Sepsis, new stent, and heart rate monitoring

I had a rough week, but am feeling much better now. I went to sleep last Thursday night with temp of 98.8, and woke up Friday morning with a fever of 103.1 and heart rate of 140 bpm. I called the GI, and they said to go the ER. The ER wasn’t too bad, and I got admitted later that day. The hospital stay was Friday through Wednesday. The blood cultures were clear, but they diagnosed it as sepsis, in all likelihood a bile duct infection.

While an inpatient, they did an ERCP. My wife and I had hoped to have the stent taken out (this is the second one to be infected), and the endoscopist said he would be very thoughtful of our wishes. But unfortunately, he did have to put in a new stent to keep a stricture open. Here’s the note on the stricture - “A 10mm long stricture, about 2mm in diameter, noted in common hepatic duct just distal to bifurcation with upstream dilation of CHD to about 10mm.”

I feel good about the treatment going forward. Cytology brushing are negative. I’ll get CA-19-9 checked again. The endoscopist said I needed to get an abdominal MRI to look for CCA, not just an MRCP. I had thought that an MRCP was the same as an abdominal MRI, but are they actually that different?

Also, I have a wearable activity monitor, and with both infections so far, it’s alerted me to a high heart rate overnight. I’m really happy to have this info, as it’s been important in deciding whether a fever is something to be concerned about. I wish there were some other early warning signs, so that I’d know when to start taking antibiotics by mouth.

I am so sorry to hear this but glad you are doing better.

I have yet to have any scents or sepsis, but still have elevated ALP and Bilirubin.

You mentioned you had no warning. You didn’t have any prior RUQ pain or discomfort of itchiness beforehand?

I can’t believe how quickly things progressed.

I have a standing blood test that I fill when I start to feel unwell and it lasts and if my pain or discomfort persists, I start taking Cipro and metronidazole which I also have a standby prescription of. For me it is a good indication that something has gone awry but you mentioned there was nothing on the blood panel.

I don’t take the meds lightly and only go that way when things don’t improve because I hate waving bye-bye to my good bacteria. As a vegan though, repopulating should be okay with high fiber foods and fermented foods.

Thank you, Birdy. I didn’t have any significant RUQ pain, just a little twinge every now and then. I did feel a little tight under the ribs (a doctor called this “epigastric tightness”). I had tried going on a jog a few days earlier and my heart rate kept spiking, so that’s maybe a warning sign, but it’s all so subtle.

Bloodwork at the hospital had my bilirubin around 2.3 and ALP around 1200 on admission, and bilirubin at 0.9 and ALP around 650 on discharge.

Glad to hear you’re vegan. I’m vegetarian, and my wife is vegan. I’m definitely eating the best food I can for healing, and am also trying to keep in good shape.

Cipro and metronidazole – yes, that’s what I’m on for the next five days… I end up with a very bad metallic tase in my mouth from the metronidazole :-/

Landau,
Thanks for the update. I’m glad you got to the ER and received the treatment you needed to bring the infection under control. It’s a shame they couldn’t balloon dilate and it hold in place to avoid that stent. They are just breading grounds for infection as you have found out. How long was the time between when it was first placed and when you had it changed out? It sounds like they left it in too long.

Mark

When I had sepsis, I felt like crap all day. Got chills and went to bed under a wool blanket and electic blanket. Took my temp and was102,7. Because I thought it was due to the blankets, I kicked them off and had the same temp an hour later.

Like MBland, I had an ERCP, but no stent.

I had that monitoring system several years ago, but it did not detect anything screwy.

MBland, I am glad you have gotten better.
Jeff

MBL
I am still much earlier in my disease progression, but my heart and prayers are with you… this is a great group to have behind you. Stay strong!

Mark

The first stent was in for 12 weeks and got infected right at the end, and the second stent was in for 7 weeks before getting infected. Now on stent number 3. I’ve read lots of differing recommendations for how long they should be in… I guess it’s a balancing act of risk vs. reward, but it’s definitely annoying either way.

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