Hip Infection 2 stage revision, hip infection

[KcSweet1975]

@dinsmaum
Hello and good luck today with you surgery I just had my surgery last Wednesday. Like you I had nothing grown on the culture from the aspiration I did prior to surgery and when the infectious disease doctor tested the implants still no growth. He did say they will let it be for about a week more but the antibiotic I am on is a broad spectrum so it will take care of all infections. He said it's very common to have no growth but it doesn't mean you don't have an infection it's just one that is a different bacteria from what they test for.
I have to say this recovery is different but the same from an implant surgery. The important thing I can say and advise is get your cocktail of meds down to control the pain. It took a couple different meds for me to find the right one.
I came home last night and everything is good and have lots of help. That's another thing, get as much help as you can because you'll need it. I am 50% weight bearing so it's a little bit of a challenge.
All in all not to bad, I think you will be just fine.
If you have any questions please ask
Good vibes being sent your way!


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[glynis]

How are things in Michigan?

 

[Krista]

Sure hope your surgery went well, @dinsmaum. Wishing you the best in this first stage of the revision.

 

[dinsmaum]

Hello Everyone! It has taken me a while to get back to the computer!
The surgery was April 19th, and went well. There was evidence of an old fracture, and when they started to remove the stem, it was clear the bone was going to break. So, they sawed off the side of the femur, put in a plate of some kind, and cabled it all back together, with "super cable," lol!

Came home 4 days later, and got set up with the IV antibiotics. I was so lucky to get the eclipse homepump, instead of the bad hanging from a pole, and this has made the infusion process so much easier!

I need much, much more help than I anticipated, and fortunately my sister and brother in law were in town for other reasons, recognized the need before I did, and stepped right up! I am so grateful.

So, having a spacer is in no way like having a joint, artificial or otherwise! It feels different, unstable and uncomfortable. And noisy! Oh my goodness! The grinding, popping, crunching sounds are beyond disconcerting. I have had to really work with disconnecting from a fear reaction: that pop sound means dislocation to my brain! The sounds were freaking out some of the nurses in the hospital, and most certainly family and friends.

I was told there would be no physical therapy during this interim, just getting up and taking care of daily needs would be plenty. But then the home health care service set me up with PT,and I assumed everything had to be cleared with surgeon, and so figured he changed his mind. We had the evaluation session, and then the next time started the exercises, with the accompanying sound effects. The physical therapist did not like what he was hearing at all, or the discomfort I was experiencing. He stopped the session, and put in a call to the surgeon, and said don't do any of the exercises until I hear back from him. I did have a new pain, on the side of my knee, and the thigh pain had increased. The PT called me back a couple of hours later, and said that the order for PT was an error! I was NOT supposed to be doing those exercises! Yikes!

My leg is still hugely swollen. Trying to keep it elevated, which helps some, and still icing a couple of times a day. It is certainly disconcerting, and gets pretty uncomfortable.

Getting in and out of the bed is painful and slow. Getting in is the single most painful action I do. I can walk with the walker, with a flat foot, and small steps. Very slow going, and very tiring.

Pain is manageable if I stay on the schedule of 2 percocet every 4 hours. I actually feel fairly comfortable some of the time. However, have had to stretch it out, as there weren't enough pills to get me through to Monday, in the prescription! The assumption was I would alternate with Tramadol, but Tramadol gives me a splitting headache. So, we will need to do some adjusting.

I see the surgeon Monday, and the infectious disease doctor the following Monday.

My feeling at this point is that I won't be trying to go to work in between surgeries. It is hard to imagine having the energy!


Has anyone else had the noise problem? Does it get better as time goes on?
I assume the pain from the incision and the muscle trauma will continue to improve. Is there pain specific to the spacer that sticks around? I assume so, and am not worried about it. The overall level is likely to improve, right?

My basket on the walker is a life saver. Still don't have a good way to move food from kitchen to my chair. I got a really nifty tray, but it does not leave room for my legs to walk and I can't get close enough to put weight on my arms. I think there must be a better design.

This is all kind of random, lol! I am sure I have more questions, and as always welcome any input, tips, etc.!

