Amputation Left Above-Knee Amputation, 22 April 2025

[EalingGran]

So sorry to hear this.

 

[Layla]

So sorry, WFD. You deserve a break. Will hope and pray you get one this time.
Please keep us posted and wishing only the best for Friday.
@WFD

 

[WFD]

Thanks, everyone.

 

[sistersinhim]

This should not be happening to you. You have been through enough! My prayers are with you.

 

[WFD]

Not quite four weeks since second stage of two-stage revision -

So yesterday I went to the hospital to meet with the PA and the surgeon that performed the muscle and skin grafts during the second stage of my revision (a reconstruction, really).

He agreed that the portion of the skin graft where the hematoma formed was dead, and cleaned it out, along with the underlying hematoma.

I thought that meant I would have to have another skin graft, but he says that no, we will let it heal. Granular tissue (the early stage of scar tissue formation) was already forming, but eventually it would be replaced by skin cells. I have to admit I don't understand how that can happen over a triangular area maybe 1.5" x 2.5" but I have to assume he knows what he is talking about.

The bad part is that I have to wear the immobilizer brace and undergo frequent dressing changes for six more weeks, where if the hematoma had not formed, I might have gotten rid of the brace and been able to move on to exercises to work on my flexion. When all is said and done I will have spent at least 10 weeks after the surgery with my knee held immobile and that can't be good for my knee.

I did get the staples out and that is nice. They were starting to drive me crazy.

Also the pain level is very low. I haven't had an oxy in at least a week, and am only taking Tylenol, totaling 3,000mg per day. It's not doing much for me so I may discontinue it.

 

[WFD]

...oh, and in the third week of using a PICC line, with IV Daptomycin and oral Rifamipin. The Rifampin is giving me stomach aches, but I'm used to it, since it is my fourth time.

 

[Jockette]

Also the pain level is very low.

This is a bright spot in your situation.

I’m so sorry you’re going through so much. My thoughts are with you.

 

[Layla]

WFD,
I am sorry you have to wear the immobilizer brace for an additional six weeks. Thankfully the staples are gone and your pain level is low. I'll bet it feels like progress to be off the Oxy. We appreciate you documenting your journey here and wish you brighter days soon.
Besides drinking lots of water, have you tried any teas to help with the stomach issues? You may want to research teas such as Ginger, Chamomile, Licorice Root or Peppermint and see if they're safe for you.


@WFD

 

[Jamie]

@WFD … although I’m sorry to hear that you have to go through a bit longer period of immobilization, I am really heartened to hear this latest report from you. The body is truly amazing in its ability to heal and yours is demonstrating that big time right now. The fact that you have granular tissue developing is huge. It means everything you and your medical team are doing is right on track. I know your wound seems like a large area to regrow tissue, but I recall another BoneSmartie years ago with a really bad infection that had something similar to overcome. But she did and the wound healed. She was on a wound vac, which really made the difference. I think you mentioned you have that as well. It does sound to me like things may finally be starting to resolve for you. I know you can do this and you will. Don’t hesitate to give us even the tiniest updates. We are all in your corner and rootin’ for you!

 

[mendogal]

I want to reassure you I have seen granulation work very well on much larger wounds.

 

[WFD]

I think you mentioned you have that as well.

I don't have a wound vac anymore - that was just in the hospital. I was speculating that if I have another graft, they would send me home with a wound vac to carrry along with me like Mary's Little Lamb.

 

[WFD]

I want to reassure you I have seen granulation work very well on much larger wounds.

Thank you, that's encouraging. Did you see good skin form over it?

 

[mendogal]

YES

 

[Jamie]

This is even better news. If your body is responding in this way without the assistance of the wound vac, then things are better than I thought. I am really encouraged by this news, @WFD.

 

[EalingGran]

Thank you, that's encouraging. Did you see good skin form over it?

Agree with @mendogal on this.
I worked in health care and also saw granulation produce good skin cover.

 

[otto21]

Do they typically do iv antibiotics and rifampin after the stage two? That is surprising as I thought the idea was that the infection is gone at that point. How long do you have to take them for?

 

[WFD]

Do they typically do iv antibiotics and rifampin after the stage two?

I think not usually, but in my case because the infection was undiagnosed for two years and had a chance to embed itself, plus the fact that it kept coming back after all the previous treatments, motivates us to be very conservative. If it comes back this time I am pretty much out of options and may have to get an amputation, so another six weeks with the PICC line is cheap insurance.

This is my fourth PICC line so i am used to it.

 

[Layla]

Some very encouraging news in these last several posts. Positivity!
You've been through so much and here you are pushing forward as usual. Sending best wishes and holding you in thought and prayer. May the good news continue.
Happy Sunday, WFD.
@WFD

 

[WFD]

So Saturday night 3/22 I came down with a fever. Monday the visiting nurse redressed the wound and thought it looked OK so i thought the fever was just one of those things.

Tuesday I had a follow up appointment with the surgeon and PA. By then there was green goo coming out of the incision and i had quite the fever. This all despite the heavy duty IV abx.

The surgeon had me admitted then and there, and Wednesday I went in for a debridement and washout. The surgeon found the wound full of pus and the infection went all the way to the bone.

We don’t have the results of the cultures yet so we don’t know if this is a return of the old infection or something new.

For some reason I have almost zero pain and am only taking Tylenol for pain relief.

I just had the post/op conference about options and we both agreed that above knee amputation is my only option to kill this infection.

This surgeon could get the surgery done next week but I am going to get a second opinion from a well regarded plastic surgeon known for sophisticated amputation procedures, so it may add a few weeks.

I’ll also get to spend a little time at home and get things ready.

I feel like I’m riding a roller coaster just as it goes over the top and heads straight down at break neck speed and it’s too late to get off.

 

[mendogal]

I am so sorry it's the only viable option left.

Good for aiming to get the best possible surgeon on your team.

Words otherwise fail at this moment. Just know you have Team Bonesmart pulling for you. Sending a hug to you and yours.