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Patient defies odds, beats deadly infection (w/video)

By Elena Watts
Nov. 30, 2013 at 5:30 a.m.

Ruben Aguirre, 48, takes his breathing treatment as Hailey Gyllenband, 34, a registered respiratory therapist, listens in his hospital room at Citizens Medical Center in Victoria. "I can feel when I need a treatment, my lungs start to feel closed up, heavy," Aguirre said.

Mediastinitis Facts

Swelling and irritation (inflammation) of the area between the lungs (mediastinum). This area contains the heart, large blood vessels, windpipe (trachea), esophagus, thymus gland, lymph nodes and connective tissues.

Mediastinitis usually results from an infection. It may occur suddenly (acute) or may develop slowly and get worse over time (chronic). It most often occurs in patients who recently had an upper endoscopy or chest surgery.

Patients may have a tear in their esophagus that causes mediastinitis. Causes of the tear might include endoscopy, forceful or constant vomiting or trauma.

Source: ncbi.nlm.nih.gov/pubmedhealth

Had Ruben "Bear" Aguirre, of Port Lavaca, waited one more day to seek treatment for a large mass on his chest, his mother would have lost her only child.

He has survived emergency surgery, an induced coma and days of around the clock medication and prayers to rid his body of a massive infection.

Now, he is ready to continue living but this time with a little different zest.

"I'm stubborn, and I don't like doctors or hospitals," Aguirre said. "Every time I go in for one ailment, they find lots of others."

The 48-year-old chef contracted a rare infection after he fell and hit his chest against a kitchen sink.

Dr. Yusuke Yahagi, a cardiologist with Citizens Medical Center in Victoria, has only seen three cases of mediastinitis since 1996.

The chest infection is usually caused by respiratory or gastrointestinal infections, but Yahagi believes, in Aguirre's case, the bacteria entered through an open wound.

While patients typically have a 50 percent survival rate, Aguirre's chances were more like 5 to 10 percent, said Yahagi.

High blood pressure, diabetes, cirrhosis of the liver, a bleeding disorder and an enlarged spleen made the infection much more deadly.

Indulging in alcohol and cigarettes and experimenting with drugs have contributed, if not caused, many health problems, Aguirre said.

"I've come close to dying before because of accidents," Aguirre said. "But this was self-inflicted stupidity."

Aguirre was transported by ambulance from Memorial Medical Center in Port Lavaca to Citizens Medical Center on Nov. 2.

Before surgery, Yahagi was not sure whether a broken sternum and internal bleeding or an infection were to blame for the swollen chest. So he prepared for different outcomes with ample supplies of blood and antibiotics.

When Yahagi opened Aguirre's chest, the problem was clear.

"The infection was the most extensive I'd seen," Yahagi said. "Instead of one infected pocket, his sternum, all of his pectoralis muscle fibers and his mediastinum were infected."

The heart, aorta, esophagus and trachea are contained in the mediastinum, which is the central compartment between the lungs and the sternum.

The severity of the infection prevented Yahagi from closing his patient's chest for six days, during which time Aguirre was in an induced coma.

An irrigation system pounded the chest infection with antibiotics 24 hours a day.

"I wasn't sure whether he would make it," Yahagi said.

Aguirre's mother and stepfather, Irene and Ray LaMotte, of Lytton Springs, visited their son every three hours after the surgery. His condition moved from critical to stable on the third day.

Yahagi closed his patient's chest Nov. 11.

When Aguirre woke, he was surprised to find that strangers - nurses, doctors, janitors and other patients' parents - knew him. They had witnessed or heard about his narrow escape from the deadly infection.

"We prayed and hoped he would survive," his mother said.

Aguirre went to his parents' home in Lytton Springs to recover when he was released from the hospital.

"I've lived on the streets and done lots of things I'm not proud of," Aguirre said. "But I have no regrets."

Yet this episode has been a wake-up call for him.

Aguirre's mother is grateful to have another chance with her son, who she describes as happy-go-lucky.

"That's a chance I didn't have just a week ago," Irene LaMotte said. "I hope that he continues to work to make a life for himself and that all turns out well."

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