Preventing infections of the artificial heart valve implant

[gary]

Does anyone keep on hand at all times a super strong antitbiotic or been advised by their cardiologist to do so?

It occurred to me while on vacation outside the United States, that, though I always take a 'scrip bottle with ten thousand mg of Amoxycillin in it just in case I sever a blood vessel that routs directly to the heart, that I should ask my cardiologist or GP about keeping something on hand far more potent.

Has anyone been told that with the increased susceptibility to infection artificial heart valves have, that they should ALWAYS keep on hand XYZ drug in syringe or injection form?

Or is that speed unnecessary as long as an Antibiotic, like Amoxycillin, is taken orally, quickly after the cutting injury?

Gonna ask my GP when next I can by phone, but would like to know if anyone else has already been there, done that?

[LUVMyBirman]

Protection against infection is of the utmost importance. Starting with good oral hygine and regular visits to the dentist. Check out the American Heart Association's site. Prevention against Bacterial Endocarditis.

As far as keeping a supply of antibiotics on hand....think you will find that your physician will control this. They usually want to see you and or at least make contact with you via telephone to access the situation.

If you travel outside the country...having a filled RX on hand is not a bad idea. Ask your physician for his/her recommendation

[Mara]

Gary-
I am with Gina.
You don't want to get "immune" to the effects of antibiotics bt sefl medicating. I know. I got a 30 minute lecture from my cardio about self medicating with anticiotics when I thought I had strep throat and didn't! See, it was esy for me to get antibiotics because my dad is a pharmacuetical rep. Since then, I only take antibiotics when prescribed.

-Mara

[Nancy]

Hi Gary-

Husband Joe gets a scrip for an antibiotic which is a little stronger than usual, but still in pill form for dental procedures. It's only a few pills.

Using an injectable form of an antibiotic without a doctor being very aware of it is a bad idea. My husband had an almost life-threatening reaction called serum sickness to an injected antibiotic used during surgery this last time. The funny thing is that it was used before for several of his thoracic surgeries without any reaction at all, and he had no known allergies to antibiotics. He has to be careful now.

[sylviayasgur]

hi gary!
i am in total agreement with everyone here. personally, i like to consult with my dr (and the same goes for my family). i carry amox. with me when we travel to remote islands (which we often do), for fear that they may not have certain familiar things there. i wouldn't worry about taking antibiotics with you within the usa though, there are many dr's and pharmacies here that can be helpful. in fact, when joey was in afib about a year ago, while we were in mass., he realized that he had not brought enough coumadin with him. we stopped into a pharmacy, got his cardio on the phone, and our problem was solved.
hope all goes well,
sylvia

[McCln]

You should also be aware of a potential problem associated with taking antibotics, the chance of an allergic reaction to penicillin in the antibotic. With taking penicillin over time, you can get a allergic reaction to penicillin. All antioboics that have the part, cillin, has penicillin in it. So be careful with antibotics. And I agree with the others, antibotics is measured by symptoms. And you should be seen in person, not over the phone. You keep hanging in there.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

[Zazzy]

Okay.. gotta put my two cents worth in here!! lol

I do know that the more you take antibiotics the chances of your body becoming resistant to them is greater. This means that if and when you ever really need an antibiotic they would have a hard time finding one that would be effective for you! Not a very good prospect in my opinion! This is why docs do not prescribe antibiotics for viral infections... they don't work on viruses.

Take care,
Zazzy

[gary]

not have been clear about why I'm asking.

Regarding penicillin, as a youth from age 13 to 21 I was administered 1,000,000 units of penicillin per month, every month by injection. I never once had a reaction to it. In those days, 40 some years ago that was the protocol. It's since changed a lot of course, as we all know.

But my question has nothing to do with that kind of useless but well-meant prophylaxis. (as it turned out after all those holes were poked into my tender buns.)

My concern is more targeted. Such as being caught on a boat and tearing a blood vessel on a rusty nail, or a huge fish hook, and being miles from land, vulnerable for hours to the damage of horrid infection raging thru the body that would damage the valve.

[sylviayasgur]

hey gary,
have you asked your doc/cardio about this?

