Knee Infection* CABLAND's 11/13/2023 LTKR Recovery
- Thread starter cabland
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for you!cabland
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Am definitely planning to take it easy during my in-home PT next week and can tell I will have to "enforce" that message with my PT tech.
I am a little frustrated that I can't even bear full weight this far out from my surgical date, but I think the infection just set me back...even do far as to put me in the negative. It is getting better, just not there. Overall, I find myself sitting...a lot!
The evenings are, of course, not fun as the pain sets in and is hard to quell (note: still taking the narcotics round the clock which I'm also frustrated with but, again, hope it is primarily due to the infection set back). A battle I know many endure.
On the plus side, IV antibiotics seem to even out narcotic constipation!
I know every recovery is unique, so trying not to compare, especially with the infection complication.
Appreciate the folks here on the forum and, as always, will gladly take any/all prayers.
As an aside, I received word that my insurance company approved my second knee for replacement after we appealed. Of course, it seems like God's providence that it was originally denied given what has happened with my left knee. I would NOT want to have undergone bilateral AND had an infection!
I am a little frustrated that I can't even bear full weight this far out from my surgical date, but I think the infection just set me back...even do far as to put me in the negative. It is getting better, just not there. Overall, I find myself sitting...a lot!
The evenings are, of course, not fun as the pain sets in and is hard to quell (note: still taking the narcotics round the clock which I'm also frustrated with but, again, hope it is primarily due to the infection set back). A battle I know many endure.
On the plus side, IV antibiotics seem to even out narcotic constipation!
I know every recovery is unique, so trying not to compare, especially with the infection complication.
Appreciate the folks here on the forum and, as always, will gladly take any/all prayers.
As an aside, I received word that my insurance company approved my second knee for replacement after we appealed. Of course, it seems like God's providence that it was originally denied given what has happened with my left knee. I would NOT want to have undergone bilateral AND had an infection!
I always say that things happen for a reason. It is clear why you did not have the second surgery! It has turned out good for you. Now, you have the time to clear up your infection and recover from your first surgery before going through another one.
cabland
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Well, I'm 19 days out from my LTKR on 11/13. I'm doing daily outpatient IV antibiotics ever since I left the hospital. My knee redness has greatly diminished. I am pretty fatigued, but can't tell how much of that is from the surgical recovery, the IV antibiotics, or the various pills I'm taking (oxy, acetaminophen, aspirin, colace, cha, cha, cha).. My labs show the sed rate has come down, but RBC, Hemoglobin, Hematocrit and platelets are still out of range. I suspect the CRP is still out of range too, but that result is still pending (grrr....lab!).
My surgeon was reasonably pleased with the appearance of the surgical site, but not crazy about where I am on range of motion. Because of the infection and resultant pain, I didn't start doing any material PT until this past Wednesday (eg 16 days post-op). I am still using a walker and can't reliably bear full weight on my knee for more than a few steps. Flexion is at maybe 75 when really pushed...feels like a darn brick wall.
I think I may have tried weening off the pain meds (oxy) too soon as I am in some level of pain all the time w/o them and walking or exercising ratchets it up and has me back in the recliner. I think that may be putting me in a position where I am simply not moving enough and just need to take the pain meds, keep the pain at bay, and be able to walk, do my exercises, etc. and not bail on them after a few reps. Thoughts? (note: I find I have to take 10 mg oxy every 4-5 hours to really keep the pain at bay to allow me to exercise, walk, etc.).
Thanks and I appreciate this forum and all of you.
My surgeon was reasonably pleased with the appearance of the surgical site, but not crazy about where I am on range of motion. Because of the infection and resultant pain, I didn't start doing any material PT until this past Wednesday (eg 16 days post-op). I am still using a walker and can't reliably bear full weight on my knee for more than a few steps. Flexion is at maybe 75 when really pushed...feels like a darn brick wall.
I think I may have tried weening off the pain meds (oxy) too soon as I am in some level of pain all the time w/o them and walking or exercising ratchets it up and has me back in the recliner. I think that may be putting me in a position where I am simply not moving enough and just need to take the pain meds, keep the pain at bay, and be able to walk, do my exercises, etc. and not bail on them after a few reps. Thoughts? (note: I find I have to take 10 mg oxy every 4-5 hours to really keep the pain at bay to allow me to exercise, walk, etc.).
Thanks and I appreciate this forum and all of you.
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Hi!
A reminder: many surgeons don't have a goal of 90 degrees flexion til around 6 weeks post op, and in your case the infection set you back.... and a goal is aspirational, not a rule; many of our peers here have taken significantly longer.
It sure sounds like scheduled pain meds would get you back on an even keel so you can at least do the short hourly walk with the walker and some gentle range of motion.
My 2 cents, FWIW....I'd suggest that until you can *comfortably* both walk with the walker and do very gentle range of motion, other exercises should be deferred.
A reminder: many surgeons don't have a goal of 90 degrees flexion til around 6 weeks post op, and in your case the infection set you back.... and a goal is aspirational, not a rule; many of our peers here have taken significantly longer.
