Guest guest Posted April 24, 2006 Report Share Posted April 24, 2006 What do you mean it came back " positive " but they don't know what for? They should know what it's positive for, and treat accordingly with the proper abx (one the bacteria is sensitive to). If the pain in your finger doesn't get better soon, you need them to switch antibiotics, based either on the cultures they already got but failed to tell you about, or on new cultures. Infections can be missed. The fact they did a bone biopsy, means they think there's a good chance of osteomyelitis. Don't let them shrug their shoulders after one test. If the Clarythrimycin's going to work, it should work fairly quickly. If it doesn't, they need to react quickly. Stay on them. penny Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2006 Report Share Posted April 25, 2006 It came back positive for an infection --- they just don't know what type. They did indeed think that the bone had an infection, and at one time, I had three doctors in the room with me -- all very concerned. I am seeing two orthopaedic doctors and one Infection Specialist. The Infection Specialist is guessing around 3 to 4 weeks for Clairthomycin to start working. I have been on it since the Saturday before Easter. > > What do you mean it came back " positive " but they don't know what for? > > They should know what it's positive for, and treat accordingly with > the proper abx (one the bacteria is sensitive to). If the pain in your > finger doesn't get better soon, you need them to switch antibiotics, > based either on the cultures they already got but failed to tell you > about, or on new cultures. > > Infections can be missed. The fact they did a bone biopsy, means they > think there's a good chance of osteomyelitis. Don't let them shrug > their shoulders after one test. If the Clarythrimycin's going to work, > it should work fairly quickly. If it doesn't, they need to react > quickly. > > Stay on them. > > penny > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 The choice of clarithromycin for a bone infection goes against the grain of anti infective guidelines.Bone infections are treated with aggresive drugs vancomycin or gentamicin/kanamycin/tobramycin/ plus a penicillin/cephalsporin as a dual therapy approach, clarithromycin is good for someone who gets a sinus infection/lung infection yesterday and they are treating immediately.It's a soft tissue drug more than a bone penetrating drug which is also the same problem faced using cipro/ levafloxacin. The problem with his clarithromycin approach is that he doesn't rely on drugs to get the job done he hopes the surgery that will be offered in the future after this failure will get the job done. > > > > What do you mean it came back " positive " but they don't know what > for? > > > > They should know what it's positive for, and treat accordingly > with > > the proper abx (one the bacteria is sensitive to). If the pain in > your > > finger doesn't get better soon, you need them to switch > antibiotics, > > based either on the cultures they already got but failed to tell > you > > about, or on new cultures. > > > > Infections can be missed. The fact they did a bone biopsy, means > they > > think there's a good chance of osteomyelitis. Don't let them shrug > > their shoulders after one test. If the Clarythrimycin's going to > work, > > it should work fairly quickly. If it doesn't, they need to react > > quickly. > > > > Stay on them. > > > > penny > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 I don't have a bone infection -- it is a tissue infection that they think is mycobacterium ... something. Are you implying that he is hoping that he will have to do surgery?? He told me that surgery is going to be his last resort -- that maybe adding antibiotics or switching meds might come next -- after a few weeks. > > > The choice of clarithromycin for a bone infection goes against the > grain of anti infective guidelines.Bone infections are treated with > aggresive drugs vancomycin or gentamicin/kanamycin/tobramycin/ plus > a penicillin/cephalsporin as a dual therapy approach, clarithromycin > is good for someone who gets a sinus infection/lung infection > yesterday and they are treating immediately.It's a soft tissue drug > more than a bone penetrating drug which is also the same problem > faced using cipro/ levafloxacin. > The problem with his clarithromycin approach is that he doesn't rely > on drugs to get the job done he hopes the surgery that will be > offered in the future after this failure will get the job done. