questions every time you visit, preferably of the treating physician. Ask what meds he is on and the dose, and ask "is there anything else we could do?"
Thank you for your reply, went to see dad tonight and they were bringing him out of the induced coma very slowly, they are still treating him with a very strong antibiotic, bloods which were tested today came back normal, his temperature was 37.6 and coming down. I think they had also have given him something to bring it down. He is now stable but a long way to go. Having a meeting with the surgeon tomorrow to get more information about what's going on. Hopefully tomorrow dad will be a bit more alert when we visit him. I think he will still be very sleepy due to the pain killers. He is on something stronger than morthene. A opium based pain killer
Thank you again for your answer and we are all praying for him to get well.
The thing to watch out with any opiate is that bowel obstruction invariably takes place eventually because of a cesation of peristalsis. If this happens the surgical end often pressures the family into a "temporary" colostomy. While this works, another alternative is to intubate, provide gastric lavage, keep under sedation and administer nalaxone hydrochloride intravenously, which will restore bowel movements. Keep this in mind.
Had a meeting with the surgeon and he went through what exactly is going on. The food wasn't going through due to a bowel kink sorted this out was happy. The bowel was perforated a couple of times while he was **** this but repaired them. They are almost certain there are no bowel leaks. It was bile running into his stomach and could not find where it was coming from so cleaned this a put a drain in, yesterday when we seen dad the bile tube was beginning to run clear.
If there were any damage to the gall bladder the surgeon said that can repair as long as we keep the drain on
He is on oxycodone for the pain relief and still on very strong antibiotics.
This morning they may be removing the ventilator which will please dad his arms keep going to try and pull it out.
Still very sedated because of him getting to stressed and trying to pull things out. Last time he came round he was very confused, swore at one of the nurses which is all so out of character.
In intensive care dad began to come round trying to talk to the nurses only of course couldn't due to the ventilator. So then they decided to remove the ventilator and began to recover. They couldn't believe it because the drugs he was on would have knocked anyone else flat out. He went from intensive care straight back onto a normal ward missing out the high dependency ward.
He was there for two weeks and gradually they began to take things off him catheter drains and once he started to feed they took the bag of liquid food off him which was being fed through his main vein.
Thought I would share this with you just to show how things can change for the better.
He is still very weak having been in intensive care for two weeks but getting stronger and stronger day by day and so pleased to be home after his 2 months in hospital
Kind regards x
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