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Knee Infection* Alternatives to spacer & antibiotics<

I think that most people are able to give their own IV antibiotic through the PICC line.
Is that right, @KarriB ?
 
I was able to give myself the antibiotic infusion through the PICC line. The day I came home from the hospital a home health care nurse visited my house and brought everything I’d need for about a week, including wipes, syringe, flushing syringe (can’t remember what it’s called) tape etc. She showed me how to do everything, but I highly advise someone being there with you to take notes and overall know what’s happening. My sister and friend were with me which was a blessing because I was exhausted after leaving the hospital, the drive home and getting settled. Giving yourself IV meds is much better than having to go to a clinic or hospital everyday. I did try to make it the same time everyday when I would be settle in, not up and about. Depending on the machine they give you the time varies. It took 45 min to an hour for my antibiotics to run. My ID wanted me to take a good probiotic to help with all the meds as I was on oral and IV antibiotics.

I didn’t have a two stage revision ( just a washout/debridement and spacer exchange), but I know people who did. They were allowed toe weight, but every doctor is different. My OS told me I’d be toe weight only which would’ve made stairs difficult.
 
KarriB, thanks for the info. I go to see my OS on Friday. I was wondering if you might have any suggestions that might help me if I do for sure have to have this surgery? Like, needing a wheelchair, walker or crutches. Making casseroles and freezing them? You know stuff like that. I am at a complete loss thinking about not being able to put any weight on my knee. I am totally freaking out. So very tired of messing with this knee. You Know???
 
Madbkseller- Like you I am also really worried about getting around with the spacer and doing injury to the area around it .And the picc line worries me too. My OS told me that a nurse would come to me to administer the antibiotics. But my question was what would I do if my insurance didn't cover that .He said then I'd have to actually go to the ID doctor's office for them to do it. I'm nervous about that scenerio because how would I get there.

Although I initially was against it, I decided to go into a rehab facility for a few weeks after they put in the spacer because I live alone. Maybe this is something you could consider? I think I'll develop more confidence to go home after being under the watchfull eye of professional (I hope) caregivers .

I think what scares us most is the not knowing. But others have gone through this and I know we will be just fine once we get to the other side.
 
I had my surgery June 4. I didn't know going into it if I would come out with a knee or a spacer and all the uncertainty was absolutely the worst part. Thankfully I have a knee and not a spacer BUT my infectious disease doctor isn't sold on it being the right thing to do. I am trusting my OS. The PICC line is scarier sounding than it is. Whether you do your own infusion or someone comes to you or you go somewhere depends on your insurance, how many you need each day, and where you live relative to an infusion center. I am doing twice a day, 8:30 am and pm. A nurse comes twice a week to draw blood and one of those times she changes the dressing on the PICC line. She will take my staples out tomorrow. The anxiety of not knowing what would happen was the worst.
 
The PICC line is not a big deal, I worried about it and even had an anxiety attack when a nurse mentioned the procedure. It was winter for me, so I wore long sleeves which covered the site and sort of protected it, but I think there are sleeve protectors you may be able to find at a pharmacy or medical store. But I was able to give the antibiotics myself or with the help of family, however the nurse did come once a week to change/clean the dressing and take a blood draws. I don’t know how I would’ve handled going to an office for infusions everyday. Fighting an infection is quite tiring not to mention the nuisance of getting in/out of a car.

It really all depends on what your Dr says about weight bearing. I’d think you could get around the house with crutches as long as you don’t have any shoulder or hand issues, but may need a chair for other activities that require a lot of walking. My house isn’t huge, even a walker was tricky in my narrow doorways. If you can use a walker in the house you can get a plastic basket with a flat bottom and zip tie it to the walker to help carry things. We did this for my dad when he had his THR. Although my mom was there, he likes to be independent and the basket helped him to carry snacks, mail, the paper etc.

Making/freezing meals ahead of time would be a good idea because just like after your TKR you won’t feel well enough to do much besides grab things from the kitchen. Our local Walmart does a grocery pick up. You order and pay on line, then just drive to the store for pick up. Friends or family can pick up for you until you’re driving.

