Knee Infection* Right knee has been replaced

[sistersinhim]

Wow! You finally got out of the house for normal things! You have got to feel better emotionally! I pray after a nap, you'll be revived!

 

[Celle]

You did well, Marian.

I'm glad you found you can drive again, even if only for short trips. It's a comfort to know that you wouldn't be stuck in an emergency.

It really sounds as if you are starting to make progress.

 

[Pheebs52]

Wishing you the very best @newlybionic and hoping your health will soon be completely restored!

 

[newlybionic]

If I could just get my stomach in line with the program I probably would be doing better. I had bee taking zofran two or three times a day for nausea but yesterday after my day out and just eating a few French fries(plain) and part of a hamburger pattie I was so sick I was vomiting for a few hours. I eventually grabbed one of my scopolamine patches, that I use for motion sickness, and after a half an hour my stomach calmed down. I still have the patch on now. It's good for three days so I'm keeping it on today.

I'm still anemic though I haven't gotten my last lab result yet. My Hgb was only in the mid 8's so I get tired very easily and even though the weather is warm I feel cold most of the time. I've been trying to eat better but it I eat anything other than very bland food my stomach complains. It's happiest when I'm eating dry crackers and water. That's not exactly a good diet. I've tried smoothies and milkshakes and it's difficult to get much down. I was going to try to get some supplements but I know after one mouthful I would toss it out. They are too expensive to waste in that way.

My knee is still very stiff but I've been at least trying to walk normally. I'm still not to 90 and I go back to my OS in a few weeks and he has what I consider unrealistic expectations. In addition my entire leg aches most of the day. My PT and I have tried massage and it's still achy. It makes it hard to sleep. Pain meds haven't helped much at all. I tried the muscle relaxer yesterday without helping either. Needless to say I usually don't get much sleep at night. Right now I can't even find a comfortable place to sit or sleep. I'm really sick of being sick.

Monday morning I have a visit with a PA in the primary care office where I want to be established with. While I would rather see one of the docs, I will finally have someone overseeing my medical 'mess'. It will be nice to be able to call one person with questions rather than try to figure out which doctor I should call. However I will send a message to my OS about my leg aching so much. My circulation is good and the muscles aren't cramped at all. For once I have idea what is the cause unless it's just a result of the two surgeries.

 

[Celle]

I'm sorry you're still having so much trouble with nausea and vomiting, Marian. Since the Scopolamine patch seems to have helped, could you ask for a prescription for those?

It also sounds as if you need a pain medication that will be more effective for you. With a low Hb, poor nutrition, 2 surgeries in a year, poor sleep, and an infection to fight, your tolerance of pain is bound to be low. It couldn't be anything else!

 

[Red's Mom]

Marion. You are so strong and determined. Truly amazing. I hope each week is a bit better any you start feeling more like yourself. Hang in there! Tuesday will bring you a bit of freedom!


Sent from my iPad using BoneSmart Forum

 

[sistersinhim]

{{{Marian}}}

 

[KarriB]

Marian, I was thinking the same day thing as Celle. Could you get a few more patches? Would peanut butter with the crackers stay down? There's some protein there that may help. Two more days of the Vancomycin! Will you stop the rifampin Tuesday also?

 

[newlybionic]

I've been off the Rifampin for two weeks now. While I was taking that nothing helped the nausea and I found it hard to even sip a little bit of water. The ID told me that even though Vanco doesn't typically cause nausea just having the PICC line and taking IV antibiotics makes some people feel ill. So Tuesday after my last dose a nurse will come here to remove it. Then it's Doxycycline 100mg twice a day for over 4 months. The one side effect the ID doc mentioned, of course.... nausea!! At this rate I'll be losing more weight. I can't picture myself trying to work and being nauseous at the same time. Patches for a month are about $200 and I'm afraid that I might fall into the Medicare 'donut hole' for prescriptions. At that point I will have to pay full price on all my meds until I spend several thousand dollars on my own. I'm not sure I can come up with enough money to pay for all my meds. I went through this a number of years ago and I had to chose which meds were more important for me to take. The oral antibiotic, even the generic, is $230 per month.

There were changes to Medicare part D ( medication coverage) over the last few years that were working towards closing the donut hole. I'm worried with the current political climate where there is talk about rescinding these changes. I used to fall into the donut hole in late February and having to pay everything myself afterwards. Now it's probably July. It's just very worrisome to me. And will my infection become a pre-existing condition if it comes back after Jan 1? It's almost too much to think about right now. I live paycheck to paycheck and I thank my company for short term disability. Their health insurance is more expensive and covers less than what Medicare covers. So getting their insurance will be no help to me.

Then I did a minor Manipulation without anaesthesia on myself tonight. I have only 1 step down from my main level to my family room and of course I stepped down with the wrong leg and forced the other one to bend more than it was ready too. I yelled out loud scaring my friend and my dogs. The one good thing is that I didn't fall at all. If I did the floor is vinyl over concrete and with my luck, being so good lately, I would have broken something for sure. Maybe if I do that a few more times before I go back to my OS he will be happy with my ROM. ( just kidding!) So here I am with my knee in ice again and hurting more than before. I don't think I'll get much sleep tonight again. O well. Who needs sleep anyway.

