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Knee Infection Three surgeries to clean out infection

Celle

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I know there has to be some person out in the world who’s been in a situation like mine who’s had an infection & who’s overweight & has my same health challenges & who’s had the flap surgery & come thru it successfully! That’s what I need to hear about, you know? And by the way, I’ve continued losing weight here in the hospital — I’m eating, I guess just eating better than I was!
Well done on losing the weight.

SusieShoes gave you a link to PegGar16's thread, in Post #105.
It's a really long thread, but well worth reading, if you have time. About the last 12 pages deal with the plastic surgery, if you don't have time to read the entire thread. Here's the link again:
https://bonesmart.org/forum/threads/finally-finishing-up.33783/

To encourage you, this is what Peg wrote towards the end of her thread:
Hello Everyone!
I can't believe it has been a year since my surgery...time is flying. The leg is doing fantastic! Better than anyone expected. I feel so blessed to have the doctors I do. I have a trainer that I see three times a week now. I am trying to get the whole body healthy now and it is going well. I took off 6 pounds and 9 inches in February!!! After being down for so long it feels great to be exercising all the muscles. I figure this will also help with further injuries, like the shoulder..LOL. My balance is 100% better :) I am also trying very hard to keep the other knee out of the OR. I really can't put into words how happy I am these days. If I am having an off day I just remember where I was 1,2 or 3 years ago. Now I get to dance to Sesame Street with my grandson and play with cars on the floor with him. I really want to show that there is light at the end of the tunnel and good outcomes. Sometimes it just takes a little longer.
 

SusieShoes

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Better yet, PegGar includes pictures along the way, including at the end one of herself with her knee. She looks happy and ready to take on the world.
 

KarriB

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The good news is Dr. N is a plastic surgeon, he won’t be the one deciding what actually happens with your knee. He’ll be dealing with the skin, not the bone. It’s not much but something to hold onto. This is not easy to go through, I cried quite a lot through my infection. We are all thinking of you!
 

skigirl

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Yes, I thought of you a few days ago and hope that all is well with you. But let us know so that we can stop worrying about you!!!
 
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Maisybo

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**Update from Maisybo - long**

Things have been very difficult, to say the least...

After Dr Maale did surgery 3/26/18 to clean out infection, I went to another orthopedic surgeon in Dallas for a second opinion; surgeon’s name is Dr Cyrus Abbasschian. He was so positive & told me he really felt that he could help me & that he would answer any questions I had. This also meant a different plastic surgeon; Dr Sam Jejurikar.

After careful thought & a lot of prayer, I decided to switch to Dr Abbasschian for my knee surgery. He removed my original hardware 5/8/18 & Dr Jejurikar did a tendon graft to help close the huge wound on my knee.

Then 6/8/18 Jejurikar did a wound debridement on the tendon graft wound & a skin graft to cover knee wound.

I’ve been in a long term acute care hospital since then receiving IV antibiotics & wound care.

I was just moved to a nursing home/rehab facility for physical therapy & wound care on June 20; Dr Jejurikar has had me on complete bed rest since May 8 when I had the tendon graft; he hasn’t wanted me to put any weight on my leg to keep the graft from rupturing. It’s been extremely difficult to not be able to get up at all...having to use a bedpan is humiliating.

The physical therapist had me stand for the first time yesterday. She didn’t allow me to put any weight on my right leg because she said she has to have a written release for that (supposed to have been faxed).

My left foot was partially amputated at age 4 in an accident, & I’m missing the inside half of it & also missing my big toe, second & third toes.

The pain of putting all my weight on my left foot (w/a walker) was a 10; I couldn’t stand it. I’ve always protected my left foot & leg & have let my right foot & leg be the stronger of the two.

The therapist also tried to have me use a transfer board to get in a wheelchair, but every time she slid it under me it pinched my upper thigh & private parts; it really hurt. I can’t use a wheelchair in my apartment because there’s just not room, so the only reason they were trying to teach me how to transfer was to get me to the gym to do PT.

I’m terrified I’m not going to be able to walk again! I don’t know if the Physical Therapist is taking the best approach to helping me be able to walk with a walker.

