I agree with Jockette. Now, is not the time to let someone inexperienced to be assigned to your case. Please find someone with experience.
Knee Infection* Revision #3 Journey
- Thread starter celynda
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celynda
senior
Thanks for your concern, Jockette and Sisters. Normally, I would agree with y’all 100% - see the best you can especially for complicated situations and boy do I have a complicated situation…
Since I don’t have any emergent symptoms right now, I am comfortable establishing with Dr B in UVA. If anything changes, I know she’ll consult with HSS for both Ortho and ID support. Otherwise, I would plan to travel to NY on a regular basis. If the infection reoccurs or worsens and UVA can’t/won’t support Chalmers ideas, then I’ll be back in NYC on the next flight.
I am going to continue with PT, the locking knee brace and the walker and accept I‘m probably as recovered as I can expect to get.
Since I don’t have any emergent symptoms right now, I am comfortable establishing with Dr B in UVA. If anything changes, I know she’ll consult with HSS for both Ortho and ID support. Otherwise, I would plan to travel to NY on a regular basis. If the infection reoccurs or worsens and UVA can’t/won’t support Chalmers ideas, then I’ll be back in NYC on the next flight.
I am going to continue with PT, the locking knee brace and the walker and accept I‘m probably as recovered as I can expect to get.
I think your plan is logical since the latest testing results were acceptable and didn't show the infection to be an emergency situation. It sounds like you are going to be closely watched and that's important. The liaison with HSS is a plus as well. Let us know how things go.
celynda
senior
7 Feb update:
I saw the new OS and ID docs at UVA Charlottesville on Jan 30. I am very glad HSS is staying on the case as the new OS is so very young and inexperienced. In reviewing the MRI, she noticed that it didn’t cover the lower leg where the remaining still healing wound is located. She ordered a tib/fib MRI to look for a sinus tract there. It’s scheduled for late Feb.
The ID doc agreed with the RX regimen I’m on: Doxy for life. He also suggested getting the knee aspirated. After consulting the ID, the OS wants to wait until after the MRI or I develop symptoms of an infection. If an aspiration is to be scheduled, the ID doc suggested stopping the a/b two weeks before to see if anything grows. If/when infection symptoms re-occur, I will definitely have the DAIR procedure. Whether it’s in Charlottesville or New York is TBD. I’ll need to learn a lot more about the UVA process. I know HSS does a double DAIR.
I’ve also stopped PT as it’s not going to make a difference. I will continue to do the exercises at home. I‘m working on using the walker less and a cane more. If I am careful, I can walk slowly without any assistive device. I will always take the walker and cane when I leave the house.
I still have to be very careful. The other evening, I slipped in the shower and ended up flat on my back. I tried for 10 minutes to get up on the shower seat. I got within two inches of the seat but couldn’t manage the last bit. I did manage to turn off the water, crawl out of the shower, put on my nightgown and pull/crawl to the phone so I could call 911 for a “lift assist.” When the EMTs arrived, they used the throw from the couch and pulled me up and on the couch. Fortunately, I didn’t hurt anything - just my ego.
Lesson Learned: take phone everywhere.
I saw the new OS and ID docs at UVA Charlottesville on Jan 30. I am very glad HSS is staying on the case as the new OS is so very young and inexperienced. In reviewing the MRI, she noticed that it didn’t cover the lower leg where the remaining still healing wound is located. She ordered a tib/fib MRI to look for a sinus tract there. It’s scheduled for late Feb.
The ID doc agreed with the RX regimen I’m on: Doxy for life. He also suggested getting the knee aspirated. After consulting the ID, the OS wants to wait until after the MRI or I develop symptoms of an infection. If an aspiration is to be scheduled, the ID doc suggested stopping the a/b two weeks before to see if anything grows. If/when infection symptoms re-occur, I will definitely have the DAIR procedure. Whether it’s in Charlottesville or New York is TBD. I’ll need to learn a lot more about the UVA process. I know HSS does a double DAIR.
I’ve also stopped PT as it’s not going to make a difference. I will continue to do the exercises at home. I‘m working on using the walker less and a cane more. If I am careful, I can walk slowly without any assistive device. I will always take the walker and cane when I leave the house.
I still have to be very careful. The other evening, I slipped in the shower and ended up flat on my back. I tried for 10 minutes to get up on the shower seat. I got within two inches of the seat but couldn’t manage the last bit. I did manage to turn off the water, crawl out of the shower, put on my nightgown and pull/crawl to the phone so I could call 911 for a “lift assist.” When the EMTs arrived, they used the throw from the couch and pulled me up and on the couch. Fortunately, I didn’t hurt anything - just my ego.
Lesson Learned: take phone everywhere.
