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[KNEE INFECTION] Persistent Infection<

Josephine

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1. Pain level when walking is about a 6-7 and when sitting only about a 2. Legs elevated 1-2.
Well, I suppose you are only recently out of surgery so that's quite to be expected.
2. I was prescribed hydrocodone every 4hrs as needed and they are 7.5/325 mg. I take one every four hours except when I am sleeping through the night 8-9 hrs.
I'm sure you are prescribe 1 OR 2 at a time, are you not? You really do have to get on top of your pain so you need to take 2 as prescribed.
3. Legs are swollen as the middle photo moderate, ankles like the photo on right HUGE
OOh, nasty!
4. Had no ROM measured as yet, however, based on my last few surgeries and the way I felt then, feels like flexion is 90+ and extension is -7 to -8
Well considering everything, that's not too bad!
5. I ice my knee with a cooler type pump machine that circulates the water through a bladder around my knee twice per day, for about 1-1½ hrs. each time depending how much ice I put in the cooler. Once the light blinks continuously the water is getting warm so I quit at that time.
Good
6. Not elevating my leg enough, just when I ice the knee.
Good
7. Very little activity. No housework, walking a bit through the house and that is about it. A few doctor office visits to various doctors.
Excellent
8. I am doing no exercises at home and no PT yet
Excellent!
Walked to my bathroom, and a good 6oz or more of the clear fluid, hardly no blood at all, gushed out and got all over the floor. Is it better to leave this fluid in with the ace bandage or is it better not to wear the ace bandage and let the fluid run out into the gauze pads that I wear?
It's always best to allow a wound to drain. So stop putting the Ace bandage on it but keep a dressing that can absorb the drainage. Oh yes! And I seriously doubt it was 6 fluid ounces! A little goes a very long way, y'know!

I also think you should report that amount of drainage to your surgeon.
 
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iggyw1

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Thanks again. I was not sure to let it drain or not. Could his fluid (almost clear) be the antibiotic beads that OS put into my leg or is it just natural body fluid? OS is on a cruise and will not be back until 11-28-18 the day of my next appt. with him. Scriipt for Hydrcodone states (1) tablet every for hours as needed for pain. I have taken two of them sometimes before bed. Is two at a time safe?

Thank you!
 

Josephine

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Could his fluid (almost clear) be the antibiotic beads that OS put into my leg or is it just natural body fluid?
No, the beads don't do that. It's obviously serous or tissue fluid.
OS is on a cruise and will not be back until 11-28-18 the day of my next appt. with him.
Surely he must have left some to contact in case of emergency@
Is two at a time safe?
Quite safe - most doctors prescribe it 1 OR 2 every 6hrs.
 
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iggyw1

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No emergency contact number by the doctor except the E.R. at the hospital he works at. I am thinking about going there if things don't improve by Monday. My OS won't be back 'til Thurs.
 
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iggyw1

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It is about three weeks out from my last wash out for my infection. OS wants to see me Tuesday and he will let me know if he has to go back in AGAIN for a third wash to get rid of the infection. I have one spot (a hole the size of a Q-tip) in my incision that just will not heal. The fluid is still pouring out of it.

I am now wondering if anyone has had this problem where a spot just will not heal and the fluid still comes out non-stop? I am thinking about talking to my OS to see if I should try a wound specialist which I have real close to home here. Can a wound specialist do anything for the wound I have if there is infection in it or does my knee have to be re-opened again?
 

Josephine

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I have one spot (a hole the size of a Q-tip) in my incision that just will not heal. The fluid is still pouring out of it.
I find that very concerning because to me, that would be an indicator of continuing infection. Which means your knee requires not washouts but a revision.
 
