TKR Right TKR is done

[KarriB]

Definitely have someone drive you. As Celle said you may need pain meds and don't want to be stuck.

 

[Jamie]

I agree. Get someone to help you. You'll be much more comfortable and prepared in case you really need the assistance. Having someone there for moral support is important.

 

[GingerP]

@KarriB @Celle @Jamie Thank you all for telling me what I already in my heart of hearts knew. I think I'm strong and independent and all, but somewhere down deep I know that this is going to hurt and be out of my comfort zone and when I woke up this morning had decided that I was going to have someone take me. You guys are the best. Today I'm in a kind of crying sad place. Reality that I'm going to get this taken care of and the difference in having to deal with an apparatus to finally heal up and being in need of a second knee surgery and......too much weighing heavy on me at the moment. I at least have a few days to get things done around the house prior to next week. It doesnt help that its cloudy and overcast today. I'm blessed to have all of you here for me. Thank you.

 

[SusieShoes]

I agree you should have someone go with you to the wound opening. You can't be certain what will happen in terms of drugs used or your reaction to the procedure.

For the wound vac, the nurses considered me homebound, and I pretty much was with my bad knees and all making errands painful, but the nurse didn't have a problem with me going out once a week with my husband to do grocery shopping. And one time, I admit, we took Mr. Sucky downtown to a theater performance. Those tickets were expensive and we weren't wasting them! I didn't tell the nurse and I didn't get caught. They didn't grill me about my whereabouts ever. For the most part I was a happy honest homebody during the wound care. If you're going to be home and off your feet a lot anyway as part of your recovery, consider the home care, unless your hospital is close and easy to get to. For me going to the clinic would have meant an hour driving round trip through heavy city traffic. Major. Headache. If it's an easy trip, though, it does get you out of the house.

So glad you're going forward in a good direction.

 

[KarriB]

Your welcome, Ginger. It's expected to be emotional when you hit this kind of a bump in the road, but I'm sure you'll feel better when you get things ready. Then next week when the procedure is over you can sit back, relax a bit and let the vac do it's job.

I am single and independent also, but I realized I couldn't do things on my own right away, especially where the infection was concerned. It was a a real switcheroo when I was being cared for instead of being the caretaker, however I learned a lot about myself and my wonderful family/friends.

 

[GingerP]

My dear friend that retired the same day as I did has agreed to take me. She is 6 years younger than me but had enough years of experience and we were both fed up with the lack of leadership and the work ethic of the new hires and when opportunity presented itself the two of us never looked back.
My son called today and we had a nice chat about this and I told him I was having a teary eyed morning. He helped me be realistic about it and said I have beeN through a lot already and managed and I will again. It's just not the plan I had to start with and that is what is disappointing. I have given up on getting my right knee done now until fall, but, that doesn't mean it still doesn't hurt that it should have been done by now.
Living in a town of 4000 has its advantages. The hospital where I did my pt is only 12 blocks away from my home. I don't have to take the busy main street to get there and it's not hard to park and get to the entrance. I just need to hear from the nurse on Monday to get a better understanding of the process with them. She is also the diabetic instructor so for me that may be another advantage. I loved the county nurse that came to the house for my surgery. She strictly informed me that there are only a few reasons to be away from home - dr appts, hair appts and church. So, here again going to get milk at the store, people would know. I will need to work this out.
I'm trying to get busy at my list these next two days to get my mind on something else. Thanks everyone......

 

[newlybionic]

The definition of home bound is that you are not out shopping, going to movies and other such types of activities. As Karri has stated you can go to doctor's appointments and make a quick stop on your way home. You are also allowed to go to church services if you desire to do so. I would think in the first few weeks you might want to have home nurses come visit you to do the vac changes because you might not be up to wanting to go to the wound care center several times a week. The patients I took care that had wound vacs had the dressings changed three days a week. You can always shift to going out to the wound care center a couple of weeks into that period. It's something to consider especially if you will have dressing changes three times a week.

 

[KarriB]

It may also be that the vac may make it difficult to wear regular pants. You may need sweats to stretch over the vac and I know Wisconsin isn't terribly warm at this time of year. Leaving the house often may be inconvient. Can you hold off making the decision on home health coming in?