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 A tissue infection is possible. Tissue infections can spread to bone. I'm just surprised he did a bone biopsy at this stage if he didn't suspect a bone infection. Let's hope it's still just in the tissue and you start seeing results quickly. If not, he should switch antibiotics. A few weeks seems odd to me. Infections usually respond rapidly to the right antibiotic. Please remember that docs don't like dealing with these kinds of infections. They're difficult and costly to treat. Don't let him try to get away with anything less than the best treatment possible. Do your research, so you understand everything. penny > > > > > > The choice of clarithromycin for a bone infection goes against the > > grain of anti infective guidelines.Bone infections are treated > with > > aggresive drugs vancomycin or gentamicin/kanamycin/tobramycin/ > plus > > a penicillin/cephalsporin as a dual therapy approach, > clarithromycin > > is good for someone who gets a sinus infection/lung infection > > yesterday and they are treating immediately.It's a soft tissue > drug > > more than a bone penetrating drug which is also the same problem > > faced using cipro/ levafloxacin. > > The problem with his clarithromycin approach is that he doesn't > rely > > on drugs to get the job done he hopes the surgery that will be > > offered in the future after this failure will get the job done. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 , This makes no sense, " it came back positive for infection, they just don't know what type " . Then how do they know there's an infection? Other than observation, and perhaps elevated CRP and SED, the only other way to identify it is by culturing the sample they took and seeing how pathogenic (toxic) it is by how abx resistant it is. They should be able to know what kind of bug it is, unless it's some new strain they've never seen before. And that's highly unlikely. You'd be in the medical journals and they should tell you this. Telling you they can't identify the infection is a big red flag, either they're not telling you what they know, they're covering something up, or they're idiots. Doesn't sound like the latter. It makes no sense that they have not identified the bug and have you on clarithrimycin. I'd ask them specifically which tests they did to identify the organism and ask for copies of those tests for your records. You should always get copies of all lab work. It's your right. Perhaps they're guessing and haven't actually tested your orgnisms, although why they took a bone biopsy is beyond me. Perhaps they messed up the sample and didn't get any results? They need to be forthcoming with you. penny > > It came back positive for an infection --- they just don't know what > type. > > They did indeed think that the bone had an infection, and at one > time, I had three doctors in the room with me -- all very > concerned. I am seeing two orthopaedic doctors and one Infection > Specialist. > > The Infection Specialist is guessing around 3 to 4 weeks for > Clairthomycin to start working. I have been on it since the > Saturday before Easter. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 Maybe I confused you.... the Bone Biopsy was negative for infection, cancer, or tumors. The tissue biopsy showed some sort of infection. It has been sent to Duke University where they said a culture test is being done -- and it sometimes takes three weeks for results. > > , > > This makes no sense, " it came back positive for infection, they just > don't know what type " . Then how do they know there's an infection? > Other than observation, and perhaps elevated CRP and SED, the only > other way to identify it is by culturing the sample they took and > seeing how pathogenic (toxic) it is by how abx resistant it is. They > should be able to know what kind of bug it is, unless it's some new > strain they've never seen before. And that's highly unlikely. You'd > be in the medical journals and they should tell you this. Telling > you they can't identify the infection is a big red flag, either > they're not telling you what they know, they're covering something > up, or they're idiots. Doesn't sound like the latter. > > It makes no sense that they have not identified the bug and have you > on clarithrimycin. I'd ask them specifically which tests they did to > identify the organism and ask for copies of those tests for your > records. You should always get copies of all lab work. It's your > right. Perhaps they're guessing and haven't actually tested your > orgnisms, although why they took a bone biopsy is beyond me. Perhaps > they messed up the sample and didn't get any results? They need to > be forthcoming with you. > > penny > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 The reason they did the bone biopsy was because the bone appeared " washed out " on the x-rays. As far as cost, I have excellent health insurance and money is really no issue here. > > A tissue infection is possible. Tissue infections can spread to > bone. I'm just surprised he did a bone biopsy at this stage if he > didn't suspect a bone infection. Let's hope it's still just in the > tissue and you start seeing results quickly. If not, he should > switch antibiotics. A few weeks seems odd to me. Infections usually > respond rapidly to the right antibiotic. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 I hate to even think it but you could be totally right about the doc waiting for surgery. I've had ENT after ENT and oral surgeon after oral surgeon who were not in the least bit interested in trying to treat or even identify my sinus/jaw organisms. They just want to cut. That's the reality of surgeons. Treating bone infections is extremely expensive. Surgery is cheaper. Debridement (removal of necrotic/infected bone) is probably necessary, if it really is a bone infection. But you need to have all the information for good follow up care. What you don't want is a doctor who just says, we can't identify/treat the bug, so we have to remove the finger. God, this pisses me off. Hopefully, the i.d. doc is independent enough to keep the surgeon in line. If not, needs to get at least a second opinion before letting anyone remove that finger. penny > > > > It came back positive for an infection --- they just don't know > what > > type. > > > > They did indeed think that the bone had an infection, and at one > > time, I had three doctors in the room with me -- all very > > concerned. I am seeing two orthopaedic doctors and one Infection > > Specialist. > > > > The Infection Specialist is guessing around 3 to 4 weeks for > > Clairthomycin to start working. I have been on it since the > > Saturday before Easter. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 That's the problem. Your insurance company doesn't like paying for this kind of treatment. They could care less about you. It can easily cost $100,000.00 to treat your little infected finger if they do it right. It's a whole lot easier to cut if off. Keep yourself on guard. penny > > > > A tissue infection is possible. Tissue infections can spread to > > bone. I'm just surprised he did a bone biopsy at this stage if he > > didn't suspect a bone infection. Let's hope it's still just in the > > tissue and you start seeing results quickly. If not, he should > > switch antibiotics. A few weeks seems odd to me. Infections > usually > > respond rapidly to the right antibiotic. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 Okay, that makes a lot more sense. Also, just because the bone biopsy was negative, doesn't 100% prove it. They can be missed. But that's good news so far. penny > > > > , > > > > This makes no sense, " it came back positive for infection, they > just > > don't know what type " . Then how do they know there's an infection? > > Other than observation, and perhaps elevated CRP and SED, the only > > other way to identify it is by culturing the sample they took and > > seeing how pathogenic (toxic) it is by how abx resistant it is. > They > > should be able to know what kind of bug it is, unless it's some > new > > strain they've never seen before. And that's highly unlikely. > You'd > > be in the medical journals and they should tell you this. Telling > > you they can't identify the infection is a big red flag, either > > they're not telling you what they know, they're covering something > > up, or they're idiots. Doesn't sound like the latter. > > > > It makes no sense that they have not identified the bug and have > you > > on clarithrimycin. I'd ask them specifically which tests they did > to > > identify the organism and ask for copies of those tests for your > > records. You should always get copies of all lab work. It's your > > right. Perhaps they're guessing and haven't actually tested your > > orgnisms, although why they took a bone biopsy is beyond me. > Perhaps > > they messed up the sample and didn't get any results? They need to > > be forthcoming with you. > > > > penny > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 26, 2006 Report Share Posted April 26, 2006 , Seriously, do some pubmed searches on infections and treatment. Almost every single study you read will talk about the cost factor. Doctors know that they have to keep costs as low as possible to appease the insurance companies. This does NOT apply only to HMO's. Treating infection is difficult and very costly. That's a big reason why the entire medical community has its head in the sand. It's also why pharmaceutical companies are continously creating more abx. Although, recently, there's been a reduction of abx research, because the drugs can't keep up with the bugs. It costs a lot of money to create new abx and lately they don't last very long before the bugs beat em. Do not blindly trust. You have to educate yourself here. It's vital. penny > > > > > > A tissue infection is possible. Tissue infections can spread to > > > bone. I'm just surprised he did a bone biopsy at this stage if > he > > > didn't suspect a bone infection. Let's hope it's still just in > the > > > tissue and you start seeing results quickly. If not, he should > > > switch antibiotics. A few weeks seems odd to me. Infections > > usually > > > respond rapidly to the right antibiotic. > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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