She also had me do ankle exercises while I was lying in bed to strengthen my muscles.
Does anyone have any advice about what’s the best way for me to be able to walk again with my other issues - partially amputated left foot, etc? It felt like my legs didn’t belong to my body.

I have 20 days (Medicare) to get walking & standing so I can go home to my apartment. I’m determined to make it happen because if I can’t walk, I suppose I’d have to go live in a nursing home, & I just can’t even consider that.

I still have to have new hardware installed in my knee, but the wounds have to be healed before that can happen.

I’ve been away from my home & my dog for 3 months & I just want to go home for a while.

I appreciate all advice, suggestions, etc.

Thanks for reading,
Maisybo
 

Jockette

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It is so good up hear from you! I’m sorry things are so difficult. :console2:I don’t have any knowledge to advise you but I wanted to say hi. I can understand that you just want to go home, I would feel the same way. You are in my prayers. :console2:
 

Celle

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Hello again, @Maisybo . :friends:
My, you have been through a lot since your previous report. I'm sorry you've had to have so much done and I hope you continue to make progress.

Can you tell us what decided you to change from Dr Maale? Just for interest.

I think you will walk again, but maybe not within that 20-day time frame. Can you appeal that? You may need certification from your surgeons, to help with that.

It's a shame that the PT didn't bring someone else to help with getting you into a wheelchair. It can be done, but she needs someone else to lift you a bit, so that sliding the board underneath you doesn't hurt you.

I also don't like the idea of you having to live in a nursing home.

Do you have any help at all at home?
Who's looking after your dog? I was thinking that, if you could be put into a wheelchair, it might be possible for you to be wheeled to an outside area where your dog could be brought to see you.
When my son was in hospital after an accident, he was allowed in a wheelchair and I was able to bring his cat to visit him. We met in a little garden in the hospital grounds.
Being able to do something like that might lift your spirits a little.
 

Jamie

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Sadly, Celle, there is no appeal for the Medicare coverage. There are only a specific number of days covered in a skilled nursing facility under Medicare. But, since I see that you are not covered by Medicare because of your age, Maisybo, how is it that you have that coverage? Are you on SSI or disability? Do you have any secondary insurance that could kick in after the Medicare term runs out?

If you haven't done so, please ask to talk to the social worker at the facility where you are. That person may be able to offer some options for you for care until you are mobile again. You have been through so much and you have more to go, so you're going to need some support.

I'm not surprised that you have weakness and some pain when trying to stand or transfer. You have been basically immobile for so long and muscles atrophy during that time. Therapy will help with that so maybe you can get the therapist to try once more with the transfer board. Ask for that second person to help as Celle suggested so that you have more opportunity for success. Surely there is a nurse or other CNA around to help!

I know this is terribly frustrating for you. I agree that it would be a real "upper" to get to see your dog for a bit. Maybe that could be arranged. But even if that's not possible, please try and hang in there. You are strong-willed and that will go a long way toward things getting back to some semblance of normal in the coming weeks and months. Please keep in touch with your BoneSmart family....we care about you and are always here to talk when you need to.
 

Pumpkln

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Maisybo,
Thanks for the update, sounds like you are in good hands. Sending positive thoughts that you are able to go home.
 

pacosmom

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I’m so sorry things are rough right now, I agree it would be very uplifting to be able to see your dog! Will say a prayer for healing.
 

PegGar16

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Hi @Maisybo. You have been through a lot! I also went through tendon grafts andthe flap..which I think your skin graft was. Which tendon was replaced? I had the patellar and quad tendons grafted along with a knee cap. I had my husband at home so I didn't have to go to a rehab facility. Do they have you in a brace at all? My surgeons had a knee/foot immobilizer of hard plastic made for me before my skin flap surgery. When strapped on it was like a full leg plastic cast. You will be able to walk on it again....no fears. I had to go 6 weeks with no weight on it and no bending. It sounds like my surgery was done a little differently than yours. I had a surgery for the skin flap done first, then a second surgery for the tendon grafts and new knee replacement. It was a process and very successful for me. Please let us know how you are doing.
 

