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Knee Infection* Three surgeries to clean out infection

Maisybo,
Reading your concerns about your Patella being removed, you should be able to do all the items you are concerned about.
@sistersinhim and @PegGar16 do not have patellas, they are able to walk, they are able to live at home alone, they have pets, they do not wear braces, and Peg was able to dance at her sons wedding.
Sending postive and relaxing thoughts your way.
:console2:
 
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Dana, I would call the office and check to see if the doctor takes Medicare. My doctors don't list Medicare for some reason with the other insurance companies online but they do take Medicare. I am so sorry that you have been suffering. I have been living through something similar but perhaps not quite as difficult as what you have been through and I too am frightened. I have several autoimmune diseases that I think exacerbate the knee replacement situation. I also am alone with no family to help or even call for moral support. I will keep you in my prayers because I understand how difficult it is to be alone and not well. I wish you the very best and a speedy recovery. I just noticed the dates of your original post so you probably have already seen someone by now. Just know that you will be in my prayers. Best wishes!
 
ucsbgal1971,
I did see Dr Maale & he does accept Medicare.
I'm having daily IV antibiotic infusions now & scheduled for surgery March 26.
I feel the same as you -- scared to death...my patella may have to be removed...several members here have told me their patella had to be removed, & they're able to walk OK, so I'm encouraged by that.
Thanks for your message of encouragement; I really appreciate it.

Pumpkin,
Thanks for your message of support & encouragement, too.
 
Maisybo,
I am happy your surgery is coming up soon, and you can start healing.
 
Please let us know how you are doing. Did you have your surgery today?
 
Long Surgery Update April 7, 2018 for Maisybo:

Dr Maale did surgery on my right knee March 26, 2018.
He saw me very briefly before surgery, looked at my knee & told me there was still too much infection to remove & replace the hardware; he was only going to be able to clean out the infection & we’d have to do a 2nd surgery later to remove & replace the hardware.

I’ve been driving myself over 50 miles every day, 7 days a week to receive Rocephan & Daptomycin via IV to clear up the infection, but there was still too much infection on surgery day to remove & replace the hardware. Dr Maale didn’t seem to be overly concerned.

After surgery, I stayed in the hospital 5 days & Dr Maale sent me to an acute care hospital in Dallas.

I have a very large hole in my knee with a wound vac attached. I felt surprised that there was so much tissue gone, but I understand Dr Maale does things differently & I wasn’t too worried because I knew the infection had to be cleaned out.

Dr Maale’s surgery coordinator called me 2 days after I was admitted to the acute care hospital & said Dr Maale wanted me to make an appointment with Dr Alexander Nguyen, a plastic surgeon, because Dr Nguyen would need to be in the OR for the 2nd surgery to do a “flap” to cover the big open area from the first surgery. I wasn’t 100% sure I understood how the “flap” would function, but understood enough to feel OK about it.

Friday, April 6 the hospital transported me to Dr Nguyen’s office @ 7 am.
Dr Nguyen came right in & what he said to me totally gutted & devastated me.
He told me there was a 60% chance my whole leg will have to be amputated, because there have been 5 wash outs for infections since my initial knee replacement in 2014 & since I have venous insufficiency in my lower leg & I’m obese, the likelihood of a hardware changeout is not going to be successful; he said I will continue to have infections because of having so many infections already, because the venous insufficiency won’t allow my leg to heal, & because of the fact I’m obese. I’m 5’3” & weigh 250 lbs, which is 70 lbs lighter than last year.

He didn’t mention me being immunocompromized because of Crohn’s Disease. He said the only other option besides changing out the hardware was to find another surgeon to remove my current hardware, put in antibiotic filled spacers, wait 6-8 months & then have a 2nd surgery to install new hardware, which he claims Dr Maale doesn’t do anymore. Dr Maale hasn’t told me he doesn’t do that anymore, so I’m confused.....??

I wept throughout the entire visit with Dr Nguyen & he was very cold & unsympathetic. Never once since I’ve been seeing Dr Maale about my issues with my knee has he even mentioned amputation; that prospect has never entered the realm of possibilities for me.

