THR Need a friend who has been on the other side of a late infection

[tashia]

Barbie, How are you doing. I thought about you today so I came to say HI. Dogs are so great. Keep us posted on how you are doing. We do care.

 

[BarbieJ]

Thanks for checking in with me tashia. I am working hard right now since I am in one the busiest times at work. My lesson right now at school is the favorite for students and my least favorite because it requires a lot of extra work, staying late after school and physical prep. I never attempt to pick up a 50 pound box. I empty it until it is 10 pounds. I have worked hard on my gradual release of instruction so that the children do as much as possible all on their own. It wipes me out and I never have a moment to sit down.
I wonder if anyone else has a persistent problem with aching of their surgical scar. I have had such problems with it hurting from day one. I can't wear tight jeans anymore and it still gets pinker by the end of the day no matter what type of pants I wear. Little red dots come and go and it so worrisome. Otherwise, it looks good, especially first thing in the morning. I still get an occasional deep sting, then I get anxiety, then I feel exhausted, then I don't want to do anything. On Sunday, I had my first good day since my surgery over a year ago. My first day where I felt normal. Then, Monday it came back again, the off and on deep aches and burning of my hip on the outside plus the IC symptoms.
I am hoping to have more good days. BTW, my neighbor has you beat! She has had both knees, both hips and both shoulders done. Did not have any problems with any surgery. She just doesn't understand why I have had such a difficult time. I have just now been able to lift my left leg to get in the car without excruciating pain. I still have pain to do it but mild. Mayo says I do not have any infection because I have such solid CRP and ESR numbers. I am going to wait until spring arrives to drive up there again for a steroid injection. My insurance won't pay for it because it is going into the hip. They would pay for one in the knee. ? Anyway, I am waiting until spring, so the drive up is a pretty one and not a white knuckle one. I see you have had your hip for two months longer than I have. Does it ever bother you?

 

[BarbieJ]

I finished my messy project at school. On Sunday, one week ago, I was cleaning and straightening my house. I noticed a minor scratch on the top of my hand, the sort of scratch that looks like a cat scratch or paper cut, with almost no blood but a tiny speck. The cut is about an inch and a half long. I washed it with soap and water the minute I noticed it. I will be honest I have no idea how it happened. I always wear latex free soft lined gloves when cleaning bathrooms etc., but I was just moving things in my dining room so I did not have gloves on. I think it was from a stack of matte board that I was relocating from my dining room table. I wore gloves the next day at school since I was to be starting my clay unit. It never looked bad but it stings the way a paper cut does. I am so fearful about infection, and its been a week now and does sting a bit still from time to time although it looks mostly gone. It is at the top of my hand and my hands have been very dry. I am an art teacher and my hands are busy as you can imagine. I wore a waterproof bandaid the rest of the week.
Just worried. RestAssured tashia What should I do for minor cuts, since I know this wont be my last one I ever get. I would hope that it would be a bigger cut that I would need to take antibiotics for.

 

[bottomshollow]

Cuts and scratches are just a part of life. We all get them at one time or another. Just be sure and wash them with soap and water, apply an antibiotic, and bandage if needed. And have no fears. This is not the type of thing that causes an infection that might be a problem for your implant.

The truth of the matter is that very few joint replacement recipients get infections at the sight of their implant. Reasonable caution needs to be taken against blood borne infections regardless of having an implant. So, relax and don't worry yourself unduly over small cuts and scraps. Now, a really deep stab wound might be something else.

 

[RestAssured]

I
Just worried. RestAssured tashia What should I do for minor cuts, since I know this wont be my last one I ever get. I would hope that it would be a bigger cut that I would need to take antibiotics for.

Well, let's see! I stabbed myself with a knife, broke my big toenail almost completely off by using it to push open my car door, fell and had numerous "ouchie s" from that!

That's all part of what I call living the "rest of my life". I need to be more careful, I know, but I will not obsess over every cut or scrape! Felice asked me yesterday, "What happened to your arm?!" I looked down and it was scraped up! I didn't even know. Shows how much attention I pay to the minor things in life anymore! Don't worry about your cut. If you washed it out and put a bandaid on it you should be good to go! My thumb should have been stitched but I used steri strips instead and it looks pretty darned good now!

 

[BarbieJ]

Thanks bottomshollow RestAssured. I appreciate your quick and kind responses. It's so nice to know there is someone out there I can talk to and ask questions. This forum is a shot in the arm of courage and support for me. Wish I did not have all these questions but when I do, it's so helpful to have someone out there to chat with.
I have an appointment with a colo rectal surgeon in two weeks. I don't know if I should premed for that appointment. I have never been right down there since my first elimination after my THR, which was horrendous. I think I have an anal fissure. Never ever imagined I would have all of these complications after my surgery. In fact, I never heard of this. Just add to the mix of everything else I am dealing with. Thanks again everyone.