 

[GingerP]

I was told that there would be changes 3 times a week with one of those at the wound clinic each week where they will take pictures and measure and such.
My other situation is that my almost 89 year old mother lives 25 miles from me. She is beginning oxygen therapy 5 days a week for 8 weeks and she doesn't drive to Dubuque for treatment. I have arranged for drivers for her, but if something should need to be done for her, I'd hate to be in a tough situation. I have some questions to ask yet.
I'm wondering if I should be concerned that it seems like I'm getting less drainage from my little hole. Maybe it's nothing to worry about. In a few days it will be taken care of. The surgeon told me I would be on antibiotics while having the wound vac. Does that seem logical? I've been on antibiotics for nearly 6 weeks but there was never any infections in cultures taken? Thanks.

 

[Celle]

I wouldn't worry about the drainage right now. As you say, all will be revealed on Wednesday.

As for the antibiotics, now that the wound centre has taken swabs I think it should be up to them to decide whether you need them and, if so, which one/ones.

 

[GingerP]

@Celle . Thank you for the information regarding antibiotics. I know the surgeon mentioned that he would give me a script for antibiotics next week. I guess I'm concerned about how long I'm being put on them and how effective they'll be later in my life. Maybe i should ask him if the wound dr should make the prescription call. Appreciate your insight.
On another note....don't know if any of you are basketball bracket folks, I'm sorry if Wisconsin spoiled it, but I'm tickled that the BADGERS are going to the sweet 16 in NY. My son has plans to go and see a dear friend of his while there to cheer them on as well, so there was some good parts to the day afterall.

 

[Celle]

I don't think you need to worry about how effective the antibiotics will be later in your life. What's important at this stage is to be taking an appropriate antibiotic for your leg, while you deal with this problem. Maybe you could show the prescription your OS gives you to the doctor at the wound clinic, and check that it is appropriate?

If you do have any infection, it is important to take the appropriate antibiotic for long enough, so that the infection doesn't come back. Nobody will want you to be on antibiotics any longer than is necessary.

 

[KarriB]

There are people on lifetime low dose antibiotics and do just fine. Splenectomy patients are usually on low dose antibiotics for life. If there is an infection you want it taken care of before it goes anywhere else. Pick up a good probiotic just to help insure you keep the good bacteria in your gut. Chances are you'll just be on them for 6 weeks, but this is where an infectious disease dr comes in. He/she will run blood labs to be sure your body is handling the meds as well as how the infection is coming along, if you have one.

 

[Jamie]

I agree about the antibiotics. Just because a person is on them for an extended period of time doesn't mean you build up an tolerance where they no longer work. In fact, most of the problems with antibiotic resistant bacteria comes from just the opposite situation....people who take an antibiotic, start feeling better and then stop before the full course that was prescribed is completed. This can allow bacteria to mutate and become more resistant to that particular antibiotic. The probiotic is a good idea to keep your digestive system working well. Ask for that if you aren't on one.

 

[newlybionic]

When cultures are taken they try to grow any bacteria that was in your wound. Then they test which antibiotics will eradicate that bacteria. That should be how the antibiotic is chosen no matter which doctor is prescribing your medication.

 

[GingerP]

@newlybionic thank you for the tip on how the cultures are used to come up with the best antibiotic. I appreciate that information!

 

[ACDCJen]

@GingerP

I would definitely have someone go with you when you have your "wound management" appointment. My OS did it as an outpatient surgery because he felt that it was big enough that it may shock my system. I'd already had 3 major surgeries in the 6 months preceeding it, so I know he was being cautious. I had general anesthesia while he did it and then my dad drove me home. It was a 13 minute surgery! Quickest ever! After my first dressing change, I was glad they did it under anesthesia since it was larger than I thought it would be and it was heavily packed. I would not have wanted to feel or see that.

One of the things that I would suggest is to make sure they wet the wound when you have dressing changes. It is considered a wet-dry change, but if the foam is pulled out completely dry, it can hurt and cause trauma to the healing wound bed. My visiting nurse would cut the tube about 4 inches long, and inject sterile saline into the tube down into the foam. She did this a few times and let it sit for a minute to get it all wet and then pulled the foam out. MUCH more comfortable and much less traumatic. For me, the first 2 changes were the most painful, but DEFINITELY not too much to handle. You've had the TKR, pretty much everything pales in comparison to that pain-wise!