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iggyw1

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I hope to God not! The fluid coming out does not necessarilly mean it is infection, does it? There is no odor to it and it is almost clear fluid. Slowed down somewhat after I started packing it on Friday (home nurses rcommendation). When I removed the packing this morning, it was pretty wet as well as the top dressing over the packing too. But I sat there with it unpacked and uncovered for about 20 minutes and it was bone dry during that time. A few days ago, I would have had a mess running down my leg and onto the throw away pad on the floor, so to me that was a good sign or was I just wishful thinking?
I did not mention that my nurse removed a big knot from a stitch down in the wound. It was a ways down there. Seems that stitch should have disolved to me.
 

Kenello

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Yes, my husband went with an infection almost 18 mos. (including a horrific surgery in which part of his calf muscle was used to close the hole that wouldn't heal over the kneecap) before his TKR was removed, as he was beginning to get sepsis. A spacer was placed for 3 months, and then a revision.
 

PegGar16

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Hi @iggyw1. I know the stress you are going through and truly don't want to add to it. Make sure your ID is also involved in your appointment tomorrow....better safe than sorry. What you are describing is what what my infection looked like at the beginning. I tried the conservative route (against my ID's recommendation) with a wash out. Three months later I was in for the removal. 10 days after I had finished the antibiotics the infection was back full force. At least with all the information you are getting here and your ID you should be able to make an informed decision on how to proceed. I hope your appointment goes well tomorrow.
 

KarriB

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Three washouts is a lot. If my knee hadn’t stopped seeping after one washout my OS wanted to do a 2 stage revision. It did take a month for the seeping to stop, but in the meanwhile I not active at all and wrapped my knee in an ace bandage along with being in an immbolizer to keep it from bending. What does your ID say about your labs?
 
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iggyw1

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My ID said that last week was the first time in about 8 weeks that all of the numbers went in the right direction, and a very good amount into the right direction. The home nurse took more blood today. I will get the results of these labs tomorrow before my ID or OS gets them, and I will be going to see my OS tomorrow too.
 

Josephine

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The fluid coming out does not necessarily mean it is an infection, does it?
It doesn't necessarily mean it's not, either.
I did not mention that my nurse removed a big knot from a stitch down in the wound. It was a ways down there. Seems that stitch should have dissolved to me.
These synthetic dissolvable sutures can take around 6-8 weeks to break down. Sometimes even longer - it depends upon the thickness of the suture material. And yes, that does make a difference.
 
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iggyw1

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OK, I hope now that I just had my last surgery concerning the matter of my infection in my right knee. My OS removed dead tissue from my incision that would never close because it was dead. He removed the dead tissue until he got to the good live tissue all the way around it. This procedure was done on Monday (two days ago).

Had a lot of pain from it on Monday and Tuesday but better today. Doctor put a wound pump on it Monday and he will be replacing it tomorrow at his office. I only spent one night in the hospital. Not much blood in the wound pump filter but there is some there.

I will be wearing my IV bag an additional two weeks after this last surgery. I was suppose to get off the IV on Dec 26, but now my ID extended it to Jan 19th. Hope this helps with my infection problem. I will be going on oral antibiotics after the IV bags end.
 

sistersinhim

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That wound pump should help you heal. I pray the infection is gone!
 
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iggyw1

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I went to my OS today, and he looked at the current wound vac that I have in place. When he saw how little it "sucked" up into the filter over the three days that it was in place, he said to me that it "looks great, that is a good sign and he does not want to change it today as planned'. He told me to leave it alone as long as the green light is still blinking on the vac (that indicates a negative pressure). He said the vaccuum will quit in seven days automatically as it is designed to run only seven (7) days then quit. He said if it quits before the seven days is up, he will replace the WOUND VAC dressing with a new one (same vac pump) until it quits on its own IN SEVEN DAYS, but really there is only a small amount of blood in the filter of the current wound vac.
He will be on vacation all of next week, and he told me to have my home nurse remove the vac pump and the dressing on Monday when she comes over if it is done sucking. If not, she will be coming over again on Wednesday, the day after Christmas, and she will remove and replace it then.
 
