Revision TKR May Have Loosening Of My Implant!

[nancy2]

Morning All!
Well I know I haven't posted for awhile. I guess when it rains it pours. Anyhow, I am trying to get my thoughts/questions together. I always type them on a sheet of paper for I and my husband to have when I come out of surgery. As we all know many of us are in "la la " land when the docs come in - so I try to have my hubby ready too.
Any and all help appreciated from you. I guess lst will be:
1) how much "adhesion" did he see and does Dr. Bostrom believe it was enough of a "debridement to make a difference for me" also
2) Dr. B had mention inflammed tkr and that is why "blood pool" is sitting there. So ask about that too??
3) Anything else he had to do?
4) What steps are they taking to make sure there is no infection post op?
5) When he does this type of revision what is the "norm" for recovery and what "red flags" to watch out for also
6) to whom do I check in with? I have no infectious disease Dr., and I no longer go to the OS that did my original tkr so
will my family physician work? Or do I have to fly back to NYC? YIKES
7) It was my understanding that I would be RICE ing it for about 2 weeks - so when can I go back to work?
Well those are my ?'s so far - anybody want to advise? I'll appreciate it! I better go - I'm at work and trying to sneak this is!
Take care everyone
Nancy

 

[PhoenixS]

Just caught up on your posts. I am sorry you are having to do this, but I am happy that you don't have an infection.
I know your struggle (long story), and it is very hard to keep pushing forward. But that is what we gotta to do.
I wish you the best of luck on the 1st. Hopefully this scope will be the end of it.
I think your questions are appropriate. Hopefully you will not need an ID Doc, but if you need one, I'm sure that Dr. Bostrom could direct you to one closer to your home.
I was pretty sore after my arthroscopies prior to my TKR's, but I made it back to work at 2 weeks.

Keep up the good fight.
Sandy

 

[nancy2]

Thanks Sandy,
I barely remember the arthroscopy that was done to this knee prior to tkr also. I can't seem to remember, it was "sore" and swollen some, but I just can't remember much. The one thing that really has me concerned is, I forgot to put down on my medical info sheet, that the tkr was my most recent surgery and that's when the anesthiologist (sp?) came down stairs to my room and told my husband and groggy (violently ill me) that I seem to have a BAD reaction from morophine and they changed the drip to demerol I think.. but my major concern is how do I now get that listed so that HSS is aware, I'm afraid to leave it at just telling the anesthiologist 20 minutes before they meet & greet you! I need to stop them from giving that to me for the operation and recovery. I mean I am violently ill, all kinds of nausea rx until they figured it out. Will they take my word for it?
I know I will have myself a complete wreck by the time we fly out Sunday 9-30. ugh
Nancy

 

[vicledsome]

I too had bad reaction to morophine. I had surgery last week and and was asked no less than 4 times by 4 people of any allergies. Tell them Also the anesthesiologist, they are the one to make decision on med. Morpohine made me violently ill and made me itch. Told anesthesologist and said no problem. He also told me that Nubane is is remedy for morophine but is in short supply.
They will take your word for any allergy, they don't want to make you sick.
Wishing you the best with your surgery and a speedy recovery!

 

[Josephine]

1) how much "adhesion" did he see
That might be difficult for him to answer in a way you would be able to understand. If he said he saw "some" or "lots" how would you know what that actually meant? With what are you going to compare it? See, you can have one band of adhesions like a 1" length of knicker elastic cord which could cause no-end of problems and someone else could have a sheet of adhesion the size of a 2" ribbon which would not be so much of a problem. Just some thoughts to ponder on!
does Dr. Bostrom believe it was enough of a "debridement to make a difference for me" also
I very much doubt he would be able to answer that clearly. Mostly it's "do the best we can and see how it goes". You just can't tell with these things sometimes.
2) Dr. B had mention inflamed tkr and that is why "blood pool" is sitting there. So ask about that too??
A 'black pool' would be old blood which might be innocent and then again might be sinister. No doubt he will take samples for the laboratory to rule out infection.
4) What steps are they taking to make sure there is no infection post op?
Well, apart from the usual aseptic technique used in all surgery, it will be likely that he will put you on prophylactic antibiotics as they always do when interfering with a joint replacement.
5) When he does this type of revision what is the "norm" for recovery and what "red flags" to watch out for also
.There is no answer to this. It's one of those "how long is a piece of string" questions. Be most interested to hear his answer if you do ask it.
7) It was my understanding that I would be RICE ing it for about 2 weeks - so when can I go back to work?
Another interesting question. But whatever he says, add at least two weeks - surgeons are very often 'economical with the truth'!

 

[PhoenixS]

You will be asked, like a thousand times, for any drug sensitivies or allergies. Once you add Morphine to the list, there it will stay. They give you an allergy bracelet. Make sure you check that MS is on it.
Best of luck! Keep us updated.
Sandy

 

[nancy2]

Hi Josephine!! Thank you as always for your invaluable insight..but I have to ask you from part of your post "See, you can have one band of adhesions like a 1" length of knicker elastic cord which could cause no-end of problems and . " What is length of knicker??? Ha ha I am like from the floor to my knee? What? Isn't a knicker a knee??? Cool!