Jamie

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I wouldn't swear that there aren't programs out there, but each state would be different in their coverage. That's why I suggested she talk to the social worker at her current facility. It may make a difference due to what Medicare coverage she's under as well (that's why I asked about that). But I believe Medicare wouldn't ever just automatically kick in. There would be an application and qualification process that takes time to wind through the hoops. This is a time when you really need a good social worker either connected to a hospital, a care facility or a county social services office.
 
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Maisybo

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I have Medicare only; I’m 56 & disabled. I have tried to get Medicaid too but Health & Human Services advised me I make too much money with what my disability benefits are; supposedly $17/month over the limit. I’ve worked full time since age 16 & it has actually hurt me that I worked almost 40 years before I got too sick to work any more.

My sister is keeping my dog, thankfully; her dog & my dog love each other & play well together & she has a big fenced in yard.

I decided not to use Dr Maale because of the plastic surgeon who told me I would lose my leg, etc; there were no other plastic surgeons who work with him who accept Medicare. The other big reason I decided not to stay with him is because he wouldn’t communicate with me & take the time to answer my questions....I tried repeatedly every visit to ask questions & get clarification on exactly what was going to be done in the surgery. He’d barely talk to me & start dictating my visit into the recorder while I was still talking to him & asking questions & then walk out of the examination room. That was unacceptable to me.
I’m walking about 10 steps with my walker now; it’s painful but I’m doing it.
I’ll have home health care for wound care & physical therapy when I go home.
I’m going home Saturday July 7.
There’s no more Medicare coverage without a $170/day co-pay, & I can’t pay that, so I’m out of here. I’m beyond ready to go home after over 3 months in hospitals, anyway. My sister’s picking me up Saturday & it’s a 3 hour drive home.
Thanks for reading — Maisybo
 

Celle

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I'm sorry Dr Maale treated you like that. You might have been able to put up with the plastic surgeon, if Dr Maale hadn't disappointed you as well.

Never mind, it sounds as if you've found another good surgeon.

I'm glad your sister is going to pick you up and take you home. That will be a big boost to your spirits.
 

Pumpkln

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Maisybo,
Thanks for the update and your decision making.
Safe travels on the 7th, let us know how you are getting along.
Home Sweet Home!
 

Jockette

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I’ll have home health care for wound care & physical therapy when I go home.
Don’t let the therapist do anything to you that hurts. Don’t let him/her bend your leg. At all. Move it gently yourself.

I had a similar experience with a surgeon I saw recently for a second opinion, I had a list of my symptoms to discuss with him in my hand and he took it from me, nicely, and set it aside. He says, just tell me. Well everything I wanted to say went right out of my mind, which maybe was his intent. He whizzed in and out so fast I’m not sure what all he said. He spent maybe 15 minutes with me. I was very disappointed.

He came highly recommend and is a top surgeon, with good reviews about how well he listens to patients. Not the day I saw him. It took me 2.5 hours to get there and the return home trip took 3. I was very disappointed.

I will only “hire” him if I have an emergency with my knee before I get another opinion, as I don’t feel I can continue with my original surgeon.
 
