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Knee Infection* Alternatives to spacer & antibiotics<

Glad to help---it helps that in your case, the solution was just sitting there!!!
 
So, I called to get an appointment with my cousin. Lady said he wasn't taking any new patients. I told her he was my cousin. She took all the info. It has been a week and he still hasn't called me. Thanks cuz!!! My son has been having trouble with his hip so he was recommended by a friend to a Specialist in Decatur. An hour away. He really like him though. But now I have to call and see if he is even in my network. UGH!!! I am really so tired of all of this. I just want to sit back and enjoy Christmas. Is that too much to ask. So, I have an appointment next month on the 17th. And I will let you know what he says. Thanks again everyone!!!
 
Madbkseller said:
So, I called to get an appointment with my cousin. Lady said he wasn't taking any new patients. I told her he was my cousin. She took all the info. It has been a week and he still hasn't called me. Thanks cuz!!!
Click to expand...
Be pushy. Call him at home - ask other family members for his phone number, if you don't have it.

My brother-in-law is a consultant surgeon and his office filters who gets to speak to him. The only way to get through to him is to phone him at home in the evening.
 
I am with Celle---tell your cousin you need his opinion---we all love to feel important by our family.
 
I agree with the others. Get that cousins cell phone or home number and give him a call. He might not have even known that you called at all. If he still says no that's one less Christmas present you need to buy!:heehee:
 
Update. My cousins nurse did call me back about a week after I called. She wanted me to pick up my records and bring them to the office so he could review them before we set an appointment. Meanwhile, my son, who has problems with his hip from an accident when he was 12 found an OS about the same distance away that he really likes. He had a friend who was going to have hip replacement but went to this Dr. for a second opinion. The doctor did a surgery where he reshaped the hip and he has had no problems since his surgery. My son suggested that I go to him. He said he has only been out of school for 8 years and hence knows all the newest procedures. I have checked on Healthgrades and he is highly recommended. So, I have made an appointment with him for January 13. Friday...the 13th. OUCH. LOL.... So, I will see what he has to say and then go from there. Right decision???? Hope so.
 
It never hurts to get another opinion. A second or third opinion is good insurance. I'd still see your cousin as well.
 
I wish I had the money to be able to go to both, but I don't think I can. So, besides having my right knee "clicking" out of place...Now it has begun to give me extreme pain. It radiates from my knee on the outside, down and up on the outside as well. It comes and goes. I have had to get my walker out from when I had my surgeries. The pain is an absolute 10. I can't walk at all. Then it just goes away for awhile and then comes back. I have never experienced anything like it before. Help. Any ideas what it could be. I do have the appointment with my new OS and will definitely ask him about it but that isn't until next Friday. I can't believe that I might be stuck on the couch for a week. Luckily I don't have anything that HAS to be done. Just when you think it can't get any worse....it does. GEEZ
 
Ok...so here's more of my story. Sorry it is so long. A couple of weeks later, UPDATE

Oh my gosh. Just when I think that things can't get any worse...they do. So, Tuesday I went to my new OS. As usual I was put in the room and told that it would be just a minute before someone came in to see me. After quite a long time a girl came in and said, are you ready for this, "Why are you here to see the doctor today." I almost fell out of my chair. I told her that when I was there before that he wanted to get more records from my previous OS. I also told her about the lump on my knee and he was going to do an aspiration today. She asked me if he had ordered blood work. I said that I was never given any paperwork for it and he had not mentioned it to me. So, she said well, hold on and she left. I sat there, so frustrated, put my head between my hands and started crying. I AM NOT a crier. Not at all. She came back in after awhile and said, Oh, don't cry. It will be alright. I told her that I had been hearing that for over 4 years. She said that the records did not show that he had ordered blood work, but he would be in in just a few minutes.

Pretty soon he came in. You could tell that he too didn't know why I was there. He said that they were still "working on" getting the rest of my records from my previous OS. He said that he thought that he would do an aspiration of the lump on my knee and see if it showed anything to give him a clue as to what was going on. His assistants proceeded to set up the stuff for the aspiration. He came back in and they swabbed the stuff all over my knee. It started running down my leg and no one made any attempt to keep it from getting on my socks.

Sorry this is so long. He pulled out a long needle that was very thick. I am not afraid of needles...but Geez!!! He put the needle in, nothing, pushed it in further, nothing.... Moved it around...hit a nerve...OUCH. Nothing... It seemed like 10 minutes but it was probably more like 2. He got NOTHING out of my knee. He finished with that, bandaid...and then said that he wanted to do some blood work and then would see me back. Oh, and I asked for a stronger pain medicine. I do have Tramadol, but that is for my back troubles. They said I needed to ask my GP for that.

So, all of that for NOTHING!!!!! I hate it. I am so sick of this. I am SICK of doctors who seem to not care at all about what is going on with me.

On the way home, oh, by the way it's an hour drive...I stopped and looked at some recumbent bikes. I have decided that I am going to get a bike. Try to strengthen both knees. See how that works. Then maybe....

