TKR Brownie's Good, Bad, & Uglies

[new knee in June]

Dearest brownie,
I am so sorry you are going through this thank god we have josephine
She sees why you are in so much pain, so you must get proper pain management.
Remember before your surgery you started a forum about pain management.....you had 10
Ways to get the meds. You needed. Go back to that list & starting Monday get on the phone......
Call surgeon, pcp, go to the e.r if you have to
No one should have to fight for pain meds.......
Remember, June sunbeams never give up...we are strong.
Hugs & healing vibes coming your way
Diana

 

[Brownie51]

Josephine there is the swelling over the area, about 2 inches in length. But are you saying it's possible that there is no actual fracture but just the big screw holes causing the problem?

 

[Brownie51]

OMG! new knee in June you are so right! But that was when you are in the hospital. But you are right. I will tough it out through the weekend I guess and then get on it. Beachmom suggested that I go to the ER, they could address both issues! And maybe I would get lucky and they would do an MRI to boot. I thought it was a good idea but then I would have to ask someone to take me and I don't want to bother anyone. They are already helping me so much. I live alone. I hate to ask my daughter or a friend to take me to the ER.
Oh I already called the surgeon and he told the office manager to tell me I can only have what he gave me, no more. I think thats awful because I have a painful complication in addition to the 2 week old knee!

 

[Josephine]

just the big screw holes causing the problem?

Possible, yes.

the surgeon told the office manager to tell me I can only have what he gave me, no more. I think that's awful because I have a painful complication in addition to the 2 week old knee!

I think it's awful too. Have you tried contacting your GP to see if s/he is more helpful?

How much acetaminophen does your Percocet have in it? You could take enough Tylenol to up it to 1,000mg so long as you don't exceed 4,000mg per 24hrs. It might help some. And stay off the leg!

 

[new knee in June]

Brownie,
You bother everyone you know......they will be happy to bring you it's time to raise the roof, make a lot of noise
If you don't have good pain management, all you will be thinking about is the pain
It is one of the most important things in our mantra
I certainly think you are worth it, but sorry you have to fight so hard
I hope you have a restful night......I want only the best for you
Diana

 

[Brownie51]

Josephine yes I have been adding more Tylenol all along. I just ordered myself a brace in my size.
And thanks Diana! So sweet!!!
My son is an ER doc in Texas and is going to talk to his ortho friend about all of this but he says the bone scan is an inferior test to an MRI. MRI more likely to show a problem. He agrees with Josephine about the screw holes could be the problem themselves. He also had concern about osteomyelitis due to the infection. I don't have a fever, the wound is healing but still has a deep hole that is full of scab, which gets tiny dots of blood on gauze. He said stop wearing the brace at night, there is no point. But to bear no weight whatsoever. He suggested stopping the celebrex for a few days and see if Ibuprofen will help. 800 tonight and 800 in morning. It's not good for bone healing but to give it a try.
I told him I don't want to go back to Dr. Reff at all. But my son wants me to wait on that till he gets some info about what's standard practice. My trust is gone and I can't get that back unless he would apologize to me which is not going to happen.
By the way, my home health PT Betsy said on Monday that she would hold off on coming out until she talked to the doctor about what she should do with me since the complication. She never got back to me. Why do I have this luck. I called, never got a call back. Losers! Who needs her anyway. All she did was force my knee to bend and she shouldn't have done that anyway.
I can barely bend my knee now. Losing my flex because it hurts too much to bend it without having enough pain med on board. I'm not even at 90 tonight, looks like about 45! and I was able to bend so much more a week ago, well over 90. Sitting on the table I could put my feet under the table so that was more than 90.
But think it's progress getting myself a boot that will not be hurting my tibia. The swelling actually got worse AFTER I got the boot. Also feel like I am slowly making a plan.
I wish my son had gone into ortho!
Have a good night everyone and thank you all for your help! I feel uplifted because of you all!

 

[bottomshollow]

 

[Brownie51]

Thanks Bottomsho llow!!!!

 

[Josephine]

bone scan is an inferior test to an MRI

And he's dead right!

He agrees with Josephine about the screw holes could be the problem themselves

He also had concern about osteomyelitis due to the infection

Didn't want to actually mention that but it's a concern of mine also.
It would certainly account for a lot of the pain and swelling.

He suggested stopping the celebrex for a few days and see if Ibuprofen will help. 800 tonight and 800 in morning

AND the Tylenol! Don't forget the Tylenol!

My trust is gone

Hardly surprising.

I can barely bend my knee now. Losing my flex because it hurts too much to bend it without having enough pain med on board.

You may not actually be losing it literally. It's more likely regressed due to the swelling and pain.
Remember this Swollen and stiff knee: what causes it?

The swelling actually got worse AFTER I got the boot.

That may be coincidental though I am sure it didn't help.

