Knee Infection* Alternatives to spacer & antibiotics<

[sistersinhim]

Wow, you have cut way down on that smoking. Good for you. I quit in the early 90s. I kept suckers on hand so I'd have something to do with my hands that resembled having a cigarette. It worked!

 

[Madbkseller]

I can believe it! I did a lot of drugs when I was younger. I was an actual real life "hippie" Ha!!! I was able to do whatever and then be "normal" well as normal as I could be the next day. I do get a little anxious now and then but I just pop in some chocolate.

 

[MathProf]

Congratulations on making such good progress. I am really proud of you, and praying that you can get this over with sooner rather than later!!

 

[Madbkseller]

Ok...so new question.

I have had virtually no pain in my knee after about the first week home. Since I have the rods in my knee I am unable to bend my knee at all and the PT guy at the hospital said I can only put enough weight down when stepping that I wouldn't break an egg and that's what I have been doing.

The last 2-3 weeks I have been rolling around in my wheelchair trying to do a little picking up that my husband just can't seem to get around to. I mean he's taking good care of my needs but just isn't one for "unnecessary" housework. It's like he doesn't even see it but it is beginning to drive me nuts.

Anyway, my question is: My upper thigh is really stiff and sore. My knee and little bit. And it is more painful for me to get in and out of my wheelchair and out of my Lazy boy. Do you think it's from my doing more?

If it is should I stop doing so much??? Or continue doing little jobs and hope that I am keeping those muscles active so they don't all totally atrophy on me?

@MathProf did you have this happen to you?

Suggestions from all welcome. And I don't really want to have to take pain pills again.

 

[sistersinhim]

It could be because you are a little more active now. I am going to tag @Josephine our forum director and nurse to address your concerns.

 

[Josephine]

Do you think it's from my doing more?

Well, I won't be able to answer that until I know how much you are doing now! So with that in mind, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Madbkseller]

Absolutely @Josephine. Thanks for taking the time.

 

[MathProf]

Since I wasn't immobile like you have been I can't answer that question. But I know my husband never sees the clutter around the house. It is invisible to him. So THAT pain I can identify with!

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Celle]

Just to confirm - so you had the original knee hardware removed and an antibiotic spacer inserted?

You never did answer my question and I'm still confused. Currently, do you have an antibiotic spacer in your knee?

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.

Do you mean a date to have the antibiotic spacer removed and a new knee replacement inserted?
Or have you not yet had the antibiotic spacer?

Since I have the rods in my knee I am unable to bend my knee at all and the PT guy at the hospital said I can only put enough weight down when stepping that I wouldn't break an egg and that's what I have been doing.

What rods?

The usual procedure to treat an infected joint is to remove the original knee replacement and insert an antibiotic spacer during the first surgery. That's Stage One. Most people are allowed to walk a little, using a walker, while the spacer is in place.

Some time later, when blood and aspiration tests confirm that the infection has gone, the antibiotic spacer is removed and replaced with new knee replacement hardware. That's Stage Two.

If your treatment has been different, please tell us what it is, so we can all learn. Thank you.

 

[Madbkseller]

ok...now I have time to answer these questions. First of all: @Josephine

1. I am sitting in my LazyBoy with no pain at all. It is the getting in and out of my chair, wheelchair and using my walker. The pain, soreness is about a 3.

2. I was prescribed Narco - 10-325. I don't take them any more. Mostly I just take acetaminophen 500 mg. I take two when I take them about twice a day.

3. There is no swelling at all.

4. I have full extension and 0 flexion. When my OS took out my knee and replaced it with the anti-biotic spacer he put two rods in my knee to keep it totally straight.

5. No icing at all.

6. No elevating, just straight in front of my in my chair.

7. Minimal activity. Having a straight leg that I can put absolutely no weight on limits most movement completely. I do try to pick up a little here and there, but it is almost impossible. Dr. stressed being super careful so as not to fall.

8. No exercises at all. No pt.

 

[Madbkseller]

so @Celle

Yes, original knee removed and an antibiotic spacer inserted along with two rods to keep my knee totally straight.

Yes, I have surgery scheduled for 10/30 to have my new knee put in. I have had the antibiotic spacer with the rods in since 6/29/18.

