Revision THR Two stage revision

[Cyndian]

My husband had an anterior hip replacement July 24, 2017. Surgeon sent him back to work end of August. By October the pain started. By December it was impossible to work. The surgeon wouldn't listen and kept saying it was this or that but didn't investigate.

Long story short our PCP took over. Tried PT. By end of April surgeon said he'd send him to University of Iowa Hospital. Before that was arranged our PCP ordered MRI which was abnormal so we had a nuclear bone scan done which indicated loose stem and bone infection.

1st of May my husband could not get out of chair and pain was excruciating and PCP put him local hospital on IV Dilaudid. Ortho on call ordered bone aspiration May 4th and original surgeon came in May 4th and said he was doing a revision the next day, Saturday May 5th. (without waiting for cultures).

Of course, Monday cultures came back dirty and he had a Hickman catheter placed and started IV Vancomycin for 6 weeks. At the end of antibiotics surgeon refused to allow a repeat bone scan saying they've never had to repeat one in 17 years. My husband agreed, still trusting the surgeon.

Let me add, I've been an RN 32 years and I was angry! Here we are in October. My husband's hip and leg were so infected we did go to University and he had a 7 hour surgery to remove entire hip, including splitting the femur to get it out, and had Hickman placed and antibiotic spacers placed. Here we are home on IV Vanco AGAIN! The plan is 6 to 8 weeks Vanco a 2 week antibiotic vacation and recheck for infection. Then another THR.

My frustration is through the roof not to mention I'm 67 and exhausted!

Has ANYBODY been through this? What kind of surgeon doesn't know the infection will colonize a new appliance and doesn't wait for TWO days for a culture result?

Sorry to carry on so. Our upcoming appointment trips to Iowa City are 200 miles round trip and hard on Patrick.

 

[Mojo333]

Oh poor Patrick. I really don't have any thing constructive to allay your concerns but we have some members who have dealt with some serious infection issues.
@Fractured just had replacement after removal of initial prosthetic.
Perhaps he can weigh in.
Also @Mireille who is also on her way to good again.
Sorry for poor husband's terrible time of this.

 

[BeBe]

{{{{ @Cyndian }}}}

Praying for you! And your husband!
You've been through so much - still more to come. Your nursing skills are being put to task for sure.
One day at a time and hopefully, prayerfully, you will get through this trial of a hip replacement.
No where to go but forward now.
Glad you found your way here; if it has happened with THR it has been discussed here on BS.
Probiotics for the gut health, good nutrition for your husband and yourself.
You will get through this

 

[Crisps]

So many times when I read our posts, some problems stem from consultants not listening to patients or their families, they way they dismissed your husbands pain, is so so bad. I have my fingers crossed for you both, at last you seem to be with the right team so hopefully heading in the right direction for this nightmare to come to an end.

 

[Layla]

Hi @Cyndian
Welcome to BoneSmart. Thanks for joining us. I'm happy you found the forum because you'll find a lot of support and encouragement here. There are many successful Hip Infection stories to read, if interested.
Tap on any red "Hip Infection" you see and all of the Hip Infection threads will open.

I'm sorry for your husband's pain and long suffering which ultimately affects you also. I pray the infection is resolved and your husband has a successful revision in a few months. Please stay in touch. We'll be here to spur you on as you journey through the process.
Wishing you both comfort.

 

[Layla]

Hi again @Cyndian
We need some info, please

THR July 24, 2017
Revision May 5, 2018

Please let us know which hip was replaced and the info will be added as a signature.
It's helpful for those stopping by the thread to comment to be able to glance at the dates / procedure.

 

[Josephine]

I feel for you both. You've been dealt a low blow.

What kind of surgeon doesn't know the infection will colonize a new appliance and doesn't wait for TWO days for a culture result?

As a passing matter of interest and one nurse to another, what difference do you think it would make if the surgeon had waited for the culture result? Per-prosthetic infections aren't like the usual infections at all. The infection arises from a substance in and around the implant called bio-film. You can read about it here Peri-prosthetic infection - also known as late onset infection.

There are also other articles in our Library
Peri-prosthetic infection: study by the Mayo Clinic concerning prophylactic antibiotics (Scientific Articles)
Periprosthetic infection: Mayo Clinic study shows that dental procedures are not a risk factor (Scientific Articles)
Periprosthetic infection (Scientific Articles)
Peri-prosthetic infection: study by the Mayo Clinic concerning prophylactic antibiotics (Scientific Articles)

The treatment your husband has had thus far appears to be about right. I do hope it works for him.


I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[skigirl]

I nursed my husband through many procedures and I totally understand the anger and the frustration. I found that I often got angry instead of scared!! I hope you husband is going to have a new surgeon put in the new hip. For you I will give you some advice, that I did not always take myself. but try to get out a little. I had a home health nurse come by twice a week, she did dressing changes and sat and talked with Bob for an hour or so. I often when to starbucks and just sat there drinking coffee and eating lemon pound cake. But, it was an outing and it did help me.

I did ask a few of Bob's friends to sit with him while I went to the movies once in a while (matinee) and they seemed happy to do it. I would leave them with a snack and coffee and it seemed to work. I think it helped Bob too that Nurse Cratchett went out of the house sometimes and a happy wife walked back in. It is hard to be a wife and a nurse---I understand the exhaustion. Yes, your husband is ill and needs help---but your needs have to be addressed too. It helped me when i remembered that!!

