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Knee Infection* The girl with the two fake knees

I have been discharged from home PT!! I measured 102/-2!! Never thought I'd get hyperextension again! My left knee is even better, but wasn't measured. I'm still pretty preoccupied with my wound, but I feel like I'm getting around better. I'm hoping to use the cane more in the next week or so instead of the crutches.

As for the "hole," it now measures 4.5 and 5 cm in different places, an increase from just yesterday! The outer/top edge is good and solid, but more pockets keep appearing underneath. I should be getting the Dekin's solution tomorrow (if stupid Rite Aid doesn't forget to order it again) and I can start packing it with that and gauze. I'm using the Aquacel until then, about a foot each time. My home nurse said she was going to have their wound specialist come and look at it. She mentioned that she would suggest a wound vac if it doesn't get better. I see my OS next week and he has wound experience, so I'll make sure to have a swab taken just in case of infection. I will also ask for a wound vac and see if it's an option at this time. Every time I clean it to remove the slough, deeper pockets open up, even though I'm very careful. I can see a black stitch in the side way up in the wound near the top, so I'll see if they can remove it next week, even though the PA didn't think that was the cause. It hurts quite a bit in the outer, right side of the wound in my leg, and it does not feel like nerve damage. I just hope it's not from the wound! I do feel the actual wound a bit more, especially when I pack it, but it's very tolerable still. I keep imagining a huge pocket under the surface that's completely open, even though I know that's not what's happening. I joked with my nurse today that maybe I'll see the implant! I'm grateful that I have a really high pain and grossness tolerance!

Thank you for your concern, suggestions, and well wishes. It feels very comforting to check in, even selfishly, and get words of wisdom and encouragement.

Jen
 
@mbrown

I wasn't ignoring you, I promise! When I had the staples removed, a part of my incision wasn't completely closed. This was several weeks ago, and it opened up and has gotten deeper since then, unfortunately. One of my nurses said there were pockets underneath that are opening up, and the PA wasn't sure why it keeps getting deeper and more pocket-y? They thought it might be a stitch, but probably isn't. So, I just clean it and pack each day, hoping I'm not going to wake up in China in the morning!!!

Always a fun time with knees, huh?

Jen
 
Jen, I know what you mean about being grossed out. I normally would've been totally grossed out by the seeping after the infection surgery, but I became obsessed with it. After removing the gauze bandage I'd date it and take a photo, thinking my docs might want to see it! Neither one wanted to and looked at me like I was a nut!
 
@ACDCJen I had something similar happen on a previous surgery on the other knee a few years ago. Part of the wound stayed open and was very deep like yours. Early on, Mine was acting as a drain because I had a bakers cyst removed. One day it looked as if it was closing up but was kind of puffy around it so I pressed on it and fluid literally shot across the entire room. It was crazy. (That was actually when the wound opened up). It continued to drain and leak for several weeks and was deep like yours. It eventually closed up.
 
Jen, I'd be freaking out if I were in your place. You are amazing to be able to keep your positive attitude and sense of humor. You go girl! You've got this!
 
ACDCJen said:
As for the "hole," it now measures 4.5 and 5 cm in different places, an increase from just yesterday! The outer/top edge is good and solid, but more pockets keep appearing underneath. I should be getting the Dekin's solution tomorrow (if stupid Rite Aid doesn't forget to order it again) and I can start packing it with that and gauze. I'm using the Aquacel until then, about a foot each time. My home nurse said she was going to have their wound specialist come and look at it. She mentioned that she would suggest a wound vac if it doesn't get better. I see my OS next week and he has wound experience, so I'll make sure to have a swab taken just in case of infection. I will also ask for a wound vac and see if it's an option at this time. Every time I clean it to remove the slough, deeper pockets open up, even though I'm very careful. I can see a black stitch in the side way up in the wound near the top, so I'll see if they can remove it next week, even though the PA didn't think that was the cause. It hurts quite a bit in the outer, right side of the wound in my leg, and it does not feel like nerve damage. I just hope it's not from the wound! I do feel the actual wound a bit more, especially when I pack it, but it's very tolerable still. I keep imagining a huge pocket under the surface that's completely open, even though I know that's not what's happening. I joked with my nurse today that maybe I'll see the implant! I'm grateful that I have a really high pain and grossness tolerance!
Click to expand...
@ACDCJen
I'm going to ask @Josephine what she thinks about this. I'm not happy that your wound seems to be getting deeper all the time.
 
I am so sorry this snag hit Jen.. I am thinking of you and hope your OS has good news.
 
I hope this thing starts closing up. I can't imagine why it's growing. I'm praying for you, Jen.
 
Here is the length of stitch I got out of the wound today. It's dark green with little barb looking things on the side.

[Bonesmart.org] The girl with the two fake knees



This is my wound as of 1/5/17. It's really hard to get a picture of the depth because I don't bend that way and it's dark in there!!! The top of the pic is the kneecap and the bottom is my thigh and the top of the incision. The hole goes back underneath towards the top of the incision. I measured it at 5 cm today.

[Bonesmart.org] The girl with the two fake knees


I started the Dakin's today. I have to wet gauze with the solution and pack it in! It's made with bleach and I smell like a pool. I will have to practice doing this so I don't get it on my good skin. I have to coat around the hole with antibiotic cream to protect it. I hope it works!!