Thanks!
Kim

 

[Krista]

@dinsmaum, first let me say that I am glad you made it through the surgery and that your attitude is so good, considering everything you are going through. That's so tough about what your poor femur has to go through! Do they think it will heal well? And just how awful was that about the PT being incorrectly ordered and you having a session causing pain before it was stopped! Guess we always have to question things if they are different from what we were told. I certainly hope you can keep your pain under control, what with not enough meds because of reactions you weren't expecting. This spacer-revision thing is a huge deal, and I am very glad that you are getting extra help from your sister and BIL. If they can't stay long enough and you still need more help, perhaps your insurance would pay for you to be in a rehab facility for awhile. It sounds like you are quite debilitated still, understandably, and will need big-time assistance. Thanks for sharing what is going on, and hope things improve soon!

 

[dinsmaum]

I still seem to be missing something when trying to use the @ with your names; it doesn't turn blue and turn into a notification or link. No space between the @ and the name.
Any ideas?

 

[Krista]

@dinsmaum, I have only done it when using my computer. I type the @ and then start typing the name, with no space between the @ and the name, and then the name mysteriously appears in a box below where I am typing. I click on that and it finishes the name next to your @. Then when you post, it appears in blue as a link. I took a screenshot of when I did it for your name. Hope this helps!

 

[dinsmaum]

Okay, let me give it another try!
@Krista

Let me know if it works!

 

[dinsmaum]

Ha! It did! Great! Thanks so much!

 

[Krista]

Yes, it did! You are very welcome!

 

[dinsmaum]

@KcSweet1975 : Hello, week -ahead-of-me- friend! How are things going for you at this point? Any changes, positive or negative? Hopefully you are moving ahead steadily!
@sharonslp : Where abouts in Michigan are you? Have you been getting all the rain? About how long has it been since your friend completed his revision process? Love to hear about long term success!
@keepmovin : How did your appointment go? Did you get the weight bearing restriction lifted? What did you find out about on-going monitoring? How is your recovery continuing to go? I am really looking forward to being on the other side of the second surgery!
@glynis ,@Cynthia777 ,@Josephine ,@Krista , and anyone else I may have missed tagging: I fully intended to respond to each of you individually, but I have totally run out of typing steam. This is happening a lot, lol! But I wanted to thank you each again for your warmth and support, and helpful words. I have taken something of value with each and every response, and it means so much. The well wishes before and after surgery were like getting virtual hugs,at a time when they were truly needed! I am so glad I found this site!

 

[KcSweet1975]

@dinsmaum
Hello!! I am doing really good!!! Everyday it's gets better and better
In glad to see your doing well! I to needed the help and support from family to help out hubby and getting he kiddos ready and off to school. Mornings getting out of bed are the hardest but once in up and at it in good.
Yes! My nurse to was freaked by all the noise and the day after surgery was the gut wrenching worst as far as pain. I have to say my advice to you is get up and walk as much as you can in the house and if you have a patio sit outside and enjoy. I'm in Arizona so drinking my coffee in the mornings are a wonderful start to my day.
I had to take a leave from work because there is no way I can do my job in this condition. I'm a school bus monitor so there is no way getting on and off the bus with a walker. I am 50% weight bearing so the walker is my friend for another 4 weeks then another few weeks after the implants are put back in.
I found out the other day at my 2 weeks post op check up a pathogen grew and it's strange.. It's a skin bacteria that effects people with acne! I did read in can grow on implants as well but it's rare. I did request a allergy test to the metals to see if their is a sensitivity just in case cause I don't want to go through this again. Some people are allergic and don't even know it! I believe allergy testing should be a must before this surgery.
Like you getting into bed is the most challenging, but like I said everyday gets easier and so does getting into bed.
I'm glad I have a friend going through this with and if you have any more questions please ask.



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[sharonslp]

Dinsmaum, I'm in the greater Lansing area. I left town this weekend to see grandchildren in Denver....so I've been stuck with SNOW for the past 3 days!!!

My friend has been well over a year since his full recovery from the revision surgery, and still doing 100% fine.