It sure sounds like scheduled pain meds would get you back on an even keel so you can at least do the short hourly walk with the walker and some gentle range of motion.
My 2 cents, FWIW....I'd suggest that until you can *comfortably* both walk with the walker and do very gentle range of motion, other exercises should be deferred.
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cabland
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Update: my latest labs show my CRP is now back in range, but RBC, hematocrit, hemoglobin and platelets are still out. I see Infectious disease doctor tomorrow. Pretty sure he will want to stay the course on IV antibiotics for now.
Saw my surgeon today. He was pleased with my range of motion progress since last appointment - not awesome, but decent.
My pain is somewhat constant though and, as so many here indicate, worse at night...was up for hours last night.
Surgeon prescribed Gabapentin, which doesn't seem uncommon, BUT when my wife picked up the prescription, the pharmacist said not to take it with the oxycodone...hmmm. I will call my surgeon tomorrow, but does anyone take gabapentin while also taking oxycodone? A friend who recently had BTKR took gabapentin with tramadol, but the latter is considerably less potent than oxy.
Finally, one more question...I have used the lounge doctor pillow during the day, but does anyone sleep through the night with one? (Note: these questions might be better served with separate posts)?
Thanks all - this site continues to be my go to for any question!
Saw my surgeon today. He was pleased with my range of motion progress since last appointment - not awesome, but decent.
My pain is somewhat constant though and, as so many here indicate, worse at night...was up for hours last night.
Surgeon prescribed Gabapentin, which doesn't seem uncommon, BUT when my wife picked up the prescription, the pharmacist said not to take it with the oxycodone...hmmm. I will call my surgeon tomorrow, but does anyone take gabapentin while also taking oxycodone? A friend who recently had BTKR took gabapentin with tramadol, but the latter is considerably less potent than oxy.
Finally, one more question...I have used the lounge doctor pillow during the day, but does anyone sleep through the night with one? (Note: these questions might be better served with separate posts)?
Thanks all - this site continues to be my go to for any question!
Yes, that's not unusual. You are still early days in this recovery. Keep icing and elevating as much as possible and try to stay ahead of the pain by taking your pain meds on a regular schedule. It will get better; it just takes time.
Yes, some folks do sleep with it. I found it was a little too high for me to be comfortable, so used a pillow stack in bed. Give it try!
When it comes to your gabapentin question, checking with your own doctor is the best course of action.
I don’t have a Lounge Doctor, I have a different brand which is a slightly different shape, and I still sleep with it all night, almost 7 years after my surgery.
All in one post is fine, or separate posts, it’s up to you. Just stay in this thread, as it’s better for all of us if you only have one Recovery Thread.
cabland
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Thanks all. I'm 4 weeks out from surgery as of yesterday. Have now been on pain meds (oxycodone) every 4 hours and it is keeping up with the pain...mostly. However, any material amount of PT and I have to increase the dosage amount at least a couple times a day.
I actually took all day Saturday off and just iced and elevated...no walking, no PT. It actually seemed to help which seems to reinforce a lot of the bonesmart way.
My biggest problem right now is pain right at or below the joint line particularly when moving from extension into flexion (i.e. the initial 5 -15 degrees) - primarily in the front of the knee (maybe right below the knee cap area). It is true when I am just sitting and move it and worse when walking (i.e. weight bearing). It hurts enough that it makes me not want to walk or do the exercises consistently. There is a lot of clicking and movement in there too in this initial movement...can't tell how much of that is normal. Pretty frustrating as it feels like yet another wall I'm having trouble making any progress on. Not sure if others have experienced this.
I actually took all day Saturday off and just iced and elevated...no walking, no PT. It actually seemed to help which seems to reinforce a lot of the bonesmart way.
My biggest problem right now is pain right at or below the joint line particularly when moving from extension into flexion (i.e. the initial 5 -15 degrees) - primarily in the front of the knee (maybe right below the knee cap area). It is true when I am just sitting and move it and worse when walking (i.e. weight bearing). It hurts enough that it makes me not want to walk or do the exercises consistently. There is a lot of clicking and movement in there too in this initial movement...can't tell how much of that is normal. Pretty frustrating as it feels like yet another wall I'm having trouble making any progress on. Not sure if others have experienced this.
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Hello and Happy One Month Anniversary!
Your leg endured major trauma, in a very small area, albeit controlled. Your muscles, tendons, ligaments and other soft tissue is going to cause you discomfort and pain for a while yet. Take the meds for as long as you need to in an effort to remain comfortably mobile and able to rest easy.
I hope you had a good night of restorative rest and today is a great day!
I believe this is your body signaling that you are overdoing it.
This was wise of you.
Your leg endured major trauma, in a very small area, albeit controlled. Your muscles, tendons, ligaments and other soft tissue is going to cause you discomfort and pain for a while yet. Take the meds for as long as you need to in an effort to remain comfortably mobile and able to rest easy.
