Knee Infection* Infection after 5 weeks

Hi, Doopy. I just read your latest post as we got in from my Physical Therapy. You have Really been through so much! The basic rehab from a TKR is a challenge in itself, but then, a complication ( infection) poses it’s own set of problems. Like you, I didn’t really have a lot of pain initially, & was doing great. Then this infection came. My hospitalization was just 1 day shy of a week, & my surgeon did a cleanout surgery & replaced the liner in my knee. I found that this second surgery hit me much harder! When I mentioned this to one of my nurses, she said, “ of course....you’ve just had this second surgery little more than a month after your first surgery, you have an infection, and your tissue is inflamed”. And my Infectious Diseases Dr said the same: “ of Course, you tire easily.” It seems the recovery has been a little harder this time, a little slower. My older sister told me her Dr. once said, “ just remember, if you get just a Little better each day, that is progress “ I try to remind myself of that daily, it helps. My fatigue is getting better, but my sense of balance is still off. I am 6 weeks out from my cleanout surgery. - had my PICC line removed yesterday! ( 6 weeks on IV antibiotics) , and now on 3-6 months of oral antibiotics. But progress! Like you, I did have a time when I was so sad, found myself crying over nothing, but it did pass. Maybe we just need that sometimes. I think maybe a combination of fatigue, medications, and, just the situation. And it’s understandable, especially in your case, you have been through a Lot , even before this. I’m keeping you in my prayers that you will see some improvement soon. Remember that saying I often see here...” baby steps.”. Do take care, and remember that there IS light at the end of the tunnel. And don’t be hard on yourself, I think this just takes time, sometimes more than we’d like.
Wow, you've really been through it too! You are about the same as me - surgery one month after the initial TKR, and now 6 weeks post-clean-out surgery - we must have been going through it at the same time, opposite sides of the world! It's good you've had an infectious diseases doctor on your team - here I've just had the one surgeon, plus nurses in hospital, and now the Tissue Viability team. It's being in that vacuum with no-one to explain that it's ok and normal to feel exhausted as you heal and take meds which has been tough - all I've had is Dr Google to consult! (no, I know, not good!!). Thank you for your kind and understanding words - much valued. Please get well and strong yourself - sending you positive thoughts from over here.x:wave:
 
@doopy
Words fail me...but I'll try!

I have no advice at all on the mechanics of your medical problems as my TKR has been straightforward apart from my popliteal issue which has little to do with my surgery.
But
I can identify with the exhaustion and subsequent tears.

I don't sleep more than a couple of hours a night [if I'm lucky] and combined with the added problem of always on edge looking out for my husband [disabled thro' MS and has just finished cancer treatment], I am just plain old tired out.
I have to say to folk sometimes 'don't be nice to me' as it can precipitate floods of totally unwanted tears so your tearful reactions are normal, therefore cross that one off any potential 'am I over reacting' list.

Our NHS is over burdened and comes in for a lot of stick but when it works, it truly is a thing of wonder and I am so pleased you're getting the care you need.

Chin up and get another box of tissues for when those taps behind your eyes leak. Kleenex has been a good friend of mine. :)
Yes, you are so right - the poor old overstretched NHS is a total marvel, especially in the situation we are in right now - fantastic care, we are very fortunate. Thank you for your words of understanding and empathy - gosh, it must be hard for you also caring for your husband as well, and I send him good wishes for recovery too. Yes - if anyone is kind to me I just erupt into floods, as I also do when I just can't do something, like get my boots on. I keep getting the blasted tubes of my wound vac caught in the mechanism of my recliner (bought in a panic from a local BHF charity shop post-op!) - always when I need to rush to the loo! I guess I'll laugh about this one day soon :heehee:. Take care!
 
One of the nurses reminded me that I had had 2 big operations within 5 weeks, and the healing required is massive - is it? Do you think it is doubled?
Short answer - yes! You have been through so much and are still fighting off this infection. No wonder you are exhausted and teary!

