TKR Brownie's Good, Bad, & Uglies

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Well...it's almost 3 am here in the eastern time zone and I am still awake! I am doing pretty well...am using a cane and starting to go out in the community again. I may have over done it today...breakfast out, grocery shopping and another errand...so i am having rebound swelling and pain. Took a break from PT this past week which helped my pain levels...but will restart outpatient this week. My bend is still pretty limited...but my knee was so very damaged...my FINAL angle will be 90...I may be at 60 pr 70 right now...I am so very concerned about you...and feel that my challenges are very tolerable..just really want you to feel better! :console2:
 
You mentioned you lived in Truckee and then Reno in Tashia's thread. I thought you needed something a little lighter, and a fun blast from the past.
When you were in Truckee I was at Kirkwood and South Lake Tahoe.
I live in Reno, both Truckee and Reno have changed a lot since the 70's. We are in the middle of Artown, mostly multiple free events on a daily basis. There is a new ball park with a AAA baseball team. The downtown and midtown of Reno are buzzing again after years of neglect.
 
Hi,
I just read your posts about the surgery. I also had the CAD. The marks it made were about midway up on the shinbone. I also had to go back in and let them put a stitch in it, as it popped out. I had a little knot there for a while, but it eventually has gone away. There was some pain in my shin after the surgery for a couple of weeks or so. Have you been able to get in touch with a doctor?

Vickie
LTKR Feb 12, 2013
 
Oh my gosh, Brownie!!! I'm off the forum for a week or so and look what has happened with you! I'm so sorry you are having all this pain and worry. Have you made arrangements for that MRI yet? I would be concerned about the possibility of infection just as you are. Is there a wound specialist you could see that your GP could recommend?

Please keep the updates coming. I'm ready to hear some GOOD news from you!!!
 
Brownie, I got your email. Are you still on antibiotics? Have you heard from your son yet? If this is progressing you should think about a visit to the ER. It's iniquitous that both your surgeon and your GP have left you high and dry with it, totally iniquitous.
 
Dear brownie,
How are you...are you getting any help from your doctors.....possible contact a patient advocate at your hospital.
This is ridiculous.....You should be seen by a doc.
Thinking of you :angel: for some relief from your pain,
Diana :)
 
Brownie,
I hope you have made some headway with your doctors, I agree a trip to the ER may be in order.
Take good care and keep us posted on how you are doing.
 
Josephine Poof and friends. Thank you so much. I went to my primary doctor this am. She saw how much pain I was in and ordered me a shot of Demerol before I left. That was at about 9am. It took away the burning on my shin. Finally some relief! She ordered me Norco 10 1 or 2 q 4 hours. It worked for my right knee but hopefully it will work with my new shin pain and left knee. She told me to take the boot back and insist on a size small.
My son talked to his buddy an OS and they don't see any issues with weaning the pain med at 2 weeks! Give me a break! He had already told me to stop wearing the boot at night. But now my son says I just need to be non-weight bearing that there really is no need for a boot since I don't have a displaced fracture or anything. (sure makes sense!). My primary said she thought it would be difficult to get another ortho to take me since I have a complication.
Wrote that earlier, now have my pain under control. But more weird news. First of all, the office manager at Dr. Reff's office called me (they had already heard how lousy I am doing from Betsy, my PT). I told Esther that I had gone to Dr. Ha and was now feeling better. I told her I needed a size small boot and she said they can do that. But then she starts talking about me going to pain management since they have someone who does that in their office a couple days a week. I said no thank you, my primary is managing my pain now. She really didn't get it and I finally said, "I do not need any pain medication from Dr. Reff." She asked about Dr Ha as if they'd never heard of her yet she is all over my chart and did my clearance for surgery.
A little later I get a call from my primary dr. Dr Reff called her and was rude to her. He told her I was taking/wanting too many narcotics. She assured him she'd known me for 15 years, and I was not a drug addict and that she would take care of my pain control. Then she asks him if he got the culture results (negative) and he didn't seem to even know what she was talking about with a culture. She explained she took a culture last Saturday and put me 3 antibiotics (one just a shot). He denied that he knew anything about it! I remember it very well because I couldn't get ahold of him over that weekend when the incision opened up and had drainage so I'd gone to my primary. Then Monday I called their office and they had me come in. He looked at my incision and said "that's not an infection but finish up the antibiotics". So he is saying he had no knowledge of that and resented that Dr. Ha had not called him with that info.
Then he says he has heard I am not wearing the boot! She said, she is wearing the boot.
So my PT also came today and was shocked at the jumbo boot and was going to report back to them that the boot is not safe. I can actually pull my foot all the way out of it even at it's tightest. Betsy, PT, and my primary are still concerned about infection in the incision. Betsy put more steri strips on my knee incision since the edges were never approximated correctly and so I have little flaps.
My son is going to call Dr. Reff. Tomorrow I have my bone scan. My worst fear is osteomyelitis but I feel pretty sure its a matter of those screws holes just maybe collapsing on themselves or something. Its my son who has the osteo concern as well as Josephine. ha!
I want to get a second opinion. Lets say this is a stress fracture, I need to have a doctor I can trust when he tells me what to do. Wear an over sized boot 24/7 even when not weight bearing? I want someone I can trust and I don't have one spec of trust left in this guy now that he called me doctor. I think he's got dementia! How could he have forgotten that whole thing with the incision infection and me calling him all weekend and him not knowing who was trying to get ahold of him!!! He forgot that whole thing!
So after my scan I am going to see if I can get an appointment with Dr. Kharrazi with Kerlan Jobe. He doesnot do replacements but recommended me for one then treated my left knee while Dr. Spitzer treated my right leg. (Dr. Spitzer could only handle one leg at a time! ha!).
My pain is under control. I can't tell you how that feels. Such a relief. And no nausea now since it's just hydrocodone!
So hopefully I can get a second opinion and he will just take my case so I never have to deal with Dr. Reff again.
Thanks for listening! M
 
