Knee Infection* Revision with infection
- Thread starter LolaBee
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TortiTabby
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I'm am so sorry you feel so bad. Sending kind thoughts from Minnesota... Hang in there.
I'm so sorry, hoping for quick resolution.
TimeBuster
member
Something is not right.
If you can't draw blood from the PICC line, then I would have it checked immediately.
Sorry, you're going through so much pain, hope the Dr. gets back to you soon.
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LolaBee
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My husband called surgeon's office. His nurse sent a script for same Norco 7.5, but said she would check with him when he's out of surgery to see if they can increase to 10, or try another med.
Still no word from Infec Dr. Home health said hold off this morning's IV until they get instructions.
Still no word from Infec Dr. Home health said hold off this morning's IV until they get instructions.
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LolaBee
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5pm. Finally have new meds. Norco 10. I've taken one to see how strong it is.
Had to have nurse out to draw blood again this afternoon. I'm to start the IV vancomycin tonight. Thurs I will go to lab to have blood drawn, then surgeon visit in same building. Hope to get staples out. Then home for IV.
Infec Dr is still trying to get approval on Daptomycin.
PT comes tomorrow afternoon.
Had to have nurse out to draw blood again this afternoon. I'm to start the IV vancomycin tonight. Thurs I will go to lab to have blood drawn, then surgeon visit in same building. Hope to get staples out. Then home for IV.
Infec Dr is still trying to get approval on Daptomycin.
PT comes tomorrow afternoon.
@LolaBee
While you have the antibiotic spacer in place, flexion is not an issue. It's more important to get the infection cured than to worry about flexion.
You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you
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While you have the antibiotic spacer in place, flexion is not an issue. It's more important to get the infection cured than to worry about flexion.
You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:
- That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
- If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
- Having only one thread will act as a diary of your progress that you can look back on.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you
If you prefer a different thread title, just post what you want and we'll get it changed for you.
Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
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LolaBee
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Thank you, Celle.
I am in total agreement with you on the non-issue that flexion numbers should be during this spacer time.
I was looking for other like minded opinions.
I went for my surgery follow up appointment today. My surgeon gave me instructions to work towards 90° degrees. I thought, and still do, that he is out of his mind!
He has the bedside manner of a cold, dead fish, but today's visit left me very upset. He was very dismissive of my pain, and suggested I stop the pain meds as soon as possible.
I tried to talk to him about my kneecap pain, and how a lot of the pain seems to be there. I suggested it felt like the kneecap is getting hung up, perhaps on spacers, or just not tracking right. ?? He shot that down immediately and showed me in the xray where "everything looks fine and normal."
I am having huge regrets allowing this surgeon to do my revision.
Day 14 and every day is worse than the previous one for pain, swelling, antibiotic side effects, mental outlook, etc.
I am in total agreement with you on the non-issue that flexion numbers should be during this spacer time.
I was looking for other like minded opinions.
I went for my surgery follow up appointment today. My surgeon gave me instructions to work towards 90° degrees. I thought, and still do, that he is out of his mind!
He has the bedside manner of a cold, dead fish, but today's visit left me very upset. He was very dismissive of my pain, and suggested I stop the pain meds as soon as possible.
I tried to talk to him about my kneecap pain, and how a lot of the pain seems to be there. I suggested it felt like the kneecap is getting hung up, perhaps on spacers, or just not tracking right. ?? He shot that down immediately and showed me in the xray where "everything looks fine and normal."
I am having huge regrets allowing this surgeon to do my revision.
Day 14 and every day is worse than the previous one for pain, swelling, antibiotic side effects, mental outlook, etc.
Oh you poor thing! 
You're only 2 weeks out from removal of hardware and antibiotic spacer insertion and it's a real shame your surgeon lacks all empathy.
Some surgeons are like that - excellent at the technical stuff, but no good at emotional healing.
Your knee will bend when it's ready to bend, but right now it's still traumatized.
Don't worry about ROM or exercises at the moment. Let your knee get over the shock of the latest surgery and just bend it a bit when you can.
You're only 2 weeks out from removal of hardware and antibiotic spacer insertion and it's a real shame your surgeon lacks all empathy.
Some surgeons are like that - excellent at the technical stuff, but no good at emotional healing.
Your knee will bend when it's ready to bend, but right now it's still traumatized.
Don't worry about ROM or exercises at the moment. Let your knee get over the shock of the latest surgery and just bend it a bit when you can.
TimeBuster
member
So deeply sorry of what you're going through. Empathetic Dr. doesn't help the course either.
Hang in there I'll be praying for you.
Hang in there I'll be praying for you.
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LolaBee
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It's been quite a long time since I last updated. My original post detailed my 1st stage revision on May 30th and the rough couple of weeks afterwards.
