Knee Infection Whew!! it's finally done: the Good, the Bad and the Ugly

[2happy]

I am glad you are doing okay. I can relate to the PT and insurance (for me workmen comp), you can’t refuse BUT please speak up. The aggressive PT I received caused nerve issues.
Best of luck to you [emoji4]

 

[BionicBob]

Well the nurse just left and all is well. Some minor leakage and blood stain noted, but no need for concern. Now I need to sit tight to hear from a PT. Supposed to be any time now. Even though I strongly agree with the BS consensus about PT, I am anxious to get at least some PT started. I'm not sure the exercises I'm currently doing are sufficient. It's been pretty brutal the last couple days when I first get up and I think its because I'm not moving the knee enough. And honestly, I'm hesitant to even coming close to pushing the pain threshold where it involves flexing. On a positive note though, the nurse agreed with me about that overdoing incident with the knee so soon after surgery and it was not really an acceptable practice. Granted its her opinion, but it at least makes me feel I'm not being unreasonable. She also agreed that 6-8 weeks is absolutely ridiculous for an expected return to work time period and she would stay on top of that with my OS to ensure I returned to work only when it was safe and appropriate for me...that made me feel sooo much better. Not sure how much weight her authority carries when it involves my OS, but having someone like this on my side eases any fears I currently have.

@liam2015 I'm glad you and the others are enjoying my little saga. My intentions were to make it somewhat entertaining while also making it factual for the benefit of those who are close to going under the knife. No doubt just the thought of what I was facing was hard to accept and there were many times over the last couple months that I had second thoughts. One reason why is that the pain level had decreased compared to what it was earlier this year. Even though my ortho doc is no longer treating me, he still keeps in contact with me to see how I'm doing. He assured me the decrease in pain is likely due to me not working/stressing the knee and that the damage is already done and will not correct itself. I would trust my life in his hands and hearing what he said did help get through the waiting time. He also said the fear is normal and don't get worked up over it...easier said than done.

@rubyyarn I had to laugh at your fuzzy brain comment. I have an incident to share that I thought was wildly insane if not ridiculous. I'll be sure to post it

@SusieShoes yeah it was unfortunate that I had to go through that agony. Not knowing any better, I followed their instructions as these are professionals that are supposed to be acting in your best interest. Live and learn i guess. One thing is for certain, even though I will allow the PT for now...still not sure if I will complicate my treatment coverage by refusing any PT...there is absolutely no way I will allow anyone, including my OS and his PA to use their hands to force any knee flexing. I'll walk out of his office before that happens. And I have the proof of what I just went through to back up my position. BS and its members gave me that confidence and I'm grateful for it.

I've been dragging my feet and stalling for time waiting for the PT guy. He supposed to be here in about 10 mins or so, so I'll have to end it here for now. Don't want to get my head too wrapped up in posting my experience, as I'd rather stay focused on what I will and will not allow concerning PT. I learned a valuable lesson from that unfortunate PT experience, and I'm not about to get fooled into doing it again.

Sit tight folks, I'll be back sometime soon to continue...

 

[sistersinhim]

I wish you had the option to refuse PT like so many of us have. Your recovery would be so much easier and quicker. Try to do as little aggressive therapy as you can, just to keep WC happy.

 

[Celle]

I wish you had the option to refuse PT like so many of us have. Your recovery would be so much easier and quicker. Try to do as little aggressive therapy as you can, just to keep WC happy.

I agree with sistersinhim. It seems you can't refuse to do PT, but you should be able to control the type of PT you do.
Do the exercises as long as they don't hurt, but refuse to do them to excess and refuse to do any that hurt. Don't let the therapists pull or push on your knee.

You can also control the amount of exercise you do at home - if you have a heavy session at PT, then do no exercises at home the following day. If they ask if you're doing your home exercises, just nod and smile.