I do understand that that is the usual procedure. On 6/29 my surgeon removed my infected knee and replaced it with the antibiotic spacer and two rods to keep my knee totally straight. (I don't know why). I then went home to get 6 weeks of IV antibiotics. Waited 2 weeks without antibiotics. Went to OS for knee aspiration, then another week for results of culture. Culture was clear of infection. Went back to doc for him to tell me I HAVE to quit smoking or he won't replace my knee and then scheduled it for Oct. 30. 18 weeks of total disability. No fun at all.

Thanks for your help.

 

[Josephine]

Yes, original knee removed and an antibiotic spacer inserted along with two rods to keep my knee totally straight.

This is totally bizarre! Never have I heard of a knee being treated that way!

The pain, soreness is about a 3. Mostly I just take acetaminophen 500 mg. I take two when I take them about twice a day.

If you have any pain, you should take two acetaminophen 3-4 times a day. You see, it only stays effective in yur body for about 4-5 hours so if you only take it twice a day, you are spending several hours with no medication coverage at all which is not good for you.

 

[lovetocookandsew]

I'm no expert, so this is totally my opinion, but it sounds to me like your doctor is so anti-smoking that he's letting it cloud his vision to the point of being unable to see what he's unnecessarily putting you through to force his opinions on you. Making you suffer so he can try to force you to his way of thinking is wrong in so many ways. I don't smoke, never have, and think it's a bad thing to do health-wise, but I also believe he has no right to tell you how to live your life. He can make suggestions, but in the end it's your life, not his. There are many smokers who've had TKRs successfully. Someone needs to throw the bs flag on his play!

 

[Celle]

On 6/29 my surgeon removed my infected knee and replaced it with the antibiotic spacer and two rods to keep my knee totally straight. (I don't know why).

Thank you for explaining, @Madbkseller .

Like Josephine, I've never heard of rods being inserted along with the antibiotic spacer.
Many people do wear an external splint, to keep the leg straight, though.

About the smoking - I agree that your surgeon is being too rigid and rather unkind.

In April, because of major surgery, after being a smoker for 60 years, my husband had to give up smoking - the hospital does not allow smoking anywhere on its grounds. However, he was helped, because the hospital supplied nicotine patches while he was an in-patient and gave him a prescription for more patches when he was discharged.
He also uses an e-cigarette.

Although he had tried many times to quit smoking, this time it had worked. He hasn't had a cigarette since the beginning of April.

I wonder if the nicotine patches would help you?

 

[Madbkseller]

Celle and lovetocookandsew, like you, know that it is wrong to smoke and that it is rather unforgiving of my OS to require me to quit. I have read a lot about the effects of smoking on any surgery, before and after. It drastically reduces the amount of oxygen throughout the body, which impedes healing. In fact, it might have led to me getting the infection in my knee.

I don't want to lose my knee for sure and I don't want to have to go through all of this junk again. I WILL quit. My daughter said that a friend of hers had some luck using a straw. Cut it off to cigarette length and sucked on it. I have been doing that and it has helped me cut back a little bit more. What I need to do is put the cigarettes nearby so I know they are there, but reach for the straw instead when I get that urge. So, still working on it. I'm just getting to many things on my plate that just has to do with me....I prefer taking care of other people.

 

[Celle]

Anything that helps you quit is worthwhile.
For my husband, the e-cigarette not only helps with the craving, but it also gives him something to do with the hand-mouth urge - something to do with his hand. I think a straw would do something similar, so well done for thinking of that.

 

[Josephine]

Well very good luck with your battle. It's not an easy one but well worth the effort

 

[PegGar16]

Hi @Madbkseller. It sounds like we have a few similarities but my surgeries were a little different. I had to quit smoking at least 8 weeks before the surgery for the flap that was put over the knee. Where the surgery was so vascular the plastic surgeon went as far as drug testing me to make sure that I was not smoking and could not be using nicotine replacement. I also had 2 rods inserted with the second spacer to keep the leg straight with a brace. This was all done because there was so much damage from the infection that they had to make sure that there was enough flesh to cover everything that was being put in. Of course the rods came out and everything is working well. Giving up the smoking was brutal but I had no choice. My poor husband got the brunt of it

 

[Celle]

Thank you for your post, @PegGar16 . Very helpful! I hadn't realised you also had those rods inserted.