Remember before when I told you that my cousin is an OS? Well, I don't want to go back to any of my previous doctors, so I am thinking about down the road going to see my cousin. I am a Christian and listen to Christian radio. You know how you ask for signs from God sometimes?....well, I was in the bathroom and had the radio on and they said that someone wanted to dedicate the day to their doctor, Dr. Ted Maurer, because she was having hip surgery with him that day. Oh my gosh, that is my cousin. I have NEVER heard anyone dedicate a day to their doctor. I was in shock.

I have decided that I don't have enough confidence/trust to go back to the last OS that I saw so I called to get an appointment with my cousin who is also a revision specialist. I can't get an appointment with him until the end of June. AAARRRGGGHHH!!!!! I even "secreted" a note to him when I took my records over to his office last week, begging him to get me in earlier. He is MY COUSIN...and he had his nurse call and say that was the earliest they could get me in but put me on a cancellation list....
Ok...so I know that there can be some popping and stuff with a TKR...but since I have this huge knot on my knee is sounds worse with the grinding then it did when it was bone on bone. I am totally lost as to what to do.
I am going to call both my previous OS's and find out who the manufacturer of my equipment was for my replacements. Do some research there.
Now, another thing. My cousin's daughter's husband is my GP. He goes to church with my cousin who is the OS. Should I get an appointment with my GP and show him my knot on my knee.....tell him I am trying to get in with my cousin....and see if he will talk to him about it??? Just a shot. LOL:what::what::what:

So, I went to my regular doctor. Told him about how much pain I was having. He had prescribed Vicodin before and it doesn't seem to help at all. 1/2 does nothing and a whole one just makes me sleepy. He suggested that I try oxy so I have that now. And guess what??? Nothing....it actually does nothing. Doesn't help the pain or make me sleepy or even get me high. Darn it!!! LOL. He asked about my OS. When I told him it was my cousin and that I couldn't get in to see him until the end of June....he was shocked. He picked up his phone and was going to text him right then but he didn't have his number. He promised he would talk to him about how much pain I was in and then get back to me but I haven't heard from either one of the yet.

So, now, the back side of my knee feels like I have pulled a muscle. But I know I didn't because I don't move around enough to pull a muscle. The weird thing is that even though the back of my knee is killing me my knee itself doesn't feel bad at all??? And there is like a new "Sliding" feeling when I walk.

When I stood up from my couch earlier today I told my husband that I can't even believe that for over 4 years I hurt every time I stand up. Like I said before...sometimes it hurts so bad that I feel like I could almost pass out.

So, now, should I call me GP, Pete, and see if he talked with my OS and see what he found out about getting me in earlier, if anything... Or should I just get an appointment with the Dr. who did my revision and see what he thinks I should do?

Sometimes I feel like all I am doing is making the wrong decisions. I feel like I could write a book. I'll bet a lot of us could.

Thanks for your help. I truly appreciate it.
 
O my goodness. IMO I would call your GP, your cousin at home, any of your relatives who can call your cousin and get them to help you now. You know there is something wrong and he is family. Don't go back to the OS who didn't even remember why you were there. Gather as much info as you can get together and fight for yourself. In my job as a nurse there have been many times when I had to call multiple times and multiple doctors to get the help my patient needed. It a sad time in healthcare where if you don't push for yourself it seems no one else does either.
 
Sorry to hear your revision is still giving you a lot of problems.
For the type of implant you have, call the hospital and ask for the sticker sheet, you may have to sign some medical release papers. The sticker sheet will have the type of implant, size, and serial number.

I think getting your cousins opinion is a good idea and a place to start. I agree with Marian, only you can advocate for yourself.

Will your GP or regular Dr order a c reactive protein test for you? It is an indicator of inflammation, and will be helpful for your Cousin to have at your first appointment.

Hope you find some answers soon, :console2:
 
I know all of this has completely worn you down. Pain and frustration can do that. But the posts above are right....it's time to be the "squeaky wheel." I can't believe that your cousin couldn't work you in somehow as an emergency. Family is family!
 
oh what a sad story---and I can not even imagine how frustrated you are!!! I think your best bet is with your cousin. When I am on the cancellation list, I often get in way earlier than my regular appt. Don't worry, at my Pulmanologist he said that someone cancels every day at least.
!
 
Just when you think things are looking up...well..you know. So, I had a TKR and 18 months later a revision because it had come loose. Then last August 2017 I had to have arthroscopic surgery to remove scar tissue. After I healed from that I virtually had no pain in my surgical knee. WOW. it was great..but temporary.

Little by little the pain started coming back. I saw my OS's PA and he thought that if I did more exercising and walking and strengthened it that I might see some relief. I did that and nothing helped. I returned to see the PA on 4/13/2018. He looked at the x-rays and said he didn't see anything wrong. Asked me to try the stretching and exercises another month and meanwhile make an appointment with my OS. So, I did.

My appointment with my OS was on 5/23/2018. He said he thought there was another build up of scar tissue again. Did I think that I would like to try another arthroscopic surgery? I said sure. He said he wanted to do blood work to make sure there was no infection. He didn't think there was, he felt my knee and asked if it had been warm or swollen? I told him no, but wanted to make sure before he started the scope and then ran into any infection. I have had NO SWELLING, NO DISCOLORATION, NO WARMTH AND NO FEVER. So, he sent me to have blood drawn.

