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Knee Infection* Alternatives to spacer & antibiotics<

@Madbkseller, My PT just left and we were talking about what my ID said yesterday that I would be on an oral antibiotic for at least 3 months after my PICC line is removed. The PT said, "be sure to keep taking Florastor so you don't get C-Diff." I had talked to my PCP and she had said to go for a probiotic that wasn't the most or least expensive. But my daughter had Florastor recommended to her. I switched from the more generic probiotic when they took me off vancomycin, and I think I'll stay with this one for a while. It is expensive but there is a coupon online for $10 off at the company website.
Also we spend part of the year in Galesburg, and I see you are from Lincoln. Are you working with a doctor in Springfield or Peoria? Just curious.
 
I’m late to the discussion. I had a debridement and washout if my knee for an infection. My infection was from MRSA. Since it was considered an ‘early’ infection ( within a couple of weeks of the original surgery) my OS did not do an antibiotic spacer and removal of the knee. I hade a PICC line for a couple of months and was on Vancomycin once or twice a day depending upon my blood levels. I had no restrictions on putting weight on that knee. I did have a lot of pain and didn’t want to walk very often but did what I needed too. After the PICC line I was on an oral antibiotic twice a day for a few months. An infectious disease doctor prescribed the antibiotics and followed me in the hospital and once I went home until I was through the antibiotics. I was told the infection could come back but fortunately it never did. As far as the c diff problem the Vanco didn’t cause that problem for me nor did the oral antibiotics I was given. My ID doc told me the antibiotics I was taking usually didn’t cause c diff. I did not take any probiotics at all and had no difficulties.
 
Well, I had my surgery on 6/28. OS was hoping to only have to do the antibiotic wash, but decided to go ahead and do the two stage procedure. I was in hospital overnight and was released the next afternoon. Went home and had to have my poor husband, daughter and son pull my fat backside up the front stairs. Got settled in my recliner which is where I have been since I got home. So much easier getting into and out of than my bed. I am now able to take my wheelchair to the door of the bathroom and then walk with my walker into the potty. I can also get to the back door and let my dogs outside. Every little bit I can do makes me feel a little more "normal". I do have a PICC line in. Wow...it's so easy. I give myself my antibiotic 2 times a day at 9. The Infusion and Home Health care nurses have all been great. My pain is very minimal. First week I was on Narco every 6 hours. Now I only take a half of one when needed. The home health nurse took my staples out on Thursday. It pinched a little with every one but it was tolerable. I have my last infusion on 8/9. Nurse said that if they have seen no more infection for awhile before that then I will be able to stop. I see the ID doctor on 8/8 and then my OS on 8/10. Hopefully I will be cleared by then and be able to schedule my next surgery to get a new knee in and try to start getting back to normal. I honestly believe that all the worrying I did was just the fear of the unknown. I do try to keep the attitude that if I am worrying I am not trusting my life to God.....and I definitely trust my God.
I have no new questions for you today....just wanted to update for anyone else who is getting ready to go through this that it obviously isn't fun....but it's doable. Thanks for the support that you have all given me through all this.
 
You have a wonderful attitude! It sounds like with your positive outlook and faith in God, you will come through this just fine. :prayer::prayer:
 
Welcome home again, @Madbkseller
Just to confirm - so you had the original knee hardware removed and an antibiotic spacer inserted?

I'm glad you're managing the PICC line so well.

It sounds as if your domestic arrangements are going well. It's good that you can get around in the wheelchair, so you don't feel totally helpless.

Here is the recovery reading we give to everyone. Mos of the articles will apply to your surgery, too.
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
What a great attitude. You have been through a lot and deserve some down time and support from us and our members. I hope all goes well in August and put an end to this period of your life!!
 
Yes, any bit of normal goes a looong way! I’m happy to hear you’re home and getting around a bit. The whole surgery/infection scenario was difficult because I felt out of control, but I tried to remember God was in control even though I wasn’t. I’ll be thinking of you.
 
So, new question. After I get my new knee in and stuff, how do I make sure that I NEVER get another infection. Will they likely put me on oral antibiotics? I can't even IMAGINE having to do all this again.
 
Yes, the usual procedure is to put you on antibiotics for a long time.
Your Infectious Diseases doctor (ID)shoudl still be on your team.
 
This is my biggest fear too. I might be wrong, but the best information I can find seems to indicate that blood tests need to be done and that CRP monitored, which your ID will do. As I said on my recovery thread, I am looking at this like I did when I had breast cancer. I had surgery, radiation therapy, no chemo was indicated. Then I took an oral medication and went for blood tests for 5 years. I had a cancer marker that bounced up and down, but was always "high" but eventually, the oncologist said, "You're good to go." And now I'm 9 years cancer-free. The longer I go, the less likely it is to recur, and that is the attitude I am having here. That I might not really know for sure, until it is long enough - who knows how long that is - and then I'll be okay. And maybe like @KarrieB, that will mean antibiotics forever. I feel your pain....I really do. It scares the you-know-what out of me to think about a recurrence. Hubby and I debated this today (with me in tears).
 