-sylvia

[McCln]

We are well meaning by educating you be telling you to talk to your cardio doctor. It is better safe than sorry. And if something were to happen, say like, a big cut on your hand, emergency room people will give you what you need in , if any. antibiotics. So talk to you cardio doctor about your concern about infection worries. You will be glad you did and we will be happy also. We aorry about everyone here. And please also head to warning about a possible, someday reaction to antibiotics. Your body can build up against antibiotics. Ask your doctor. Better to be safe than sorry, for future warning is good for your awareness. Be safe, be careful.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

PS. I also had consulted a physician when I saw an article more than 15 years ago about allergic reaction to penacillin. He said that it is true that over time, the body can build up on so much penacillin that it may take one dose to create a reaction. So it is not usless information. It is to mare you aware of what can happen over time, dear. Take care.

[gary]

Not yet, but I plan on doing so.

It seems to be taking an unnecessary risk to travel without a strong emergency antibiotic that could be administered orally or by injection within minutes after the blood stream is contaminated. I came so close to being 'stabbed' by a fish hook the size of a small dagger, while being an hour and half from shore and another half hour or more from a hospital recently that I began to wonder it never occurred to me why I had not thought about this risk before.

Apparently no one knows for sure what their physician would say about it.

I thought that with the valve being vulnerable, more so than even a diseased native valve, that, just like children's aspirin is recommended almost religiously in the afermath of implants that an emergency AB kept on hand at all times would be too.

But now I will contact my GP or cardiologist within a day or so and report any information I learn about implementing this precaution.

[LUVMyBirman]

If you were within a couple of hours of treatment.....i.e., off shore fishing, etc........realistically you may not get the antibiotics into your system any faster than if you were waiting in an ER for treatment. I really don't think a couple of hours delay would make a huge difference, unless you where bleeding uncontrollably of course.

A good pair of gloves and a first aide kit with antiseptics may put the mind at ease. While gardening....I have gloves available to protect my hands. The first aide kit is never too far behind.

[gary]

I think OHS has caused a fracture in my writing ability.

What I meant by the terms "Useless" prophylaxis" and "well-meaning" intentions was that the physicians at that time were taking extraordinary precautions. The remarks were not directed at the respondents on this forum.

What I meant was that all those shots, once a month, for so many years were "useless" although "Well-meant", as discovered in subsequent research.

Whew.

[Rain]

Gary,

I laughed out loud by the time I read your last message. :)

I talked my cardio into giving me a prescription for antibiotics when we went to Mexico. I had to practically beg to get them, he acted like we were almost committing a crime! Crazy, they trust us to dose ourselves with rat poison, but you gotta beg for antibiotics. :confused:

Have a great day!

Rain

[gary]

Made the call to my GP this a.m. and awaiting his or his crispy white uniformed nurse to call me back at this time.

I have a thing for crispy white uniformed, white shoed, nursey-hatted medical personnel. (of the distaff side, of course).

Calling Nurse Betty!

[Lisa in Katy]

Gary, like you, I was dosed with prophylactic antibiotics for years. I had the monthly shot for about a year when I was 14-15, and then convinced my doctor to let me do 1000 mg of oral V-cillin per day, which I continued until I was about 24-25. Boy does that drug make your pee stink! Like everyone mentioned, when I did get an infection, they had to call out the big dogs. I finally stopped taking it at that time on my own. However, when my oldest entered daycare, my cardio said that I should go back on it because of higher chance of exposure, which I did until I got pregnant with my youngest. I stopped then, and now only take antiobiotics when necessary or for dental work.

If traveling out of the country, I would probably have some on hand, just in case. In fact, I keep a supply in my medicine cabinet for dental work.

By the way, though I started the prophylactic antibiotics in 1976, the last time this was recommended was in 1991, not all that long ago, so apparently some doctors still think it's a good idea.

[LUVMyBirman]

Glad your back. Hope all is well in your world.

Can you elaborate on the use of the sub Q prophylactic antibiotics. Are you saying that your physician had you doing this on a constant basis in the event that you may come in contact with an bacterium? Had you had bacterial endocarditis that would warrant this type of precautionary medicating?

Just curious....never heard of this practice.
Guess we learn something new every day. :)

For the first twos year I had my valve......was very concerned about getting it infected. Used antibotics when most likley had a virus to air on the side of caution. Have learned how to differentiate between a virus and a bacterial infection. Have rode a few colds out this winter so far with no problems. Was on an antibiotic just before Thanksgiving for a sinusitis and that's it. Usually I am on my 6th cold of the season at this point. Kids, kids, kids. I try to stay away from my daughters classroom as much as possible in the winter months. It never fails.....everytime I volunteer or organize a party.....3 days later I am sick. Either my immune system is stronger...or it's a mild cold/flu season.