And do remember that major surgery itself can bring on PTSD. Add into the mix your sudden infection and all that it brought - I think you are doing remarkably well!

Be good to yourself. You are being very brave through all this. And we are with you all the way. Please keep us updated!
Thank you for your words of advice, Jaycey - I'll take it on board and try to be calmer. Bless you for being here! :flwrysmile:
 
I know when I get in a similar emotional state (and that has happened with my standard TKR recovery), I try to shift the focus. It may be hard because there are so many troublesome thought balloons swirling but can you think of something that brings you joy that you can do while sitting? It would have to be something that won't be difficult to pick up again if you need t take a break to rest. Strangely, I thought I'd be finishing all of my knitting projects but I have not picked up the sticks during this recovery. I've done puzzles and adult dot to dot and lots of game apps and way too much bad tv - all intended to pass time and take my mind off my recovery.

My hat tips to you @doopy. Rest when you can and come here to let us ease your burden, if only a bit. You've been through a lot and you are still swinging!
Thank you - you are right - wise words!! I think that whilst settled in my faithful recliner I'll try getting back to doing some genealogy research on my laptop - if I get bogged down, I can just shut the lid and close my eyes! And as you say, a bit of bad TV thrown in!!
 
How's it going?
 
How's it going?
Well, I'm still here! And thank you for enquiring!
The news is that on 4th Jan, after 11 weeks, I finally was released from the wound vac.:happydance:
It has made a big difference to me, both physically (I no longer get the tube caught on the gas cooker knob and risk blowing up the neighbourhood!), and mostly psychologically: I feel a it less of a victim without it. Recently I made a short foray to a lovely barn shop in the countryside, but the vac felt such an encumbrance I couldn't enjoy myself. I didn't feel embarrassed by it over my shoulder, but it somehow meant I felt like an obvious "poor old me", if that makes sense. The wound now seems to be almost totally healed, though surgeon and Tissue Viability think there's still a tiny hole there, so now it just has an ordinary sort of film plaster.

But the Ciprofloxacin is a major problem. I can barely move my left arm (& of course, I'm left-handed), both shoulders are agony, especially in bed, and my Achilles tendon is threatening to go. I have zero energy, can't sleep at all, still cry at the slightest thing, and most of all I'm terrified of these side effects being permanent and irreversible (which for some people they are). Also the Cipro has messed with my thyroid - it seems no-one in the hospital (where I was for 2 weeks) or my GP have any idea that Cipro apparently inhibits the uptake of levothyroxine, and the 2 should be taken 6 hours apart. My already unstable thyroid (RAI treatment for Graves, 2010) has veered from being a bit overactive to wildly underactive in a few weeks, so that's not helping my joints, muscles, mood or energy levels either. I was due to stop Cipro this Friday but have ditched the last few doses - I've taken 73 days out of the 77 day course, so I don't think that will make too much difference, whereas I feel every extra tablet I take of it is another toxic dose.
However, I know that Cipro halted the infection in my leg, so I can't be too damning, although I'm so anxious about the infection resurfacing now I've stopped meds. As my surgeon said, the microbiologists will say that at some point you do have to stop and see what happens.......

I'd love to hear from anyone who suffered from Cipro toxicity and recovered - sadly the internet is mainly full of horror stories.

I continue to try to eat really healthily, lots of lean protein etc, and a multivitamin & mineral tab, and am going to use magnesium oil to replace that depleted by Cipro (now that I've stopped taking it.)

I guess there is improvement, for which I am grateful, but boy, is it slow!!! And I'm such a lily-livered scaredy-cat!!! :dubious:
 
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@doopy ..... I can't recall any of our BoneSmarties who had the reactions you're talking about to Cipro. I'm sorry you're going through this and hopefully once you're off the medication, things will level out. You might talk to your pharmacist about what you're experiencing. He or she could have some suggestions. One thing you could ask about and consider it to take some really good probiotics to help get your gut back to normal. You'd want to discuss that with your GP as well, but it might help.
 