 

[bottomshollow]

I think you might find that some of the things that happen after our surgeries have nothing what ever to do with them---no relationship at all.

I had the same experience with elimination after my hip surgery---no one told me what to expect---I found out the hard way .

But we are all getting older---and with age comes a slow break down of so many functions. Hope things go well with your appointment and everything can be taken care of easily.

Take care and keep us posted. We care.

 

[RestAssured]

Thanks bottomshollow RestAssured. I appreciate your quick and kind responses. It's so nice to know there is someone out there I can talk to and ask questions. This forum is a shot in the arm of courage and support for me. Wish I did not have all these questions but when I do, it's so helpful to have someone out there to chat with.
I have an appointment with a colo rectal surgeon in two weeks. I don't know if I should premed for that appointment. I have never been right down there since my first elimination after my THR, which was horrendous. I think I have an anal fissure. Never ever imagined I would have all of these complications after my surgery. In fact, I never heard of this. Just add to the mix of everything else I am dealing with. Thanks again everyone.

My goodness, a possible anal fissure now? I could write a book about my horrendous experience I had after hemorrhoid surgery! The doctor messed up everything and ended up going back after creating an anal fistula; he split me wide open like a filleted pork chop!

I had to go to another doctor in a town far away who didn't know him to get care! When the 2nd doc saw me, he said, "who butchered you?" He did keyhole surgery to remove as much scar tissue as possible, but he told me I am being held together by scar tissue so he can't and neither can any other surgeon operate again! I was furious with the original doctor. I still have problems 7 years later!

 

[BarbieJ]

My first elimination in the hospital was a nightmare. Felt like when I had my first child when I had terrible back labor pains and I tore. I live in fear of going to the loo. I have to be very careful of what I eat and drink always. I was perfect before my THR. I am damaged for life now. I think there is a connection between the interstitial cystitis and this anal fissure. Last weekend was bad. I spent most of it in bed. I am cold all of the time. It's creepy feeling and not normal. I believe I am having metal allergy problems. My new hip is a titanium modular short stem with a cobalt chromium trunnion (the articulating piece that the ball attaches to).
I have metal everywhere except the liner. Zirconium ball, titanium cup and titanium stem. I told my surgeon that I had a problem wearing cheap earrings and jewelry and he told me that titanium was biocompatible. I never knew I had this short stem until a couple weeks ago when I went to Mayo. The OS there showed it to me on my X-ray.
My cobalt and chromium tests were low so they are not looking at metal allergy anymore.
14 months post surgery and I am sick feeling all of the time.
My skin burns and itches all of the time from my thighs up, especially on the hips, but there is no visible sign of any rash.
Groin pain, I have to lift my leg with my arm to climb into bed or get in a car.
I usually do my stairs two footed to eliminate some pain.
Standing for hours at work is horrendous.
Not comfortable lying down or sitting either. Hurts my sitting bones. Mayo wants to do an injection in my psoas tendon.
I wonder if Josephine can tell me what she knows about my prosthetic. Is my prosthetic considered MoM?
My coworker had the same surgeon and he got titanium stem and ceramic ball. Why did my OS do all titanium with that !!!! Cobalt Chromium piece. I have a lot of anguish and I feel I'll like I have the flu all of the time. Hey, if I could I would throw back a beer or glass of wine i would but I can't do that anymore. I get extremely ill with burning cystitis and nausea. What has happened. I am grieving because I honestly thought I would be a success story. I have been cleaning drawers and papers trying to get my affairs in order in the event I don't make it through all of this. I know I have a revision surgery ahead of me at some point. Possibly worse.
I was happier, healthier and more comfortable before my THR. I pray to God everyday to give me strength to get through each day.
I read about MarkC with his MoM and his psoas tendon release surgery which I may need.
I wish I knew how things end up with him. I read the posts and feel often like I don't get to know how things end up. When he said he felt fatigue and cold all of the time I thought, YES, ME too. My blood work is all normal, thyroid normal too.
Sorry RestAssured. I don't mean to dump. I have no one to talk to. No one understands, my husband is sick of hearing me complain and has enough on his plate caring for his 86 year old mother who had a stroke.
I used to be a really happy cheerful person. Want to be that person again. I will wipe my tears away and try to be strong. This is horrific and I wish I could turn back time.

