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TKR Lesions caused by metal sensitivity

The hospital where I had my surgery does not swap surgical candidates for MRSA, but I know of other hospitals in the area that routinely swab patients in the OR prep area.

sent from my Galaxy 4
 
I don't remember getting swabbed, but I was such a nervous wreck it might have happened and I'm not remembering.
 
The protocol used by my surgeon included a MRSA swab as part of the pre-op exam and all patients are required to use Mupirocin twice a day for 3 days prior to surgery. I suppose the idea is to minimize any possibility of picking up an infection in those last days before surgery. But I guess Mupirocin can have side effects so unless there's clear proof that patients who use it do better, I can understand a doctor choosing not to prescribe it.

This is just my personal opinion but I think you have to remember that "old and run down" doesn't necessarily mean "unsterile" or not as good. The hospital system that my surgeon is part of has a brand new, state of the art facility - it's only 5-6 years old and at least one other surgeon in the orthopedic group does his joint replacements there. But my surgeon, who is the Chair of the joint replacement program, will only do replacements at the old, main hospital in the surgical suite that he designed. I want my doctor to work where he's the most comfortable and successful because in the long run, I think that translates to the best outcome for me.
 
That is a good point Susie. My doctor left and came back so I guess he likes it there or maybe it was too much to get on at another hospital and start over. The hospital is up for sale and the floors were dirty so that bothered me. Who knows if the OR is in fine condition. I went to the best/newest the first time around and it didn't turn out too well so I guess the OR isn't everything. I do worry about infection though as I guess most of us do. The doctor admitted that he has had patients who developed infections but he knows how to handle them. That bothered me. Maybe they all do. I was under the impression that if things were done properly, there should not be an infection. I am now in the process of applying to be considered by a Dr Siegel in Alabama. He has done 8000 revisions and is the one who has done the most of the Aesculap Revision system. I will have to travel from California to Alabama and I will be alone so that is a bit of a concern. I have heard that one should always have an advocate when one goes into the hospital. I am hoping maybe I can hire someone. The hospital is associated with the University of Alabama so maybe there is a starving student who would like a job for a few weeks. I have put the whole matter in God's hands. What is meant to be will be. I am so frightened that I go back and forth about having another surgery. Sometimes I think I should not take any more risks and just live with what I have but I would give almost anything to be able to ride my bike, walk up and down stairs and live again. I hate this disability! One thing I already like about Dr Siegel is that he has personally emailed me twice. I read that he is available to his patients via email. I like that. Once my surgery was over the first time around, it was not possible to speak with my doctor again. That was not good.
 
I remember being swabbed and I think they put something in my nose because I had a reaction to it for a few weeks. I probably was allergic to it. Whatever they did I am glad of it because at least I don't have an infection.
 
I hope Dr. Seigel is able to help you. Confidence in your doctor is so important, especially when it comes to soothing fears and worries.
 
I definitely wouldn't go to a hospital that looks dirty.
Dr. Seigel sounds promising. You can always check him and his hospital out on the Healthgrades website. The hospital probably has a web site too and if they have any special recognitions or certifications they are sure to highlight those.
 
I have developed very loud tinnitus which is very bothersome. I just read that it could be from my knee implant. Does anyone know anything about this or experienced it? We thought it may have been caused by my blood pressure meds so my doc has changed them a few times but my tinnitus has not resolved. I hope this won't be a lifelong problem caused by the implant! On another subject, I had a second allergy test done by Orthopedic Analysis to see if anything has changed since I had my TKR. I have now become reactive not only to nickel but also to Vanadium and Molybdenum. I spoke to the scientist who performed my test and he told me that he dosen't recommend the Aesculap knee because it is made of titanium nitrite. I thought it was made of zirconium. Good thing I had another test. Maybe my new sensitivities are what is causing my ear ringing. Please let me know if anyone has had such an experience. Thanks.
 
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I'm sorry I can't answer your question, but have you seen an ENT specialist about the tinnitus? From what I understand there are different types of tinnitus, and an ENT would be the go-to doc for this. I hope you feel better soon.
 
