Knee Infection* Infection after 5 weeks

[doopy]

Back here again after a THR 2016, had TKR 7/9/21. (I’d like to say “great to be back!”, but although I’m looking forward to my new knee bedding in, 10 days post-op I’m feeling it’s mixed blessings to be here!)....

Anyway, question is, as I left hospital I was advised to be a bit more careful of Covid as my immune system would be a bit compromised right now (just because of the massive toll surgery takes, or is it because of any meds used to help the implant settle? - I don’t know?), though of course I am double-jabbed. I’m due for a flu shot tomorrow - is it ok to go ahead? Husband is getting his, & as he’s a teacher I need to think about all the bugs he could bring home, so I’m keen to get flu jabbed but my body is so exhausted I’m scared of putting it under more stress - or doesn’t it work like that?
Sorry to show my ignorance, and apologies if I’m not posting correctly!

 

[Mojo333]

@doopy
I see you had your THR about 6 months before my surgery.
I've heard members say knee surgery recovery can be a bit tougher?
Which Knee did you have replaced on September 7th? We will add this information to your signature and get you added to the September Sapphires Knee Group.

Everything I've researched says it is safe to get vaccinated after surgery.
However, I noticed on various sites that different surgeons recommend waiting anywhere from a few days to several weeks post op. Can you contact your OS for his recommendation?

The main reason for the recommendation to delay, as I understand it....is so any potential side effects would not be confused with surgical aftermath symptoms.

Vaccination is a chain of reactions that involves immune cells which are one of main factors for inflammation.

So if you take a vaccination immediately after surgery, the inflammatory response of vaccination can be amplified. Fever, headache, muscle pain, etc.

It doesn’t mean there would be a serious problem. It’s very unlikely. Actually, there is no evidence that vaccination immediately following a surgery increases the complication.

If you have had the shot before, and had noticeable side effects....you may want to wait a bit longer, in my opinion.

 

[doopy]

Thank you for your swift reply! I have had Right knee replaced, and had steroid injection into Right hip at the same time.
Husband just asked at the pharmacy where we are booked for flu jab, and pharmacist is of the opinion that it is exactly because I may be a bit immuno-suppressed due to the injection that I SHOULD get jabbed - he says that if I were to catch flu I would be a lot iller.
I take on board your very important point re inflammatory response, but I’m lucky in that for some reason - possibly hypermobility /hEDS related?(I might need to ask more questions on this later!) - I heal really fast: 10 days out and I’m only on a couple of paracetamol and one small ibuprofen a day, with v little visible swelling. It’s a tough call, and I’d certainly delay the jab except for the fact that we’ve been warned of the shortage of vaccines in our area, & appointments are like gold dust, which is what complicates it all.
Would love to hear from others re their experiences?
Re knee being harder than hip, so far I’m fortunately finding the opposite, with the exception that my brain is just cotton wool and I’m crying all the time - a total emotional mess. I had to do 2 flights of stairs yesterday and could barely form a sentence for hours - those diagrams on here re the Energy Drain are so accurate & helpful!
Thanks as ever for being here!

 

[Jaycey]

@doopy post my LTHR I had a flu jab at the same appointment as my suture removal - 10 days out of surgery. I did ask the nurse when she offered it and she said the same as your pharmacy. If you can get the jab now I would go for it! Wish I could do the same but it's not yet available in my area.

 

[doopy]

Brilliant - thank you! I think I will go ahead, nervously asking the pharmacist one last time as he stands, needle poised! I’ve never had a bad reaction to a flu jab, so that’s one thing in favour
I’ll report back, one way or the other!

 

[Pumpkin]

@doopy
back to BoneSmart,
Sounds like you will do fine with the flu jab.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

​

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

​

Activity progression for TKRs​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

OneStep App Request

Since December, BoneSmart has offered a number of pilot tests and special promotions with our partner, OneStep. Members were allowed to use this unique app at no charge to help us evaluate the program’s effectiveness for prehab and recovery for joint replacement patients. Feedback has been...

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[doopy]

Brilliant, thank you!
Well, I went ahead & had my flu jab (about 6 hours ago) - all good so far. Checked again with (different) pharmacist before he injected - same reply that I should have it exactly BECAUSE I’m slightly compromised.