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Well that's quite an ordeal in the tub! What a relief to come out uninjured (and clothed!).
Your update is appreciated and it must feel good to have HSS backing you every step of the way. To a resolution of this in 2024!!!!!
Your update is appreciated and it must feel good to have HSS backing you every step of the way. To a resolution of this in 2024!!!!!
lovetocookandsew
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I'm glad to read your update. What an awful way to learn to take your phone everywhere, but I'm glad the only thing harmed was your dignity, although that's no fun either.
I also learned the hard way to take my phone everywhere, although nothing near what you went through. Even now, I take my phone with me everywhere, even from room to room inside. Our house is large, and my husband would probably not be able to hear me if I fell and he was at the other end, or outside.
I'm glad you're getting good care and I hope they find out what they need to know so they can do whatever needs to be done. You've been through so much, and I hope things can get taken care of and you can move on to whatever your future brings, leaving surgeries and infections behind you.
I also learned the hard way to take my phone everywhere, although nothing near what you went through. Even now, I take my phone with me everywhere, even from room to room inside. Our house is large, and my husband would probably not be able to hear me if I fell and he was at the other end, or outside.
I'm glad you're getting good care and I hope they find out what they need to know so they can do whatever needs to be done. You've been through so much, and I hope things can get taken care of and you can move on to whatever your future brings, leaving surgeries and infections behind you.
I’m so sorry about your fall experience! Like you needed anything else to happen to you!
I have, on occasion, put my phone on the floor of the bathroom, so if I fall coming out of the shower it will be easier to get to.
This is a really hard lesson to learn, but telling us about it has probably led more of us to constantly have our phones by our sides!
It sounds like you have really good doctors on your case. Thanks for the updates, and please keep coming back and letting us know how you are. We care!
It does sound like you’re getting the medical attention you need right now. I’m sorry there is waiting involved, but that always seems to be the case these days. Thankfully only your pride was damaged with the fall. You are fortunate and I’m glad of that! Hang in there.
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celynda
senior
It happened again today… I was standing at the sink washing my hands and my R knee buckled/collapsed and I fell.Of course, the phone was in the living room so after dragging myself through the hall, I was able to call 911 for the second lift assist in 11 days. Fortunately, other than tired muscles from trying to pull myself up, no medical attention needed.
I am now scared of the future - how can I go about my daily routine not knowing if/when the next collapse will be a serious one.
I sent a note to the UVA OS asking if it’s time to discuss the double DAIR in preparation for another revision including tendon repair? I may also send the question to the HSS OS once I hear from the OS.
TIA for your thoughts and prayers. Additionally, any advice on managing this is greatly appreciated.
I am now scared of the future - how can I go about my daily routine not knowing if/when the next collapse will be a serious one.
I sent a note to the UVA OS asking if it’s time to discuss the double DAIR in preparation for another revision including tendon repair? I may also send the question to the HSS OS once I hear from the OS.
TIA for your thoughts and prayers. Additionally, any advice on managing this is greatly appreciated.
Oh, wow, I’m so sorry you fell, and so far from your phone. I’m glad you didn’t need any medical attention as a result.
Sending hugs and prayers. I wish I could do more.
Sending hugs and prayers. I wish I could do more.
lovetocookandsew
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I'm sorry you fell again. I know how painful a fall can be, and how emotionally scary and devastating it is to think that it may happen again. My first thought is to always carry your phone with you. You can carry it in a sling bag, purse, neck bag, pocket....whatever works best for you. I take my phone everywhere these days as I never know what may happen. I fell hard on Christmas night; it was a doozy, and not in a good way. I was lucky that time as my husband, and a few others, were there and helped me up and into the car. Fortunately, I didn't do any damage that required any kind of repair; I just bruised or strained a lot of stuff inside that took weeks to heal. Oh, and I royally damaged my pride falling in public, but that also healed with a little time.
I also would consider using a walking aid to help catch me when my knee buckles. My leg gives way at times also, but so far I've managed somehow to stay upright. The fall on Christmas was a result of stepping into a hole, not from my leg itself, other than that maybe I could have stopped the fall on a strong leg, but maybe not. Anyway, I worry that one of these times I may hit the ground when I forget and turn too quickly, or even just out of the blue for no particular reason. I'm extremely careful, but things happen. When we go places where I would need to do a lot of walking, I gave in to common sense, swallowed my pride and now use a scooter to make sure I don't set my leg off, and end up with problems. Around the house I walk on my own, but I always have my phone with me.
