Become an Insider

Revision TKR Fourteen months, one knee still raw.

Status
Not open for further replies.
Those suggestions are great and I thank all of you for taking the time to respond. I have not had the chance to get anything together before tomorrows surgery, 'when falling, dive' is my philosophy now. I can order those things on Tuesday, plus, since I donated all my recovery paraphernalia from the BTKR, I'll need to reorder that stuff too. Do those raised toilet seats and shower benches work for someone who can't bend the leg? -I don't remember, guess I'll relearn as I go along. All in all, I'm glad I finally have an answer to what has been ailing my left leg, kind of the worst case scenario, but whatever. Guess I can trip on Oxycodone and just let go for a couple of weeks. Feeling pretty good though, I put in some transplants from my old New Jersey garden and got my music room set up for an invalid. Oh, do they administer an epidural when taking out the prosthesis? Do I get a trade in on the old parts at least? :scratch:
 
Bath transfer bench sure worked for me when I had little-to-no bend--I kept my surgical leg outstretched on it with the non-surgical leg inside the tub. Otherwise I'd not have been able to wash without assistance. (Of course, it helps to have a handheld showerhead--very cheap & easy to install with a diverter valve and stick-on bracket. The whole shebang can be had for <$30 at a discount dept. store such as Target or Wal-Mart. Perhaps a relative, friend or neighbor can install it for you while you're "in the joint," so to speak).

Raised toilet seat or commode frame also works--just have something on which to prop your surgical leg. In the hospital they took a wastebasket and laid it on its side.

Good luck!!! Post when you feel able and not one moment sooner.
 
Hi Plexiburg
You already seem to have your spirits well in place as you face this next challenge. No matter the recovery, clearly this infection needs to be taken care of! All the suggestions you're getting are fantastic and really I have none to offer - I'm just chiming in to provide moral support. I'll be thinking of you - keep us posted.
j
 
It is wonderful that there were experienced people to help with all the mechanical stuff of non weight bearing. I do some hope the next news is better!
 
The surgery is done. they found three "bone cavities" filled with puss. Fair amount of bone erosion, enough to cause the implant on the femur to be slightly loose , but there is plenty of bone left to hold the next joint. It was an aggressive form of stapf but they have me on an antibiotic that is effective. They are still trying to grow more bacteria in the dish to see if there are any other bugs hiding.

Interesting post op so far. A different morphine (Duramorph) was used this time around and what a difference the first 24 hours was, absolutely no pain and I was not out of it at all. Well, after 24 hours, hello pain!!! To my surprise I was able to support my weight on the leg and walk down the hall with the walker and do a few stairs. Having the leg hang without touching the floor is a truly bazaar feeling. -also could stand and pee without the catheter, but now the pain is fully ramping up even with oxycodone, time to manage this before it's full throttle up. :scary:

Doc says only 1% of knee replacement patients develop an infection, and though I seem to be an unlucky person these days, I'll bet there are allot more than 1%. So, it looks like the total treatment will take six months, a third of that will be with the spacer. I adore the staff and my new doctor, and I have resumed collecting these cool grippy socks again.

All and all, this surgery was a breeze compared to having both knees done at once. Of course the recovery wont be a breeze.
 
[Bonesmart.org] Fourteen months, one knee still raw.
Plexiburg, congrats on getting through another surgery and starting a new recovery. I have changed your title prefix to Revision TKR since that is what is going on now and will be helpful to other members who need a revision and want to locate someone who has had one. Just follow that BoneSmart mantra for the best recover possible. BTW, love your avatar!

Take care and keep us posted. We care.
[Bonesmart.org] Fourteen months, one knee still raw.
 
If I were doing a search on Revision TKR's would I find people who have gone through what I'm going through now? Actually at this point I'm two days out from an "explant" and have an antibiotic infused cement spacer where the the artificial joint used to be. Of course this is the result of an infection that I seemed to have contracted last year during my BTKR. The BTKR sucked and now the infection and explant sucks even more. I may have my definitions wrong, but does the monicer "Revision TKR" really describe my situation? I feel I really earned the BTKR in my signature and since only 1% of patience develop infections I feel I'm really getting short changed with my prefix. Are there no prefixes like "Infection" or "explant" or "anoying member"? :loll:

Anyway, I just had a picc line put in to receive the antibiotics over the next 6 weeks. I had no idea of the protocol they have to go through in order to prevent the catheter from introducing infection into the blood stream. they turned my hospital bed into a sterile operating center. The pair spent more time scrubbing and isolating the my arm for the catheter installation than the actually procedure itself. So far the lab has found coag negative staff and possibly Gram + cocci staff, so now I'm just waiting for the antibiotics to come down so we can start kicking some bacteria's butt.
 