I can walk around my apartment unassisted & walk with a rollator everywhere else.
I have an appointment Tuesday April 10th with Dr Maale & will talk to him about all this...I feel like I’ve been broadsided & I’m in shock! I can’t lose my leg! The attitude Dr Nguyen conveyed is that it’s a foregone conclusion I’m going to lose my leg. He also told me I was not a candidate for a prosthesis because of my size. I reminded him I’ve lost almost 70 pounds in the last year & he said “That doesn’t matter; you’re still extremely obese & your healing will be compromised because of it.”

He told me I should get a 2nd opinion or go back to my original surgeon & have him change out the infected implant or we could proceed with Dr Maale’s plan to change out the hardware in one surgery but I needed to understand the surgery wouldn’t be successful & my leg would have to be amputated below my knee.

I’m begging all of you members for help — I can’t lose my leg! I’ve cried all day until my eyes are swollen shut; I feel hopeless & lost!

I’m receiving IV antibiotics here in the acute care hospital & I have a wound vac. I’ve got to see what Dr Maale says at my Tuesday appointment, but Dr Nguyen painted a very bleak, hopeless situation for me & I feel completely terrified...

Thank you for any & all comments, suggestions, advice, etc, please help me!
Maisybo
 
@Maisybo I am so sorry to read how horrid that surgeon was to you. He's a plastic surgeon not an orthopaedic specialist. Surely the expert (Dr Maale) would have mentioned this complication to you earlier if indeed it was a risk.

I would wait and discuss all this with Dr Maale. I would also suggest you tell Dr Maale that you don't want this heartless doctor anywhere near you in theatre. If he has this attitude he certainly won't be doing what is best for you.
 
Maisybo,
Sorry you had a bad experience with such an insensitive plastic surgeon. I agree with Jaycey, find someone else, you do not need Donald Downer in the OR with you.
:console2:
 
@Maisybo

I'm so sorry Dr Nguyen was so horrid to you and what he said is worrying you so much.
He is a plastic surgeon, as Jaycey said, not an orthopaedic surgeon skilled in curing infected knee replacements.
He doesn't know enough about orthopaedic surgery to pass any opinion.

Dr Maale knows what he is doing and if he thought you might end up having an amputation, he would have told you so. He has cured many, many people of their infected knee replacements. Trust him and try to ignore what Dr Nguyen told you.

Please, do tell Dr Maale exactly what Dr Nguyen said, and how he treated you. Write it all down, so you don't forget anything. In fact, copy your post to us, and hand it to Dr Maale, as well as telling him. He needs to know how his patients are being treated and how Dr Nguyen tried to discredit him.

I agree with Jaycey that you don't want Dr Nguyen to do anything for you. Please ask if you can have another plastic surgeon.

Please try to stop worrying. Amputation is extremely unlikely to happen.
@PegGar16 went through a long process to cure her knee infection, including plastic surgery, and she is completely healed now.
 
Maisybo....I'm am so sorry to hear about the way you were treated by the plastic surgeon who was supposed to be helping you! I agree that the best thing to do will be to copy your excellent post above and let Dr. Maale read it. I'm pretty sure he would not have sent you to a plastic surgeon if he thought you might need an amputation, so try and put that out of your mind right now.

I would think you'd need the opinion of a vascular surgeon before anyone tried to diagnose you as have venous insufficiency in your lower leg. So all this just doesn't sound right to me. Dr. Maale has a tremendous amount of experience in these matters. I recall one woman in New York who saw many surgeons and was consistently told she had to have her leg amputated. Her daughter got her to Dr. Maale and he was able to help her. While everyone's case is different, I think you are wise to believe he may have a completely different approach in mind than what this plastic surgeon thinks.

