Knee Infection* Revision #3 Journey

[EalingGran]

The case conference sounds like a good idea. Sorry about the access but hope they can come up with a good treatment plan.

 

[celynda]

1 April Update - heard from HSS and met with UVA doc last week. No changes to treatment or surgery planned until/unless I have active infection symptoms (which I currently don’t have). The OS did order an ultrasound to evaluate the abcess under the Gastroc flap. I’m working on getting this scheduled even though I think we’re just checking a box.

I am definitely my own worst enemy with this situation as I cannot seem to stop picking at the scars. One is mostly healed (which is good while two are still open. I am going to go back to keeping them covered. Today, one of the bandaids was saturated with clear ooze. I press on the top of the bandaid and a clear liquid came through the holes. No color or odor. So odd.

Anyway, thanks for letting me vent. I am so tired of this merry go round.

 

[CricketHip]

Well, I guess this is a good update, right? So pleased to read that you are covering your scars again. No picking allowed!! I understand the nervousness that probably causes you to pick, though. The clear fluid is most likely lymphatic fluid, it helps to clear and clean any injuries/wounds. Like what you see when a blister pops. Again, I am so glad you have started covering them again.

Wishing you the very best going forward and hopefully all of your updates from this point onward show positive steps in the right direction.

 

[Jamie]

How are things going with your oozy spots? Better, I hope! I'm glad you decided to cover them because, as I'm sure you know, picking at a healing wound is one way to end up with problems. Do whatever you have to do to keep from that, please.....

 

[sistersinhim]

Hands off of those scabs! You do not want another infection. Let your poor knee heal.

 

[celynda]

May 15 Update after seeing the ID and OS yesterday at UVA.

ID - As I don’t have any symptoms of an active infection and no surgery is planned, the ID discharged me. I am to take the Doxy forever. the ID is calling my primary provider to make sure she’ll continue to write the RX as she was reluctant to prescribe long term antibiotics.

OS - The implants looked good per the X-rays. I’ll continue to see her every 6 six months with Xrays every three months. I’ll send her the images to review and she’ll let me know if there’s an issue. Of course, If there are any changes, I can see her if needed.

Discussion - I’m having sharp achy pain when walking. It’s intermittent and I’ve not let it interfere with activities. Turns out it’s probably bursitis or hamstring tendonitis. There’s nothing to be done for this other than limiting activity.

More News - I fell last (130 am) night landing on the R knee. The EMTs came and got me up. Even the I was in some pain, I declined transport to the ED. The pain (I think) is more soft tissue or muscle. I landed in the same position as when I broke my femur in 2020. Fortunately the pain last night was nothing compared to the femur break.

I sent the OS a message about the fall to see if it makes sense to get an xray. In the meantime, I’ll add ibuprofen to the Tylenol and Gabapentin. I also plan on resting and elevating as much as possible.

I am rmostly resigned to my situation realize that I will be this way (walker and limited mobility) for the rest of my life be it long or short.

 

[Jockette]

I don’t have any symptoms of an active infection and no surgery is planned,

Awesome!!

I fell last (130 am) night landing on the R knee.

I’m so sorry! I hope it’s just soft tissue damage, though that can take a while to heal. I fell last year, on my PKR leg, and it swelled quite a bit. It took 2 months to heal, but nothing was broken or needed any medical care. (Yes, I saw an OS and got X-rays)

I am rmostly resigned to my situation realize that I will be this way (walker and limited mobility) for the rest of my life be it long or short.

I’m sorry. Sending lots of hugs.

 

[sistersinhim]

Falling is always a fear we all have. I'm glad yours seems to be damage-free except for soft-tissue pain. I pray this disappears quickly.

Even though you have limited mobility, at least you are mobile. It could always be worse.

 

[EalingGran]

As I don’t have any symptoms of an active infection and no surgery is planned, the ID discharged me. I am to take the Doxy forever. the ID is calling my primary provider to make sure she’ll continue to write the RX

Glad to hear the infection seems to be settled with doxycyline.
So sorry about the fall. It is always scary to fall. Glad it sounds like just soft tissue injury and good plan to rest and elevate.