I don't have experience with your challenges @doopy, but think the improvement must be welcome (even if it is slow). I hope the cessation of the cipro provides the relief you want without the risks.
 
I just caught up on your story and Oh..My..Goodness! So much has happened since Sept! You are allowed to feel all the feelings you've had, anyone would be scared too. I'm so glad you were able to connect with @Starsfan22 and @Catalien45 , who have been through similar experiences. That's what's great about this site, no one knows what you're going through better than someone else going through the same thing.

Take care and here's a big ole hug from me to you. :friends: I hope your pain eases as the Cipro levels out in your system.....
 
Hi, doopy, catching up again & saw you had a new post, I’ve been wondering how you are doing. I’ve never taken Cipro, & forget what my IV antibiotic is. Right now, I’m taking cephalixin in a liquid form ( Nasty tasting stuff, but, Sure beats the IV). Most antibiotics are in big tablets, & those don’t work for me since I’m lacking my colon. But liquid forms generally work well. I looked up interactions in general on the internet. I’m also taking a probiotic to try & avoid side effects of the antibiotic on my body, and, asked my dr about spacing, he said an hour apart is fine. Also, I take a generic of Pepcid. That can interfere because of the magnesium it contains. So! I’m writing down when I take each. Trying to space the antibiotic as close to 8 hours apart as possible. If I get up at 6, or close to it, it all works pretty well, & I can take that last dose by 10 or 10:30. you might check with your Dr about what you’re taking, how to best take it, interactions. Or possibly the Internet. We find that Mayo Clinic is a good source in general.... or, just google your specific problem. Protein! Boy, I’m really focusing on that, too. Mostly lean meat, poultry, fish & eggs. I find myself seeing how much I can pack in our meals, & like you, veggies. I like to think we are really getting into some healthy habits. How is your appetite? I find eating right is a lot easier now that most food tastes good.
Just a thought....you mentioned the fatigue & muscle soreness. Could you possibly have had a “bug”? A few days back, both my husband & I were achy, super tired for no reason we could think of.... now, we think it may have just been a short-lived bug going around. Other than Dr visits & PT , I’m not getting out, & he only gets out for grocery shopping, prescriptions, that sort of thing, & he wears a mask. But, still, there is other stuff out there. And, it took me some time before the fatigue went away after this second surgery, you are probably fighting that. SO easy to do too much! Do you like to read? I found reading really helped distract me, and, if I was more tired than I thought I was, I’d get sleepy, & before I knew it, I’d taken a good nap of an hour or two. I had several good historical novels on Pre- Tudor time in England. And, I found an old book written by A.J Cronin. I loved his books as a teenager.

I’m hoping by this time, you are feeling some better. ( it has taken me some time to finish this, I apologize). and hopefully, your Dr can guide you as to side-effects. It may be that they can come up with something different that will work as well without you having to go through so much. Do take care, & don’t fight the rest. And remember that most everyone heals in their own way. That light at the end of the tunnel is there, you are just having some unpleasant detours. But you will get there. Take care, and I’ll be keeping you in my prayers to feel some better each day.
 
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

Boy does this sounds familiar. Like you, I've recently soldiered through cancer, artificial knee infection, an A-fib scare, and I even ran over myself (the wheel up onto my TKR leg including over the TKR, and then back the other way when they rolled the car off me). We are tough! And then a slip makes it all pour out. And even though we've been through decades of joys and disappointments and learned to deal with just about everything, I find that in our "Golden Years" (ha-ha!) we are more emotionally fragile. I was very pleased when one of my sons told me that he admired how I went through everything I went through.

Let yourself have your disappointment, sadness and even limited periods of hopelessness. They'll pass on their own.
 
Thanks to all who responded - love to you all for being there and taking the time to read and reply, and I'll reply individually as well.