 

[RestAssured]

Barbie, I am not an expert on hip replacements, but I too have bad metal allergies. They put in the Smith & Nephew especially because of my metal sensitivity and it has never been an issue! Some people do not have as smooth of recoveries as others and we know that! That is why we are here! I don't think you are whining and complaining as much as I think you are just plain scared. What I am hearing from you is, you are worried that a part of the hip replacement was metal? You think you will probably need to go through a revision. You have an anal fistula that is causing major problems. Your husband is sweet, but there is only so much he can do and he wishes he could "fix" your problem, but he can't so he is frustrated! Am I correct in my thoughts?

Barbie, we are here for you to lean on! All that stuff going on in your life will not make you "strong" at this point. Just hang on, and we will help see you through the rough times! We care!

 

[glynis]

Gosh, BarbieJ, I'm sorry you have got yourself into such a state.

I am not for one minute trying to belittle the very real pain, discomfort and worry that you are feeling. But you owe it to yourself to calm yourself down, take the deep breaths which Tashia, Rest Assured and others have recommended, and try to get your worries into a different perspective.

First of all, forget the experiences of your family, or neighbours, or workmates. It is not relevant information. We all know someone whose next door neighbour's brother-in-law's first wife had every joint in her body replaced, open heart surgery and a major organ transplant, all within the course of a month, and completed a marathon in a record time just two weeks later.

Maybe these kind of people exist. Most likely they do not. Don't spend time thinking about them.

Believe me, I am hardly one to talk. I had a 2-stage revision before Christmas, after an infection developed 18 months after my original hip surgery. In January I came down with a wracking cough, and convinced myself that there was a big sign inside my body, conveniently placed for all the strong, healthy germs to read. It had an arrow: This Way to the Prosthesis. I spent one afternoon convulsed by tears.

I don't know what caused the infection I had. I don't suppose I ever will. I may get another infection. But, like Scarlett O'Hara, "I'll worry about that tomorrow".

It is always a good idea to have your documents in order, but I think perhaps your constant sorting through all your papers might not be such a good idea at present. Perhaps it could be adding to your anxiety? Are you up to going out? To the countryside, or the shops, or just a walk round the block? I think you would feel better for it.

Forgive me if you think I am being uncaring, and offering an opinion you neither need nor want.

By the way, I love your dog. My friend keeps Shelties. She lives in a very small bungalow, and has 5 dogs. It is like Dog City in her lounge. She is involved with a rescue centre, and when she gets a phone call from them she just can't seem to say No.

Very best wishes.

Glynis

 

[RestAssured]

Barbie, I went back and reread some of your earlier posts. It does not sound like a metal allergy. Have you tried Benedryl to see if the itching would stop? It could be dry skin also with the winter weather. Sometimes it doesn't look dry but just below the initial layer it is, causing itching and burning. My husband has that problem! I hope you can find some relief soon.

 

[Josephine]

I believe I am having metal allergy problems. My new hip is a titanium modular short stem with a cobalt chromium trunnion (the articulating piece that the ball attaches to). I have metal everywhere except the liner. Is my prosthetic considered MoM?

Most definitely not! A metal on metal hip is one where the ball and the cup are both metal so metal is bearing on metal. Yours is metal on plastic. And none of your symptoms indicate metal allergy problems.

I told my surgeon that I had a problem wearing cheap earrings and jewelry and he told me that titanium was biocompatible.

It certainly is.

My cobalt and chromium tests were low so they are not looking at metal allergy anymore.

No, you won't have positive tests because your hip is not metal on metal.

I think there is a connection between the interstitial cystitis and this anal fissure.

I would agree with you. The anus and the urethra are very close and even share the same area being the perineum. E coli contamination (being the normal intestinal bug) is very common in bladder and vaginal infections. Anal fissures are inevitably heavily contaminated with E coli and other bowel bugs. It's pretty common - not nice, but common.

I am sick feeling all of the time. My skin burns and itches all of the time from my thighs up, especially on the hips, but there is no visible sign of any rash.
I feel I'll like I have the flu all of the time. I get extremely ill with burning cystitis and nausea. I feel I like I have the flu all of the time.

These symptoms don't sound like anything to do with the hip replacement.

Groin pain, I have to lift my leg with my arm to climb into bed or get in a car. I usually do my stairs two footed to eliminate some pain. Standing for hours at work is horrendous. Not comfortable lying down or sitting either. Hurts my sitting bones. Mayo wants to do an injection in my psoas tendon.

But these do. At least inasmuch as they are connected with the structures around the hip.

I think you have two things going on here - the outfall from your infections in the bladder and the fissures. Who are you seeing about these conditions? Are they being active in your treatment or just playing a "wait and see" game?

