Knee Infection* I have been told I have an infection

[arizonaone]

Good luck! My thoughts will be with you today

 

[sistersinhim]

Good luck. Let us know how you are as soon as you can.

 

[KarriB]

Let us know how things go and what your OS decides to do.

 

[MathProf]

Well the surgeon felt he could get good results the a one stage revision, but the infectious diease doctor is very skeptical. Thanks is not good to have divergent opinions. <sigh>

 

[Marguette]

good luck; sending goid thoughts.

 

[MathProf]

just spoke with my OS, and he is absolutely sure he did the correct thing, as I had significant bone loss due to the infection. He said the 2stage course would have made that situation worse. The PICC line goes in today. Hospital staff doing a good job with my pain management. And I will not worry about being a star in 'joint camp'. I need to re-read the article about post op depression

 

[KarriB]

Good to hear your surgeon was confident. The PICC line wasn’t a big deal and I was so worried about it! I did have some major down time after my washout, so know,that may be coming. What is your surgeon saying about movement right now? Mine put me in an immbolizer and then non-aggressive PT due to the state of my soft tissue after infection and washout.

 

[SusieShoes]

You're going to be an expert on patience by the time you get through this. It does sound like your surgeon made a good call. I had a PICC line once (not for knee or infection) and it wasn't difficult (certainly better than having an IV in my hand!), but I only had it for two weeks. Sending healing thoughts your way!

 

[MathProf]

oh they are making me go to joint camp, but I am not going crazy, the PT's aren't watching too closely. I am officially weight-bearing as tolerated, with a rom of 73*

 

[MathProf]

Here is an update: @KarriB @SusieShoes you were sure right about the PICC line, that was no big deal, but then I got to hear quite the back and forth about whether the PICC line could be used to draw blood. The hospital policy had changed and no longer allowed it. BUT I have lymphedema in my right arm from breast cancer in 2009, so there are no blood draws there. The ID doctor ordered that blood draws be done from the PICC line, so that got resolved, yeah! My Thursday visit to joint camp was painful and PT forced my knee to 95* and all I could think about was this forum. Finally got discharged at 9:30 pm in a Florida downpour. I had to have an infusion and it ended after the shift change, and so confusion ruled the day.

Overall the hospital stay was better than my previous two stays (same hospital). I had the same nurses most of the time, the anesthesiologist listened and I was much less nauseous after surgery. Only the joint camp was worse, and I was able to avoid it 3 of the 6 times !

It was great to sleep in my own bed, but boy was yesterday hectic. I had the first visit from home health care, to change the dressing on the PICC line. Two nurses, the younger was the supervisor who has done home health care for 10 years, but only with this company for 3 months. The older had been an RN for 43 years, and also not with the company long. The older nurse had no idea how to do what she was supposed to be doing. The younger woman stopped her twice, and she was about to mess up the sterile process, and eventually took over and did it. After they left, I got a call from the supervisor's supervisor and I told them I would not let the older nurse back in my home, that the younger worman and done the bulk of the work, and the older nurse was not able to do the procedure I need. The younger nurse called me as well, and assured me that someone different would come on Monday.

Physical therapist showed up in the afternoon and she was GREAT. Doesn't believe in pain. Doesn't think you should worry about strength (as in leg lifts) until later. We did some stretching and with virtually no pain I made it to 100*. She will also come again Monday.

I am on 1250 ml of Vancomycin twice a day, and we managed the evening dose with no problems. A neighbor brought dinner. I am taking two Percocet every 6 hours and doing better with the pain than I remember from before. Icing a lot. Elevating most of the time, but sat at our table for dinner - which is much more pleasant.

So I am feeling good....and waiting for the next thing to go wrong! But trying not to buy trouble! I did have quite the meltdown after the home health care left yesterday. Thank you to everyone for reading, praying, and encouraging me

 

[sistersinhim]

My Thursday visit to joint camp was painful and PT forced my knee to 95* and all I could think about was this forum

Thank goodness you are away from that now. Just think what happens to a baby knee when someone forces it to bend farther than it's ready to do. All those inside stitches are helping to knit together all the tissues that were cut during the surgery. When forced to pull, that knitted together skin has to reknit. That sets the recovery back. That's why we stress to do only what doesn't hurt now or afterwards. The knee should always be the boss, not PT or anyone else, even yourself!

Good job on getting back home. Dorothy is so right, "There's no place like home!"!

 

[KarriB]

I’m glad most everything went well. It can be VERY confusing when home health comes to give instructions. I live alone, but thankfully my sister and friend were with me to get the directions as well. I’m happy the draws will come from the PICC. There were a few times mine couldn’t come from the PICC (for the ID I think) and I had to go to the hospital clinic to have it done. I hope you have the same nurse coming each week to change the dressing. It helps to have the same one. Mine also checked my incision which was comforting for me.

