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So sorry to hear of your troubles. It is good to vent here. I found it helpful when I was back in hospital after my surgery. Try to keep strong.
Knee Infection* Revision #3 Journey
- Thread starter celynda
- Start date
celynda
senior
Saturday 0830 update.
Still waiting for OR time. Will push for go/no go at 10a.
Caused excitement around 0500.
The Pure wick leaked. When Assisstants came in clean up,
there were![[Bonesmart.org] Revision #3 Journey](https://data.bonesmart.org/attachments/78/78297-bc5170d68e22efcf44864a68017ddaa8.jpg?hash=vFFw1o4i78 "[Bonesmart.org] Revision #3 Journey")
gasps of horror and I’ve never seen anything like this. Approximately 500 ML was expressed. Check out the very gross. Thumbnail.
Still waiting for OR time. Will push for go/no go at 10a.
Caused excitement around 0500.
The Pure wick leaked. When Assisstants came in clean up,
there were
gasps of horror and I’ve never seen anything like this. Approximately 500 ML was expressed. Check out the very gross. Thumbnail.
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celynda
senior
I’ve made it clear there’s a go/no deadline of 10:00. This pushes date to Monday.
The Orthopedic resident was very resistant to this plan
I’m holding firm.
They also charged pain meds from Norco to Oxy. So I’m a bit stoned and will be until Surgery.
The Orthopedic resident was very resistant to this plan
I’m holding firm.
They also charged pain meds from Norco to Oxy. So I’m a bit stoned and will be until Surgery.
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God bless you. Prayers are being sent up for you. (((celynda))) hugs to you.
Oh my….things have really changed for you in this sort time. I’m thankful you got to a more skilled hospital quickly. As I’m sure you know by now, septic arthritis (actually any type of septic situation) can get serious very quickly. I’m also glad you have an infectious disease doctor on the case. This is critical.
Am I understanding correctly that you are opting not to have surgery until Monday unless it could have been done by 10:00 today? If so, I can understand the resident’s concern about that, as it concerns me too. If this is the case, I suggest you discuss this with your infectious disease doctor. Septic infections are notoriously fast moving when not aggressively treated and can move quickly to impact your entire body. It’s not anything to fool around with.
I’ll take a look at all the resources involved in your case. Since you are in a trauma center, I’m going to guess that your team is pretty good. These folks are used to the more serious cases that require fast action. They are frequently the best of the best in a specific area.
Thanks for taking time to provide a photo of your knee for us. Septic arthritis is not a common problem with knee replacements and it is helpful to see what it looks like. For people looking at the image, the discoloration covering most of her leg is a betadine solution used to help prevent further infection on the skin. Since it contains iodine, it tints the skin a yellow-orange color. That is some photo…..sending supporting hugs to you!
Am I understanding correctly that you are opting not to have surgery until Monday unless it could have been done by 10:00 today? If so, I can understand the resident’s concern about that, as it concerns me too. If this is the case, I suggest you discuss this with your infectious disease doctor. Septic infections are notoriously fast moving when not aggressively treated and can move quickly to impact your entire body. It’s not anything to fool around with.
I’ll take a look at all the resources involved in your case. Since you are in a trauma center, I’m going to guess that your team is pretty good. These folks are used to the more serious cases that require fast action. They are frequently the best of the best in a specific area.
Thanks for taking time to provide a photo of your knee for us. Septic arthritis is not a common problem with knee replacements and it is helpful to see what it looks like. For people looking at the image, the discoloration covering most of her leg is a betadine solution used to help prevent further infection on the skin. Since it contains iodine, it tints the skin a yellow-orange color. That is some photo…..sending supporting hugs to you!
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The Carilion Clinic Roanoke Memorial Hospital is a good place to be. They are a large hospital associated with the University of Virginia Medical Center, a teaching hospital. This is usually where the latest treatments are available. It’s a Level 1 Trauma Center which means the doctors are used to seeing difficult and serious cases. The fact that they have an infectious disease doctor as primary on your case is good too. Be sure to have lots of discussions with this doctor about what is going on with your knee in terms of the sepsis, as this is a very serious condition that can become life-threatening if not aggressively treated.
The three surgeons you listed all sound very capable of dealing with both the infection and whatever revision surgery is needed. Their first order of business is going to be getting the septic infection under control. Dr. Coobs is a bit younger, but still has good credentials. Dr. Adrados appears skilled with complex revisions and has studied periprosthetic infections. Dr. Sloboda has many years of experience dealing with joint revisions. I think you are in a good position with any of the three doing whatever surgery is needed. It appears they operate as a team on complex cases, so you really have the benefit of three brains at work on your treatment from an orthopedic perspective.