Well, had my weekly hospital clinic check with the surgeon. You may remember that last week I was finally released from the wound vac and I had just a small plaster bandage on my wound. I left this on all week, and waited for the surgeon to remove it. Although nothing had come out via he wound vac for t least 6 weeks, I was dreading that the bandage might have some seepage on it inside, meaning the wound hadn't sealed and healed. As it came off I nearly fainted - a large black patch!!:yikes: But turns out - haha - it was a piece of silver-impregnated fabric the Tissue Viability team had slipped in when I wasn't looking! Wound is now a massive dent in my leg (who cares?!), but looks fine. I am now free of all dressings (feels scary!).

I confessed that I'd chucked in the Cipro a couple of days early, and he wisely just shrugged and said it wasn't a big deal after 3 months, and so I am now enjoying what he terms an "antibiotic holiday" - ie I stay off the drugs and we watch and wait. If my bloods and leg don't indicate a problem over the next 3-4 weeks, then it's looking good (at least, for now - I do know joint infections can re-surface years later). My full blood count figures are all pretty much normal, but my CRP had annoyingly gone up (from just hitting normal at 9 the other week) by 4 points last week, but had dropped back one point this week. Disappointing and scary that the CRP and ESR remain raised, but surgeon isn't too bothered. My CRP is 13 - post-debridement surgery it had hit 175. But I've read that even anxiety and depression can raise it - one reputable health site listed "optimism" as the last in a list of things which can help lower it, so maybe it's time I tried to get over the shock of all this and see myself as now healing and emerging as well.

The Cipro should have left my system after around 22hours (according to its half-life), and a couple of days later I did have the energy to go out and spend nearly 2 hours in a freezing garden planting the bulbs I bought just prior to my emergency admission. I also did a lot of housework the net day, and I do think maybe I am a bit better. I certainly look better in the mirror - healthy and less haggard. But the insomnia is still a big issue, which never helps anything.

Finally, I made an appointment to re-start physiotherapy. I can walk without an aid but it is an effort as I do the penguin waddle, and my sense of balance has gone again (didn't help the yesterday the pavements were all icy). My dear friend over the road had her THR last week and we are planning to hobble up and down the road together as exercise, with my 86 year old mother-in-law in tow who has lost muscle tone through isolation in lockdowns here. What a group we shall make!!!:friends:
 
@doopy ..... I can't recall any of our BoneSmarties who had the reactions you're talking about to Cipro. I'm sorry you're going through this and hopefully once you're off the medication, things will level out. You might talk to your pharmacist about what you're experiencing. He or she could have some suggestions. One thing you could ask about and consider it to take some really good probiotics to help get your gut back to normal. You'd want to discuss that with your GP as well, but it might help.
Thanks Jamie - yes, I agree the a chat with the pharmacist might be a help (notch chance of getting access to a GP here at the moment!). And I think probiotics are a good idea - I haven't experienced and digestive issues on the Cipro but it must have taken out all those good bacteria. Milk products were contra-indicated with Cipro to some extent, so I had avoided the usual organic yoghurts I'd normally have been eating - time to re-introduce them now!
 