Thanks Sandy and Vicki, I really am getting anxious over this and I worry like nobody's business anyhow. But I am feeling very solid and postitive about Hospital for Special Surgery and Dr. Bostrom. Nearly 16 months of pain, swelling, and just plain miserable with this has just been too long. BUT...if it wasn't for this forum and it's members I do not truly believe I would have found Dr. Bostrom - there's this solid confidence I feel that I did not have for the original TKR.

Thank you everyone - I am so looking forward to posting when I get back home!

Nancy

 

[RestAssured]

Nancy,

We are so glad that you are here with us also!

You will be fine and you have found a great surgeon! Who could ask for more?

 

[Josephine]

Oh dear, these cultural differences are a nightmare, aren't they?

Knickers you probably know as panties, a word we now use. But in the old days they were called knickers and help up with elastic, a stretchy ribbon what goes inside a hem at the waist of the knickers! As a schoolgirl, if your knicker elastic snapped it was a disaster as your knickers ended up round your ankles!

Elastic cord is a much thinner variety like a thin string, used in lighter fabrics or even babywear.

My intention was to describe a small adhesion as being like a piece of thin string about one inch long.

 

[nancy2]

Hey there,
I know I typed in a long post yesterday, I don't know why it didn't show up. But whatever, it is getting very later here and I have to get some sleep before 5 am comes to leave for airport. Had a fiasco on my hands while I was at work late Thursday. Long story short between HSS in new York and BMH local dr. and hospital my bloodwork was not scripted correctly so last week was a bust but no one knew it until I had my hubby go to Dr. office and check about FAX. here a "CMP" metabolic panel was never done. HSS called and said surgey for Monday was a no go if pre op not done. OH man I was so upset. Somehwere things got mixed up, I ate not supper, ran up to hosp. at the crack of dawn, special courier came to take it to lab and send results (which they did NOT DO) I called late in the day and she admitted not sure about fax, gave her the number AGAIN and stayed on phone until sure it went thru. Finally at 5 PM call came from hospital - was cleared for surgery and we will fly out tomorrow morning. My surgery is for 8 am and I am to be at hospital at 6 AM.
I do not like my list of ?'s and thought I had posted that last night...I am not articulate with medical lingo and my better half is worse. Oh here I go, I pray that even if I can be 75% better I will be soo happy. I do not post from my iphone so it will have to wait till I get home.
So Sonja and Jancie and Sandy and Vicki and Josephine all prayers gratefully accepted. The support from my fellow forum members has been constant and I need my dose of compassion! Oh I am sooo anxious.
I hope my band of Angels know how to get to Manhattan
Nancy

 

[RestAssured]

Nancy,

Things will be fine!

Let the recovery begin and after that life will be grand!

Prayers will continue!

 

[Pumpkin]

Nancy,
Like Sonja said you will be fine.
Take good care, looking forward to your posts when you get back.

 

[jancat]

Nancy, See, the bloodwork thing working out means it was meant to be! AND you will have a great outcome!
Wishing you the best! Keep us posted!

 

[nancy2]

Hey Everyone,
Here I am, I'm home and couldn't sleep much and knee is kinda hurting so thought hey I'll post and let people know I'm alive and well. I sure don't want to make this a long post but it probably will be.
1st. I sure hope what Dr. Bostrom did - did the trick. I have 3 areas around my knee cap where there is stitching and it hurts pretty good. The stitching to the outside hurts the worst and especially when I bend. I have done little or not exercising but have definetly been walking. Day after surgery walked around Manahttan to go to my friends' favorite restaurant and then walked all around airport for 4 hours part because we were early part because of 2 hour delay. Knee really began to bark back at me late that night.
I am trying to "process" all that took place at the Hospital for Special Surgery (HSS) for some was not good. Not in my opinion. The pre-op staff were not as professional as I am used to. English language was definetly not the primary language spoken. No sense going into it here, this is not where I need to sound off, so I'll just try and stick to the procedure.
Unfortunately I do not know a lot about that either. When Dr. B spoke with my husband and friend, as I was recovering, they both told me he spoke only 3 minutes never made it to 5 minutes - so many ?'s not answered. I only know that there was adhesions removed mild or moderate I do NOT know, density - I do NOT know.
Just today I found out that since the discharge nurse went over everything with only me and I had no recall whatsoever - we thought I was to get my stitches out in 2 weeks - wrong - 1 week. I have no antibiotics, and my discharge sheet shows not one word written on it for me just a form sheet. Also just found out today that I am to return for a check up in 5-6 weeks not 8 weeks (I don't know where I heard that but it was all I had to go on-maybe discharge nurse said it?? ). I was wheeled out to where my husband was and I had papers on my lap that I didn't even know how they got there. My friend laughed because I had a cane and I couldn't answer her how I even got it. Very upsetting. My husband and friend tried to track someone down to talk to - long story.
I have called and emailed the Dr. - his nurse is to get back to me sometime tomorrow.
I must put this much down - I was literally gouged 6 times by 4 different people (including 2 anesthiologists) 5 times they failed to get an IV in me.
I can only pray and I still have a solid feeling about this that Dr. B did well by me as far as the surgery itself went. But as I put in this post earlier I am "processing" my experience.
I was hesitant to post as 1) I don't feel real great right now and 2) it would be upsetting for me to have someone tell me that this is just the "norm"- ahh NOT!
So I am off to try and get some restful sleep.