Questions you may want to ask are:
1. How many knee revisions does the surgeon do each year?
2. Has the surgeon or infectious disease doctor successfully dealt with cases like yours in the past? What worked?
3. When open surgery is done, will antibiotic beads be placed in the wound before closing?
4. Have they been able to isolate the particular bacteria, virus, or fungus causing the infection?
5. Is it possible to have Home Health assist you with your PICC line once you’re home?
6. Are the doctors aware of Dr. Paul Marik’s treatment for sepsis? In 2016, this doctor with Sentara Norfolk General Hospital developed a breakthrough treatment for sepsis that consistently helps his more serious cases. Using a combination of Vitamin C, steroids, and thiamin given intravenously he had excellent success with his patients. This treatment is safe to use with other treatments and helped patients literally within hours of beginning the IV solution. Since 2016, a number of clinical trials have yielded mixed results and, probably for this reason, the treatment is not widely used. But it might be worth considering, since it is so safe to administer. There is a fairly recent (2020) PubMed review of the protocol available online for the doctors to review if they aren’t familiar with it or they could contact Dr. Marik directly….just a thought.
All the best to you as you meet this challenge. Good for you for dealing with it quickly. It’s a good lesson for us all not to ignore symptoms when things just don’t seem right. Keep in touch. I’ll be praying for you.
The three surgeons you listed all sound very capable of dealing with both the infection and whatever revision surgery is needed. Their first order of business is going to be getting the septic infection under control. Dr. Coobs is a bit younger, but still has good credentials. Dr. Adrados appears skilled with complex revisions and has studied periprosthetic infections. Dr. Sloboda has many years of experience dealing with joint revisions. I think you are in a good position with any of the three doing whatever surgery is needed. It appears they operate as a team on complex cases, so you really have the benefit of three brains at work on your treatment from an orthopedic perspective.
Questions you may want to ask are:
1. How many knee revisions does the surgeon do each year?
2. Has the surgeon or infectious disease doctor successfully dealt with cases like yours in the past? What worked?
3. When open surgery is done, will antibiotic beads be placed in the wound before closing?
4. Have they been able to isolate the particular bacteria, virus, or fungus causing the infection?
5. Is it possible to have Home Health assist you with your PICC line once you’re home?
6. Are the doctors aware of Dr. Paul Marik’s treatment for sepsis? In 2016, this doctor with Sentara Norfolk General Hospital developed a breakthrough treatment for sepsis that consistently helps his more serious cases. Using a combination of Vitamin C, steroids, and thiamin given intravenously he had excellent success with his patients. This treatment is safe to use with other treatments and helped patients literally within hours of beginning the IV solution. Since 2016, a number of clinical trials have yielded mixed results and, probably for this reason, the treatment is not widely used. But it might be worth considering, since it is so safe to administer. There is a fairly recent (2020) PubMed review of the protocol available online for the doctors to review if they aren’t familiar with it or they could contact Dr. Marik directly….just a thought.
All the best to you as you meet this challenge. Good for you for dealing with it quickly. It’s a good lesson for us all not to ignore symptoms when things just don’t seem right. Keep in touch. I’ll be praying for you.
celynda
senior
Sorry, if was unclear (blame on the Fentanyl/Oxy cocktail). The 10a time was a deadline having it scheduled. I didn’t if the SX started 2, 3, 4 or 6. As long as there was a high level confidence, it would HAPPEN. About 2, I was on the schedule for 4p. Pre-Op came for me at 230. I was all set, waiting on the OS. At 345ish, Dr Coobs came to see me. The team was setting up the OR and a Car Accident came. So that pushed us to at least 7 for 3-4 hour surgery.
Dr Coobs agreed to push the surgery until Monday where I am on Dr Adrados schedule for late afternoon. He decided to check on the OR situation and learns something has change requiring his attention so there was never going to be a surgery today.
I’m still on IV antibiotics; with no side-effects, thank goodness so tomorrow is a true day of rest and reading up on septic arthritis
@Jamie, thanks for your research and questions, I’ll respond to them in the initial post.
celynda
senior
celynda
senior
5) that is preferred. I am not sure I want do it so may go to a SNF while on IV Antibiotics if insurance approve.
6. I will this ask this along with the others and let know. I wlll see if I can see a copy of it.
Again, so many thanks for all your help support in my journey.
celynda
senior
Gasps of horror from the medical professionals?!
Well, that is certainly discouraging and unexpected. I am sorry you had to experience that.
I know. I told me that things really were serious. In addition, the Night Shift has very little experience. It was the nursing assistant’s first shift working independently. The RN has been an RN for six months. They called for Medicine Support and a wonderful Nurse Practitioner came and took over.
OTOH, If the Assistant had the inserted the PureWick (female external catheter) correctly, it might not have been discovered for hours. It’s only when they came to change the bed that they noticed the oozing (which they persisted in calling (leaking) that the oozing mess was discovered. I didnt notice any anything and there no odor. Thee sheets were a mess - sure why I slept though that. Oh well.
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This sounds good that you have additional medical support over the weekend. Saturdays, Sundays, holidays and nighttimes are often a little light on the seasoned medical personnel and that just means you need to be extra alert to anything going on. Do you have friends or family to help with your advocacy? That can make things easier if someone is there to hear along with you what is said and help ask questions. If not, just keep a pen and pad close and write down any questions that come to mind for when the doctors or nurses come in. Don’t be afraid to pester them with explanations of what they are doing, what is going on, and any concerns you have. Your participation in your care is a critical part of the treatment process. Hang in there and hope you rest well tonight.