Only comment today is that I know I’m eating really badly - erratically, & alternating healthy with garbage (cappuccino & muffins), then walked a bit far, did too much, & chatted to oldest friend on the phone for nearly 2 hours and I am nearly beside myself with exhaustion. I wish I’d learn! The energy drain from talking fir a long time - this healing lark takes no prisoners! Rest, rest & more rest!

 

[Pumpkin]

Glad you flu jab is behind you, now it is time for .

 

[doopy]

So, 48 hours post-flu jab, absolutely no problems, if anyone else needs reassuring.

Just been to the nurse for my bandage off (2 weeks today post-op, hooray!), she says it all looks fine and is leaving it uncovered, so it just has steristrips holding it which will fall off in the shower.

I don't think that I have upped my activity level much in 14 days (although, yes, of course I have, if I think how I was last week, or the day post-op), but as I said, I've had virtually no pain until now, but last evening (after pottering in the kitchen for about 20 mins), pain really started, mostly on the outside of the knee, and round to the back of it. I took one paracetamol and one ibuprofen, which helped, and another paracetamol before sleeping and it was perfectly fine this morning.....until I started moving around. Took one of each tab with breakfast, went to see nurse, walked about 100yards, then came home in car.

Pain is the highest it has been, am resting now and elevating, and it is wearing off. Told nurse, she said obv to keep a watch and that a bone infection would manifest itself in unusual reduced ROM, throbbing etc. She felt it was unlikely, as she said that at this stage the only port in for infection should be the wound, and that looks perfectly fine.

Have I just been lulled into a false sense of security by not having had pain so far? Is it normal for pain to escalate once one starts doing a bit more? I guess one can't expect a constant positive trajectory when the body is so traumatised, and also I suppose suddenly muscles etc which haven't been used for years are suddenly being asked to perform.

One positive to report: from the very first steps post-op, I was able to roll through taking a step on the ball of my foot. For about 2-3 years I had been pointing my toe inwards, resulting in severe pain across the top of my foot - all gone almost instantly! And my foot walks straight! New shoes required, as they are all deformed because of my odd gait.

(Please advise if I'm not posting in the correct way, or rambling too much - am just hoping to share what's going on with me, and keen to hear from others).

 

[Jaycey]

@doopy What you are feeling is very normal. If your pain is increasing due to more activity - scale back a bit and try a slower approach. Listen to that knee. You are very early days in a process that can take up to one year or longer.

No problem with your posting! I'm sure other members will be comforted that you are sharing your experience.

 

[doopy]

Thank you!
I just looked back at all my posts from 2016 (TLHR), and am amazed at how much I posted, and how incredibly valuable all the replies and support were. I honestly thought that I wouldn't want to check in again here this time (as a know-it-all veteran!!), and now look at me! Heavens, this forum is a godsend! Just changing my Amazon Smile thing to support Bonesmart (the amount I spend there should generate something, I hope!).

 

[doopy]

Just had my first physio appt, thankfully with a great guy who I'd seen before and who has trained in dealing with hypermobility (which I have - no "official" diagnosis yet, but most agree I am, with poss hEDS - hypermobie Ehlers-Danlos).
Anyway, was still in agony in outside of knee, and was glad to be able to find out what's going on. He wasn't too worried, thinks I've just been unlucky and have aggravated - what??? I didn't listen!! - but some "leathery long tendon?ligament?" which runs right down the outside. His advice was to go back on the ibuprofen full regular dose for 72 hours, not to overdo it and to just do very basic gentle exercises for a while, and to ice at least 3 x pd. Which I confess I haven't been doing, and I suddenly realised why not: I can't feel it!! I had been expecting to feel the relief everyone here describes, but all I get is a mild cool feeling - my knee is numb! I'm not bothered by that, and I assume the icing benefit will still happen even if I can't feel it, so I'm doing it now as I type.
And as I live v close to the surgery, I was so relieved that I didn't call my friend to collect me, and I walked home! It's only 285 metres, but it's the furthest I've walked in years! I was so triumphant! It didn't hurt at all, so I think it was ok, and no bad after effects so far. But am v tired today, so taking it quietly - I believe in listening to my body.