Well I see your sense of humor is intact, and your patience is being tested. Doctors refer to joint infections as "devastating," or something like that. I am in the 1% on another front that was no fun, but pales in comparison to infection. Yes, you deserve some metals to wear on your chest. I'm not sure they have one for "annoying member," though.

Too bad that coping with difficult circumstances makes you feel annoying. It's OK to complain and moan and indulge in "life isn't fair" mode.
 
[Bonesmart.org] Fourteen months, one knee still raw. Yes, what you are undergoing now is step one in a two part revision because of infection. We have had several members who have gone through this because of infection and are designated as "Revision TKR". This in no way takes away from the fact that you had bilateral TKRs. I can only imagine how difficult this must be for you, but I can certainly understand how unfair you feel it is.
 
It's my first day home and the reality of this grueling recovery is sinking in. Since I will be physically isolated from the rest of the house I'll have to send my 5 year old on secret raids on the goodie shelf in the kitchen. Since mommy will be on the prowl, due to risks incurred (bedtime with no IPad) my daughter wants 80% of the loot, is that fare? I suspect she is taking advantage of my situation.

The PICC line seems to be my new navel or sacred gate to life. Everything is about the PICC line now. I can help some with the dossing, but my wife has to do most of the scary stuff, like making sure there are no bubbles in the syringes, line cleaning etc...she thinks she is going to kill me with the slightest mistake.

My blood pressure is low, so I do everything at 1/20 speed, also the precariousness of the knee joint with the cement spacer seemingly tumbling around freely is very freaky. This has required some mental adjustment from the usual recovery trajectory of a knee replacement; there is no building of strength or ROM, the knee just needs to be in suspended animation so the antibiotics can do their work. I can almost bare weight on the joint, that is if the spacer has settled correctly, but I think I will be stuck with a walker for at least 6 weeks. I foresee madness. :yes!:

Here is a first: I fell asleep while my wife was in mid sentence! The pain relief is beautiful, but Oxycodone makes it very hard to interact with the living.

Saturday, July 20 2013.
Lots of seizing pain today and swelling. I had one of those half asleep dreams when you stumble and kind of jolt in bed. Boy oh boy did that little jolt hurt my leg I might as well have fallen right on my face in real life. I can sleep for maybe an hour at a time. Taking two oxy's every six hours which brings an overall sense of well being for a couple of hours only. Finally had a stool and took a nice shower with the picc arm cling wrapped completely to keep out moisture. At this point I have stopped putting any weight on my leg. The spacer is audibly rubbing and scraping all day long. The dosing takes about two hours twice a day, and at least I don't have an IV line in me all day. Heart is pounding pretty hard all day, I think the low blood pressure needs to be addressed.

Sunday, July 21 2013
First PT session was kind of a wash out, we did mild stairs and flex excersizes which was enough to leave me with another fever and some of the worst pain I have experienced from both surgeries. It seems that there is really nothing you can do with a knee that has a spacer. I'll call the doctor Monday, because something is causing a stabbing pain that is beyond debilitating. I was ready to smash the room to pieces before the additional oxy kicked in. Yes, I would agree that an infection is devastating. The good news is that I had one of the best chicken pot pies ever. I'm liking Virginia!
 
Just a little update regarding my battle with infection. Twelve days out from my explant and am finally able to get at least three two hour stretches of sleep a day. The key is to lay flat on my back and have the bad leg rest with my foot pointing to 10 o'clock. This seems to prevent the cement spacer from settling up against nerve and soft tissues when I fall asleep. My whole challenge before was trying to wake up before the knee woke me up with what felt like an ice pick right through the knee cap.
One of the problems now is that my foot is starting to point left in an unnatural way. I have to do a little coaxing to get it to point out straight again. The knee also wants to stay bent, so it takes a little more coaxing with very loud creaking and clunks, to get my extension back to 0. Still I have to say that none of this would be possible with out oxycodone which does wonders for relaxing the body and mind. The bandages came off for good and the new incision does not look half as scary as the original incision last year.
They still have yet to isolate the exact strain of Staph that I have, but for now I am administering 2000 MG of Vancomycin through my picc line every 12 hours, using one of those Eclipse pressurized balls. The sensation of the cement spacer sliding around where the implant used to be does not bother me as much as last week. It does bother my wife to hear my leg creaking like a loose floor board. I've lost ten pounds in 12 days and despite my little exercises, I can only watch helplessly as both my legs begin to wither and I still have six weeks to go before they will consider putting a new joint in.
The bad leg has to be moved around manually but perhaps after it heals a little more I'll be able to do some leg lifts. I'll be on a walker for the duration of his treatment. My good leg has saved my life, though I'm pushing the implant to the limit, it is holding up pretty well. Think I'll name my knees "the odd couple."
 
