Past organ trauma, current illness

Lebby

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My character is a veteran. He was injured more than 10 years ago by an IED, and he lost his spleen at that time. It was a serious, career-ending injury, but he obviously survived. This was prior to the action of my story.

Now, he is in his late 30s and appears healthy. He enters the hospital with a (relatively) minor injury, and promptly acquires pneumonia. Because he has no spleen, I want to threaten him with septic shock, but he has to survive and be capable of a decent if slow recovery. I feel pretty confident about conveying all that at the level of detail I want, which is not exactly a medical play-by-play.

However, he would have had other injuries at the time of the IED, and I am wondering if, and how, they might complicate things further. For instance, it seems reasonable that he'd have injured his liver (and/or intestines or kidneys?) at the same time, and my research so far shows that he could still have had a good outcome and not needed to have parts of his liver removed or anything. But I assume it would be scarred? Would it? And would that make organ failure more likely now? Is that something his medical team would be noting in his chart? Would it affect his prognosis in a way I could play with? And: If he does have previous healed injuries to other organs, am I making it too unrealistic that he'd survive now? I want the situation to be dire and for his brother to believe he might be dying, but I don't actually want to kill or cripple him.
 

MaeZe

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The liver regenerates. So liver damage from years ago wouldn't still be an issue.

You can decide what outcome you want then build the injuries around it. Why not pick a pathogen that has serious drug resistance?

Post splenectomy is more susceptible to both pneumococcal and meningococcal pathogens, either of which can produce sepsis and be difficult to treat.
 
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GeorgeK

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MaeZe beat me to it. It is the simplest believable answer and having worked in a military hospital years ago and the VA, it's very possible that after the splenectomy they forgot to give him the proper post splenectomy vaccinations.
 

Tsu Dho Nimh

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No spleen makes you more susceptible to pneumococcal and meningococcal infections - it does something to filter them out or slow them down. It also makes malaria more dangerous because the organisms aren't sequestered by the spleen.

The blood smears of spleenless persons are "trashy". A major function of the spleen is grabbing and destroying old RBCs. It's not a dangerous condition, but it's obvious when checking the CBC slides that there are some really senile and battered cells in there.

Being spleenless does NOT automatically make you ineligible for military service. My ex-BIL was in the Army. He was kept out of areas with malaria, such as Vietnam, but they sent him to Guam and some other places.
 

MaeZe

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I don't know about "trashy" but the above post reminded me, both my brothers had their spleens removed (hereditary blood disorder) and both of them have outrageously high platelet counts in the 700,000 plus range. Both have to explain to new doctors seeing such high numbers that it's the splenectomies, not a sign of a malignancy.

Recently one of my brothers developed pulmonary emboli from leg clots. He's OK now, but PEs would be one complication a writer could use.