I have a lot of anguish. What has happened. I am grieving because I honestly thought I would be a success story. I have been cleaning drawers and papers trying to get my affairs in order in the event I don't make it through all of this. I know I have a revision surgery ahead of me at some point. Possibly worse. I was happier, healthier and more comfortable before my THR. I pray to God everyday to give me strength to get through each day.

One thing I can clearly see is that you are seriously depressed - and little wonder. I suggest you go see you GP and either get some antidepressants and/or some counselling to help you through this. Whatever, you can't go on like this, expecting 'probably worse'. As far as your hip is concerned, you will very likely find a revision will solve much of this pain and poor function. But the rest is down the to infections which are a different matter.

So sorry I can't help you more than this. I truly wish I could.

 

[BarbieJ]

Hi RestAssured,
I am taking one Zyrtek day, which helps my IC and also helps the itching skin. Think the paresthesia from having the anterior approach feels like burning and stinging. I am taking only over the counter meds,
Zyrtek
Metamucil
Probiotic
Vitamin d and a multi vitamin
An occasional tylenol - took one 325 mg yesterday
Also Premarin cream for post menopause symptoms
Thats it.
I have a miserable time with medications. Always have. My abdomen has a mild rash every morning but it disappears.
Your summary above of my situation is spot on. I could deal with one thing but I am having a hard time with all of this piling on me:
Groin pain from psoas tendon
paresthesia from lateral nerve damage
Burning itching skin on thighs and torso and urethra anal area
Anxiety from worry
Tooth pain still even after the extractions
Pain in lower back and bottom, cannot sit at all on a firm or hard surface
I was so well before my surgery, right as rain. Strong, fit, fun to be with.
My surgeon made it sound like my surgery would be fairly easy because I am thin and young. Honestly, I thought things would be so good. I could never have imagined this scenario. In my presurgery class they talked about infection, blood clots, the usual concerns. I just never anticipated I would be the small percentage that does not have a good outcome.
My little cut is almost invisable now. One less thing on my mind.
You know what the hysterical part is? I am almost pain free when walking.
At least that part got corrected. I sleep most nights like a lamb, probably a nice side effect of the Zyrtek.

 

[BarbieJ]

Thanks for your post glynis. I need a friend to point me in the right direction.
Also, Josephine, I have an appointment with an anal rectal surgeon in one week. I think this has been a wait and see. I had blood in my stools for 3 months after surgery. Colonoscopy did not have anything in the report of an anal fissure, only hemorrhoids. It took a month to get into urologist and colo rectal. I would definitely say so far this has been a wait and see approach by my internist. We'll see what we find out next week. Every test I have had for urine culture and blood work for ESR and CRP has been negative for infection.
The burning is often unbearable.

 

[Josephine]

An occasional Tylenol - took one 325 mg yesterday

Why only one and why so infrequently? You do know that the most effective dose of Tylenol is 1,000mg? And that you can take it 3-4 times a day?

Every test I have had for urine culture and blood work for ESR and CRP has been negative for infection.

Have you been on antibiotics? Any course of antibiotics within the last 3-4 months will give false negatives in cultures and bloods.

 

[RestAssured]

Barbie, you have had CRP and SED rates which keep going down! "Yippee"

When you go to see about the possibility of an anal fistula that will help ease your mind further.

Tell your hubby how glad you are that he is there, and that even though you know he can't fix it, just having him listen and care means the world to you!

You say no pain when walking? Talk doggie for a walk! It is amazing what a change of scenery does for the body and the mind.

Talk to us anytime! We are always around!

 

[BarbieJ]

When I went to Mayo it had been only 8 weeks since I finished a course of Augmentin. They told me that I should not have had any for 6 weeks so they were still okay to do the blood work. I was on a 4 pill premed for a tooth extraction on Jan. 4th which would have been only three weeks, and when I mentioned that they said that the one dose would not prevent them from doing the test. I understand what you are getting at though, Josephine, which is why I titled my thread about my fear that I have a late infection, since I feel quite honestly that I may likely have one and it just has not been able to take hold enough to show on the tests. I feel like I am waiting for something very dark and ominous to rear it's ugly face and it's no fun, let me tell you.
All I can do is wait and try to put one foot in front of the other. Don't know how I will be treated for a late infection if I have interstitial cystitis and a chronic anal fissure since I understand those are both chronic conditions and I suppose I would just have a two stage surgery and if that fails be on antibiotics for life or amputate. None of this sounds like what I want to hear or think about.
Did not have any of this before my surgery. It had been 5 years since I had my last UTI prior to surgery, but I can't lie, I have had a number of them in my lifetime.
You would never think to look at me that I have all this happening and this pain. I actually have worked hard even with my LLD, to not appear to limp. People say how nicely I am walking. I politely say "thank you". That's why this forum has been nice, to have someone who knows a thing or two out there to talk to, if I talk to anyone around me, they haven't the foggiest what I am talking about.
I did walk my Sheltie. It's dark and dreary here, but still feels good to be out there, even though my body is so chilled to the bone all of the time. Thanks for listening.