Hurrah!! Hurrah!! I just got a call from the Home Infusion Office. They said that my vancomycin counts have FINALLY stabilized and they will only have to come out and draw blood once a week. I didn't mind the blood draw because it comes out of my picc line, but we have 2 dogs that I don't totally trust around people they don't know, so we have to put them outside. They are getting smarter...and it is getting harder to convince them to go outside. LOL.... So, instead of 3-4 times a week only once...that is going to get easy. I am on 750mg 2x a day. Pretty good my nurse said. So good report today. My husband just went to get Taco Bell and then we are going to watch a movie. Good Day.... Thank you Jesus. Thanks to all of you for your support too!!!
 
What good news! Now, you and those dogs can relax!
 
Ok so new question. Did you only have to have the usual 6 weeks of IV antibiotics or did you have to have more? Do you know how the ID doctor knew that your infection was gone so that they could stop the IV's? Today is 5 weeks on IV's and so I go next Friday to see my ID doc. Do they just do a CBC and then the other test for those two (ESR/CRP) counts? Then same day I see my OS. After I see him then I have to wait 2 weeks and then have an aspiration...right? Then HOPEFULLY....PRAYERFULLY... I will get scheduled for getting my new knee in.
And, why couldn't they do an aspiration? I will tell you my OS couldn't get anything out for a long time and he kept moving the needle around and around....UGH. He finally got it to start drawing but OMG...so much pain.....
 
I can't believe how much the aspiration hurts. You could NEVER describe it to someone...WHEW!!! I had a trough drawn yesterday. Dr. said still looks good so I have another week of the same strength...then I go next Friday to see her. Hopefully she will remove my PICC and be done with me. Then on the OS same day. Yes...I know I can do it and thanks for the encouragement. I haven't had any crybaby days yet. I had a couple with previous surgeries. I just got really down and depressed but good so far with all of this mess. Go figure... this is so much worse in a way. Maybe I'm just getting used to being disabled. My cousin is a parapalegic...it sure makes me appreciate his situation so much more. Good luck on Monday. I'm sure everything will be fine. So nice talking with you.....
 
@MathProf So - what I think is double bad news. Well, I went to my OS on Friday. He did the aspiration, OUCH!!! again.... Nurse came in to schedule my replacement surgery for my antibiotic spacer. October 30th. Yes, that's what I said. So now I get to sit with this straight leg for another 9 1/2 weeks. It has already been 8 weeks and I thought that was hard. I did ask her to put me on a cancellation list, which she said she would do. Then she told me that Dr. said I have to quit smoking. Completely. Or he won't do the surgery. Talk about having you over a barrel. I know you'll say that it isn't good for me to smoke....as if I didn't already know that but geez..... I know the reason is because smoking deplete the oxygen in your blood and makes healing harder .... I know all that.... Just know how hard it is going to be to quit especially since I will be sitting here with not much to do....WAITING. Ugh!!
 
Oh, man! I don't know what to say about another LONG wait. And if he wanted you to quit smoking, why didn't he tell you earlier....like before the first surgery????? I have a friend who desperately needs a hip replaced and her doctor won't do it until she loses weight - which she has been trying to do for 4 or 5 years unsuccessfully. What happens if you are still smoking? Will they cancel the surgery? Have you tried patches? Or hypnosis? I never smoked so I don't have any advice but it seems pretty unfair to me to get you into the process and then make a declaration like that. I think you need to post this on your thread, and maybe someone else would have some advice....the secret to how to stop smoking. I really feel for you. {hugs}
 
@Madbkseller - I have copied several of your posts from MathProf's thread into your own thread, because you've given information there that isn't in your own thread - you hadn't updated your own thread since July 20th.

Please remember to update your own recovery thread with information about your journey, instead of putting it all in MathProf's thread.
It's really good that you and MathProf are supporting each other, but you both need to write about your own recoveries in your own threads.
 
I think that there are nicotine patches that help and there is a new drug that I saw on TV as well. You will need help and he will have to prescribe what you need. I don't think that you should have to sit around with an infection in your leg for 9 and 1/2 weeks. That sounds crazy to me. An infection is an emergency!!! I am going to tag @Josephine to advise you on this!!!
 
Ok...so I was smoking anywhere from 25-30 cigarettes a day. First day and second day down to 12 a day. Third and fourth days - 8 cigarettes. Fifth day - 4....yeah!!! Bad day yesterday - 7 whoops and so far today...4 pm I have had 5. So....I am doing pretty good. I just got a call from my doctor's nurse. My culture that I had taken last week for infection came back clean....So I am good to go. I told her to tell the "powers that be" that I am down to 4-6 cigarettes a day so if they can schedule the surgery sooner than 10/30 I would really truly appreciate it. She said she would let the doc know. So pray for me that I can TOTALLY stop the smoking and that he will be able to get my surgery in sooner. Please Please Please!!! Again...thanks to all of you who have ever responded to my questions and problems....I can't tell you how much you have all meant to me. God BLess.
 
Congratulations on reducing smoking, I know you can do it. I used to be a nurse at a jail, and I once had an inmate tell me, "I've done, meth , heroin, alcohol, and all of them were easier to quit than smoking." That really opened my eyes to how addictive they are, so high praise for what you are doing!!!
 
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