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Maisybo

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Latest **long as usual** update from Maisybo:
I went home July 7th w/spacers in my leg & it was extremely difficult to walk even a few steps. My leg felt as if it was being bent backwards as far as it would go all the time & I was in really bad pain just walking a few steps with my walker.
I had PT & wound care at home from July 7 to September 10. The giant hole in my knee was covered with the tendon graft & skin graft by Dr Jejurikar, the plastic surgeon & it actually completely healed! I couldn’t believe it!
Of course my leg is ugly & forever deformed where the tendon graft & skin graft was done & there’s a big sunken in scar from the giant hole in my knee, but I have my leg, so I can deal with it.
I could not, however, deal with the spacers in my leg. I had told Dr Abbasschian when I was released from that hellish nursing home in July that I was just going to live the rest of my life with only spacers in my leg because I didn’t want to go thru all the Hell I had been thru again.
But I couldn’t stand the pain & discomfort of the spacers & having to keep my leg stretched out straight in front of me all the time; it was unbearable if I tried to bend it.
Dr Abbasschian did surgery (my 9th on this knee in 4 years) September 10 at Medical Center Plano & put new hardware in. The brand is called “LINK”. He didn’t remove my patella nor did he resurface it.
The difference in how easily I can bend my leg & how much LESS this replacement hurt was astonishing. I could walk with ease from the first day; it feels much more fluid, if that’s the right word than my Conformist knee felt. The only “bad” thing after the surgery was my hemoglobin went down to 4.9 despite Dr Abbasschian saying I didn’t have excessive blood loss. My Crohn’s causes me to have chronic anemia, & since my diagnosis & bowel resection in 2012 I’ve gotten regular iron infusions. Despite the iron infusions my hemoglobin stays at an 8 or rarely a 9. So I received 4 units of blood & 6 iron infusions. My hemoglobin went from 4.9 to 8 & has stayed there. The doctors were OK with that since that’s where it seems to stay. I get tired really easily & feel extremely fatigued pretty much all the time.
Now the complications.....of course nothing can be easy for me....☹
Dr Abbasschian cut around the middle of my kneecap for the surgery to install the new hardware because of the past grafts & my skin being so thin therefore . I had a big black scab over my incision, & the skin in the center of the scab above my kneecap died. Dr Abbasschian said he wasn’t surprised because it was so thin & the skin was grafted skin. But he was very optimistic that the skin underneath the big scab would grow enough to close the area of dead skin. I had several days of Vancomycin & another IV antibiotic & took a couple weeks of oral antibiotics called Cefdinir at home.
I was ecstatic to be home; I can’t explain how happy I was —I cried tears of joy!
I saw my local wound care doctor last week & he communicated with Dr Abbasschian’s PA & they decided my wound needed to be debrided. The nurse put numbing gel on the wound for a few minutes & then Dr Martin cut some of the black scab away. Sutures are still in place. Everything seemed to be OK until I went back to Dr Martin, Lufkin wound care doctor yesterday (Monday) for more debridement of the wound. The nurse told me my wound culture came back positive for “Klebsiella pneumonia”.
So a little more debridement was done, & the doctor became very concerned about the hole underneath the black scab & the yellowish fluid coming from the wound. I texted pictures of everything to the PA, & after talking to him & Dr Abbasschian by phone, they told me I’ll need to be taken into the OR at Medical Center Plano for further debridement & Dr Jejurikar will be there also to do another, bigger skin graft, which terrifies me because I know how painful it’s going to be.
Dr Abbasschian wants to do it Wednesday Oct 31 & his surgery coordinator will call me today to advise if they can get an OR.
I feel so disappointed but more scared than anything. I’ve been alone except for the day of surgery for most of my surgeries, & I was alone for some of them. I live 4 1/2 hours away from Plano, & my only support is my 2 sisters. They have to work, which I understand, but I’ll be scared & alone with no one to advocate for me. I know I’m a grown woman, but with all the previous surgeries & just being all alone day after day in the hospital, I’ve just laid there in the bed and cried all day. There have been so many surgeries & hospital stays that I feel like I’ve been in a time warp or like I’m the guy in the movie “Groundhog Day”. I’m past being tired of it all. I have lost my temper & talked rudely to the nurses when they wake me up to check my vitals or draw blood. I usually just don’t say anything, even when something happens or someone really does something that makes me furious, but not anymore. I complain to the charge nurse, & it actually helped because she told the nurses not to wake me up, etc! All my friends live in the Houston area — I lived in Houston almost 25 years until 2014 when I became too sick to work from the Crohn’s after my bowel resection & I was having to use a wheelchair because my knees were so painful. I was fired & lost my house & nearly everything I owned & had to move to Lufkin so I wouldn’t be homeless . So I rarely if ever see all my friends & former co-workers from the Houston area anymore.
I seriously feel all the stress of this for so long has changed my personality. I’m at my wits end....but I don’t want to lose my leg, so I have to just deal with it I guess...I feel very scared...
Thanks for reading — Maisybo
 

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