Josephine my trip to my primary was about like a trip to the ER in a way. The Demerol got my pain down to a zero and seems like I just needed that complete obliteration of it. I took 2 norco at 2 and now the burning in the tibia is starting back up so I just took one Norco.
My son said he is going to call Dr. Reff but he didn't know about all the other stuff, Reff calling my primary so I texted him and hope he reads what happened before he calls him.
Oh Josephine yes I am still on the antibiotics and should be done with them soon. I'm hoping that hole in the incision isn't a little sinus tract down to my screw holes! UGH. I do not see any sign of granulation tissue. I just keep getting little dots of blood and those little green boogery things that came out last night. I should them to Dr. Ha and she thought it was okay.
I sure hope the scan will give me some answers. I appreciate your help so much! All of you thank you so much for your support! :thankyou:
 
Brownie....I'm so disappointed in that surgeon of yours. Thank goodness your GP had the guts to stand up to the little twerp when he got all huffy with her. I tell you....the egos in some of these guys!!!

I think you do need some new eyes on things. Push as hard as you can for a second opinion from an orthopedic specialist. But, as I suggested before, if you can't get that, try a wound clinic. They are really good at dealing with healing issues and getting to the bottom of something that's not healing properly. That's all they do...and they have a lot of special techniques to encourage better healing.
 
:doh:, take care of that leg of yours. Sorry to hear you are having such a hard time with the OS.
Glad to hear your pain is coming under control. :SUNsmile:
Hoping one you find a second opinion soon!
 
Jamie I think that's a good idea about the wound clinic. If that hole doesn't close up soon. Maybe I should ask my OS. hahaha I don't think he's find it necessary. I am soooo dreading going to him Wednesday. I will have to defend myself against all his little accusations, the drug thing and now regarding wearing an over sized boot (the punishment boot!). UGH!
But I feel so much better now emotionally. I no longer have to count on him for pain medication and that feels good. I just need to prepare myself for the garbage he will throw at me Wednesday. I think I will write down all my issues with him and have it ready when I see him. I would like to ask why 2 large screws were necessary. Seems like you'd only need screws that big for putting in a plate or a hoffman thingy. I sure as heck would have treated my leg less aggressively if I knew I had those relatively large holes in my leg.
 
Have not been on for a while and am so sorry to hear all of this, Marianne. I really do feel for you. That Dr Reff is just unbelievable!! I hope things improve before too long :angel: Thinking of you :flwrysmile:
 
Brownie,
So glad your primary is taken care of you :) when is your bone scan.....are you going to write up a
Complaint about your o.s, I really think you should consider it :ok: keep a record of every interaction you have
With him & his staff. This is just not right :umm:
Take care,......talk soon,
Diana :console2:
 
Hoping today is better. :console2:
I had problems with my OS, but more time to be prepared for my last visit with him, it went well. Having someone with you for the appointment will help a lot. Breathe!
 
I think Pumpkin is right, take someone to the appointment with you. If there are witnesses, I am sure he will mind his manners then. Hugs and so happy your GP helped you out. One thing I really love about my family doc, he always covers my pain!
 
But now my son says I just need to be non-weight bearing that there really is no need for a boot since I don't have a displaced fracture or anything. (sure makes sense!).
I totally agree!
My primary said she thought it would be difficult to get another ortho to take me since I have a complication.
I totally agree!
Betsy put more steri strips on my knee incision since the edges were never approximated correctly and so I have little flaps.
Those little flaps mean that the skin was overlapped and sutured like that. Generally the wound heals underneath anyway, so the Steristrips will not do anything. What happens is that the flap eventually spreads out and flattens but in time, you'll just end up with a broader scar than the rest of it. I have a couple of scars like that. It's just careless skin closure, is all. Another blot in his copy-book!
My worst fear is osteomyelitis but I feel pretty sure its a matter of those screws holes just maybe collapsing on themselves or something.
They don't collapse, they fill up with blood which organises and then becomes impregnated with new bone cells and eventually turns into new bone.
I want someone I can trust and I don't have one spec of trust left in this guy now that he called me doctor. How could he have forgotten that whole thing with the incision infection and me calling him all weekend and him not knowing who was trying to get hold of him!!! He forgot that whole thing!
Oh I'm sure he does remember! But 'not' remembering is the safest road when faced with a poorly managed cock-up like this. Think of it - he's in court and being asked difficult questions about it all. It's his best defence to claim he knew nothing and has no record of it. :wink:
Josephine my trip to my primary was about like a trip to the ER in a way. The Demerol got my pain down to a zero and seems like I just needed that complete obliteration of it. I took 2 norco at 2 and now the burning in the tibia is starting back up so I just took one Norco.
Which gives me considerable hope that it's not osteomyelitis!
I do not see any sign of granulation tissue. I just keep getting little dots of blood and those little green boogery things that came out last night.
Well, that is a form of granulating. The exudate means it's likely healing up from the bottom. Another good sign.
I would like to ask why 2 large screws were necessary. Seems like you'd only need screws that big for putting in a plate or a hoffman thingy.
There's no big mystery about that - it was the guidance arm. But do ask him what type of CGI device he uses. There are quite a few on the market.
 
