Hip Infection Burning<

[lpolovchik]

I'm not thrilled with my PT at this point. I'm going to speak to the surgeon about it when I see him next.

 

[Josephine]

You shouldn't BE doing any PT, lpolovchik. Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

 

[lpolovchik]

Yes, I agree with you. I will speak with my surgeon next week.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Josephine]

You may not get much sense out of him if he's a PT enthusiast.
Point is, it's YOUR choice. Read this on consent.

 

[lpolovchik]

I was thinking about that. The surgeon wrote the script for 30 PT sessions and they are all covered at 100% by my insurance. I've already told the therapy people about one machine I refused to use. I don't see much help in anything there other than the recumbent bike and the peanut ball. I've notice more than usual swelling after PT sessions and my next morning pain pill doesn't work as well also. My last session was three days ago and this morning I took 1/2 pill. I do feel okay this am. Although I'm sure by 7 pm tonight I will be reaching for a pain pill. I guess I will need to use some tact at the PT center on Tuesday and I will speak to my surgeon the following week. Thanks


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Jamie]

@lpolovchik .... you may notice that I've moved this discussion you and Jo were having to your recovery thread. It was in another member's thread who had a BTKR and was causing that thread to go off topic. It's more appropriate here. Hope you don't mind!

Good luck talking to your surgeon. No matter how it goes, though, it's important for you to do what feels right for your body. When you try to push through pain with exercises, the result is almost always bad and it can seriously delay your full recovery.

 

[lpolovchik]

No problem. Thank you.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[lpolovchik]

@Josephine. I have some med questions for you.

Firstly let me tell you that I have RA, OA, and osteoporosis. My rheumatologist said that three weeks after hip replacement surgery was okay to begin methotrexate. Shortly after beginning methotrexate the staph infection showed up in my hip. I haven't been on it since September.

My rheumatologist today ordered Celebrex 200mg twice a day and Plaquenel 200mg twice a day. I see my surgeon next week and will let him know about these med changes. I see rheumatologist in two months for a follow up. Rheumatologist is thinking after I've been off methotrexate for six months I will begin to show signs of RA again and need to go back on it. He said I have no damage yet only bone thinning around my fingers.

I can't tell you how much pain and swelling I'm having in my joints of my hands, wrists ankles, knees and elbows. More pain than my hip at this point. My blood pressure was also up today and I can't help but think it's from the PT. I have one more PT session before I see the surgeon next Thursday. I think after that I'm going to sit out a couple weeks before I make more appointments. I'm still at the point that I'm concerned about overdoing and developing another infection or another complication or if going back on the Methotrexate will harm my progress.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[kaliella]

I'm so sorry to hear about your infection and revision--and thank you for sharing, even if it's scary to read. I'm not Josephine and don't have her knowledge, but I do have RA and take both methotrexate and Humira.

My rheumatologist had me discontinue them 1 week prior to surgery and resume both two weeks after surgery. I read a scientific study (I think it was actually a meta-analysis of other studies) at some point in my hip research that indicated that taking methotrexate was not associated with an increased risk of hip infection, but biologics are.

The methotrexate might have allowed the bacteria to rear its head earlier than it might have otherwise, but it sounds like maybe a bad coincidence - not that methotrexate caused your infection, as my understanding is that the bacteria would have to have been there already.

IMO, if you're hurting that much and given that it's been almost two months since your revision, you might consider going back on it. Not sure of your dosage but the inflammation in your system is not helpful to healing, either.

 

[lpolovchik]

Thank you for your input.

When the infection showed up the surgeon insisted that either the RA or the Methotrexate had caused the infection which sounded like a blame game. The culture came back as Coagulase Negative Staph and I was then told that I was contaminated in surgery. Yes, bad luck for me.

I was so unhappy with my surgeon after the spacer was put in. I seriously considered having a different surgeon from a different group do the revision but I also felt that would have delayed the revision surgery as well.

Last night I took a pain pill and a Plaquenel. I slept a good bit last night. The rheumatologist said it will take the Plaquenel the next two months to work. When next I see him I'm just going to ask for the Methotrexate.

The rheumatologist had always said that I was very lucky that I had improvement with that drug as most people don't and need Humira along with it. My incision looks great. I'm also thinking about taking a break from the out patient PT for a few weeks.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Jaycey]

I'm also thinking about taking a break from the out patient PT for a few weeks.