Hi, doopy, catching up again & saw you had a new post, I’ve been wondering how you are doing. I’ve never taken Cipro, & forget what my IV antibiotic is. Right now, I’m taking cephalixin in a liquid form ( Nasty tasting stuff, but, Sure beats the IV). Most antibiotics are in big tablets, & those don’t work for me since I’m lacking my colon. But liquid forms generally work well. I looked up interactions in general on the internet. I’m also taking a probiotic to try & avoid side effects of the antibiotic on my body, and, asked my dr about spacing, he said an hour apart is fine. Also, I take a generic of Pepcid. That can interfere because of the magnesium it contains. So! I’m writing down when I take each. Trying to space the antibiotic as close to 8 hours apart as possible. If I get up at 6, or close to it, it all works pretty well, & I can take that last dose by 10 or 10:30. you might check with your Dr about what you’re taking, how to best take it, interactions. Or possibly the Internet. We find that Mayo Clinic is a good source in general.... or, just google your specific problem. Protein! Boy, I’m really focusing on that, too. Mostly lean meat, poultry, fish & eggs. I find myself seeing how much I can pack in our meals, & like you, veggies. I like to think we are really getting into some healthy habits. How is your appetite? I find eating right is a lot easier now that most food tastes good.
Just a thought....you mentioned the fatigue & muscle soreness. Could you possibly have had a “bug”? A few days back, both my husband & I were achy, super tired for no reason we could think of.... now, we think it may have just been a short-lived bug going around. Other than Dr visits & PT , I’m not getting out, & he only gets out for grocery shopping, prescriptions, that sort of thing, & he wears a mask. But, still, there is other stuff out there. And, it took me some time before the fatigue went away after this second surgery, you are probably fighting that. SO easy to do too much! Do you like to read? I found reading really helped distract me, and, if I was more tired than I thought I was, I’d get sleepy, & before I knew it, I’d taken a good nap of an hour or two. I had several good historical novels on Pre- Tudor time in England. And, I found an old book written by A.J Cronin. I loved his books as a teenager.

I’m hoping by this time, you are feeling some better. ( it has taken me some time to finish this, I apologize). and hopefully, your Dr can guide you as to side-effects. It may be that they can come up with something different that will work as well without you having to go through so much. Do take care, & don’t fight the rest. And remember that most everyone heals in their own way. That light at the end of the tunnel is there, you are just having some unpleasant detours. But you will get there. Take care, and I’ll be keeping you in my prayers to feel some better each day.
Hello, what a lovey message, and thanks for taking time to reply - it was very helpful, and made me feel better. Sounds like you are dealing with similar issues - trying to get the magnesium into your body without compromising the antibiotics, eating enough protein etc. Yes, I do have an appetite, and try to pack in things like nuts, avocados and cottage cheese, along with bananas, fruits and whole grains for lunch. Husband took over the evening cooking, he's a big meat-eater, so I get whatever he decides to experiment with!
I don't think I've had a bug, as I'm not seeing anyone much (Covid - everyone is very cautious here), but I do suffer with a bit of fibromyalgia (according to my GP), so I guess that flares up. I've not been active for so long that my muscles are just mush anyway, so that also causes issues. The fatigue is lifting a bit now I'm off the Cipro, but the insomnia is not helping - caused by both the drugs and probably anxiety. But things will get better, I'm sure. Our bodies have taken such a battering - it's not surprising they let us know they need a rest!
Thank you for including me in prayers - that's so touching. I hope you are doing well, and I send positive thoughts back to you. :) :-) (:
 
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

Boy does this sounds familiar. Like you, I've recently soldiered through cancer, artificial knee infection, an A-fib scare, and I even ran over myself (the wheel up onto my TKR leg including over the TKR, and then back the other way when they rolled the car off me). We are tough! And then a slip makes it all pour out. And even though we've been through decades of joys and disappointments and learned to deal with just about everything, I find that in our "Golden Years" (ha-ha!) we are more emotionally fragile. I was very pleased when one of my sons told me that he admired how I went through everything I went through.

Let yourself have your disappointment, sadness and even limited periods of hopelessness. They'll pass on their own.
Hi there, thank you for your message - it does sound like we've been on the same journey! (though i havent had my leg run over - yet!). I think it does all just take its toll, and I have this feeling that my brain is now so programmed to expect massive medical failure / catastrophe that every little thing looms like a crisis. I am trying to work very hard to tell myself that I am getting better, and that people DO recover from this, and STAY recovered - unfortunately its always the horror stories which make it to the surface. But Spring is on its way, and I just booked to go to our beloved France now the borders opened again on Friday (I missed a 10 day trip in Oct when I was in hospital with the infection, and again at Christmas when I was unable to stray far from the hospital appointments), so I'll try to be positive. I hope you are doing well, I re-read all your posts and found them very helpful. Take care of yourself!!!
 

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