 

[Josephine]

Well, it seems like you had a really rough time and the HSS seems to have such a good name too. I'm so sorry. Let's just hope you get some information sometime soon ........

 

[vicledsome]

Hope doc gets back with you with more information. Each of my 4 knee surgeries have had staples and stitches removed in 7 to 10 days, so that sounds right.
Most of all hope you get relief from pain. Wishing you a speedy recovery!

 

[nancy2]

SOS - I could use some help right now - it is late in the night here - I will try to make this short I wish I knew how to get in touch with one of the administrators or some BoneSmartie that has been in my situation. Listen I am from a small town - so I did not go to the emergency room. I do not have an OS anymore in my home town as Im had the OCT 1 debridement done in New York.

Here is what's happening: I went in to my Dr. On Monday and got the 3 areas of stitching removed. All was ok. The knee was feeling tight and some pain - local med called in a script for generic Voltren?? Anti-inflammatory - but here at the same time New York - HSS called one in for Celebrex.

I have not been on any antibiotics -zip - nothing before or after the procedure last Monday - I am so panicked I can't type - oh any how I spoke with my pharmacist he said Celebrex is the easiest on the stomach - so I said ok fill for Celebrex 200 mg once @ day. So I take one last evening and I take one this afternoon as knee is thumping and feels swollen doesn't look it.

Late last night where the old incision is for the TKR it is getting a little pink but I don't get too concerned. I take my Celebrex this afternoon and go to early dinner and movie with friend - my knee is getting more of my attention as it seems to be getting redder and warmer to the touch. Again it isn't like that around the 3 spots where the stitches were no - it's right where the prosthesis is!! Oh Lord, don't tell me this is an infection set in from last Monday!

There is no way I am going up to the emergency room at this time of night - please understand my family and I have done this before - sooo many times they send you home with a weak antibiotic (I have amoxicillin) or an anti-acid. We have these "hospitalists", once you go to the hospital my Dr. cannot come in and take care of me - they do. I'm sure some of you are familiar with this bad turn of events in some of our hospitals. Too long a story.

I don't know what to do - I will call my local MD in the am to see if they can squeeze me in - but I will not be able to get in to see a local OS asap as I would be a new patient.

I looked up side effects of Celebrex and in some cases it does cause a skin rash - but mine is redness & warm - is anyone out there familiar with this???? I am hoping that's all it is.

I am emailing the RN that works with Dr. Bostrom tonight (but that's New York) and I am faxing the email to them also. I am calling my local family doc in the morning as soon as they open. But I am scared to death this is an infection.

Can any one tell me they had the same experience with Celebrex? Or is this a sign that my 10/1/12 surgery got my TKR infected?

Thanks for any and all help.
Nancy2

 

[maryo52]

Nancy, I see you are freaked out. But of course you are. You're having something going on after hours and you don't know what to make of it. It is not an emergency I don't think but something you will need to address first thing in the morning. Dr. Bostrom's office needs a call as starters, and where you go from there I don't know. Your local doc should be able to make some initial determination. When you call of course you will tell them it's urgent.

I'm not sure, but I bet you can call HSS tonight and tell them you're having symptoms following a recent surgery and need to talk to a doctor ASAP so you know what to do.

I agree, I had a second opinion at HSS and there were things I thought were not done real well. But it's where your knee was last treated and so they are responsible for your knee right now.

 

[Janet2012]

Nancy, there is nothing worse than feeling alone with your fears late at night! I'll tag Josephine and Jamie for you, but it is only 4am in England. I wish I had some reassurance to give you, but I simply have no idea. Whatever it is or isn't, you'll likely survive the night and be able to figure it out in the morning. Just be thankful it isn't a weekend! I take Celebrex, and that I have had no rash from it doesn't mean anything. I have had rash reactions from various drugs, and it has usually been a broader reaction, say on the torso, arms or legs. If it seems worse, or still concerns you, get on the phone in the morning and be assertive with whoever you call. If your OS is out of town, send pictures. Don't worry about it now, just make the calls or see who you need to tomorrow so that you will feel better about it or know what action to take. It's late, I'm sure there are others around, but I wanted you to know that you weren't alone tonight, even though I have no help for you!

 

[karmigirl]

Nancy,
I would call Dr. Bostrom service, there should be someone on call that can address the problem. Most OS have a way to be reached or someone that can be reached at anytime. Good luck and let us know what happens we care.