He believed that we would have the results right away. His nurse call me the next day and said some of the counts were a little high, but there were many things that could cause that and he wanted to do an aspiration to double check. I went back a week later, 5/30 for the aspiration. It took him a long time to get any fluid at all, but when he got some it was reddish and had some cream color as well.

He said that they would get some results in 2 days and the rest in 5-7 because they had to culture it. I left for vacation 2 days later. On the following Tuesday, 6 days later, his nurse called and said that there was infection. She said the CRP was 1.7 and she didn't have the number for the ESR but it must have been high. She said Dr. wanted to see me asap. I told her I was in Florida.

She went on and on about how important it was for me to see him and that I could become septic. I told her I couldn't get back until the next week. I mean if I hadn't gone in no one would even know that I might have an infection. His PA and himself neither one thought there was infection. So, now his nurse told me that he probably wants to talk to me about having a spacer, daily IV antibiotics, no weight on my knee for 3 months...etc. I really don't understand. I have absolutely NO symptoms of an infection.

Here are my questions. First, should I ask for another aspiration? Just to make sure.

Secondly, are there no other options to spacers? I have read about debridement and antibiotic flushing, then IV antibiotics until infection is gone.

I am - was - a very active person. I have already had trouble with the two surgeries and then arthroscopic surgery. I truly don't believe that I could survive 3 months of not being able to get around. Also, I would be soooo afraid that I would accidentally put weight on my knee.

Please help me. I am wide open to comments and suggestions.
 
I feel your pain. Literally and figuratively. I too have an infection and can add some insight

Your CRP appears to be in range? Why didn't the Dr give you the sed rate results?

Also, you don't necessarily need to feel sick or have a fever to have an infection. I have neither but have had pain and swelling since day one and my CRP and sed rate are in the high range.

If you don't feel comfortable with your OS' diagnosis maybe get a second opinion? And of course wait for the more knowledgeable people on here to respond.

Wish I could be of more help.
 
Hello @Madbkseller

I'm sorry to read you're back with another problem.

You'll notice that I have merged your newest thread with your original recovery thread.
Since your original thread was in 2015, I wouldn't normally have done that. However, merging your threads will give us a much-needed continuity of your knee's history.

For most recoveries, we do prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
 
@Madbkseller

I hope that, when your surgeon sent the knee aspirate off for culture, he requested that the infective organism be identified, together with which antibiotics it is sensitive to.
It would be a good idea to ask to have an infectious disease doctor on board for your treatment, as well as the surgeon.

Has your current surgeon had experience in dealing with infected knees? If not, you need to find a surgeon who has. You need a surgeon with a lot of experience for this.

When your surgeon talks about an antibiotic spacer, it will not be a matter of a simple spacer replacement.
If he is talking about a 2-stage revision, the TKR hardware should be removed and replaced with an antibiotic impregnated cement spacer for a period of months.
During that time, you should be given the appropriate antibiotics intravenously and orally.
You will be able to get around on crutches or a walker.

Once all signs of infection have cleared, which usually takes some months, the spacer will be removed and a new set of TKR hardware inserted.

I think you need to see your surgeon and discuss your options, so you have more facts on which to base your decision.
It may be that an aspiration and washout is sufficient, but possibly not.

Here are some article about knee replacement infections:
Acne pathogen implicated in peri-prosthetic infections
Peri-prosthetic infection: study by the Mayo Clinic concerning prophylactic antibiotics (Scientific Articles)
Peri-prosthetic infection - also known as late onset infection
Periprosthetic infection: Mayo Clinic study shows that dental procedures are not a risk factor (Scientific Articles)
Periprosthetic infection (Scientific Articles)
Peri-prosthetic infection: study by the Mayo Clinic concerning prophylactic antibiotics (Scientific Articles)
 
I am so sorry about this problem. Since you are in Florida are you near MAYO? I think I would get a second opinion before I agreed to anything so drastic and yes, you need an infectious disease specialist on your team.
 
arizonaone: I got the crp from my doctor's nurse. She was looking at my chart and some notes he had made. She said the ers wasn't on there. I think maybe she didn't want to scare me. Also, like I said I have only had pain, similar to the pain that was resolved after my arthroscopy. I have never had swelling, warmth, discoloration or fever.....
CELLE: I have an appointment with my OS on Friday. I have a lot of questions to ask. I am not a person who just accepts what I am told by a doctor or anyone else. One of my questions, if he doesn't say so first, is if an infectious disease specialist IS on board. I do understand the whole two-stage procedure. I am just extremely worried about getting around with wheelchair/crutches or walker and not injuring the area of my spacer. Do you know of anywhere, here or website that gives you suggestions for what you need to plan for when you come home? Also, do you know if after some help will I be able to be home and do my IV antibiotics myself? I understand that I will have a PICC line. Right? Geez and they say God won't give you more than you can handle. Well, I think he's pushing it a little bit here. LOL.
Thanks to you all for your help.
 
The red 'KNEE INFECTION' title will take you to those who have had infections if you click on it. You are sure to find some really good information there.
 
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