Hang in there, hon! We are all here to support you and listen if you need to talk in the days leading up to your appointment with Dr. Maale. And, if it's any consolation to you, I know he did a revision on one of our staff members (RestAssured) who was much heavier than you and who had had multiple bouts with MRSA infections. You can read her journey here:

https://bonesmart.org/forum/threads/story-of-my-knees-by-restassured-pt-3.14209/
 
@Maisybo, I have no words. Dr. Maale has such a wonderful reputation, so listen only to him when it comes to your knee. This Dr. Nguyen doesn’t specialize in knees and, besides, he sounds awful. You must not let him be your plastic surgeon. You need someone you can trust to want to help you.

Wound vacs do good work. I’ve had one (abdominal wound) and @GingerP had a wound vac on her infected knee. Mine lived in a nice cloth purse for carrying around and when I went out in public. I hope you are finding yours easy to get along with. I named mine Mr. Sucky.

And do read PegGar’s thread! Her story is so inspirational. :console2:
 
Dr. Nguyen sounds like he needs to go back to school to learn some bedside manners. And as a plastic surgeon, he might be in big trouble with that attitude. Is he a native English speaker? If English is his second language, he might have a cultural problem as well. He sounds very condescending and judgmental. Plastic surgeons are everywhere, you can get another one I am sure. Don't settle for that one, insist on someone else. I had to deal with an arrogant and condescending surgeon once, and it was awful. I didn't know enough to fire him, and I was so scared with what was going on with me that I let him examine me and give me his opinion.

Do you have someone who can help you with this situation? Is there someone who can go with you to your next doctor's appointment and assist you in remembering what to ask and what you are told? I bet that nasty Dr. Nguyen wouldn't have been talking to you that way if you had an advocate with you.

Even if there's no one to go with you, please do print out your post for your doctor to read. If you don't have a printer, go to the library and use the computer there and print it out. Or go to Kinko's and print it out. If you are anything like me with something this upsetting going on, you'll be crying and not able to think very clearly. So, let's say you can't get it printed out, then make a written list of all the points you made in the post and take that with you for the doctor to read.

Just remember, these bozos work for you and you are paying them to help you. They have no business judging you for your weight or anything like that. It is their job to take care of you and help you.

Please keep us posted. We care and we are here for you!
 
Maisybo,
I want to congratulate you on your weight loss. It is never easy, with all the challenges life throws at you.
:friends:
 
Maisybo,

I can only reiterate what everyone else is saying -- definitely print your post about this experience and take it to your appointment with Dr. Maale.

I, too, want to congratulate you on your weight loss. You've done a tremendous job under difficult circumstances. So proud of you!
 
@Maisybo If you have lost 70 pounds and are now at 250, that means you were at 320 and have lost over 20% of your body weight. That is FANTASTIC! You go girl. Congratulations. :loveshwr::wowspring::flwrysmile:
 
Maisybo said:
He also told me I was not a candidate for a prosthesis because of my size. I reminded him I’ve lost almost 70 pounds in the last year & he said “That doesn’t matter; you’re still extremely obese & your healing will be compromised because of it.”
Click to expand...
Honey, he's a plastic surgeon. He has NO business passing an opinion as he has no experience in orthopaedics, joint replacement or vascular work. Do write off this idiotic opinion and wait to discuss it will Dr Maale.
Maisybo said:
He said the only other option besides changing out the hardware was to find another surgeon to remove my current hardware, put in antibiotic filled spacers, wait 6-8 months & then have a 2nd surgery to install new hardware, which he claims Dr Maale doesn’t do anymore.
Click to expand...
I also find this very hard to believe because Dr Maale does sarcoma cases which invariably employ the use of 'massive' replacements. So I would say, don't listen to this other doctor about that.

Let us know what Dr Maale has to say about this, won't you?
 
Oh yes, I'm with you, too, @Maisybo! Let Dr. Maale know what that heartless Dr. Nguyen said to you. I bet he'll never get another referral from Dr. Maale one he finds out!

Congrats on 70 pounds off! I know how hard it is. You have to fight for each 1/2 pound that you lose! You go, girl! You're the bomb!

Please let us know what Dr. Maale says on Tuesday.
 
@Maisybo
How are you feeling today?
I hope we were able to reassure you a little and that Dr Maale will also do that on the 10th.

We're here for you! :friends:
 
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