To say this summer has been a very trying time is putting it mildly! My Infec Disease Dr changed my IV Vancomycin to Daptomycin. Nine days later I was in the ER and hospitalized for 5 days with Rhabdomyosis.
My kidneys were shutting down. (Normal CK lab range is 0-140. Mine was 65,000!)
I was told that if I was any older, it would have killed me. Fortunately, no permanent kidney damage.
I was then changed to Ancef IV antibiotic. Although it's taken me 5 weeks to recover from my hospital stay, I have tolerated the Ancef.
I was on IV antibiotics for 10 long, long weeks. I finished the course almost 2 weeks ago. I will have 2nd stage surgery this coming Wed, IF my pre-op lab numbers on Tues are normal. If still indicating inflammation, the surgeon will go in and change out the spacer and back on IV. If labs are normal, he will take tissue samples for pathologist to examine while I'm in surgery. If clear, I will get my new prosthetic.
Since my Rhabdomyosis hospitalization, I have not been allowed to take Motrin or Tylenol. The knee pain is much better than the first awful 6 weeks, but I'd still rate it a 4 24/7. For particularly painful nights I occasionally took CBD oil.
At my surgeon's office visit last week we discussed better pain management this time around. I also told him to find a different anesthesiologist!
I will update after surgery.
To say this summer has been a very trying time is putting it mildly! My Infec Disease Dr changed my IV Vancomycin to Daptomycin. Nine days later I was in the ER and hospitalized for 5 days with Rhabdomyosis.
My kidneys were shutting down. (Normal CK lab range is 0-140. Mine was 65,000!)
I was told that if I was any older, it would have killed me. Fortunately, no permanent kidney damage.
I was then changed to Ancef IV antibiotic. Although it's taken me 5 weeks to recover from my hospital stay, I have tolerated the Ancef.
I was on IV antibiotics for 10 long, long weeks. I finished the course almost 2 weeks ago. I will have 2nd stage surgery this coming Wed, IF my pre-op lab numbers on Tues are normal. If still indicating inflammation, the surgeon will go in and change out the spacer and back on IV. If labs are normal, he will take tissue samples for pathologist to examine while I'm in surgery. If clear, I will get my new prosthetic.
Since my Rhabdomyosis hospitalization, I have not been allowed to take Motrin or Tylenol. The knee pain is much better than the first awful 6 weeks, but I'd still rate it a 4 24/7. For particularly painful nights I occasionally took CBD oil.
At my surgeon's office visit last week we discussed better pain management this time around. I also told him to find a different anesthesiologist!
I will update after surgery.
OP
OP
LolaBee
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It's been 3 weeks since my new prosthetic surgery.
Lab work and tissue samples indicated no infection, so implant installed.
Because I had been on antibiotics 10 weeks my hemoglobin was very low. My surgery was 4.5 hrs long, as surgeon had to stop and wait for pathologist to check 10 tissue samples. Along with low rbc, I also lost a lot of blood.
I woke up on day 2. I was in ICU with lots of complications. My blood pressure was dangerously low (70/40) and I needed blood transfusions. My kidneys were failing at 85% loss.
After a few days in ICU, I was transferred to a regular room. The Rhabdomylosis tried to raise it's ugly head again, but fortunately caught early. The first sign back in July was a severe stiff neck. It was back and I told my surgeon and the hospitalist. Both dismissed it as just head manipulation during surgery. When I insisted a CK blood check for it, they reluctantly agreed to do one. Guess who ate crow later? Sure wasn't me! Why don't doctors listen to their patients???
After 6 days in the hospital I came home very weak and anemic, and fortunately no permanent kidney damage. I will always have to be careful to stay hydrated. I have to wear an immobilizer when ambulatory, as my quad muscles and overall body muscles are so weakened by nearly 4 months bedridden.
I am doing very well getting around. I spent the first 3-4 days taking full meds and sleeping a lot. I'm on iron pills. They are helping, but still tired, pale, and shaky. Last week's labs showed still anemic, but numbers getting better.
Got my staples out a few days ago. Incision looks good. Very sensitive, but my home PT gave some good advice to use your finger and draw circle 8s up and down the incision area several times a day. She said it can help desensitize and confuse the nerves along the incision. It does seem to work! I don't like blankets on the incision, but am tolerating a bedsheet.
Home PT has visited twice, but saving the limited remainder of PT sessions for outpatient that starts next week.
The last few days I've been walking 5-10 minutes at a time with the walker, several times a day. I've done light tidying housework (picking up clutter on my walks or dusting). I even drove down our long driveway to get the mail. No problems getting the car, and no trouble driving. Felt so good!
I'm better with crutches, but not confident of balance to use them except in the bathroom (walker won't fit through door).