 

[chicklet]

Sounds like you’re doing great in your recovery, MathProf. I’m definitely sending prayers and positive vibes your way and trusting that the worst is behind you now.

 

[MathProf]

Today is 8 days post-surgery, and while I had a bad day yesterday, today is better. I didn't do what I should have over the weekend, so when my therapist came yesterday, my range of motion had gotten worse. I know that I don't need or want to fixate on that, but I hated to go backwards, so I am putting more effort into getting it done today. She has me sit on a chair with my foot on a furniture slider, and slide my foot backwards as far as I can. Over the weekend she wanted me to push the left foot with my right one, and that made my right leg hurt. So now my husband sits opposite me, puts his foot on the slider too and he pushes forward, pushing me backwards, until I say "STOP" and then we go back to neutral.
I had a lot of stomach discomfort yesterday, but I think it was constipation. I took some milk of magnesia last night and that kicked in first thing today, and I feel much better. I also switched back to the Vicodin from Percocet (I have a lovely assortment!) both help the pain, but this time (as opposed to my first two surgeries) the Percocet seems to disagree with me more.
Right now my biggest problem seems to be swelling. My poor little left foot is very swollen. I have two pillows under it today, trying to resolve that.
Does anyone have any experience with a TENS machine that gives electrical impulses to stimulate muscles? The therapist I have had assigned is really big on these. I wondered if it really helps or if it is hocus-pocus.
One last thing @Celle I realized that my surgery description needs to be changed, since I didn't just have the hardware removed on June 4, I had the entire revision done.

 

[KarriB]

I don’t think it’s a great idea to have someone pushing your knee. Heel slides you do on your own without pain are really the ones that help with movement and muscles. It’s normal to have a decrease in ROM because your knee is still reacting to the surgery and chances are you’re doing more than right after surgery. There’s also the added washout your surgeon performed that can be causing the soft tissue to swell.

 

[Celle]

One last thing @Celle I realized that my surgery description needs to be changed, since I didn't just have the hardware removed on June 4, I had the entire revision done.

Thank you for telling me that. I have amended your signature.
I'm assuming that, because you had the entire revision, your knee bones weren't affected by the infection. That' sgood.

I didn't do what I should have over the weekend, so when my therapist came yesterday, my range of motion had gotten worse. I know that I don't need or want to fixate on that, but I hated to go backwards, so I am putting more effort into getting it done today. She has me sit on a chair with my foot on a furniture slider, and slide my foot backwards as far as I can. Over the weekend she wanted me to push the left foot with my right one, and that made my right leg hurt. So now my husband sits opposite me, puts his foot on the slider too and he pushes forward, pushing me backwards, until I say "STOP" and then we go back to neutral.

I think your ROM got wore because your leg is more swollen - which often happens when you first come home from hospital.
Your knee will bend more when some of the swelling has gone down.

Please don't let your husband help with bending your knee. That could increase swelling and set back your recovery. If you're going to do heel slides, this is the right way:
Heel slides and how to do them properly

You don't have to work hard at exercises in order to rehab your knee. Working too hard can sometimes even slow down your recovery, keeping your wounded tissues angry and inflamed.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
TKR: work “smarter” and not “harder”
Knee recovery - Lose the Work Ethic!!

Right now my biggest problem seems to be swelling. My poor little left foot is very swollen. I have two pillows under it today, trying to resolve that.

It's this swelling that is causing some loss of knee bend. While your leg and knee are swollen, that swelling is physically preventing it from bending more.

Instead of being more diligent with the exercises, concentrate on reducing the swelling.
re-read this article, to see how best to elevate.
Elevation: the do's and dont's

You really need 3 pillows to elevate properly, as shown in the photos below. Once you have the pillow stack made toyour satisfactoin, you can pin the pillows together, so they don't keep shifting.

Does anyone have any experience with a TENS machine that gives electrical impulses to stimulate muscles?

I believe it works well for some people. I don't think it's hocus-pocus.
TENS machines for pain management

 

[MathProf]

I just want to report that I have a great therapist, who does not believe in pain! Yesterday's bend was 110 degrees. And it didn't hurt! I think I am going to wrap the PICC line up carefully and try to shower today! Yesterday I helped my hubby make the bed (fitted sheets are not his strong suit ) and I used the microwave to heat up dinner! So far, so good. I just hope the infection is losing and vancomycin is winning.

 

[KarriB]

Press n Seal worked for my PICC line. I wrapped it twice and then used the secondary shower head so the water wasn’t pointed directly at my body.

 

[arizonaone]

Sounds like you had a really good day! I'm sure the infection is loosing! Sending good thoughts.

 

[sistersinhim]

Enjoy that shower. They can feel heavenly!