 

[benne68]

It's only 285 metres, but it's the furthest I've walked in years!

Congratulations! Since your surgery was about a week ahead of mine, I'm excited to read that you were able to walk that distance so soon after your TKR! Hoping I can replicate your achievement in another week.

 

[Reader525]

@doopy Congratulations on your walking! My stepdaughter has Ehlers-Danlos syndrome, I can imagine how much that could affect your recovery. Maybe in some ways, positively!

 

[doopy]

It's only 285 metres, but it's the furthest I've walked in years!

Congratulations! Since your surgery was about a week ahead of mine, I'm excited to read that you were able to walk that distance so soon after your TKR! Hoping I can replicate your achievement in another week.

Oh, I'm sure you will! I took it soooo slowly, with 2 crutches, but I've been virtually disabled for so long and I just was thrilled at being able to walk without my knee collapsing inward and causing me agony! I was shattered today - I meant to go out again but let myself snooze in the last days of the sun here for a while instead. God luck - I'll eep an eye out for your updates!

 

[doopy]

@doopy Congratulations on your walking! My stepdaughter has Ehlers-Danlos syndrome, I can imagine how much that could affect your recovery. Maybe in some ways, positively!

Thank you! And yes - 2 physios have told me that just for once that hypermobility might actually be to my advantage! I could certainly do the flat-leg lift-raise straight after the op, which I was told was the gold standard of recovering, and my surgeon was most impressed! I really need this to work!

 

[doopy]

Ok, well, pride comes before a .....fall. A salutary lesson! Please, everyone - BE CAREFUL!!
Today I woke after nearly an 11 hour sleep, feeling still tired, and went upstairs for a shower (I'm sleeping on the ground floor for the moment, as we have a lot of stairs). Got carried away and started cleaning the shower, and forgot that wet surfaces are slippery and ended up suddenly lurching forward. Luckily I was close to the ground, and saved myself anyway, but oh! the shock!!!!
I burst into tears, and to be honest, couldn't stop crying for about half an hour. Anyone else identify with this sort of reaction? It was just shock (I amazingly don't seem to have pulled anything, anywhere), and frustration, and desperation that I will ever be young and strong again (I used to be so physically strong, but 4 hernia surgeries, cardiac ablation, hip replacement, breast cancer and hysterectomy have, unsurprisingly, taken their toll). Feeling a bit pathetic and very sorry for myself. Boohoo .
Thank you for all being here - I know I'm not alone (and it's still not 3 weeks since surgery). Now I'm going to tackle my tax return - that'll really give me something to moan about!

 

[Jockette]

I‘m so sorry you had a close call and glad you’re not hurt (any more than “normal” at the moment.)

Here is why you feel like you do:

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

 

[Jaycey]

Now I'm going to tackle my tax return - that'll really give me something to moan about!

I think you have had enough pain for one day. Do something more fun than taxes!

 

[doopy]

I DID do my tax return, on the basis that I really needed to feel I could do SOMETHING, and I was lucky, it was v easy, so I felt I'd achieved something, even if it wasn't an Olympics athletics medal!!
I am still have a slightly sore outside of my knee, going down into the calf, which hurts after activity, so I'm taking abut 3 x ibuprofen a day and the odd single paracetamol, and I'm now following instructions and icing (& elevating).
Looking back on my THR recovery notes, I'm not doing as much as I did at the same stage, which makes me feel a bit of a failure (eg. on Day 20 with hip I went out to a garden centre - I'm not ready for that yet!), but then I now have years of zero walking behind me, so I guess there's a load of muscles to re-educate in both legs.
The absolute JOY is that apart from the surgical pain, there is NO pain in my knee when I walk - and the foot pain has stayed away too - I can't believe it!! This is what is making me get up and go for walks down the road - 308 metres today, with no problems, but I'm being v cautious and not pushing it. I'm so determined not to waste this chance of a new start towards mobility - I never really got the benefit from the THR in terms of mobility (it of course cured the hip pain perfectly), as my knee was already agony then. Fingers crossed the positivity lasts!