 

[RestAssured]

Barbie,

Please don't worry about things that may never happen! I was horribly ill when MRSA struck my implant! I couldn't take a step without screaming in pain! It seemed that the only way to get relief at the time was to die, because I hurt so bad! Of course, I opted for surgery instead!

What I am trying to tell you is Quit Waiting For The Grim Reaper to come get you!

You might have an infection in the bladder or an anal fistula but your counts aren't showing it! Be Happy! I would love to have a doctor back then that said "Sonja, your infection counts are perfect, we just took the staples out too early.

Life is too short too waste on worrying what if! What if a train hits me tomorrow? I never know about tomorrow, so I squeeze every ounce of joy that I can out of today!

My Dad died 21 years ago today from brain cancer. I made a promise that I would live my life to the fullest while I was here and enjoy the moments along the way!

 

[HappyHippy]

Hi Barbie,

There's a lot higher chance that you have what I did, which is a loose stem and/or Psoas impingement. I had exactly the same symptoms for 3 years before my revision a little over 3 weeks ago. The groin pain and increasing trouble walking were my first symptoms, and I kept going downhill. I went through 5 surgeons before someone would declare my Replacement a failure.

The good news is that this revision has been a breeze. I woke up and the old pain was gone. Sure, I'm recovering from a Hip Replacement, but there's no other way to get out of pain, and every day I'm closer to my old life.

You'll find out soon from Mayo, but I think you'll find there's more chance that you've loosened. It's the most common reason Replacements fail. And the easiest one to fix as long as you don't ignore it. Anteriors also have the highest rates of complications. I ended up with Meralgia, which is permanent damage to the lateral femoral cutaneous nerve. I have burning and stinging pain along with a large area of numbness on my operative leg. It's with me for good. Gabapentin has been the best painkiller for this, and it's non-narcotic.

What are you using for bowel care? Was there anything in the list? At the very least daily stool softeners, and my Dr. has me on a Colace/senna product. With the two, I'm not having problems and I'm still on narcotics, but also eat a diet action packed with fiber.

Read my thread and see if that sounds like you. Also make sure and get copies of any films they take. My stem was too loose from the beginning. My surgeon was inexperienced and I had an Anterior. Bad combo. By 4 months I was developing pain, and by 1 year it was getting bad. For anymore info, see my thread, but I looked for answers over 2.5 years and the pain and lack of diagnosis was really getting me down.

One thing I want to let you know is that in the Orthopedic community they often wait 2 years before declaring a replacement a failure. That's because you may still get some bone growth into your stem (in theory). I'm just letting you know ahead, that unless there's strong signs of failure, they may wait to revise. You're a little over a year, and your blood work doesn't indicate infection. They want to see a Sed rate above 45, and a CRP that's closer to 10. My Sed rate was 30 and CRP was 3.5, and I didn't have an infection - just inflammation.

Anyhow, I think you can click on my nick and find my thread somehow.

Best of luck, I know how frustrating the pain gets; I just hope your Dr. doesn't take as long as mine to figure it out. And what's especially frustrating, is any person's natural push back if they think you're diagnosing or doing their job for them. I was angry reading my hospital records from this last surgery when I read the PTs notes regarding my claim that I didn't need assistance learning how to use a walker. If the ninnie had read that I was a revision from 3 years ago, it would have been a no brainer. But they don't take the time to read, and if they think you're diagnosing yourself, you'll get a new one - that you're hysterical and then they won't listen to a thing you say. Mine just put down that I was controlling my PT program, until she read my notes two days later. Then she tried to discharge me alone with minimal services until my Dr. intervened.

Communicating with health professionals is a fine art. Many have huge egos and won't admit when they're wrong, but they wield the power. They'll write the orders, or state they're unnecessary. If they like you, things will go well, but if you cross an unethical or just self-absorbed "the patient is rarely right" type, or just "I'm not wrong" sort, they quit listening in a hurry if they think you're questioning them. Other occupations have the same egos, but they won't have your well-being in their hands. You don't want to get the "difficult patient" label.

It's a bit of a game with some, but the bottom line is that you want the best results you can have.