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Infection after DBS


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#1 billheis

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Posted 21 June 2011 - 12:40 AM

Dr Okun, I'm sorry if this the third one you have received. my dyskinesia is very bad at the moment and hitting to many keys at once.

Dear Dr. Okun
Thank you so much for all the time you spend on this forum. You have helped me in the past and I even got come up there and have you check me to make sure that I was a good candidate. My Neurosurgeon here in Orlando is Dr. Glen Monsano and my movement specialist is Dr. Alex Gonzalas. I had bilateral surgery on Dec. 3rd 2010 for placement of the leads and Dec. 10th 2010 for control unit. Everything seemed to go very well. On Dec 17th had the staples and stiches removed and my first programming. Right away I had excellent results with the programing but also started to have drainage from one of the wounds. By the time I went in for my next programing, this time by the Medtronics Rep they could see I had an infection. They put me on oral antibiotics for three weeks and it did slightly improve. I had one more programmimng session and from near the end of December until the end of February I had 3 programming sessions with fantastic results however I still had the infection. So Dr. Monsano went and removed all the equipment and I was put on a picc line and one month of 24/7 antibiotics. My bloodwork came back with the numbers for where they check for infecton all lower than they needed to be. So I went back to Dr Monsano and he was not happy with the left side, the way it had healed. So I went back in and he opened that one back up and found a very slight infection still in there and restiched and I was put on 4000mg of Amoxicillin per day for three weeks znd then was sent to a Doctor with Infectious diesease. He has monitored me for the past 6 weeks and the blood work is coming back with the numbers off the chart on the good side. The side that he had restiched still doesnt look as good as the other and afraid there might still be a slight bit of infection. What else has me concerned is I have talk with quite a few others that have had the surgery around the same time I had mine done ande also have been fighting infections. It seems that those who have had infections, get them back each time. One other question, Dr. Monsano would like me to wait about 6 months before trying again to make sure everything had healed inside. Does this sound about right? Because right now I'm just back on meds and having a very bad time with dyskinesia and if I try to back off on simemet just slightly (which Dr.Gonsalez suggested) I can wear off in less than 10 minutes. and many other problems as well ie constipation ect. Thank you again for all your dedication.

#2 Dr. Okun

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Posted 21 June 2011 - 01:03 PM

A few points here and thanks for the post.

The company reps should not be programming patients, so I want to clarify that for anyone reading the forum. Only members of the doctor's team and the doctor's themselves should program (usually assisted by a well-trained nurse or PA).

The infection issue is unusual. I am not sure I understand why of the hardware was completely removed you still have an infection and it still did not heal properly. That is something without seeing you it is hard to get a handle on.

If there are multiple infections at the same institution in the same time period we recommend infectious disease docs search for the potential causes (all hospitals have these programs).

In the meantime we often have to adjust meds and wait it out.

Everyone is different. We generally give IV antibiotics in most cases and wait several months. We then try to obtain clearance from the infectious disease docs and proceed. The most important thing is patience to be sure the infection is cleared and more time is better than less (no standard interval).

Hope that helps.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips


#3 billheis

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Posted 26 June 2011 - 01:11 AM

Thank you Dr. Okun,
The original infection showed up almost immediately and they put me on a round of two different antibiotics. Then after about three weeks Dr. Monzano took a look at it and wasn't happy with the progress. So he scheduled me to go in the next day to open it up, clean it and treat with antibiotics. He also took a sample of the tissue and sent it to the infectious disease Dr.s . They determined that it was a average staff infection and suggested another round of antibiotics, only this time stronger. After three weeks on them I went back to Dr. Monzano and he could determine that it wasn't healed and again scheduled for me to to have him open it up. I was expecting to just have the would cleaned and restitched, he however saw the infection was spreading, so he went and removed all of the equipment and then the next day they installed the picc line and the 24/7 antibiotics for four weeks. I have been seeing Dr. Wallace with Orlando Medical Center and the past two blood tests have come back with the markers for infection way below normal. In matter of fact this past Thursday he even went as far to say that I didn't even have any inflammation. So now that I am infection free they want to wait at least six months to re install the equipment. As far as my rep working on the adjustment, she has PA licence and was a RN before she started working for Medtronics, which I believe she has worked for about 7 or 8 years. Dr. Gonzalez was somewhat taken by surprise that medtronics had sent the latest programming unit and he was not as comfortable as she was. Again I thank you for your dedication to us
Bill

#4 Dr. Okun

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Posted 26 June 2011 - 02:55 PM

Bill, thanks. Once the hardware is out and the antibiotics have been given a few month waiting period is usually enough. A rep should never program under any circumstance. They can can advise on equipment but do not have a license to practice medicine.

Good luck.

Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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