TKR Late Bloomer<

[sistersinhim]

Didn't Josephine tell you not to worry about it? PT are not doctors or nurses. I think the best way to ease your mind is to go see the wound specialist. But, please try not to stress so much about it and do what Josephine told you to do. Maybe by the end of September you won't even need to see the specialist! Hopefully, you'll get in sooner.

 

[KarriB]

I think you've been very patient because I would've camped out at the OS office until he saw me for no other reason than to calm my fears.

 

[uva55]

I second @KarriB, you are not going to be able to relax until you see a doctor!!!

In the meantime follow Josephine 's advice and let it air out as much as possible. Putting yourself on the list in case someone cancels is also a great idea.

Good luck.

 

[Celle]

Yes, see your surgeon. How he and his PA can decide that you need to see a wound specialist without seeing your incision themselves defeats me! I guess they are influenced by what your PT - who is not qualified in this area - is saying.

Listen to what Josephine has said, and not to your PT. A PT's training does not include the care of wounds. He/she is advising about something in a field for which they are untrained. They are not experts in that field.

Leave the scab alone, let it dry in God's good air, and let the healing continue underneath the scab.

 

[kneeper]

My OS had me keep my incision uncovered from a very early stage. Like Josephine said, he wanted the air to get at it.

And I agree with Celle that a PT is the last person to take advice from on a wound. And I wouldn't want them dealing with bandages either. A nurse, doctor or PA would be the way to go as they actually have training in this area--knowing what looks normal as well as proper sterile procedure. Personally I think a PT attempting to advise on this and do bandages etc is way outside their licensing.

 

[jmp65]

I have never heard of a physical therapist treat a wound such as this. They sometimes treat people with lymph edema and the like who have sores from that but otherwise (or maybe that was an OT) I think not! I am a retired LPN and worked in nursing homes most of my career and treated many a wound. From what I see from your picture of your wound it looks like many I have seen. Please try not to worry so much! With a wound like yours the way it was treated was to keep it dry and clean and leave it open to the air as much as possible! Just like you have been advised here by Josephine and many others. Yes...you have to watch it for signs of infection but this type of wound needs to heal from the inside out and takes time so please try to be more patient and let your body do it's work. I know it's easy for me to say but really...worrying does not help! I hope this will give you some peace and reassurance!

 

[zzevi]

I am scheduled to see the surgeon physician assistant this next week and I plan to sound off. I don't know why the surgeon has chosen not to see me I've contacted them at least twice the past few weeks looking for guidance on my wound and assurance that everything was ok, and the feed back has come back to me mostly through the PT. PT has been cancelled now they don't want me stretching the wound further been stretching it for 11 wks why stop now. Lol.

Well the weekend is here so I can allow it more air. It's starting to itch on the side where I had that pocket of fluid that is directly across from my wound opening does this mean anything maybe healing????

 

[sistersinhim]

I've always heard that if it's itching, it's healing! Of course, it's probably an old wives' tale. But, a lot of those work out to be true! Let's hope so this time!

 

[zzevi]

Well today's a better day, I can deal with information and handle it better. I just want dr's, PTa, surgeons, nurses, assistants all to be up front and honest with me. I have been jerked around and given vague information for a while now and I allowed it. Should have been more active in seeking answers sooner instead of accepting everything that's been told to me.

Yesterday, I was tired and frustrated, I believe in Josephine's replies, but even some of you felt I should seek out a wound care professional. At this point I have about 3 wks before the appt, so I will continue to keep it clean, dry and let it gets some air. I'll go see the surgical assistant to see what they think of the wound as they haven't seen it for about 5 weeks. I didn't personally seek out the wound care professional it was set up after the surgeon seen the pictures that PT took of the wound. But I will go to see what they have to say just to put my mind at ease. I am just concerned about a underlying infection, or the rejection of the joint. I don't know what kind of symptoms some of you that have had infections or joint rejections exhibited. I just know what I have which is a open clean, dry wound, but no scab on it currently. Have developed some slight itching at times lately in the area that had the pocket of fluid after surgery not a surface like itching but a deep down itching

 

[sistersinhim]

Does it seem to be getting any smaller? At least it's not running, so it doesn't sound like an infection.

 

[KarriB]

There is no joint rejection. Some people are allergic to the metal in the implant, but that usually comes with a nasty red rash at the site. I'm not sure I've said this on your thread, but my infection came at 4 weeks with a totally closed incision that seeped a bit, but then I had a high fever (thought it was the flu) and massive seeping (think a creek or stream) from a still closed incision. We had to tape towels around my knee to keep the pus from puddling on the floor.

I am surprised your OS sent you to a wound specialist without seeing you in person. When my incision began seeping like a stream I called my OS group, the only doc there was the back specialist and PAs, my original OS was away for Thanksgiving. They told me to come in, took one look and sent me to the hospital where the revision specialist was waiting for me. I don't think you need to worry, but totally understand why you are. I believe your OS should take a look at it.