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iggyw1

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Good News??? My wound vac quit on it's own on Christmas Eve about 11:00 p.m. This was kind of anticipated as my OS told me the vac is only good for seven days and it will quit working on it's own. Monday was the seventh day! When the wound vac quit, I removed it from my knee area, and disposed of it. I put a dressing of gauze in it's place as my OS instructed me to do if & when the vac was removed. I removed this dressing this morning (Christmas day) and there was not a drop of blood, infection, or any fluid at all on it. It was totally dry when I removed it. I will be seeing my OS on Jan. 3rd so he can removed the stitches and check out the wound.

I replaced the dressing this morning after cleaning the incision area with peroxide, and tonight, (Christmas night at 8:00 P.M.) the gauze remains totally dry!!! This to me is great news as the OS performed the surgery last Monday for the purpose of removing dead tissue and closing the wound up so it will heal and not seep any longer. My blood readings of Sunday all went in the right direction as well per my home nurse. The pain in my knee that was replaced and had a major bout of infection is almost gone completely other than a sharp pain as I am rising from a sitting position. Once I stand up, I am o.k. but while rising, a a stabbing pain persists.

I am still on a 24/7 IV treatment until Jan. 19 as per my ID doctor. I will be going to see her on the 17th of Jan. and she will decide if I can get off of the bag and go on oral anti-biotics. Things are starting to look good finally for me. I hope I am not in for a heart breaker, but things are looking real good in my favor after a looooooong fight with the infection.
 

sistersinhim

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What good news! It's great that your bandage is staying dry! Yay! Hopefully, you can come off of your IV after your ID doctor's visit!
 

Jamie

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That is wonderful news!!! I'm happy for you and hope the good reports continue. You have certainly had challenges with this knee, but this time things sound really promising. :yay:
 
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iggyw1

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Hi all,

I have not written since Christmas day. Update: The day after Christmas, my PICC line pulled out again. Just enough to pull it out of my heart area. Ended up in the ER then overnight in the hospital since no PICC line team was working that night. Had a temporary IV put in my arm while I was admitted since I need my antibiotic IV 24/7 per ID doctor. Was discharged and sent home with new PICC line on the 27th. of Dec.

Jan. 3rd got stitches removed from a 4" incision in my leg to remove dead tissue that would not heal. Had plastic surgeon do the surgery for this. This incision stayed dry for four days then opened up and started oozing again. Went to see my ortho doctor today (1-10-19) and he checked things out real good. Everything has been dry again for the past two days (three days counting today). OS said the wound is finally closed and is not oozing anything right now. He said this is the best my knee has looked for the past two months, and told me to come back and see him in 5 to 6 weeks unless things change.

On Jan 17th I am going to see my ID. She is the one that has me on the 24/7 I.V. at home. She has it planned to be done with on the 19th IF my blood readings look good, then I will be on oral anti-biotics from that point on. I hope she does not have to extend the use of the IV in the PICC line any farther than Jan 19. Will report after that date and let you all know what happens. I have been fighting this infection a loooong time now. Hopefully, things will start going in my favor now. My blood readings from last Monday went in the right direction quite a bit. They checked for white blood cells (down) hemoglobin (up) and two inflamation readings both went down quite a bit. Looking better for me.
 

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Dear @iggyw1 I pop over here as I am still recovering from a TKR 29 March but am now ensconced in the Infection area of the Hip Forum ... I like to get around and spread myself thin! :whistle:

Fortunately I have not had the 'pleasure' of a PICC line and hope it keeps that way. Whilst in hospital my veins kept collapsing so I was taken off IV antibiotics, put on tablets and thankfully sent home on 1 November after 15 days in hospital. Hopefully my levels go within range on Tuesday the 15th and I can move onto the next level ... of waiting to be clear for a month before surgery is considered.

This is a long and frustrating journey we are on ... but we will all get to the end of the tunnel / pot of gold eventually.

Stay strong and positive.
 

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