Josephine and friends. Yesterday was something else. Dr. did not order the third part of a 3 part test so I still have no answers. He was not available all day, in surgery there in the same hospital. Seems like he could have gotten the message to call the doc in nuclear med. My tibia lit up when they scanned after they gave me the IV radioactive dye. So then I had to push fluids and come back in 3 hours in the hopes all the dye would go out of my soft tissues and just see what's going on in the bone. Bone lit up as well so I either have a fracture or osteomyelitis but the radiologist could not get dr. Reff to get an order so I could come back the next morning for the other test. The test I need, they take my blood and separate my white blood cells, put some kind of marker on them and then re inject me in 3 hours. Then the next day I get scanned and it's is bone infection if the bone then lights up again.
During the 3 hour waiting I went back to Reff's office and got the proper size boot.
I am so angry at my doctor and so worried that I have bone infection. I can't believe this is happening and that my care is compromised by his incompetence. My knee and tibia hurt this am. Took just one norco at 5 but another at 630 since still hurting so much. I think the 2 norco are okay. It's crazy but my tibial pain has gotten to be worse than my knee pain. I thought once I got a proper sized boot the tibial pain would decrease but it hasn't so far. My boot/ankle had been knocking around in there. I have been non weight bearing for a week and the tibial pain is actually worse.
The nuclear med people were the nicest folks in the world, so sweet and helpful. They put me on some crazy silly wheel chair where you stand and then they fold down a seat and they can roll you right up to the toilet backwards. And then the gal waited for me outside so I didn't have to holler when I was done. And they let my friend come back with me when the radiologist was coming back to talk to me.
So today I should be going for the rest of the test. I have an appt with Dr. Reff at 1130 but I am calling the office this am to tell them I need that test ordered ASAP.
I think this Dr. needs to be reported to the Board and I also feel like taking legal action at this point. I am worried about how he is going to treat me this am in his office. I am asking my girlfriend to go in with me because I am so emotional nowadays that I can't think fast enough. I am going to write down my points so I can refer to them.
I can't thank you all enough for your support. Especially you Josephine you have been a godsend. You guys are there and just help keep me going and help keep me centered. I need to get NightQuilter in here with me because she's an attorney in LA and I am honestly considering filing a complaint and also filing a malpractice suit. I wouldn't have felt this way just because of the tibial complication, but because of his ignoring my concerns, purposefully giving me a boot that would be uncomfortable, calling Dr. Ha the way he did, conveniently forgetting I told him she had treated me and for his drug comments. He ignored the infection in my incision and denied that it was infected at all. The bone scan shows infection. I am rambling again.
I hope you all have a nice Wednesday without pain.
 
There's no harm in you contacting a lawyer to talk it over with. He would give you guidance about notes to take and questions to ask. It's all in the history taking, you know. You need to be taking notes now, about every incident, phone call, discussion, everything - and in detail. Can never have too much detail.
 
You won't believe this. So this am I had called Dr. Reff's office to tell them I needed the rest of the scan ordered. They told me he didn't want to order it. So I said can I please talk to Dr. Reff. They said ok and then I was disconnected. In the meantime I had found out from nuclear med that he would not order the test. So about 20 minutes later I call Dr. Reff back and said i was disconnected. They said , we have your appointment for the scan for Monday at 9. first they take my blood then mark the WBCs then 3 hours later they inject me with the blood. then the next day I go back at 9 for the scan. Anyway I can't believe it. MY son talked to him last night after I think Reff talked to nuclear med doc. He asked my son if he was a health professional and he said yes, ER physician. I wonder if this put Reff on notice! Plus my called this am and telling the office that the nuclear med doc said I need the rest of this test to see what s going on.
Go figure.
My primary doc called back and my white count and sed rate are okay! So hopefully I don't have a bone infection. But my question for my doctor is why can't I walk. That's what I am going to ask him today? Dr. Why am I having severe pain in my tibia especially if I put the slightest amount of weight down. And please explain to me more about why I have screws holes in my tibia and an incision.
Thank you all! Josephine
 
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