The stitch started to peek through at the bottom of the wound so I clipped it there and where it was in the side of the wound and pulled it through. It's about an inch long. I couldn't pull the rest of it because I'm pretty sure it runs under the rest of the incision. I have to call my OS tomorrow to let them know. They said if I was able to get a stitch out to call them. What I clipped is in the picture above.

I'm just taking it in stride. It's a pain, but I'm doing what I've been told so far. Thank you for the concern!!!
Jen
 
@Josephine - Jen has some photos for you to see now.

That does look as if it's got worse, Jen. I'm not happy that they are expecting you to do the dressings and go into the wound to pull out bits of suture. And I'm not happy that your surgeon himself hasn't seen your wound. He really needs to see it. It's not good enough having you see the PA and the nurse. This is ultimately your surgeon's responsibility. Like others, I believe you need to see a wound care specialist. There must be some reason why it isn't healing.
 
I keep thinking of @zzevi and he problems she had with her incision not healing properly. Didn't you say you're seeing the OS once a week?
 
I do see my OS on Jan. 10 in the morning. That will be his first time seeing it,in person. The PA took pictures, which I'm assuming he sent to the OS, but I'm not certain. I was told to take out any debris when I clean it. I usually do this with clean cotton swabs to prevent contamination. It's so deep now though, I can't see what's down there, so I just sop up the blood and drainage, wash it in the shower, and do the packing and dressing. I just did the second pack just a bit ago and I really don't like this stuff, but if it helps, I'll keep doing it!

Thank you for the input. I am also taking my temp 2 times a day, just to keep track!

Jen
 
Jen, we'll see what Jo says when she has a look at your photo, but I believe you need to insist on seeing your surgeon before January 10th. I know that is only 5 days, but since the open area keeps enlarging, it is critical that you get his attention.
 
At this point you may need to be followed by a wound care center. This could be more than your OS can handle at this time.
 
I agree with Jamie and newlybionic.
Jen, I think you need to be assertive about your wound and insist on a) seeing your surgeon before 10th January, b) being referred to a wound care centre. You mustn't let this keep on getting deeper without specialist assessment and treatment. It is unacceptable that you are expected to be packing and treating this deep wound.
 
Jen,
I agree with Celle, Jamie, and Newlybionic. Your OS needs to see the wound, ask to see an infection Dr. and to go to a wound care clinic. You need more assistance and guidance with wound care. Most of all someone needs to get to the bottom of why this is happening. (no pun intended)
 
ACDCJen said:
Here is the length of stitch I got out of the wound today. It's dark green with little barb looking things on the side.
Click to expand...
They're not barbs, it's just frayed a bit, that's all! And I suspect this is a dissolvable suture called Ethibond which starts off a medium green and gets darker when exposed to blood. The fraying is just part of the dissolving process.
ACDCJen said:
I have to wet gauze with the solution and pack it in! It's made with bleach and I smell like a pool.
Click to expand...
I suspect that's a cleansing fluid call Eusol (Edinburgh University Solution of Lime!!) It's a very very old and very effective cleansing solution and was in general use when I started training! It's not caustic or otherwise harmful. I used to douse my hands in it on a regular basis as a young nurse!

However, it's only effective on tissues it comes into direct contact with and you don't know how deep this sinus is. It needs to be packed professionally, all the way down to the bottom to have a chance of being effective.
Celle said:
I'm not happy that your surgeon himself hasn't seen your wound. He really needs to see it. The PA took pictures, which I'm assuming he sent to the OS, but I'm not certain.
Click to expand...
I can't imagine he wouldn't have.So in effect, your surgeon has already see the wound.
ACDCJen said:
I usually do this with clean cotton swabs
Click to expand...
This really should be done as an aseptic or sterile procedure. And I hope you either boiled your scissors or cleansed them thoroughly with an antiseptic before you used them. I am really concerned that you are being left to manage this all on your own. If you were a trained nurse I might say okay but otherwise, it's scandalous.

That's a serious sinus you have there and no way of knowing where it's going to inside. I suggest you phone your surgeon and demand to be seen ASAP - and this time by the organ grinder not his monkey! I've similar sinuses that, upon investigation, were found to be tracking right down into the joint so waste no time. Please get yourself seen.
 
@ACDCJen hadn't been following your posts, but got notified that KarriB used me in a posting, so I just skimmed over a bit. Please, please seek treatment. I did have a spot in my incision that didn't want to heal and in ways looked similar to yours, but must say your looks deeper than mine.
Your edges look like they healed off also, like mine did. I would think at this point a swabbing needed to be done to check for infection and if needed to start antibotics (sp) and hopefully to be seen by a wound care dr who can get you on the path to getting that closed shut. That may require visits 2/3 times a week for them to treat the area and change the dressing. At this point don't let anyone give you a run around, insist to be seen and helped. I'll check back in later as I need to prepare for work. Take care.
 
I am with everyone else Jen...You have had a rough time altogether, you don't want this slowing your healing anymore than it should. You have never said, but are you diabetic? I know sometimes diabetics have problems healing. My ex brother-in-law lost a leg in a motorcycle accident, his stump never healed right and when he finally had seen several drs about it, someone checked and he was diabetic after all.
Please let us know what the OS says, and I will be praying for healing for you everyday!
Blessings,
Lene'
 
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