Plexi....you are really going through a lot and I'm sorry. In the end it will all be worth it, but...man oh man.....getting there! I love that you are keeping your sense of humor. It really helps to have a great attitude when you are faced with these challenges. Keep up the great effort!!! And do continue to post status. It will be a helpful story for others who may have a similar problem with their knee.
 
Into the third week of antibiotic treatment. Last week they doubled the dose of vancomycin however for the last four nights I've been running a high fever (102.4), so they have dropped the dose by half to see if the large dose was causing a reaction. The most common reaction to vancomycin is the "red man effect", when the body develops large red rashes. I do not show those symptoms, but the chills, fever and disorientation are enough to cause some concerns.

Before the new dosage arrives they told me to skip two treatments. So far so good, because by this time last night I was shivering under four blankets and by 1:30 I was lying in soaked sheets, out of my mind with the fever in full swing. The home care nurses took more blood today and a urine sample. I'll see the doc early this week. Ive been getting around the house a little better today with the walker or crutches, that's a first.

I just found out that our neighbor had an infection in his artificial knee as well. This 1% rate of infection does not sound very accurate to me, it's got to be much higher than that, but where there is money to be made..... Brian Williams should do an investigative report on this. :wink:
 
So sorry you are having to go through this, Plexiburg! It sounds like you are managing to keep your sanity in a very difficult situation. I am glad you posted; I have been following your thread and hoping you would update us. Stay strong and let us know how the doctor's visit goes.

Becca :flwrysmile:
 
What an ordeal you are going through! I knew sulfa could cause "red man syndrome" (been there, done that) but wasn't aware Vancomycin could do that too.

As to that "1% infection rate," I read something corollary to that in the latest issue of Consumer Reports magazine. It issued a review of surgical survival and complication rates in U.S. hospitals (nationwide best & worst for specific procedures, and a general full list of local hospitals in its Midwest edition), and there were some truly anomalous results: HSS in NYC was listed among the "worst" for TKRs; and Johns Hopkins, Mass. Gen., and the Cleveland Clinic were listed among the worst overall. In IL, Northwestern Memorial, Rush & Skokie were listed as "average" (with Skokie outscoring the other two but tiny and financially troubled Holy Cross--one of Bob's hospitals in the crime-riddened Marquette Park neighborhood--listed as "better than average"). Advocate Christ Hospital, which is consistently atop most lists of best hospitals, finished near dead-last. The highest-scoring IL hospitals were in small towns far from metro areas.

I'm pretty sure that they're failing to factor in that major teaching hospitals are taking the riskiest and sickest patients (because they CAN, due to the most renowned and innovative specialists and nurses and most advanced equipment) and that the smaller (especially rural) hospitals are "buffing"* their stats by "turfing"* the most complex and emergent cases by Medevac to the larger regional and teaching hospitals.

* For definitions of these two terms, see the classic required-reading-for-interns-and-residents satirical novel House of God (thinly disguised Beth Israel branch of Harvard) by the pseudonymous "Samuel Shem." Orthodoc, you've doubtless read this; Josephine, not sure if it was de rigeur in the UK.
 
I don't have a digital subscription and am still getting the hang of my scanner. But it's in the very latest issue of the magazine. The listings of best and worst per procedure are nationwide (and basically a sampling), but the overall rating per hospital is broken down by region--for instance, Roger would get a list of West Coast and nearby states, Luisa's copy would list the Northeast and/or Mid-Atlantic, etc. If you go to www.abc7chicago.com (or your ABC station's site) it might be on their website because they ran a story on the article before the issue hit the stands and mailboxes. CR's site is, I think, www.consumerreports.org (or .com).
 
Plexiburg said:
Into the third week of antibiotic treatment. Last week they doubled the dose of vancomycin however for the last four nights I've been running a high fever (102.4), so they have dropped the dose by half to see if the large dose was causing a reaction. The most common reaction to vancomycin is the "red man effect", when the body develops large red rashes. I do not show those symptoms, but the chills, fever and disorientation are enough to cause some concerns.

Before the new dosage arrives they told me to skip two treatments. So far so good, because by this time last night I was shivering under four blankets and by 1:30 I was lying in soaked sheets, out of my mind with the fever in full swing. The home care nurses took more blood today and a urine sample. I'll see the doc early this week. Ive been getting around the house a little better today with the walker or crutches, that's a first.

I just found out that our neighbor had an infection in his artificial knee as well. This 1% rate of infection does not sound very accurate to me, it's got to be much higher than that, but where there is money to be made..... Brian Williams should do an investigative report on this. :wink:
Click to expand...
They took me off ofVancomycin within 5 minutes of starting it because blisters and hives started developing in my scalp and my torso and were working their way down! :shocked:
 
Status
Not open for further replies.
Active Antimicrobial Hydrogel
Corganics CBD

Staff online

Members online

Total: 1,155 (members: 4, guests: 1,151)

Latest posts

Back
Top Bottom