I thought you said you were not going to do anymore PT. It really isn't helping you and in fact it sounds like it's doing more damage than good. As Jo said earlier on this thread, hips don't need PT.

 

[lpolovchik]

I need to see my surgeon next Thursday and discuss this with him. I have no idea what his feelings are on it. No, I don't think the PT at the outpatient center is helping. I think I will be just fine doing the exercises that the home care PT taught me. The weights are ridiculous to use. I still have some swelling that is made worse by the PT. I ice a lot during the day. If I had a stationary bike I would use that at home but I have only the treadmill. I'm a bit worried that I will loose my balance when I'm on the treadmill.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Jaycey]

Treadmills are fine if you hold on to the sides and don't use them at any resistance or incline. Set the speed to very slow and do exactly half of what you think you can do the first few times. Walking slowly on a treadmill is a great way to retrain yourself to walk correctly (correct any gait issues).

 

[lpolovchik]

Thank you Jaycee. My treadmill can go down to .5 mph. I'll give it a try.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Jaycey]

My treadmill can go down to .5 mph

Might be too fast. Check it before you get on it. We would not want you to go flying off!

 

[lpolovchik]

Okay


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Josephine]

Shortly after beginning methotrexate the staph infection showed up in my hip.

I don't knowtoo much about this group of drugs but I do know - as you also will - that they are immuno-suppressant and therefore most certainly will give any bugs free range to have a field day!

Rheumatologist is thinking after I've been off methotrexate for six months I will begin to show signs of RA again and need to go back on it.

I think you should steer clear of them for many months yet.

My blood pressure was also up today and I can't help but think it's from the PT. I have one more PT session before I see the surgeon next Thursday. I think after that I'm going to sit out a couple weeks before I make more appointments. I'm still at the point that I'm concerned about overdoing and developing another infection or another complication or if going back on the Methotrexate will harm my progress.

Why go back on it at all? There are many of us here who have done no exercising at all and had pretty good outcomes. I am one of them!

I need to see my surgeon next Thursday and discuss this with him. I have no idea what his feelings are on it. No, I don't think the PT at the outpatient center is helping. I think I will be just fine doing the exercises that the home care PT taught me.

At the end of the day, it's totally your choice. Read this Saying no to therapy - am I allowed to?

When the infection showed up the surgeon insisted that either the RA or the Methotrexate had caused the infection which sounded like a blame game. The culture came back as Coagulase Negative Staph and I was then told that I was contaminated in surgery.

Not really because it was very reasonable for him to suppose that. Coagulase Negative Staph bugs are also known as Nosocomial infections otherwise hospital borne infections such as the dreaded MRSA. Fact is, you could have picked it up anywhere between theatre and the ward.

Such infections are most commonly transferred by hands and it is well known that the simplest activity of all for the staff, visitors and patients is to wash hands frequently and thoroughly. Many hospitals in the UK have also issued badges for staff to wear badges with this logo

I also have this article explaining how to wash hands correctly.

 

[Cas]

@lpolovchik Hi I agree with Josephine and jaycey you don't need all this PT. Especially at this early stage. I followed the mantra on here and did no PT at all except walking and my hip is recovering wonderfully. I think you're about 8 weeks post op? May have my maths wrong! LOL ! That's still early days. Try to be kind to that hip it has been through a lot. Rest as much as possible and listen to the advisors on here they give good advice. If you do go down the PT road only do what you think is helping and not hurting. Keep well and keep us updated. Good luck.

 

[lpolovchik]

I'm officially done with PT per the physical therapist. Physical therapist said I can now drive and walk w/o cane when I able. Hoping surgeon agrees to all that. At home I can just do the exercises I was taught and walk on the treadmill at 2 mph adding minutes as I get stronger. He said walking is the best thing I can do at this point. Thank heavens someone with common sense. I stopped all painkiller Sunday. I'm taking Celebrex and Plaquenel; no Methotrexate at this point. I'm taking Tylenol for pain. Afternoons are spent on a bed with ice on my hip.


08/12/2016 THR
09/10/2016 REMOVAL of THR AND PLACEMENT OF ANTIBIOTIC SPACER
11/16/2016 REVISION THR

 

[Jaycey]

Well done @lpolovchik ! Sounds like you are doing all the right things to get you a good result with this recovery.