As for drainage, it will definitely lessen over time. When I first started, I had bright red/bloody drainage and it would fill half the canister between dressing changes (about 125-150ml). At this point, it is more pink and transparent and much less in volume than before. If I put pressure on the suction disc over the wound, I can get some more drainage out of it, but it's not a big deal at this point. The pain from the incision also gets less over time too. I initially had major pain on the lateral side of the hole, but it's all gone now. It was also bruised and swollen on both the lateral and medial side of the hole at first, but now that's gone too. I would definitely have pain medication on hand, just in case.

For pictures, I take them on my cell phone and select upload a file below this text box. If you need specific help, just message me and I can try to help. If I do it from my phone, it's a little different than if I do it from my laptop. Below are a few of the wound vac just to show you what mine looks like. If you get the same one as I do, it all comes in a box and is very easy to use. I had no instruction, but figured it out pretty easily.

Antibiotics stink though. If you do have an infection, make sure they match the med to the infection. I had Proteus Mirabilis which is usually associated with urinary and bladder infections, so they tried antibiotics for that condition. I had Keflex, Cipro, and eventually Levaquin. They all had side effects and made me feel awful (and pretty much bed-bound, definitely house-bound), but I've been off for a week now and I'm feeling more like myself. I took a probiotic in a pill form and I think that was good enough for me. I also ate yogurt twice a day to supplement that. I self-limited though because I just didn't want to be around people and in public with the vac. Plus, it doesn't sound like you've had a bunch of surgeries that you're recovering from, so hopefully you will be fine with getting out and about.

I hope that helps. I could go on forever about the vac. It's been my BFF for so long already. Good luck and keep us posted!

Jen

The pictures are: the vac in its holder; the dressing with the suction disk and tube over the hole; and the collection canister from just before the first change.

 

[GingerP]

@ACDCJen Thank you SO much for sharing thoughts and advice with me. I have someone to take me and get me home safely. I am so hopeful that it isn't terribly painful opening up the incision. I am not 'into' having extra pain these days. I have been you tube watching about how the wound vacs work and I appreciate your advice to help with helping the change of dressing to be less painful. Everything I know ahead is a huge plus.
You have been such an inspiration in your look at the process to get healthy. I don't have a kayak to get into, but a new part time summer job that I want to do my best for. After retiring, they called me to come to work for them and it made me feel that I still have something I can do, so I want to be able to go to work by the end of May without an extra BFF to take with me!
A month ago I was hoping to get the hole that was open on the top of the incision closed. I believe that the hole was part of this whole long length of incision even then but was missed. Where that hole was is very hard to the touch so I'm sure they worked hard to remove some of the fat there and got the area to heal, but it was missed all the way down the 3 inch incision. Can't go back now, but certainly have new knowledge for the time when my rtkr comes.
Continued healing to all.

 

[GingerP]

Greetings dear friends. I don't know what to think right now. I was told by the surgeon on friday that he would speak with the wound dr on Monday and work out my time line to get the incision open and get a wound vac put on foe Wednesday. I called the surgeons office at 3 today since I hadn't heard anything. I spoke with his nurse and he was in surgery all day. Oh my.....now what?? The nurse said she would text the surgeon and get back to me. I guess maybe I can see what the wound dr knows tomorrow morning when my mom goes to see him for her leg sore. I'm feeling pretty much let down. I do know I'm not the only patient, but I don't think he wants my situation to get worse, so am frustrated. Plus the surgeon is going on vacation on Thursday.
Had a call from the wound nurse at the hospital here in town about possible care following getting my wound vac and she shareD some valuable information. She will be gone on vacation the first 2 weeks I need care so that helps me to know who should care for me - the county nurses office. Now, if I can get the incision open and the wound vac on. Another day in limbo.......

 

[KarriB]

Maybe the surgeon is calling when he's out of surgery. I know on surgery days these docs can go back to back. Although, if I didn't think you'd have a hard time getting another OS to take you on I'd say call another doc. It can be difficult, no impossible, to get another surgeon involved when there's a complication. Who will be taking over your care when your OS is away?