 

[Fractured]

@Cyndian Boy can I relate... My 1st hip replacement looked like this (see xray photo). I was like this for 14 days. I complained the whole time of pain.

The day I went in to have the staples taken out my wife had to wheelchair me in I could not walk. Xrays were taken and this photo is what we saw. Surgeon had a look of terror on his face. Revision scheduled for next day. 2nd hip was installed correctly but I found it odd they used the same hardware?? Pain didn't go away and after months of pain and feeling like rubbish. an aspiration was done. My WBC was 292.

I got to have the 2nd hip removed on May14th of this year and an antibiotic spacer installed. Non-weight bearing. In a wheel chair for 3 months and the PICC line plus antibiotics. Hip number 3 installed on August 2nd of this year. YEA I can walk again...
BOOOOO I got a hematoma.

And the 4th hip installed on 23 August of this year. 4th hip got new hardware. And the wonderful PICC line was installed again for another 6 weeks of 3 bags a day and they put on a wound vacuum! What fun.

October 8th. PICC line out. Wound vacuum off. I can walk about 4 to 5 blocks. I will be on oral antibiotics for a few months but the hip feels great. The femur not so great. Not only the fracture but the femur was opened up like a book to clean it all out during surgery #3.

Surgery's 3, 4 & 5 were all done through the same incision. See the top picture. 55 staples long, over 20 inches. If you look closely at the top of the top picture you can see the scar from the lateral hip replacement (1st 2 surgeries).

All I can say is this. This forum is a great place to come hang out and vent and get nothing but positive inspiration. If your hubby strictly stays on the regimen and doesn't have anymore complications he will pull right through this. It's a pain yes, but worth it.

For the first time in 14 months I was able to make my wife lunch!! I also can get my own mail as well. May not sound like much but when you are laid up like me and your hubby Cyndian, it's a big deal. I can walk around the house unassisted and not bother my wife who deserves a medal like you do, Cyndian. It sounds like your hubby and I are cut from the same stone. He can do this!! We will be saying prayers for him!!!! I'm living proof he can win!! Ciao Greg

 

[Layla]

I also can get my own mail as well. May not sound like much but when you are laid up like me and your hubby Cyndian, it's a big deal

Your words just made a grown girl cry @Fractured I'm feeling your gratitude in the ability to once again do something as mundane as get the mail!! It's awesome when our trials give us a new appreciation in all we've taken for granted.

I hope you're able to get the rest you need and deserve @Cyndian
To brighter days!

 

[skigirl]

Fractured, thanks for a great post. This is what I love about Bone Smart. Our members always reach out to others who are having problems. There is nothing like hearing from someone who has been there and survived!!

 

[Cyndian]

Thanks for the welcome! I did want to reply to the one about known infections and referred to my statement about why the surgeon doesn't wait, etc. My point being the whole reason for the aspiration is to look for infection. HAD he waited we'd have been having our two stage started last May and easily in our last part with a new hip. Instead, we are just starting.

It's his right hip. Sorry this is so disjointed. I wasn't sure how to reply individually to the posts. I'm learning.

Tomorrow is our first home health nurse visit and Vanco trough. Our infectious disease doc wants Patrick's levels 10 to 15. The one last Friday12th was 18 so I'm curious to see this level.

The doctor says we'll always keep the dose at 2gms but will only adjust frequencies. This is new to me. Not the Vanco but the part about no dosage adjustments.

But, basically he's doing well with no temp over 99.5° and he does walk around the house each day. I'm still exhausted but then I'm 67 and he's just 61, lol.

 

[Jaycey]

@Cyndian Glad things are a bit more positive for your husband. All the worry plus being a carer certainly leads to exhaustion. Can you get out on your own for awhile as skigirl suggested? It might help to have some "me" time for just a bit.

 

[Layla]

I'm sorry you're just beginning the process. It's truly unfortunate that you've both suffered longer than necessary and needlessly. But as you know, all you can do at this point is move forward. Hate to see you stressed about something you can't change. This entire situation is robbing you of enough energy.

I'm happy to hear your hubs is doing well, considering all. I hope you are also. I agree with those before me that a break for yourself on occasion, to re-charge, needs to be a priority so you're able to keep up as a loving and effective caregiver. Come here to vent, if ever you need to. We're here for you and we'll help support and encourage you in any way we can. Sending a hug and wishes for a peaceful day.

Here's an article on tagging members since you mentioned above you weren't sure how to do it.
https://bonesmart.org/forum/threads...er-how-to-answer-when-someone-tags-you.15223/
@Cyndian

 

[clodaghcov]

@Cyndian I feel for both of you on this difficult journey,it is certainly hard and painful and frustrating for both of you---but---it will get better, it may be slow and you need so much patience but forge ahead and look forward to things it does help I promise, enjoy a little time out breathe deeply and try and relax. Big hugs and lots of hope for youxx

 

[Mireille]

@Cyndian I'm sorry you're both going through this. I can't say it any better than @Fractured . It is a long frustrating road but things do get better. I too had an antibiotic spacer and was out of work for 7 months with this ordeal. It wasn't easy, it was frustrating for me and my husband but I've been back at work for 2 months and the hip feels great. Not perfect yet but it's getting there. This forum has been a godsend and the abundance of advice and support was indispensable during my recovery. Best of luck to you both! Prayers for a speedy recovery!

 

[Fractured]

Cyndian.... Fight the good fight... Yr hubby will make it because of you as well. My wife deserves a medal!!! Yr hubby can do it!!!