 

[zzevi]

@sistersinhim and @KarriB the wound seems nice and clean, it has some stuff in it that they called slough the other day. It doesn't seem like it's mending at all, but I have nothing on it pulling it together. It's not red, hot or inflamed, I don't have usual pain, just the normal aches and pains from being up and about, it's not swelling. Just a little itchy the past few days, again it's kind of a deep itch and where that pocket of fluid once was that is where the itch seems to be and on that area I still seem or looked bruised a little. I know different times a few weeks back the one p/t asked me if I had fallen as he had comment on how the one area looks slightly bruised. I'll be glad to go to the wound care clinic just to find out maybe what went wrong and why it didn't close. I do have a auto immune disorder that I was diagnosis about 10 yrs back with, but I've had my gallbladder done since that diagnosis and never had a issue, my dad was diabetic, but so far I haven't be told I have that. I've been anemic before, but that has been under control with daily iron medication, my appetite wasn't the greatest after having the surgery but no one seems to be, so it puzzles me to why it wouldn't heal, prior surgery I had the mrsa testing and that came back fine. And I answered all health care questions prior to surgery and didn't hold any info back so the dr, had full knowledge of any underlying health issues. For the most part it's a nuisance more than anything else, and I would so love to be going for water exercise classes.

 

[sistersinhim]

I think you should think of this like you had a tooth pulled. Where the root comes out is a deep hole with nothing on the sides to pull together. So, it heals and fills in from the bottom up. I think that's what your wound is doing now. Nice and dry is the key! It sounds like you have that part covered. I just can't believe your OS didn't want to see you immediately when you told the pa about it. Maybe the pa never told him. Whatever the reason, there's no excuse for treating you this way! Do you have an appointment for the specialist yet?

 

[zzevi]

@sistersinhim Yes, I have an appt with the wound specialist at the end of the month and I am also on their cancellation list so if something comes up sooner I'll get in.

I have a follow up appt with the surgeon this next week, I know I am not down to directly see him but his assistant, I plan on keeping that appt and having a in depth talk with them to see if they can give me an idea of why this happened. I have an idea that it had to do with that excess fluid I had on the knee and bruising and I think PT and trying to work it and get it to bend along with my not elevating it very well put a lot of stress on the incision and caused it to open up, (kind of like one of the folks on here talk about trying to bend a water filled hose) continued bending and working it has probably kept it from closing.

Your view of looking at this like a pulled tooth is a good way to look at it and probably correct, just like you probably wouldn't drink from a straw, smoke, eat nuts and seeds to irritate something like that, this is probably the same.

I am out to get answers at this point, very disappointed at my surgeon at this point, it's not very good health care, when you pass up at least a couple times of the patient asking for guidance. This will all be brought up this week.

Going to this wound care specialist is going to cost me as they are out of my health care network, all of this I think could have been prevented. (I believe at this point, maybe later on I come to realize it couldn't have been prevented.) Thankful for over all good health and able to get around, I've come a long ways in 11wks in a lot of ways, this is the only draw back at this pt.

 

[zzevi]

Just want to apologize for being such a negative Nellie at this pt, I am very disappointed in my recent health care. I haven't seen my O.S in person to express my dissatisfaction so it's coming out here in the post.
Just my hind sight seems more clear on mistakes I make in the line of recovery and not following my gut instincts sooner. Thanks everyone for listening and encouraging words. I plan on expressing my feelings and being heard, hopefully everyone that dealt with me will take compassion and a different approach with future patients when and if they start experiencing issues, like they seen with my recovery.

 

[Pumpkin]

is going to cost me as they are out of my health care network

Be sure to ask for a discount if you pay cash, it may be less expensive than using your health insurance.
I agree with Sistersinhim, you wound is healing, but it is going to take awhile.

 

[sistersinhim]

You come here and vent every time you need to. I would be furious if I were in your shoes. Be sure and let your surgeon know what's been going on, if you can ever get to see him. Some of us have been so blessed to having caring surgeons and some haven't. We who have should really grateful!

 

[KarriB]

This is the place to vent if you needed. You may want to make a list of questions or concerns you have to stay on track.

 

[Josephine]

It's starting to itch on the side where I had that pocket of fluid that is directly across from my wound opening does this mean anything maybe healing?

That is exactly what it means!

I am just concerned about a underlying infection, or the rejection of the joint.

I think I've told you more than once that this is not the case and 'rejection of the joint' just does NOT happen!

I just know what I have which is a open clean, dry wound, but no scab on it currently.

Well that's good! Absolutely fantastic!

has some stuff in it that they called slough

Slough (pronounced 'sluff') is nothing serious. It looks unpleasant but it actually the harbinger of good because underneath it is the granulation tissue of which I spoke earlier. It is, in fact,the forerunner of granulation tissue.

It doesn't seem like it's mending at all, but I have nothing on it pulling it together.

I explained this before - it doesn't need 'pulling together' as the wound will heal from the bottom up. Go back to my previous post and read it again.

a few weeks back the one p/t asked me if I had fallen as he had comment on how the one area looks slightly bruised.

As if he would know! NOT!!!

I'll be glad to go to the wound care clinic just to find out maybe what went wrong and why it didn't close.

Nobody will ever be able to give you an answer to that because, quite simply, they won't know. These things happen frequently and the cause is a total mystery. I do suggest you rid yourself of this desire for the unattainable and just accept what I say.

 

[zzevi]

Just wondering if it's normal after being up and about for many hrs a day and many days in a row to experience swelling of operative foot and ankle? This swelling I noticed the first this past Saturday and today after a full day of work came home to a swollen ankle and foot. It's not sore, it's not swollen to the point of tightness or tenderness, can just see the swelling.