Sharon

 

[dinsmaum]

@sharonslp ; we are practically neighbors! I am in Flint. Grandchildren are worth the snow, aren't they? But still, come on weather! A year out for your friend: that is encouraging indeed!
@KcSweet1975 ; allergy testing is a great idea. It makes a lot of sense. Is your spacer still making a lot of noise, or has it quieted down some? I have to say, it did get to be kind of funny to see the nurses faces when they heard it the first time. And they were even warned by their coworkers, lol! Right now, at my Dad's, I do have a deck I could sit out on and have my coffee. In fact that has been my plan the whole time. However, since I have felt well enough to do so, it has been rainy or cold. :-( So I am enjoying nature through the windows for the moment, lol! I plan to go home Saturday or Sunday, and we have a nice deck, but managing getting through the enclosed porch, and the steps may prove challenging. However, I will be stronger by then!
Tomorrow I will go out for the first time since leaving the hospital, for my 2 week check up. Hoping to get the staples out, but we will see. My leg is still too swollen to fit into my pants, but I have hospital pj bottoms that will do. It just occurred to me that in addition, my foot is too swollen to get into my shoe! When I came home, it was a dry sunny day, so the few steps from the car to the condo were okay with just my hospital socks. Tomorrow it is likely to be wet, plus a long walk from car to office. Slipper socks aren't going to cut it, lol! Not quite sure what I will do. It could involve sacrificing a pair of shoes! ;-)

 

[glynis]

Well done. The sound effects sound a bit of a nuisance, but other than that you seem to be doing fine.

Regarding your tight trousers... at the risk of being obvious, don't you have any skirts? I soon found out that loose skirts or dresses are more comfortable round the house. And they are better for appointments, too. As soon as the X-ray or examination or whatever is over you can drop them back down and feel comfortable, rather than struggling to pull up your trousers and getting them stuck at half mast, just at the point when the consultant is giving you the most important information.

I only had 2 reasonable skirts, which I wore over and over, before resorting - in the middle of winter - to one short sundress, and one kaftan which I bought on a street market in Zanzibar for £10. That was a good buy! I don't know if you use the expression in the US: "Pride must abide". Meaning that at times your appearance has to take second place to practical matters. I had that well in mind as I set off in the snow and rain, dressed for a tropical island holiday.

I can relate to swollen feet, and I'm afraid that lasted quite some time. (Though it is something I've been prone to, over the years.) The only thing which helped me was sitting with them raised up on a stool. But it does go away eventually.

I had a 3-year check up last week and all was well. My infection had been so extensive that I had had to have bone grafts, but apparently these have taken very well. It's a long slog through a revision, but there are rewards to be had. Hang in there. Remember: "This too shall pass".

 

[keepmovin]

Hi @dinsmaum - You sound to be in good spirits, considering everything, and this great to hear! Interesting about the cracked femur they found once they got inside! I suppose this is a bit of a silver lining as I suspect that crack would have split sometime down the road causing a lot of damage!

I went through the same silly nonsense with my home health care wanting me to go through PT. I had one session and then the practical side of me kicked in. I cancelled the home PT until I received my new hip. I'm glad you are not doing PT with a spacer.

When I think back on my time in the hospital after the spacer was put in, I cringe. It was the worst few days of my life. The nursing staff didn't understand how to treat a patient with a spacer. It's different than someone going through a hip replacement and that's how they looked at my case. Of course, I had the misfortune of having extreme pain from my spacer. And the noise....I can still see the look on the face of one very young nurse who just didn't know how to react to the noise! Funny now when I think about it. I think the noise stayed with me for quite a few weeks. I remember the last two weeks, things improved for me. My pain subsided a little and the noise factor decreased.

My baskets on my walker were my lifesavers! I had a pretty big basket on the front which held quite a lot. I was able to get my meals from kitchen to table without a problem. It was so big that I couldn't get it through doorways, like into the bathroom, so I kept my crutches handy for these purposes.

How long will you have the spacer in place? It varies depending on circumstances and now that you have the plate installed, I was wondering how this affects your time frame before the next surgery.

This is a very slow journey, but if you know that and don't fight the urge to make things happen quickly, you will feel calmer about getting through this. I will be updating my status shortly - 6 weeks tomorrow and all's going well!

Hugs and blessings,

 

[KcSweet1975]

@dinsmaum
Hello
Yes! it was so funny to see the look on the faces of the nursing staff!! It seems they don't often have cases like ours.
I am doing no pt, I had 2 days of it in the hospital and that was it. I remember a lot from my first go around of the replacement and use it here at the house.
My noise has quieted a bit, it only happens when I get into bed or leaning over. My pain levels are decreasing more and more as the days go by and hope yours does as well.
Like you I take 1-2 Percocet every 4-6 hours and that works for me.
The only thing is my pic line itches like there's no tomorrow!! It's under the tape but the nurse that's visiting today to change it is getting hypoallergenic tape to help with that.
I can take showers now and that's real nice rather than sponge bathing and washing my hair in he sink. What a pain!
Sow and steady is how I see this part of the journey and as far as clothing, if you have dresses or baggy shorts and slip on shoes that's what I have been wearing. The sweeping will subside soon as mine did a few days ago.
Take care and have a great day!