 

[newlybionic]

@Josephine I have a couple of questions concerning my recent TKR and infection. My OS referred to my infection as an 'early' infection since it occurred within two weeks of my surgery. He just replaced the spacer when he went in and scrubbed it out. A week prior to that surgery I was in his office when it first started to show there was an infection. He took samples down to the prosthesis (ouch!) looking for what he indicated was 'abnormal' cells and found none. No culture was down at that time. He put me on oral antibiotics and when I returned the next week it was apparent the infection had taken hold and I went straight to the hospital for immediate surgery.

So my questions: 1. Do you know what my odds are of beating this infection? MRSA with 6 weeks of Vanco IV and they implanted antibiotic 'beads' deep into the wound.
Will be starting Doxycycline 100mg twice a day after my last Vanco Tuesday.

2. At what point would you think I might be clear of worry?

3. My knee is incredibly stiff but not very swollen at any given time. Could that be caused by the trauma of all the surgeries plus the beads breaking down? I was told the use of the beads were something new, at least in my area.

The ID doctor keeps telling me MRSA is sneaky and that medical people tend to have more problems. So little old nurse me is worried. I told her I already had a lot of fun with all the medical complications.

Thanks.

 

[Josephine]

Do you know what my odds are of beating this infection?
At what point would you think I might be clear of worry?

Gosh I'd be really clever if I could answer that, my dear! It's one of those questions I tend to call "how long is a price of string"!! Sorry.

they implanted antibiotic 'beads' deep into the wound. I was told the use of the beads were something new, at least in my area.

New? I don't think so. I can remember using them as far back as the late 1970s! Then they were called Garramycin beads or chain. I think the current name is Gentamycin beads. The provide an extra bolus of Gentamycin directly into the affected area. I believe they are remarkably efficient.

(Gentamycin is the generic name, Garramycin is the trade name)

The ID doctor keeps telling me MRSA is sneaky and that medical people tend to have more problems.

In my life, we always had a saying "if anything is going to happen to a patient, you can bet that patient will be a member of staff!"

 

[Bikesouth]

@newlybionic I have read about two dozen research reports and hundreds of pages of opinions with research & can tell you that your doctor's quick action lends itself to the best out come without a revision. This is not medical advice but generally speaking it's a 50% cure rate curving up to low 90% for non MRSA when caught very early. Key is no biofilm between the prosthesis & bone.

So many factors play into a successful antibiotic regimen it's difficult to predict what works best for you. If you pm me an email I can send you pdf files of research & trials.

 

[newlybionic]

@Bikesouth MRSA is the bacteria that was cultured in my knee. My OS originally gave me a 70% cure rate initially post op. The last time I was in his office he seemed very happy with my knee. There has been no drainage at all, swelling has been minimal and no other signs of infection are not present. I'm trying to be positive about it but it's always on my mind.

I finally made it to see the PA in my new PCP office. I liked her very much. She had read through my medical record prior to seeing me. ( all my doctors are now part of the same hospital group or have access to those records). It saves a lot of time going through paperwork that way. We went through my history. I had no medical problems prior to the infection. My bloodwork shows some improvement in kidney and liver function. She wanted some other blood work done so I will ask the nurse tomorrow to draw it for me prior to removing the PICC. If not I'll go to a local lab to have it done.

Tomorrow is my last dose of Vanco. I have completed the full 6 week course. Then the PICC will be pulled out after that dose. I really need a half hour shower!! I'm not sure if I have to wait 24 hours after the PICC is out or not. At this point if I have to wait one more day to make sure that I don't re-introduce any bacteria into my system it's just a minor inconvenience.

The PA gave me something for the nausea that has been driving me crazy. I tried one as soon as I picked it up and it does seem to help me better than the zofran. She also gave me a script for more patches in case I need them. I start on the oral antibiotic which can cause nausea so I hope it will continue to work for me. I'll be on the antibiotic for 4.5 months.

 

[sistersinhim]

Your report sounds so much better than it has. Great news about having all your doctors in the same group so everyone of them is on the same 'page'. Hopefully, you can get your long, leisurely shower tomorrow! That will surely feel like heaven!

I pray that your tests come back infection free! What a trooper you have been. I also pray that the nausea stays away, too!

 

[Bikesouth]

I took Doxycycline for a couple of weeks before seeing the ID doc and had no problems with it at all. So I have my fingers crossed for you!

 

[newlybionic]

PICC is out!!!!

The nurse today told me to wait a day before showering. From what I read I found that patients are told that there is no wait at all all the way up to 3 days wait. Each nurse at the same agency told me something different.

I took my first dose of the oral antibiotic this morning. Hopefully all will go well with that too. Time will tell if the infection is gone.

 

[KarriB]

I'm hoping this is the turning point for your stomach, Marian. Now you may also be able to tolerate the ice a bit better as well. Is there any way to elevate outside? The ice may feel good outside...
I wasn't given any do not shower or get the PICC site wet at all and that was from my ID. What does your ID say? What if you wrapped it or put a waterproof bandaid on it?

 

[liam2015]

i too, hope this will be a turning point and you can start nourishing yourself with lots of healthy food. on my worst nausea days all i could eat was: celery with peanut butter on top, carrot sticks, and unsweetened apple sauce, water and ginger ale, also these rice thins with sea salt (crackers). looking forward to hearing some more good reports on your recovery.

 

[Arttie]

Can you use a waterproof band-aid on the picc wound?

 

[sistersinhim]

Yippee! What good news! Boy, I don't know if I could wait to shower or not! I know that will feel so good! Maybe a waterproof bandage with cling wrap wrapped around it just to be on the safe side!