epigastric hernia

[rodknock]

i had an epigastric hernia. went to hospital operated, discharged. incision became infected, removed staples and opened up to drain and drie out. was then stiched closed, was having drainage, restitched incision. again drainage started infesced again/still. stitches removed and opened to allow drainage and drie out. this is where i am at.

any suggestions, advice, or support could really be used.

[Sheryl]

Suggest you (1) get hold of all your medical records, in particular reports of culture and sensitivity tests done on the pus. (If none were performed this is probably the root of the problem right there.) and any scans. (2) bring it all to an infectious disease specialist. Where are you located?

[rodknock]

i am located in on-nut.

i have been taking diclox-500 4times a day

can i ask a hospital for my records and take them with me?

[Sheryl]

i am located in on-nut.

i have been taking diclox-500 4times a day

can i ask a hospital for my records and take them with me?

Yes, you can and by law they have to provide them. You'll have to show proof of ID, and also sign a release if you take with you any original films/scans.

Of greatest importance are lab results and any scans done. Also record of what antibiotics have been given and for how long.

I am a little surprised that at third round of tx you are on dicloxacillin, that would unusually be a first line drug and by now I would have expected them to have moved to other drugs. But of course I don't know what the cultures showed. ...assuming they did any.

Suggested docs:

I suggest you try either if these doctors ar Samitivej Hospial Soi 49

http://www.samitivejhospital.com/DoctorProfile/INTERNAL_MEDICINE_11931553/en

http://www.samitivejhospital.com/DoctorProfile/INTERNAL_MEDICINE_11932402/en

Both trained in the US so will likely not be surprised or put off by a farang patient coming to him for another opnion or expressing concern with their management to date.

[rodknock]

doctor has now prescribed curam 625mg. three times a day. will see what results are in a couple of days, starting sunday.

no cultures have been done.

[Sheryl]

doctor has now prescribed curam 625mg. three times a day. will see what results are in a couple of days, starting sunday.

no cultures have been done.

That right there is root of the problem.

It is pretty common to just guess on the first antibiotic try (though not really "by the book") but after the first failure, and given that there was pus that could be obtained, failure to do a culture and sensitivity is frankly inexcusable. Especially in a post-surgical wound as that means likely a hospital-acquired infection, and those are notorious for being multi-drug resistant.

If I were you I would insist upon it. You may otherwise just increase what is already probably a significant amount of antibiotic resistance in the infection.

It doesn't need a specialist to order a c&s nor to prescribe based on the lab results...but in Thailand it sometimes takes a Western-trained ID specialist to appreciate the need to do this.

[rodknock]

to help lower the cost they reccommend that i purchase;

set dressing disposible any one have an idea where i can purchase these?

[Sheryl]

Large pharmacies/medical supply stores.

As you are in On Nut area, try Roong Rote Pharmacy (รุ่งโรจน์เภสัช). Soi On-Nut (Sukhumvit Soi 77), away from Sukhumvit Road, about 40m on right side.

[rodknock]

follow up; have been going to hospital daily to have dressing changed, is improving and doctor talking stitching up incision at end of week.

i have also been switched to curam(amoxicellin 500mg and clavulanic acid 125mg.

at least there is no pain.

[rodknock]

as of today, have been discharged. wound has healed.

thank you for all the advice.

[Sheryl]

Glad to hear it.