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[dinsmaum]

@glynis : Oh my gosh, I had to laugh! At myself. Skirts just completely did not occur to me, and yet it is so obvious, lol! I don't actually have any that fit right now, as I lost a fair amount of weight ( the healthy way, lol!) over the fall and winter. But that is easily remedied!
I ended up going out for the appointment in my bed slippers. They have a rubber sole, so I had good traction. I grumbled to myself a bit, but once I was up and out, I didn't think about it again. Wore the hospital pj bottoms, but had a matching blue shirt, lol! I like the saying "pride must abide" and am going to add it to my vocabulary!
@keepmovin : It looks like the plan is to do the second surgery in 6 weeks, so the spacer will be my close friend until then. I looked over the xray with the surgeon today, and just seeing that, a whole lot of what I am experiencing made more sense, particularly the noise and the thigh pain.

Got my staples out, there were well over 70! I joked that I just lost 10 pounds! It was fine, a little stingy here and there, but totally no big deal. The incision is healing very well, they say, the spacer looks solid and in place, and everything seems to be moving forward. The swelling does respond to elevation somewhat, so I will just keep doing that, unless I opt to try compression stockings. Got a refill for the percocet, and now feel like a human being with some pain, instead of a big walking talking bundle of pain posing as a human! I am hoping to get some decent stretches of sleep tonight, unlike that last couple of nights.

I had a terrible time getting in and out of the condo, which was a shock. There are only two steps, or maybe three, and I just could not manage them! I was absolutely astounded. I don't know if it is the steepness, or what. It took me, my friend, the walker and both railings, and it was still a struggle, and painful. I am hoping the occupational therapist will be coming tomorrow, and can help me figure that out. Puts a damper on going home, where I have 6 steps to get inside, and 15 or 16 to get up to and down from the bedroom and the bathroom with the tub and shower.

It was so wonderful to be outside! It was a little chilly when we first left, but still just so fresh and green and bright. There were flowering trees everywhere, and tulips and daffodils and forsythia. Just so, so lovely and refreshing!

So, the plan as it stands: follow up again with surgeon in 4 weeks. Aspiration in 5 weeks, and if that is good, stage 2 surgery in 6 weeks. I am learning, from all of you and from my own experience, patience is the key, being in the moment, and not trying to rush things.

Thanks everyone!

 

[glynis]

Just call on Professor Glynis if you want any more ground-breaking ideas, such as wearing a skirt. My rates are very reasonable.

What are you using for icing? I found wraparound bottle coolers to be very useful. You need the ones which fasten with Velcro, and open completely flat. They can be used in most positions, and keep their shape even when they begin to thaw. I have recently had another small accident and cracked my kneecap, so once again they are doing service for me. This is the kind of thing:


https://www.amazon.com/Deluxe-Bottle-Chiller-Sleeve-Champagnes/dp/B000NLFUG0?tag=ate362da-20

Can't think of any advice I could offer about the stairs. I did find stairs difficult. We had only recently moved to this house before my accident. It is "an upside-down house", insofar as the living accommodation is upstairs and the bedrooms downstairs. I wondered if I would have trouble getting used to it - as it is quite unusual in the UK - but I did score on that one, as it turned out.

Some you win...

Glad to hear your surgeon is pleased with your progress.

 

[dinsmaum]

Hey everyone! I made my own dinner for the first time post op! Thawed some frozen brown rice, tossed in a can of chick peas, some chopped spinach and cucumber, various spices, and some fresh squeezed lemon. Microwaved a sweet potato. And that, my friends, wiped me out so much I had to rest before I could eat, lol! But it is progress!

I am planning to go home this weekend, once my son gets back from his out of town trip. I still can't do stairs, much to my puzzlement, so will need to find out how to rent a hospital bed for the main floor. They ask if you need during hospital discharge planning, but at that time I had no idea this would be an issue!

My vancomycin levels were too high this week, so my dose is reduced. I do infusion once a day now, instead of twice, and a smaller dose. I know the window of safe therapeutic value is small, that is why they do the troughs. It makes me a little uneasy that it went up that much. I want ALL the medicine, you know? To wipe out the infection once and for all. At the same time, I really do want my kidneys, too!