My husband has to keep reminding me that at 3 weeks out in 2013 I was very much dealing with pain, swelling, and exhaustion, so I need to slow down on trying to do too much. It's hard to do when I have so much to make up for 4 lost months!
I have near 0° extension and flexation was 68° a few days ago when PT was here. I only do easy slides and stretches, and mostly my PT consists of strengthening whole body going very gentle on the knee.
Instead of 6 weeks post surgery IV antibiotics, I get my picc line out next week at 4 weeks. Can't wait to be done with that!
Lab work and tissue samples indicated no infection, so implant installed.
Because I had been on antibiotics 10 weeks my hemoglobin was very low. My surgery was 4.5 hrs long, as surgeon had to stop and wait for pathologist to check 10 tissue samples. Along with low rbc, I also lost a lot of blood.
I woke up on day 2. I was in ICU with lots of complications. My blood pressure was dangerously low (70/40) and I needed blood transfusions. My kidneys were failing at 85% loss.
After a few days in ICU, I was transferred to a regular room. The Rhabdomylosis tried to raise it's ugly head again, but fortunately caught early. The first sign back in July was a severe stiff neck. It was back and I told my surgeon and the hospitalist. Both dismissed it as just head manipulation during surgery. When I insisted a CK blood check for it, they reluctantly agreed to do one. Guess who ate crow later? Sure wasn't me! Why don't doctors listen to their patients???
After 6 days in the hospital I came home very weak and anemic, and fortunately no permanent kidney damage. I will always have to be careful to stay hydrated. I have to wear an immobilizer when ambulatory, as my quad muscles and overall body muscles are so weakened by nearly 4 months bedridden.
I am doing very well getting around. I spent the first 3-4 days taking full meds and sleeping a lot. I'm on iron pills. They are helping, but still tired, pale, and shaky. Last week's labs showed still anemic, but numbers getting better.
Got my staples out a few days ago. Incision looks good. Very sensitive, but my home PT gave some good advice to use your finger and draw circle 8s up and down the incision area several times a day. She said it can help desensitize and confuse the nerves along the incision. It does seem to work! I don't like blankets on the incision, but am tolerating a bedsheet.
Home PT has visited twice, but saving the limited remainder of PT sessions for outpatient that starts next week.
The last few days I've been walking 5-10 minutes at a time with the walker, several times a day. I've done light tidying housework (picking up clutter on my walks or dusting). I even drove down our long driveway to get the mail. No problems getting the car, and no trouble driving. Felt so good!
I'm better with crutches, but not confident of balance to use them except in the bathroom (walker won't fit through door).
My husband has to keep reminding me that at 3 weeks out in 2013 I was very much dealing with pain, swelling, and exhaustion, so I need to slow down on trying to do too much. It's hard to do when I have so much to make up for 4 lost months!
I have near 0° extension and flexation was 68° a few days ago when PT was here. I only do easy slides and stretches, and mostly my PT consists of strengthening whole body going very gentle on the knee.
Instead of 6 weeks post surgery IV antibiotics, I get my picc line out next week at 4 weeks. Can't wait to be done with that!
OP
OP
LolaBee
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Got my picc line out early. Labs looked good, so Infec Disease doc stopped antibiotics at 4 weeks.
I start outpatient PT tomorrow.
Still getting around great with walker and crutches.
Seems like I'm elevating and icing a lot more this time around. When not swelling I have very little pain and good movement. Just seems overall like more swelling than orig tkr.
I start outpatient PT tomorrow.
Still getting around great with walker and crutches.
Seems like I'm elevating and icing a lot more this time around. When not swelling I have very little pain and good movement. Just seems overall like more swelling than orig tkr.
You must be glad to be free of the PICC line. Has your ID doctor prescribed oral antibiotics for you now? That's the usual procedure.
Your knee has been through a lot this year, so I'm not surprised it's more swollen than last time.
Here's another copy of the recovery guidelines and articles, as a reminder:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
5. At week 4 and after you should follow this
6. Access to these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
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LolaBee
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Celle,
No, he has not prescribed oral antibiotics. He wants to see me in 6 weeks. He said we'd discuss it at that time.
Yes, so glad picc is out!!
I am getting ready to take my first real, long shower since mid-May standing up in the shower. Ahhh, the independence of it!
Then I'm off to outpatient PT.
Could you change my thread title for me, please? Just take off the last word, flexion. Thanks!
No, he has not prescribed oral antibiotics. He wants to see me in 6 weeks. He said we'd discuss it at that time.
Yes, so glad picc is out!!
I am getting ready to take my first real, long shower since mid-May standing up in the shower. Ahhh, the independence of it!
Then I'm off to outpatient PT.
Could you change my thread title for me, please? Just take off the last word, flexion. Thanks!
