Revision TKR May Have Loosening Of My Implant!
- Thread starter nancy2
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Josephine, as a theoretical question, in a situation like this, would there be a safe waiting period before a reliable blood test could be taken? Or if the physical symptoms and history suggest a potential infection, once started, should a course of antibiotics continue for a period of time? I would think the latter, and then take a wait and see position. Actually, that's what happened with me, come to think of it. When I checked into rehab late in the day on Friday, that evening the nurse was concerned about redness on my leg, and with it going into the weekend, called the doctor on staff, who approved the start of antibiotics. When the doctor saw me, she wasn't too concerned about infection, but had them continue the antibiotic for the duration of the regiment. If infection is present, doesn't stopping the antibiotics prematurely contribute to the problem of antibiotic resistant bacteria? Interesting and important subject I think.
Josephine
NURSE DIRECTOR EMERITA
Good question, Janet. But this is always a beggared topic as a doctor's first reaction if he suspects infection is to prescribe antibiotics. But the correct way of doing things is to take a swab or aspirate first and then prescribe antibiotics. Otherwise the lab report will inevitably come back negative.
jancat
graduate
What I was was told was 2 weeks off abx before reliable samples could be obtained. Very minimum was 10 days.
Nancy.....I am so sorry that I'm just now seeing your posts!! My gosh, have you ever been through the mill and back again. I'm glad you have calmed down and talked with your medical team. Take things one step at a time and you'll get through this. I like the idea that you're slowing down a bit and icing your knee. To me....it seems possible that you may have jumped back into a regular routine too soon after your procedure and this may be your knee rebelling a bit. But you're doing the right thing to get it completely checked out.
I don't understand what you were talking about with "hospitalists." I've never heard that term. Can you explain a bit more about all that and why you can't see a doctor if you go to the Emergency Room?
I don't understand what you were talking about with "hospitalists." I've never heard that term. Can you explain a bit more about all that and why you can't see a doctor if you go to the Emergency Room?
jancat
graduate
I can answer the 'hospitalist' question: basically they are a team of physicians and NPs and PAs who take care of 'inpatients' but usually following a plan of care directed by a specialist. When I was admitted to my own hospital with my toxic drug reaction to Vancomycin and Zosyn, I was admitted by my ID doc, and he saw me every day and directed my care. Yet the doctor whose 'care' I was under was a 'hospitalist' and my ID doc was a 'consultant'. However, the 'hospitalists' sometimes ordered bloodwork, removed my PICC line, wrote the order for new PICC line insertion, etc.
It seems like a racket so that 2 sets of docs are being paid.
I should add that I was not admitted this way in HSS nor in Maine Med. Ctr. I wonder if it is more of a community hospital way of doing things.
It seems like a racket so that 2 sets of docs are being paid.
I should add that I was not admitted this way in HSS nor in Maine Med. Ctr. I wonder if it is more of a community hospital way of doing things.
vicledsome
senior
In my case ID took care of my infection. The problem with just taking antibiotics is that not all antibiotics treat every situation. Some are better suited for different infections. In my case the ID cultured blood , took five days for culture to return. Needed a broad spectrum antibiotic, was allergic to the one recommended for infection. Ended up on three antibiotics.
My ID ordered blood work, monitored, removed PICC line.
My ID ordered blood work, monitored, removed PICC line.
Knitter4444
BoneSmart Staff
Our community uses hospitalists only. My PCP does not attend to me in the hospital and it is all done with physicians that work with the inpatients.
Knitter4444
BoneSmart Staff
Nancy..your insurance may not pay for a second set of the same blood tests. It is important that if you do get retested that your doctor puts on a diagnosis on the lab request that will support the same tests so soon. Just a heads up.
OP
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nancy2
junior member
Hi Jamie and Janice,
Here at my local hospital, I don't know the whys of wherefores of it all but, many of a general practioners or "family doctors" can authorize their patient to be admitted, but once that patient is admitted the "hands on" treatment and 1 on1 consulting inside our hospital is done by the hospitalist - my dr. cannot nor does not come to the hospital. This is the way of it with so many of our gp's - now of course if you're a surgeon, etc. of course you see your patient at your office and in the hospital.
My family dr. is consulted with but the directive comes from the "hospitalist" Many people in our area our very upset over this as I am too, but our local hospital claims it is the only way to keep them independent and basically not get gobbled up by a very big health corporation who has a huge monopoly on so many of the hospital near us, i.e. Pittsburgh hospitals - so many are now UPMC (University of Pittsburgh Medical Center) or as this region calls it UPMC _U Pay More Cash.
JANET,
Yes, very good question. Can't wait to see what tomorrow brings when I call the dr's office to get results - as Josephine stated it will probably be negative. And I will bring it up next week and ask for a script for a "re-do" but will ask how long to wait.