I might even consider something like one of those knee walkers to rest my knee on when standing at the sink, or similar. The rest of the time I'd use a cane, or something, to give me the extra strength and balance that my leg needs. So far, I can manage at home, but if things worsen, I won't hesitate to make sure I'm able to stay upright no matter what I have to do to accomplish that. In my case, my knee revision was a success, and doesn't give me any problems. It's my leg above and below my knee that causes the problem; that won't get better, so I had to learn to accept and live with the diagnosis. It wasn't easy, but I came to terms with my limitations, and work around them as much as possible.
The hard part is accepting that we need a little help, and then making use of that help, in whatever form we need. Have you talked to a physical or occupational therapist, or your doctor, to see if they have any ideas to help, and to try to keep you from falling again? That'd be my suggestion, as they may have ideas or aids to help. Keep us updated and take care!
I also would consider using a walking aid to help catch me when my knee buckles. My leg gives way at times also, but so far I've managed somehow to stay upright. The fall on Christmas was a result of stepping into a hole, not from my leg itself, other than that maybe I could have stopped the fall on a strong leg, but maybe not. Anyway, I worry that one of these times I may hit the ground when I forget and turn too quickly, or even just out of the blue for no particular reason. I'm extremely careful, but things happen. When we go places where I would need to do a lot of walking, I gave in to common sense, swallowed my pride and now use a scooter to make sure I don't set my leg off, and end up with problems. Around the house I walk on my own, but I always have my phone with me.
I might even consider something like one of those knee walkers to rest my knee on when standing at the sink, or similar. The rest of the time I'd use a cane, or something, to give me the extra strength and balance that my leg needs. So far, I can manage at home, but if things worsen, I won't hesitate to make sure I'm able to stay upright no matter what I have to do to accomplish that. In my case, my knee revision was a success, and doesn't give me any problems. It's my leg above and below my knee that causes the problem; that won't get better, so I had to learn to accept and live with the diagnosis. It wasn't easy, but I came to terms with my limitations, and work around them as much as possible.
The hard part is accepting that we need a little help, and then making use of that help, in whatever form we need. Have you talked to a physical or occupational therapist, or your doctor, to see if they have any ideas to help, and to try to keep you from falling again? That'd be my suggestion, as they may have ideas or aids to help. Keep us updated and take care!
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I am so sorry to read of your mishap, celynda. Have you considered any of the variety of medical alert devices?
From the smartwatches to wearable pendants some of the devices even have automatic fall detection.
It's understandable that you fear the possibility of serious injury with another fall, but at least with a monitoring device you'd be able to contact emergency services for a quick response. It may give you peace of mind.
I hope you have a peaceful evening and weekend.
@celynda
From the smartwatches to wearable pendants some of the devices even have automatic fall detection.
It's understandable that you fear the possibility of serious injury with another fall, but at least with a monitoring device you'd be able to contact emergency services for a quick response. It may give you peace of mind.
I hope you have a peaceful evening and weekend.
@celynda
Be sure that you’re using your walker as much as possible to give you stability in case you feel your knee starting to buckle.
Also, it might be a good idea to let the doctors at HSS know this is happening and see if they have an opinion on what to do next.
I’m so sorry this is happening to you.
Also, it might be a good idea to let the doctors at HSS know this is happening and see if they have an opinion on what to do next.
I’m so sorry this is happening to you.
I think having the walker with you at all times is a good idea. At least you'd have something to hold on to if the buckle happens again.
celynda
senior
I heard from the UVA OS today with the results of the tib/fib MRI on Saturday. From the visit notes in MyChart:
| “There is evidence of a fracture around the proximal portion of the tibial construct with intact cemented construct distally”. This was a surprise as I don’t have any pain below The knee. There’s nothing to be done until/unless pain develops. There is circumscribed complex fluid collection extends along the gastrocnemius flap tracking over the anterior proximal tibia and extending to the anterior skin surface. Collection measures approximately 1.6 x 1.5 x 6.2 cm. Small region of susceptibility artifact within the deep calf musculature along the posterior cortex of the tibia which is not well characterized but likely reflects calcification. She’s going to present my case to their Complex Case Conference and let me know what the outcome is. I’ve sent the MRI images and report to Dr Chalmers (HSS) for his thoughts. I know they’ll talk about it as well. While there’s nothing to do for the fracture, treatment for the abscess is probably a DAIR. Whether it’s a single or double appears to be matter of opinion and professional preference. I asked how many DAIRs she’s done. Since with UVA - about a dozen. During her HSS fellowship - ~50. My next appointment with her is March 26. By then we should have input from HSS and the case conference. So many things to think about. |
Thanks for posting this and I know you are eager to get to the bottom of what may be going on. It does sound like the doctor is continuing to work on what appears to be a rather complex problem. I’m certainly glad to see that! I do hope they can come to a consensus about treatment.
