Knee Infection* Revision #3 Journey

[WFD]

I am counting the days until the PICC line is supposed to come out (10/6).

I just got mine out last Friday, the same day the last bandage was removed. It was glorious!

 

[celynda]

Not sure why, but the foot is much more swollen then it was yesterday and the cast feels very tight at the ankle. I’ve asked the PA to call the doctor and see if they’re concerned. the PA added a diuretic to see if it helps reduce the swelling. Just what I need, more trips to the bathroom.

She also upped my Effexor dose to see if the depression improves.

 

[sistersinhim]

I hope you will hear from your doctor soon. Please know that we are praying for you.

 

[celynda]

I took ONE dose of the diuretic and said Never again. Getting up every hour to pee is not acceptable. I finally spent most of the day in bed with leg elevated. Today, the swelling is less so I’m in the recliner.

 

[WFD]

I went on a diuretic for blood pressure during one of my recoveries, and it made my swelling go down and my RoM go up. You might reconsider and give it a try.

 

[celynda]

@WFD, thanks for the note.

Maybe the one does was enough as the swelling seems to have resolved. Being in a cast from thigh to ankle makes mobility difficult so going to the bathroom everyone 1-2 hours is not option .

The cast comes of on Tuesday so I’ll put up with the swelling.

 

[mendogal]

Hang in there... It sounds like little by little things are going your way!

 

[celynda]

Sept 26 Update ~

Had 1st Post-Op appointment with OS who did the flap and graft surgery today. The cast came off and drains removed. OS said everything looked good. I need to wait three more days for a real shower as the bandages over the drain holes need to stay one for three days. On the positive side, I can wash the leg as long as I keep the bandages dry.

I asked him about best case scenario for recovery. He said “keeping the leg.” OUCH. He made a point of telling me to follow up with Infectious Disease to discuss to the antibiotic next steps. That‘s on my list for tomorrow.

I then asked about mobility best case scenario. I can expect full extension - good. Flexion? 45 degrees. Not so good. I am not even sure if that means I can do steps. Double Grr. I think I am screwed.

No ROM PT until I see him in four weeks. GRR. I am cleared to walk which is good. PT while I am still in the SNF will focus on balance work which I really need as I am definitely at risk of falling.

This picture is after cast removal. The dark scabby stuff isn’t a scab. It’s dead skin which I can wash away. I am very glad I have the knee immobilizer as it prevents me from picking the scabs.

 

[sistersinhim]

For what it has been through, your knee looks remarkably well! Your swelling is down and it has pinked up nicely!

45 degrees.

I think I am screwed.

I bet your bend will get better than the doctor says. In time, your knee will probably become more flexible as your muscles and tendons repair and realign themselves.

I'm glad you told us that the dark stuff isn't scab, just dead skin. I bet it feels good to have the cast off for a while. That coming shower will feel like heaven!

for your healing!

 

[celynda]

I have a hinged implant which means the two components are connected by coil/spring like cords. Is it possible to have lost leg length as a result?

My left leg (non-operative) is about 1/2 shorter than the Right. Since the most recent surgeries, I found walking very awkward when wearing a shoe on my Left leg and no shoe on the Right. When I took off the shoe and walked barefoot, walking was much easier. The PT said my shoulder were even without shoes. With a shoe, the shoulders weren’t level, the Right one was lower.

 

[sistersinhim]

We have read of leg length differences after a TKR or THR. These usually resolve after the areas heal and the muscles and tendons strength. I hope yours do, too.

 

[celynda]

Tuesday, 10/3 Update ~ it’s official, I am being discharged Friday morning!! I’ll need to wear the knee immobilizer until the appointment on the 24th and take two antibiotics for another 30 days, I’m hoping to start ROM activities when the immobilizer is removed. In the meantime, PT will focus on balance work and walking endurance. Today in PT, I walked 100 yards. The right leg and foot are still pretty swollen so I can’t get the only shoe I have on it. I may have some looser shoes at home. If not, I may invest in a pair of crocs so I can walk outside. I need to be able to get the mail and want to be able to walk to the glider under the pergola so I can watch the changing leaves in the distance.

Even though the bloodwork indicates the infection is gone, I am concerned about it returning. When I see my PCP on the 11th, I am going to ask her about ordering regular blood tests for awhile just to keep an eye on the numbers. Otherwise, I have to rely on symptoms: fever, sweats, chills and THEN go to the doc and determine if it’s COVID, the flu or an infection.

At least I can spend the weekend at home. I am so excited. I’m even looking forward to doing a bit of laundry.

 

[mendogal]

HOME!!!!!! Oh what a milestone for you.

 

[lovetocookandsew]

What great news!

 

[sistersinhim]

At least I can spend the weekend at home. I am so excited. I’m even looking forward to doing a bit of laundry.

It's the little things that are so missed. Praise God that you are going home! Be sure and not overdo it. Slow and easy is the way to go.

 

[celynda]

Slow and easy is correct. I talked with the OS who did the washout surgery today. He said I was a really unique case and there weren’t clear answers to my questions.

1. Wants me to continue oral antibiotics for at least six months with bloodwork at three and six months. Need to keep an eye on kidney function and electrolytes.
2. Wants to see me in December.
3. The key to keeping my leg is maintaining the extensor mechanism which means limiting flexion. I should plan on wearing a knee immobilizer and using a walker/cane forever.
4. He agreed with the flap surgeon about 45 degrees flexion being a good result. Any flexion will come in time with gravity. No PT for flexion. I’m going to ask for a script for balance work only.
5. I won’t be able to drive unless I get my car fitted with hand controls.
6. Success is keeping a leg that bears weight. He doesn’t trust the extension mechanism and if I fall or over bend the leg, I could rupture the flap repair and be in real trouble.

Needless to say, I am really bummed with this news.

I really like the OS, Dr Murillo Adrados. He’s approachable and honest without being abrupt. @Jamie, I think we can add him to our recommended list.

 

[Jockette]

Your good news is very good, and I’m sorry about the news that has bummed you out. Hopefully as you continue to heal, things will be better than you expect.

 

[mendogal]

I'm so sorry. At least you have a compassionate and honest OS. Hoping that you're able over time to exceed his expectations. Sending a virtual ((hug))

 

[sistersinhim]

I pray that they are just telling you the worst-case scenario and you will exceed his expectations!

 

[celynda]

Saturday, 10/7 Update…

Boy was it nice to sleep in my own bed last night. I am very tired today so after doing a few things around the house, I am going to rest the remainder of the day. I didn’t realize Gabapentin is a controlled substance in my state so I had to wait for a neighbor to pick up the script today. I really missed it last night - so many zingers, I had trouble sleeping. If I keep up with the Gabapentin, Tylenol, and Methocarbinal regimen, I am pain and zinger free.

The home health nurse comes today for the initial assessment. I’m using the same agency used after the May surgery. The PT pinged me on Thursday asking what happened as she discharged me the week before all hell broke loose in August. I gave her the short version. I’m looking forward to working with her on balance and endurance issues.

Because of the limited bend in the knee, I’m looking to have the car fitted with hand controls. The evaluation should be in a couple of weeks. Of course, none of the 3 - 4k cost is covered by insurance.