Nancy
Here at my local hospital, I don't know the whys of wherefores of it all but, many of a general practioners or "family doctors" can authorize their patient to be admitted, but once that patient is admitted the "hands on" treatment and 1 on1 consulting inside our hospital is done by the hospitalist - my dr. cannot nor does not come to the hospital. This is the way of it with so many of our gp's - now of course if you're a surgeon, etc. of course you see your patient at your office and in the hospital.
My family dr. is consulted with but the directive comes from the "hospitalist" Many people in our area our very upset over this as I am too, but our local hospital claims it is the only way to keep them independent and basically not get gobbled up by a very big health corporation who has a huge monopoly on so many of the hospital near us, i.e. Pittsburgh hospitals - so many are now UPMC (University of Pittsburgh Medical Center) or as this region calls it UPMC _U Pay More Cash.
JANET,
Yes, very good question. Can't wait to see what tomorrow brings when I call the dr's office to get results - as Josephine stated it will probably be negative. And I will bring it up next week and ask for a script for a "re-do" but will ask how long to wait.
Nancy
vicledsome
senior
I had repeated blood tests each week. Insurance never questioned. Was monitoring blood. Might not be an issue for you.
OP
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nancy2
junior member
Vicki,
I agree, I don't think my insurance will question it as I just had a surgical procedure done and there's reason to monitor my blood. But I think Monday I will call benefits office and get a quick answer.
Knee is holding it's own - it's feels swollen and tight, I think the celebrex does help. It's sorat pink now and cool to the touch - good change. Sciatic nerve along the knee and down my calf is back at it's "grabbing pain" it had somewhat subsided for the last 4 months, so hopefully it will again. Really don't want to go back on Lyrica. Lyrica causes too much intestinal side effects and I must return to work next week -wish I had another 2 weeks.
BTW spoke with nurse at my dr. office today, bloodwork shows no infection. I will address the "redo" on Wednesday.
Nancy
I agree, I don't think my insurance will question it as I just had a surgical procedure done and there's reason to monitor my blood. But I think Monday I will call benefits office and get a quick answer.
Knee is holding it's own - it's feels swollen and tight, I think the celebrex does help. It's sorat pink now and cool to the touch - good change. Sciatic nerve along the knee and down my calf is back at it's "grabbing pain" it had somewhat subsided for the last 4 months, so hopefully it will again. Really don't want to go back on Lyrica. Lyrica causes too much intestinal side effects and I must return to work next week -wish I had another 2 weeks.
BTW spoke with nurse at my dr. office today, bloodwork shows no infection. I will address the "redo" on Wednesday.
Nancy
OP
OP
nancy2
junior member
Hello out there,
Sounds like a lot of good vibes are going on in the recovery process for so many members. I know I havent' been online for much of anything lately. Thought I'd just post to say that I flew into NYC 12/5/12 to see Dr. Bostrom - he took his time with me and stated he cleared up more "debris" and fluid then what he thought he'd find. Also felt as though I would have a full recovery. I still have to go thru PT (although right now my knee is hurting pretty bad - I think I "wrenched" it when getting up on an eliptical machine I was trying out to purchase). But, I'm really satisfied with HSS as far as the Doc went. Still can't do steps, but once I get this painful bruised, wrenched thing feeling better I will begin to tackle steps. Oh well it is what it is.
Sounds like a lot of good vibes are going on in the recovery process for so many members. I know I havent' been online for much of anything lately. Thought I'd just post to say that I flew into NYC 12/5/12 to see Dr. Bostrom - he took his time with me and stated he cleared up more "debris" and fluid then what he thought he'd find. Also felt as though I would have a full recovery. I still have to go thru PT (although right now my knee is hurting pretty bad - I think I "wrenched" it when getting up on an eliptical machine I was trying out to purchase). But, I'm really satisfied with HSS as far as the Doc went. Still can't do steps, but once I get this painful bruised, wrenched thing feeling better I will begin to tackle steps. Oh well it is what it is.
RestAssured
alpha
It is good to hear from you again! Please keep us posted! 
jancat
graduate
Nancy, so glad to hear from you! AT 2 months out you still have a lot of healing going on. You already know this but don't overdo the PT.
Did they do an xray at the recent visit at HSS?
Onward and upward from here!
Did they do an xray at the recent visit at HSS?
Onward and upward from here!
sheryl7
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Hope everything clears up as doc stated it would and you have a full recovery.
Hang in there.
We all do things to wreak havoc on our sleves, knees included, I thought a sit down eleiptical would be helpful for me, Now i am wondering. It good to do your homework, why I watch and read other threads, to learn from them, and offer supoort where i can, seeing as I havnet had tkrs yet, someday, i am learing from where i can, this is he best place to learn. You have my support , take care and have a full recovery
Hang in there.
We all do things to wreak havoc on our sleves, knees included, I thought a sit down eleiptical would be helpful for me, Now i am wondering. It good to do your homework, why I watch and read other threads, to learn from them, and offer supoort where i can, seeing as I havnet had tkrs yet, someday, i am learing from where i can, this is he best place to learn. You have my support , take care and have a full recovery
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