Wound after surgery?

Hi all,

When I got my first surgery at 15, they put in a Medtronic enpulse and sealed the scar with dissolvable stitches and skin glue. I was happy with the scar and there was no noticeable bump after the surgery, even in the first few days. I also had minimal bruising and I don't remember feeling much at all pain after day one.

This time around, they said they were putting in a pacemaker that is the same if not a little smaller than my old one (Medtronic Adapta, this time, and not the largest version but the middle one!)

But today I changed my dressing and noticed that under the steristrips, there seemed to be a decent amount of blood, some bruising, and a definite bump... I can't tell if it's just swelled up or if the pacemaker is going to show through once it's healed. Anyone have insight here? I am only 23, and female, if that helps...

Plus, it hurts more than I remember... I keep thinking it might be because I have grown in the bust area since I was 15 but I didn't think it would be so noticeable in terms of pain... I feel like even when walking and sitting on the couch I am being careful not to jostle my body too much-- is this normal after a replacement?

Lastly-- I am on Doxycycline for 5 days to keep infection away but how should I be caring for the wound? I redressed it today because it looked like there was condensation inside the dressing the nurses put on yesterday, but other than dried blood and some bruising,it looked okay through the steristrips. It's just hard to see! Besides fever, how can I look out for an infection?

Sorry for so many questions... I am a worrier when it comes to these things!

Thanks,
-C

6 Comments

Some of what you describe

by janetinak - 2013-10-11 03:10:49

probably is normal but given that you have a lot of concerns & obviously worried, if it were me I'd put a call into your EP or cardio who did PM implantation. It may be the bleeding is a hematoma, & pain may be from that. But that is a lot on "maybe's" so I'd call & let them help you find out what is going on. Sure hope all OK & that this helps.

Janet

I agree. Hands off?call dr.

by 4mydad - 2013-10-11 03:10:54

If there was condensation under your dressing, it must have been an occlusive dressing. These are great for clean incisions, because you can see through them to check for redness, they maintain enough moisture for wound healing, and they don't allow bacteria to enter as long as the film isn't lifted or removed. Did they provide you with clear incision care instructions and explain them to you at discharge? Puffiness is expected after any injury to the tissue. It's the body's natural "clean-up crew" responding to the injury and is usually just the first stage of healing. The fluid packs up debis and carries it away. The down-side of clear occlusive dressings is sometimes the same as the up-side: you can see the incision. You seem to know what to look for, though. A temperature, chills, increased redness, drainage that isn't clear or bloody....Definately report pain that increases, as well as an increase in even clear drainage. And as Sparrow said, "Fingers off!" Call or go to see your doctor if you're worried. You know your body best, so don't be afraid that you may be "bothering" the doctor.

Thanks guys

by CRose19 - 2013-10-11 03:10:57

I was going to respond to this an hour ago but then someone from the hospital actually called to check up on me. I'm frustrated with all the mixed messages I am getting:

Nurse at discharge told me to take tylenol instead of advil b/c ibuprofen can be a blood thinner, but today the nurse said advil will relieve more pain and swelling.

Nurse at discharge told me NOT TO TOUCH the dressing at all and leave it for "as long as possible", person on the phone yesterday told me to remove dressing if it's wet but to put on another one, nurse today told me to remove everything except for the steristrips, unless I am showering (or trying to shower) or running errands and choose to cover it.

And I have been SO careful-- I haven't touched the wound at all with my hands. Before removing the dressing yesterday I washed my hands with soap and the hottest water I could stand, and even then I didn't touch the wound or anything that went onto it with my hands. So far no signs of infection-- I think being heavier on top than I was at age 15 is making it worse than last time, plus i obviously should've been taking advil instead of f***ing acetaminophen...Pretty angry with all the mixed messages I've been getting!!!!

I'm gonna go attempt to shower (at least my bottom half and right side, right?) and then take off the dressing until I go to sleep tonight so it can air out and stay dry. ANY AND ALL ADVICE STILL VERY WELCOME!

new incision

by judyblue - 2013-10-11 10:10:26

No advice, just a sharing of misery. I too got so much mixed advice. I don't know when it will be safe to raise my arm up over my head. I was told to shower immediately, and then told not to by someone else- all medical personnel. I am 51 with new PM and I can definitely feel it and see it. It hangs over my arm pit. It probably depends on the surgeon who puts it in. And I find Aleve to be the best OTC pain med; better than advil. Good luck!

I agree...

by rnff2 - 2013-10-11 10:10:38

I agree with the others to keep from touching the site unless its absolutely necessary. I had a bump under my steri strips and some dried blood that was noticable right after my dressing came off. My incision had a ridge like bump when the steri strips came off and now its a flat pink line. I am bigger up top and notice a difference with my bra on and off. My pm seems to move and jiggle alot due to my assets so that could be causing some of your pain. Pain, bruising and swelling at the site are normal, as long as they aren't excessive. I'm glad to hear you talked to someone at the hospital, but don't be too mad about the tylenol and motrin advice different doctors/nurses give different advice, motrin is better for the swelling, but tylenol is safer post procedure. I actually took both, alternating them every 6 hours after my pm. Allowing your incision to air dry is a good plan, and a dressing over the steri srips is really not necessary unless the site has a chance of getting dirty or your clothing is rubbing on it.
Hope this helps...good luck.

Incision Blues

by donb - 2013-10-11 11:10:14

Hi C Rose, I started a posting earlier today & didn't get it sent but everyone above did a great job giving advice to get you healed up. I sat down & did a research on my past 22 years of 6 pacemakers. My 1st 3 were all normal sites, healed up great until my 3rd pacemaker eroded after having it about 4 years. My site was a complete mess & required 2 surgeries to repair it.
My next 2 pacemakers were put in my right chest under muscle & unfortunately also eroded even though pre-antibiotics were given. Hospital lab tests showed no infection which was in error. As a result #5 had to be removed along with leads & 7weeks of Vancomycin IVs' was done.
My #6 replacement is now in my abdomen with longer leads up my groin with a great bonus, Like zero pain. As I'm a skinny male all my chest sites gave me much pain with any activity & also movement of each implant.
As my history of implants have been abnormal, my above record of 10 pacemaker surgeries are just not the usual scene. I can't lay blame on my surgeons as my chest area is just not the best for housing these implants but more precaution is needed when a replacement is housed with proper infection precautions. In my case it was a hospital bug I picked up & was not found with lab tests at the time
of replacement.

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.