@arizonaone if your insurance covers a rehab facility chances are it’ll cover home health care, but possibly not every day.
 
@KarriB Good to know. Thank you .They do cover rehab amd I plan on calling them in the morning to see what they will and will not cover . And for how long .
 
So surgery is Thursday. 2 more days. I am wondering if anyone knows exactly what will make my OS decide whether to do an antibiotic wash with my knee open or if he will have to do the entire knee removal with a spacer. My friend had same as me. I asked her about her experience. This is what she said:

"Yes I did have to have the new knee taken out for 3 and 1 /2 months and iv antibiotics 3 times a day for all 3 1/2 months. I won't lie to you, i was devastated. After putting in the new knee, then he had to put in a new pad. When i still had the infection, he then had to take the whole knee out. You will have to learn how to walk all over again. Your brain says of course I know how to walk, but your body says oh no you dont. I got cdiff twice from all the antibiotics from cdiff and I then got cellulitis I was out a whole year from work. Because i had cdiff and cellulitis after the infection was gone, they put me back in the hospital to treat the cdiff and cellulitis. I was back in the hospital for 3 more weeks. I was so sick with cdiff I did not get to rehab my knee, quickly, therefore, my knee did not get the bend, it needed."

So now, besides worrying about everything else....is it common to get cdiff from the antibiotics that I have to have? I am getting more and more scared as I get closer to my surgery.

Please pray for me. I trust God and I believe that he has my life in his hands. BUT...I am just a person looking towards a very serious surgery.
 
Madbkseller said:
Please pray for me.
Click to expand...
I just did!

Clink on the red buttons that say infection on them on the recovery forum page and you can learn from those that had an infection. I can't tell you too much myself but I can and will continue to pray for you!
 
When I had my infection surgery my OS said he wouldn’t know what he’d need to do until he got in there. In the end I had a washout/debridement with a spacer exchange. If you have a washout they’ll most probably exchange the spacer. I was on oral and IV antibiotics but didn’t get Cdiff, but my body did stop making white cells as a result of the antibiotics and it took 2 weeks off them to kick start my body into making white cells. My ID told me to take a good probiotic and eat yogurt. I still take a low dose of antibiotics everyday.
 
Mine says he won't know until he gets in there either. Did you find out from him what the deciding factor was?
 
I was just wondering, is it imperative that I go to PT. Last time I had to go 3x a week and it cost me $30 a pop. Really can't afford that on top of everything else.
 
If you look through the Bonesmart opinions, the answer is no. I am lucky enough to have pretty good insurance, and so I am doing home PT and she has a much different approach than I had with my original surgeries, and which I like a lot, but I don't think I'll do the outpatient PT.
 
I started on vancomycin, but after 15 days they switched it to daptomycin. I had an itching reaction at fitst, then later dizziness, and later still, ringing in my ears. I am taking a probiotic (actually started it about 2weeks before surgery) and eat a yogurt every day. So far, so good on that front. My OS said the deciding factor to the one stage was the amount of bone loss I had. We didn't get a straight answer why I had so much bone loss.
 
@Madbkseller ,
I moved your post #93 to your thread, as the question pertains to your recovery, along with MathProf reply.
This will allow you to look back on your recovery, and find the answers to your questions.
 
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Hi @Madbkseller. Your friends experience is very different and scary sounding. After taking out my prosthetic the surgeon would not put in a new replacement until they were sure the infection was gone. My recovery for the revision was pretty much the same as the original. The only difference was the tendon work restrictions. I don't think c-diff is the norm but I am not the expert. Keep the probiotics going and clean habits.
 
Along with the infection I had my patellar tendon rupture and a fractured patella so there a couple more procedures that had to be done before the final replacement. My time on the antibiotics was 6 weeks with the PICC and another 4-6 weeks of the oral antibiotics. With the final surgery they also transplanted a patellar tendon/patella/quad tendon (allograft). I had to keep the leg immobile for the first 6 weeks after surgery. After that the recovery was just the same for the TKR. My knee was out for a total of 11 months (not the norm) because of those complications. I believe you have to finish up the antibiotics and they will check to make sure the infection is gone before they put the new knee in.
 
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