 

[BionicBob]

@Celle You are a godsend Celle and can't thank you enough! I saw this reply late yesterday from my phone and realized that was exactly what I was looking for. But couldn't see it through the fog and haze. Key word being: control. I can avoid any backlash from refusing PT by instead controlling what I can and can't do. If there's an exercise I can't or don't want to do, I won't and just move on to the next one. This way the PT report...I imagine they have to keep record of what I do and what I accomplish... will show I at least tried to participate

 

[BionicBob]

Something happened, something's wrong and I don't have a clue what or why it started. I find it hard to believe that my sitting upright for a couple hours the other night could cause theses symptoms. Yet that is the only thing I can think of that might be behind it. The rest of the time I've been home post op has been in the recliner except for a brief walk to the kitchen or bathroom less than 20' away.

The last 12 14 hours have been horrible. Started around late morning and first noticed something shortly after the nurse left. By the time PT arrived I was in pretty sad shape and after he left I felt:
Total body ache...flu like feeling. I did have a recent flu shot
The front face of my shin bone was upset and yelling at me almost constantly
My entire knee area felt like a glob of a fresh concrete that's almost cured
My leg felt like it weighed 1500lbs and unable to lift it at all
It's full of pain, shooting throbbing dull sharp constant
Became shivering cold almost teeth chattering at times, outside temps mid 60's
Became so hot had to turn the AC on, glad I left it in the window pre op
Equilibrium was off, felt like a bowl of jello if I stood up.
Vision was blurry with these odd shooting sparkles at times
No excessive heart beat that I could tell but I'm no Dr, thinking heart attack? But doubt it
Super tired to the point I thought I would zonk out if tried to sleep. Just tossed and turned for hours. I did fall asleep at times but short lived.

I'm trying to think of what else but my thinking is still kinda blurry right now. I feel better than last night but no where near enough to say acceptable. Haven't eaten much due to no appetite but I'll force myself after I finish this. Orange juice did help a few times but was always short lived. To make matters worse, home alone at the worst of it. My wife was watching the twin grandsons at my daughters house.

PT finally showed up mid afternoon. At that time I was mostly just weak and in pain. He even commented that my face showed it. Today was just an evaluation and he explained to me what he hoped to accomplish. He explained what he would and wouldn't do which gave me the impression that if what he says is true, we'll get along just fine.

I'm sure I'm my own worst enemy by dwelling on the past but with all this time and nothing much else to do, it happens. All the praise and glory I felt my OS deserved is quickly fading. I don't like to use the word, but the hatred for him has started and is increasing the more I think of what happened. it may be misdirected and instead be aimed at the PT guy but my feeling is that the OS sets the rules and enforces them.

Ultimately he's responsible for my care especially while I'm still in the hospital post op. I'm glad my first appt is 2 weeks away because if I had to see him right now, it would be very difficult not to say something. I suspect when the time does come, I'm just going act emotionless and say the least possible. No sense in burning the bridge. Short of any complications, I no longer need any of his services. Just need to allow him to do his follow up check ups. Pretty sure I can bluff my way through what ever he asks me. Or at least that's my thinking right now.

Feel like I'm talking in circles and just rambling, but I wanted to get this out there for now hoping for some feedback. I have absolutely zero intention of calling his office. If an emergency situation arises, I'll call the home nurse, she told me I could if I didn't want to call 911. Worst case my wife will call 911 because I sure won't! Thick headed stubbornness tends to get in the way.

Bleeding?? What's considered normal and when should I be concerned? The band-aid has been blood stained everyday since I've been home. The nurse did uncover it and said it looked ok. She put a fresh one on but she only used a gauze and tape as that's all she had. OS told me to remove it today and leave it open to air. I disagree and would prefer to keep it covered for a few more days due to the bleeding. The nurse agreed especially while I had the ice machine on it. Anyone know here I can find those oversized band-aids?

Within about 2 hours after the nurse, my wife noticed a stain again and by the time PT arrived it got bigger. Not leaking like it did in the hospital but its obvious it's still bleeding. This is just adding to my frustration and hatred for the OS. Sorry to say it but it's the reality I'm facing right now. I really don't want to think about going back into the hospital esp to my local ER. So I'm going try and deal with it as best possible for now before I react.