Some members complain about clicking, clunking and popping sounds. It is natural to be concerned and wonder if something is wrong. It seems more often than not that noises aren’t indication of a problem. It takes time for the soft tissue surrounding the implant to heal and settle in with the implant and begin working smoothly. It should ease over time.
I hope you had a good night of restorative rest and today is a great day!
cabland
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Had another round of PT yesterday (still at home with therapist) and worked mostly on extension which is at +10 degrees. He did some pushing...tough, but not unbearable (I was glad each 15-30 second push was over of course)...BUT holy cow did I have a rough night. It really does show me how stressing the knee (even when it isn't "I was crying!" stressful) has consequences. I have done a couple more mild "gravity" stretches today (knee spanning two chairs) and am basically icing and elevating the rest of the day. Tomorrow, I'll have him go easier (note: he is willing to take the lead from me) and am planning to take it pretty easy over the weekend - as I did last weekend. My knee does have some visible swelling, but isn't that bad. I think I have a lot more internal swelling based on the stiffness I have all the time. Hoping for a bit easier night tonight.
On the infection front, GOOD news, all of my labs came back this morning in the normal range for the first time - Thank You, Jesus! I will see the infectious disease doc tomorrow. I'd love to be discharged next Friday, but I think he'll want me to go 2 more weeks on the IV antibiotics (nothing like getting infusions on Christmas Day)...we'll see!
On the infection front, GOOD news, all of my labs came back this morning in the normal range for the first time - Thank You, Jesus! I will see the infectious disease doc tomorrow. I'd love to be discharged next Friday, but I think he'll want me to go 2 more weeks on the IV antibiotics (nothing like getting infusions on Christmas Day)...we'll see!
Amen! That is fantastic news!
cabland
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My latest update at 5 1/2 weeks from surgery:
Knee Infection - Saw infectious disease doctor today. For second week in a row, all labs are in normal range (Thank God!). Surgical site looks good. If it all looks the same this time next week, I expect to stop my daily IV Antibiotic infusions (hooray). Unfortunately, I found out I will have to take oral antibiotics twice a day for the next 6 months...
- not what I was expecting, but it does appear to be a common protocol and I understand why.
Home PT - Last day of home physical therapy today. My flexion is 105, but extension is still mediocre at +13.
Pain - this is my biggest issue. I am still taking 20-35 mg of Oxycodone a day (and am often still at some level of pain). Walking is not easy - the initial bend from extension to flexion in particular. This is pretty discouraging as it stops me from doing much...admittedly, it was always worse after PT. I start outpatient PT in about a week, so I may take it easy in this gap to see if the pain reduces without PT, etc...we'll see.
I appreciate the feedback and encouragement here from all!
p.s. Christmas Day will be 6 weeks from my surgical date...compression stockings coming off!!
Knee Infection - Saw infectious disease doctor today. For second week in a row, all labs are in normal range (Thank God!). Surgical site looks good. If it all looks the same this time next week, I expect to stop my daily IV Antibiotic infusions (hooray). Unfortunately, I found out I will have to take oral antibiotics twice a day for the next 6 months...
- not what I was expecting, but it does appear to be a common protocol and I understand why.Home PT - Last day of home physical therapy today. My flexion is 105, but extension is still mediocre at +13.
Pain - this is my biggest issue. I am still taking 20-35 mg of Oxycodone a day (and am often still at some level of pain). Walking is not easy - the initial bend from extension to flexion in particular. This is pretty discouraging as it stops me from doing much...admittedly, it was always worse after PT. I start outpatient PT in about a week, so I may take it easy in this gap to see if the pain reduces without PT, etc...we'll see.
I appreciate the feedback and encouragement here from all!
p.s. Christmas Day will be 6 weeks from my surgical date...compression stockings coming off!!
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Fingers crossed your labs let you switch to the oral antibiotics!!!!
you're definitely not the only BoneSmarty to need to use the stronger pain meds for a while. With the infection abating and a break from PT perhaps you'll be more comfortable.
you're definitely not the only BoneSmarty to need to use the stronger pain meds for a while. With the infection abating and a break from PT perhaps you'll be more comfortable.
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Yes! That will be a great way to start the new year.
You're down to just hours left and then....freedom!
Toss the socks aside...or into the trash. 
Merry Christmas, cabland!
cabland
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6 weeks from my surgery today, and yeah, I still have a bunch of issues, but instead of listing them all, today, I will simply say: THANK YOU AND MERRY CHRISTMAS to all of you on this forum and especially those of you that take time to respond to the various posts from those of us in need this Christmas. Truly, you embody what He is all about.
For to us a child is born,
to us a son is given,
and the government will be on his shoulders.
And he will be called
Wonderful Counselor, Mighty God,
Everlasting Father, Prince of Peace.
Isaiah 9:6
For to us a child is born,
to us a son is given,
and the government will be on his shoulders.
And he will be called
Wonderful Counselor, Mighty God,
Everlasting Father, Prince of Peace.
Isaiah 9:6
Today is a good to get lots of rest! God bless you and yours!
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