Hi Diana, Thanks for responding. Hope you are doing well. I do have an appointment scheduled with an ENT per my cardiologist's suggestion. It was alarming when I read that it could be from the implant. I get ringing when I am having an allergic reaction but it goes away when I stop subjecting myself to the substance to which I am allergic. I can't do much about it if it is the implant. : (
 
Ear ringing can also be result of taking too much acetaminophen. What is your intake of Tylenol etc.?
 
Hi KarriB, I don't take Tylenol as a general rule because I am afraid of what it might do to my liver. I think that it is in hydrocodone but I haven't taken that for months. On a rare occasion, I have taken an Advil. I have been worried about my liver enzymes because they go up if I take some medications so I have just toughed out the pain for months. My liver is healthy but it balks at me if I take medications for some reason. I think that may be because of my allergies but that is just a guess. The lack of pain relief is probably why I have been crying a lot. Pain is wearing me down. I think I am starting to have neuropathy in my hands and feet as well so that pain combined with the knee gets to me. I tried Gabbapentan sp? but it made me go into a deep hole and I became severely depressed. I wouldn't touch that med again with a ten foot pole. I thought the ear ringing was from my medication because it has done that before but the only thing that I am on right now is blood pressure medication and I have changed that a few times but it hasn't helped. I can hear a pulsating kind of sound along with the ringing. I think it might be the blood flowing through my veins or my heart beating. It is very annoying especially at night. My cardiologist did an ultrasound of the carotid arteries and there is no problem there so that is a very good thing.
 
On a different subject, I was reading Josephine's recovery notes and saw that she did almost no exercise at all and ended up with great ROM. I was worried because I stopped exercising due to pain and when I stopped things kind of froze up. I was able to do a rotation on my bicycle before I stopped but now I cannot for example. I wonder if a person tends to make adhesions if that is what the problem is with not having good ROM and freezing up. Maybe if I had kept up the exercises, it would have kept the pump primed so to say. I can barely do a heel slide now because my leg barely bends at all. It goes straight but will not bend. My son was furious with me that I stopped exercising and blames me for what is going on with my knee. I thought that I should give it a rest because the pain increased when I exercised. I am a year and nine months out and I had read here that what a person does on a daily basis is enough exercise but I guess that turned out to not be the case for me. So discouraging!
 
Here is an update on MRSA and joint replacement:
Decontamination protocol helps reduce surgical site infection risk

Among patients who underwent elective orthopedic surgery with hardware implantation, surgical site infection rates decreased by more than 50% with the use of a preoperative methicillin-resistant Staphylococcus aureus decontamination protocol, according to researchers’ findings.

https://www.healio.com/orthopedics/...tm_medium=email&utm_campaign=orthopedics+news
 
Here are some surgeons to try near you:

broken link removed: https://www.orthopaedicsurgery.uci.edu/faculty/schwarzkopf.html - hip and knee primary and revision

Dr. Steven Barnett - hip and knee primary and revision (Orange County)

Burbank, California

broken link removed: https://www.ossburbank.com/shahan-v-yacoubian/ - hip and knee primary and revision surgery

Los Angeles, California

broken link removed: https://www.jri-docs.com/our-doctors/dr-thomas-schmalzried/ - primary and revision hip and knee surgery

Also, if you are able to travel, I would strongly recommend you contact Dr. Maale in the Dallas, Texas area. A number of our members have worked with him on particularly difficult cases. He will do evaluations over the phone providing you can send him images and documentation. He would be my number one choice.

broken link removed: https://www.dfwsarcoma.com/, Plano, Texas (Dallas/Fort Worth area)
 
I think I saw a shedule that Jo posted to help with weaning off pain meds after a TKR but I cannot locate it now. I would like to print it out in case this site goes down so that I will have it for my next surgery. It worked for me last time. I wish that I had kept it. Will someone point me in the right direction? Thanks.
 
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