[Lisa in Katy]

I had bacterial endocarditis when I had rheumatic fever, so strep could have caused a recurrence, and I was considered at very high risk. I did have strep a few more times in the years post rheumatic fever, even while on penicillin. I would get what they called a penicillinase producing staph infection (meaning it killed the penicillin) with a strep infection as well. They would have to get rid of the staph infection before they could fight the strep infection. That is when my doctor told me I had to leave patient care if I valued my life.

I listened! Of course, I am not surrounded by little first grade germs, but haven't been sick yet this year, other than minor colds.

[Mb]

Hi!
My husband had theumatic fever when he was 18. He took penicillin daily till he was about 40 years old. He has almost always had a supply of it in hand, so that he could dose himself prior to going to the dentist, or when he was having minor surgery or whatever done. He is a contractor, so when he injured himself (cuts, etc.) I can't recall the Dr.'s telling him to dose himself, but I will check with him. We were never able to get life insurance, due to the meds he took daily.

The hospital did tell us to have him stay away from all animals for about two months post surgery. I thought that was interesting.

Other than through cuts/dental work.......how else can a person get endocarditis?

Marybeth

[fdegranville]

It is interesting to see how many people had to do those shots.

First, Hi Gina, thanks for your note yesterday.

I think the shots were prescibed uniquely for patients with Rheumatic Heart Disease (I could be wrong). It has to do with the disease sort of reactivating. I too, was on the shots from the time I was diagnosed at 26 until I was 35. I still had to take the penicillin for dental work as well. Those shots were more than subQ, but intra-muscular. Ouch, ouch, ouch. My X who is a doctor used to give them to me, and I would never remind him when it was time because I dreaded them. However, I did find that a couple of glasses of wine prior helped enormously.

When I first started the shots I was living in Singapore and believe it or not, in one of the hospitals there they had a entire ward of patients with rheumatic fever

Now someone is saying that it was all for nothing? That they didn't even work, or were unnecessary!!!

[gary]

fully informed by my G.P., maybe this will help bring some clarity.

His nurse who asked him about my query says:

The shots were not then and are not now totally 'unnecessary'. But, over time, the body could become 'immune' to the power of penicillin when administered in such large doses at monthly intervals, especially in the years and decades long usage some of us endured.

So today, an infection that would be damaging to the heart valves can be dealt with within 24 hours by most patients seeing a doctor or going to an emergency room so the preventive once-a-month shots were overkill, subsequent to the powerful antibiotics that have been developed since the 40s and 50s, when the once-a-month a regime was nearly all that there was, proven to prevent further valve damage.

HOWEVER. If traveling in a fashion in which medical facilities are not immediately at hand within hours of onset, the protocols used in 'getting 'shots' for say, malaria, or Dengue Fever, tetanus, etc. should be sought after by the patient.

In other words, getting that penicillin or other antibiotic with 'shelf life' in the body is a pretty good idea if done just before travelling.

When I asked her if taking along a syringe to inject oneself instead, immediately after injury, is an even better one, she said I might hurt myself giving myself a shot and that I would in all likelihood be seeing a doctor at some point within a day of the injury, no?

I asked is that main objection: giving oneself a shot may be MORE damaging than the infection? She said not just that but there are other considerations, depending on the nature of the infection or disease one may contract.

Then, presupposing I have an adequate skill in giving myself intramuscular injections, is that not what the physician would do if I get a contaminated fish hook stuck in an artery? ( Maybe not what he'd do for a malarial fever or Dengue but just focusing on the cut or the stab) Would the injection be a far better idea? Vital to Protection of the valve?

She said the GP still felt that it was best to take the oral amoxycillin after injury and then get to medical treatment to cover ALL the bases and that an accurate, professionally administered injection without injuring onself would be beneficial but not necessarily when taken in the context that after a major injury, a trip to the doctor or hospital, as soon as possible, is the most intelligent tack to take, with little downside risk of damaging the new implant.

Those of us who carry amoxycillin (who are not allergic to it!) at all times seem to be on the right if not necessarily the most foolproof course.