Knee Infection* My L T K R Diary 2020

[Defender]

Hi Lindylee.
I went into hostpital for a week as my left hand had swollen and wrist and fingers were painfull.
They put me on iv antibiotics I came out on the Saturday and by Sunday my right hand did the same still can't get my fingers straight and my wrist is painfull.
They have taken me off the antibiotic pump and am now on two 500 mg flucloxacillin taken four times a day.
The infection seems to be going to my joints my shoulders elbowl and now my left ankle again.
My R O M isn't good 65 maybe 70 degrees my knee is still very swollen.
They have left the picc line in for now
I know I shall remember the 12 of February 2020 as the worst decision I have ever made.
What I wouldn't give to have my old leg back my walking distance wasn't great but at least I could do things and go for a cycle ride.

 

[Jamie]

@Defender....my heart hurts for you and all you're going through. Do you have an infectious disease doctor working with your surgeon on your case? This is very important and if you do not, then I suggest you insist on bringing one in to evaluate where you are with the infection. You need the knowledge and expertise of someone who knows infections and how best to treat them. That isn't always an orthopedic surgeon.

I am glad you are in the London area as you should have access to excellent care for this. Can you tell me which hospital you have been going to and who your surgeon is?

I know things must seem very bleek right now. But people do get better from even the most stubborn infections and go on to be just fine. Hang in there and know we're always here to lean on.

 

[Defender]

The hostpital I had the knee op is closed to anything other than covis.
Don't know if he was an infectious doctor but when I was in another hostpital being treated for my left hand he said I had cellulitis..

 

[Jamie]

That would be a different type of infection from a joint infection if it's cellulitis you have now. So is the infection that was in your knee clear?

 

[Defender]

The hostpital at home nurse was coming in everyday when I was on the antibiotic pump but now I am on oral antibiotics they come to my house once a week.
Last week infection was down to 43% it was around 58% last week and has been as high as 95% so coming down.
They took another blood test today and I will get results back Monday.
My red blood cells were down showing I was lacking iron but that's back to normal now.

 

[Lindylee]

So sorry to hear this is going on and on for you. Does that mean you have infections in your joints plus cellulitis? I hope all the doctors taking care of you are communicating with each other. From previous experience I know it doesn't always happen especially if you've been in different hospitals. Take care and I really hope things start to improve soon for you and the blood test results are favourable.

 

[Defender]

So sorry to hear this is going on and on for you. Does that mean you have infections in your joints plus cellulitis? I hope all the doctors taking care of you are communicating with each other. From previous experience I know it doesn't always happen especially if you've been in different hospitals. Take care and I really hope things start to improve soon for you and the blood test results are favourable.

Hi yes I have infection and cellulitis.
Now I am on oral antibiotics they are taking my picc line out in the morning.
They are still coming round once a week to take blood tests.
My infection level is still high 40s they seem happy with that.
My knee swelling hasn't gone down much which is stopping me from getting more than about 50 / 60 degree bend.

 

[Jamie]

Defender.....is there some way to take a photo of your knee in the standing position straight on showing both legs? You'd need someone to take the photo for you or do it in a mirror. It's hard to tell much about your knee with the position and cropping in the photo above.

 

[Defender]

Defender.....is there some way to take a photo of your knee in the standing position straight on showing both legs? You'd need someone to take the photo for you or do it in a mirror. It's hard to tell much about your knee with the position and cropping in the photo above.

Thanks I took these ones this morning hope they give more information

 

[Defender]

Although my swelling seems to have gone down slightly I am struggling to get it past 70 degree's.
Gets painfull to push any further.

 

[Jamie]

I know it's frustrating to have to wait this out. But with that much swelling, it's going to be difficult to get much of a bend going. You're wise not to push as that just further inflames things. Because you've had so many problems, it will likely take quite a while for everything to settle. Hang in there....and if possible, keep up regular appointments with your surgeon every few months.

 

[Defender]

I know it's frustrating to have to wait this out. But with that much swelling, it's going to be difficult to get much of a bend going. You're wise not to push as that just further inflames things. Because you've had so many problems, it will likely take quite a while for everything to settle. Hang in there....and if possible, keep up regular appointments with your surgeon every few months.

Many thanks that's very reassuring.
I got my weekly blood test today all was good and infection now down to 23 so that's positive.
Yes the knee bend does get to me but it's still very solid.
I am sort of glad I am not having physio as all they would do is push and like you say it's not going to help.
Doctors and surgeons always say if you don't get it moving it will stay like it.
I believe my next appointment with my consultant has been pushed to August now due to covid.

 

[Jaycey]

Reread these articles @Defender :
Myth busting: the "window of opportunity" in TKR
ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!

Especially relevant in your case as you have had to deal with an infection. You are doing great!

 

[Jamie]

Be sure you are getting up and walking around for a few minutes at least every couple of hours during the day and you'll be fine. The articles Jaycey gave you should reassure you that you won't be "stuck" with your current ROM if you do at least this small level of activity regularly. You can also stretch and bend your leg yourself when you are sitting or lying down. The important thing is to keep it moving gently and never to the point of actual pain - just mild discomfort when you reach the stopping point of a bend.

 

[Defender]

Thanks Jamie.
Yes I do walk around the garden and into my workshop a lot.
Maybe I shouldn't go in the workshop so much as I find things to do that I can't yet.
I often get my knee to a slight bend then sit then pull my leg a bit further in and then sit.
I keep doing this to it just starts to get painfull then stop.

 

[Jamie]

That's perfect. You're exercising your knee gently in ways that will encourage better ROM without risking more irritation that could add to your swelling. I think it's just going to take some time. Your poor knee has been through a lot.

 

[Defender]

I think my whole body needs building back up.
I lost 1 stone in weight since I first had my knee op in February I am now down to 11 stone.
Then with the infection going to all my joints I am quite run down.

 

[Jamie]

That's probably the case. Eating healthy with lots of protein should help with that. You might try adding a supplement like Ensure daily to give you a protein boost.

 

[Defender]

Yes my red blood cells showed I was anemic but I have been taking suppliments and my appetite is now better and the last test showed iron levels now ok.
I still get bad nights which is to be expected.
The only thing that gets to me is not being able to get a good R O M which I know is due to the swelling I seem to be one of those unfortunate people that tend to swell a lot.
I still often wish I hadn't gone through with this but after my first T K R 2 years ago when all went fine it's understandable
I am sure when all of this is behind me I will be glad I did.
Must say it will be nice to be able to drive again and I do miss my cycle rides

 

[Lindylee]

Hang on in there Defender. It sounds as if things are starting to improve for you. I'll keep my fingers crossed that you gave no further setbacks.

It's taken 17 months for my IT band issue on the left leg to improve and now it has there are pluses and minuses. On the plus side it's no longer painful coming downstairs or standing for any length of time, but on the minus side my leg feels a bit wobbly. I'm hoping it's just because the tissues on the other side need to adjust, but time will tell. The right leg has been fantastic from the onset. It's amazing how different they can be.

Keep taking it gently and don't overdo it.