 

[celynda]

So it’s been almost a week since the fall on the operated knee. I sent a note to OS who said to elevate, ice, add NSAIDs and rest. All of which I’ve done. The knee is still painful when bearing weight and the swelling hasn’t really improved.

The OS offered xrays if symptoms continued. Since it’s soft tissue, what can really be done other than rest, ice, elevation and NSAIDs?

Thoughts? Pix attached so you can see swelling. It looks like a 1/2 grapefruit is sitting on top of the knee. This pix also shows how bad I am at leaving the remaining wounds alone.

 

[Jamie]

When I looked at your photo, I was going to ask you about those open wounds on down your leg. But since you admit to picking at them, I’m guessing that’s why they look so angry. Please, please don’t do this! It really does open you up (literally) for the possibility of a return of your infection. Try keeping them covered with gauze pads. Or wear longer pants so you can’t easily get to them.

Since you are still having problems, you need to get your knee x-rayed. You cannot tell whether or not you may have a fracture or other damage without it. Please get a diagnosis from your doctor and don’t try to guess what is going on.

 

[celynda]

@Jamie, thanks for the quick response. The two angry sores closer to my ankle are actually closed up and healed. I’m doing better about covering the ones right under the knee.

I will send the OS the pix and get an xray to confirm.

Thanks for keeping after me

 

[EalingGran]

When I looked at your photo, I was going to ask you about those open wounds on down your leg. But since you admit to picking at them, I’m guessing that’s why they look so angry. Please, please don’t do this! It really does open you up (literally) for the possibility of a return of your infection. Try keeping them covered with gauze

@Jamie is absolutely right on this. You can get dressings now that will stay on for several days even in the shower. That will relieve the temptation until the wounds have healed.

 

[Layla]

Please understand the importance in wound care and avoid scratching / picking at a scab, celynda,
so that you do not cause further breaks in the skin, which can disrupt the healing process and increase the risk of infection and scarring. According to the Centers for Disease Control and Prevention (CDC) a break in the skin can allow bacteria through and cause an infection known as cellulitis. You seemed to be doing so well until the unfortunate fall. We'd hate to see additional issues crop up that may be easily preventable.

Wondering how long you're icing / elevating and how many tines per day? You may consider ramping it up to see if you notice any improvement.
@celynda

 

[EalingGran]

The kind of dressings I am thinking of are called hydrocolloid dressings and are waterproof and designed to stay on in the shower or bath.
Does your GP have a district nursing service? District nurses are the best people for experience dealing with wound care- although their services have been cut back here in the UK.
The other people who are good at advising on dressings here are pharmacists.

 

[celynda]

Xray completed today. I sent the images to OS. According to the report in the EMR, the x-ray didn’t show anything significant. So, it’s just a soft tissue injury requiring rest, ice, NSAIDs and elevation. Glad to learn it’s nothing serious so now I just rest.

What fun!!!

 

[Jamie]

Glad you got good news. It definitely was good to check in with your doctor.

 

[celynda]

A couple of updates.

1. The Doxy caused some discoloration on my upper teeth near the gum line. This is a known side effect in children but I guess it can happen to adults. So, we changed to cefadroxil. It’s been awhile since I’ve had pills this large. Good thing, I don’t mind them.
2. I started seeing a counselor several weeks ago as I was have suicidal thoughts. I am incredibly depressed as a result of my situation (knee, job loss, etc.). The plan is to taper off the Effexor and add Soloft. The provider also added 5m Abilfy. The RX changes are working so far but I know things could turn worse any minute.
3. I am now down to one dog. Enzo (M age 7) is a chihuahua/min pix and loves me dearly. I surrendered the others to the local Humane Society who will turn them over to a small dog rescue. They’ll find good homes for them and I don’t have to worry about them tripping me or trying to find carers for them if/when I’m away for additional treatments.

 

[Jamie]

@celynda …. it’s so good to hear from you and it does sound like things are improving at least a little for you. I’m glad you went to a counselor and are being treated for your depression. It sounds like that person is on a good path to help you with depression.

How does your leg look these days? And what about your pain levels and mobility? Any updates on those?

 

[EalingGran]

Good to hear from you and glad you are being so proactive in sorting out counselling/ medication and care of your animals. I know it's all really tough but it sounds like you are coping really well despite all the difficulties.
Hang in there and keep us posted.