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Really agree with this. You are not at your best when seriously ill with sepsis.
When my CRP was 250 in February with septicaemia- I definitely wasn't always thinking entirely straight and it helped having my husband and son to advocate for me. Keeping a record of what you are told is also a really good idea. It can get really confusing keeping tabs on what doctors say each day.
celynda
senior
I’m in a hospital 100 miles from home (WV). Family is in Florida.
I’m taking as good notes as I can. I can even read what I wrote unless the Fentanyl was just recently given. The ID takes over case on Monday one of my first questions will be whether or not to ask them to come. Mom has dementia so she’d be no help. My brother and SIL lead very busy lives. I’m afraid if I ask them to come, they won’t. I never married, am unemployed and am wondering why I should continue to fight.
Monday Update
bug identified by blood cultures as MSSA. Antibiotic switched to Ansef/ CaFazagram.
Medicine doctor says it’s 50/50 and washout surgery on Monday is attempt to save my life.
I’ve signed a DNR and don’t want an amputation.
I’m taking as good notes as I can. I can even read what I wrote unless the Fentanyl was just recently given. The ID takes over case on Monday one of my first questions will be whether or not to ask them to come. Mom has dementia so she’d be no help. My brother and SIL lead very busy lives. I’m afraid if I ask them to come, they won’t. I never married, am unemployed and am wondering why I should continue to fight.
Monday Update
bug identified by blood cultures as MSSA. Antibiotic switched to Ansef/ CaFazagram.
Medicine doctor says it’s 50/50 and washout surgery on Monday is attempt to save my life.
I’ve signed a DNR and don’t want an amputation.
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Hello Celynda,
Your family may be 100 miles away, but they're still able to support you via phone calls or social media, given the opportunity. You may consider calling them to inform them of the situation, without asking anything of them and see where it goes. You are not alone, we are here for you and only a few keystrokes away. Those of us inclined to pray will be praying. You will find many here sympathetic and compassionate to your situation willing to offer encouragement and support through visiting your thread.
Is there a hospital chaplain you'd be willing to arrange a visit with today, if interested? You should continue to fight because your situation is not hopeless as long as you have breath and you may have many healthy years ahead of you once you get beyond this. Understand that we're available to draw strength from when you're feeling the need. I am certain you'll find many willing to lift and encourage you as we watch your story unfold. We do care!
Will be remembering you in prayer.
@celynda
Your family may be 100 miles away, but they're still able to support you via phone calls or social media, given the opportunity. You may consider calling them to inform them of the situation, without asking anything of them and see where it goes. You are not alone, we are here for you and only a few keystrokes away. Those of us inclined to pray will be praying. You will find many here sympathetic and compassionate to your situation willing to offer encouragement and support through visiting your thread.
Is there a hospital chaplain you'd be willing to arrange a visit with today, if interested? You should continue to fight because your situation is not hopeless as long as you have breath and you may have many healthy years ahead of you once you get beyond this. Understand that we're available to draw strength from when you're feeling the need. I am certain you'll find many willing to lift and encourage you as we watch your story unfold. We do care!
Will be remembering you in prayer.
@celynda
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Celynda, I understand and support your not-taken-lightly decisions re DNR and no amputation. Each of us carries deeply rooted values that sometimes don't become apparent until it's necessary to make a decision.
Yet - and there's no contradiction here - at the same time I hope you're also able to find some reasons to want to live. With the kind of health and life struggles you've been dealing with, it can become difficult to tease out the difference between an existential crisis and a deep depression. Personally I'm a freethinker, yet I agree 100% with Layla that you see if a hospital chaplain is available today. In my experience they can be very good at these situations where the spiritual, ethical, and psychological intersect.
Holding you in my heart to get through today and have a good outcome tomorrow.
Yet - and there's no contradiction here - at the same time I hope you're also able to find some reasons to want to live. With the kind of health and life struggles you've been dealing with, it can become difficult to tease out the difference between an existential crisis and a deep depression. Personally I'm a freethinker, yet I agree 100% with Layla that you see if a hospital chaplain is available today. In my experience they can be very good at these situations where the spiritual, ethical, and psychological intersect.
Holding you in my heart to get through today and have a good outcome tomorrow.
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Good luck and rooting for you to pull through this ok.
Remember you are probably feeling depressed by the infection itself and will hopefully start to feel more positive once the antibiotics kick in.
I certainly felt much better mentally as well as physically once my septicaemia settled. It is a really serious illness but the drugs, and in your case surgery can really work.
Remember you are probably feeling depressed by the infection itself and will hopefully start to feel more positive once the antibiotics kick in.
I certainly felt much better mentally as well as physically once my septicaemia settled. It is a really serious illness but the drugs, and in your case surgery can really work.