 

[fiberlady]

Brownie51, just spent time this morning reading through your thread. OMG, and here I sit and whine because I have a little muscle pain and nausea, gave myself a little slap a side the head and told myself to snap out of it, so I got off my pitty wagon. Send my prayers and thoughts your way, as you need them. I do hope you get some answers and soon, not to mention pain meds.

 

[new knee in June]

Hello brownie,
How are you today I hope we'll. if I may ask you 2 questions...without seeming nosey
Why do you have the screws in your leg...are there complications, are they from a previous surgery.
Also, did your surgeon say he will not give you additional pain meds. Or no more pain meds period...there is a difference.
Your son sounds like an he will get to the bottom of this for you....
Wishing you my best & wish you didn't have to fight so hard
Hugs....diana

 

[Nanners]

Oh Brownie I am so sorry for all your pain! Sending really gentle hugs your way! I would go into your GP and state that the pain meds are not enough, you are suffering mightily, and the ortho doc won't give you more. If any of my docs do not treat my pain properly I always go to my GP and he takes care of it for me. Hugs!

 

[Brownie51]

Thank you friends! Pain is continuing in tibia and knee. Just took my little Percocet 5.
Josephine yes that scares me to death about osteomyelitis possibility. I guess it would be due to the infected wound. Although Dr. Reff said it wasn't an infection! I had had 3 days of antibiotics by the time he saw me.
new knee in June , my doctor used computerized navigation to get the alignment. I was shocked when my dressing was removed and I saw that I had an incision in my lower leg! Apparently 2 screws were used to hold down some antennae.

 

[Josephine]

antennae

It's an alignment arm!

Well, don't get too freaked out about 'osteomyelitis' - in only means infection in the bone. And you probably haven't got that anyway. It's just a thought.

 

[Brownie51]

Josephine I've seen horrible cases of it (can you tell I am catastrophizing as usual?) where it means months of IV antibiotics, with the infection coming back and back again. And needing irrigation of the bone. dark green sticky boogery-like stuff just came out of the incision hole. What is the medical name to call that hole in the tibial incision. The infection literally eats the bone. But I am thinking Jo and my son are right and the screws are acting as the fracture and that is what is causing the pain. Maybe that would heal faster than a stress fracture.
My PT finally called back and said she is going to talk to the office tomorrow and she will come see me. I will call first thing in the morning and see about getting in with my primary doc.
Today I've been watching movies from the 80s. It's fun seeing actors when they were 20-30 years younger.
I hope everyone is having a lovely Sunday.
M

 

[Josephine]

I've seen horrible cases of it where it means months of IV antibiotics, with the infection coming back and back again

So have I but do remember those were in the old days when we didn't have the sophisticated antibiotics we have now, nor the advanced OR techniques for aseptic practice. Osteomyelitis was rampant then and very difficult to treat because it wasn't treated pro-actively enough.

What is the medical name to call that hole in the tibial incision. The infection literally eats the bone

A sinus and they drained and drained and drained, didn't they? I remember a lady in 1969 who had a peri-prosthetic infection in her hip replacement - actually, her second hip replacement. The surgeon pecked and poked at that sinus for months, then finally removed all the metalware and still it kept draining. After that he laid the whole wound open and just kept it packed while it healed from the bottom up after which it was finally free of infection. I remember her well, her name was Margaret Mullaney and she spent a whole year in the side room of the women's orthopaedic ward! She was such a frequent visitor to our theatre that when she was discharged, she would come to the theatre for coffee when she had an out patient appt! And she came to my leaving party and contributed to my leaving present as well! I still have the card with her name on it. Happily theatre nurses don't tend to make such long term relationships with patients like that these days!

Maybe that would heal faster than a stress fracture.

Not actually - bone heals when it heals. Primary healing is complete in about 6 weeks but full healing takes at least 12.

 

[Pumpkin]

Brownie,
How about a virtual date at the Bar of America in Truckee, a nice escape from all our worries, and no hangover.
https://www.barofamerica.com/index.html Still there but a much fancier place.
Cheers, and pass the chicken wings.
Tomorrow we get back to work,

 

[Brownie51]

Josephine thank you so much for your insights! Oh I remember packing wounds like that too. That's right, sinus, that's my concern but I don't have anything sterile to place in there to get the depth.
Pumpkln Is this a coincidence or were you aware I had a home in Truckee long ago? My first born son we called, Chuckie from Truckee. He's a doctor now.hahahaha Had to stop calling him Chuckie. But that's hilarious about Barofamerica. Of course it was there in 1973 when we moved there and had a house built.
Don't tell me you live there??? I will have about a million questions if you do!!!!!

 

[harplayer]

Brownie...
Oh my dear .... I am so sorry about your pain and these awful complications...please know that I am praying for a rapid and complete resolution for your pain! I wish I could do more...but since I am not in your area...I will send prayers and positive energy your way.

 

[Brownie51]

Thank you Harplayer! I will pray along with you for you too. You are just out of surgery as well! How are you feeling?