I feel like I'm just rambling and talking in circles so I'm going to try and shower and eat something. I'll keep this page open and peek back in when I can. I'm disgusted as sin right now and need to shake that feeling as I'm sure its not healthy for me right now. It's not easy to flip the switch from being annoyed, upset, angry to the happy go lucky guy I was a day ago

 

[sistersinhim]

I am certainly not a doctor, but how much protein are you eating? Our bodies need protein to heal and rebuild it. I could eat little the first month or so and kept protein drinks in the fridge. I drank those as much as I could and ate mixed nuts as much as the dry mouth would allow. During your 'episode' you probably should have gone to the hospital, but I understand stubbornness! If it happens again, please go. In the meantime, try and eat more.

With your bleeding, I'd ask the OS if you can shower or not. You obviously have opened wounds and you don't want to allow bacteria to enter into it.

PT, at the hospital should have never pushed you so hard. My first and only bad PT experience at the hospital was after my first kneecap removal. The day after my surgery, they took me to PT. She took off the bandage and had me exercise. Soon afterwards, I started bleeding. And not just outside, I was bleeding inside, too. I ended up having to get my knee drained. You can't imagine the agony of having a newly operated on knee squeezed and moved all around with a needle in it. Never another PT session after that!

You might, also have some inside bleeding. I'm sure things for removing it are much easier than it was back then in the early 90s. I'd call your hated OS, if your swelling continues and doesn't go down with icing and elevating.

God bless you!

 

[PoetryChef]

@BionicBob, I am so sorry to read you are having such a difficult morning. Tagging others who are far more qualified to help you through this. Please know I am praying for you.

@Josephine @Celle @SusieShoes

 

[Dianna_WA]

Hi BionicBob. Sorry that you have been feeling so miserable. I wonder if the way you have been feeling is a response to the anesthetic that you had for your op. I have felt hot\cold, no appetite, teary, jittery, etc. up to 3 weeks after my own surgery. It could also be a combination of that, with the stress you are feeling, etc. and it has manifested itself with those symptoms.

I hope things settle down for you soon.

 

[BionicBob]

@sistersinhim
I honestly couldn't tell you if I've had enough protein or not. I'm thinking no as I've only eaten basic stuff. I'm a very bland eater and have to be very careful in what I eat or it'll haunt me. Another story for another time. I'll mention it to my wife when she gets back from getting more G2. She had me drink a bottle of that G2 stuff that I had to take the night before and the day of the surgery. Between a light breakfast and the G2, it kicked some life back into me. I attempted to head upstairs for a shower but nixed the idea. Just don't feel stable enough to deal with the stairs. Believe me I wanted one so bad I could taste it. But I also didn't want to burden my wife with the possibility of me falling so It won't kill me if I wait til later or tomorrow. My wife is truly amazing considering what she just went through, and she refuses to let me do anything.

As much as I appreciate the suggestion to call the OS, that'll likely never happen again. The bitterness is too strong and like I said I don't want to burn my bridge with him by saying the wrong thing. That specific time when he gave me the backlash over what the PT did is still fresh and vivid in my mind. Not easy to move on from what he said as it was totally uncalled for and out of line for a professional.Edited to add: not so much what he said but more how he said it and the tone he used.

As for the bacteria and risk of infection with showering, I'll do like I did Wed evening when I got home. Wrap the knee with saran wrap and then put my leg in a plastic trash bag sealing the top with tape. The nurse from the hospital told me how to do that.

Thanks for the suggestions!

 

[BionicBob]

@PoetryChef Thanks for tagging those members, esp Josephine. All 3 of those ladies are very knowledgeable so I look forward to seeing what they say

 

[BionicBob]

@Dianna WA
Knowing you experienced those symptoms does ease my concerns. I don't know why I said heart attack other than that queezy feeling along with the shooting sparkles in my vision. No chest pains, shortness of breath or shooting pain in my arms, so I assumed It wasn't that. But the overall lameness definitely got my attention to consider all possibilities. I've never had any heart issues and I passed the pre op testing with flying colors...both the Nuclear stress test and the echo cardiogram. The woman who did the pre op physical gave me cause for concern but fortunately it was a false alarm. She also labeled me as being prediebetic (sp?) due to a higher than normal glucose. However the hospital did another full blown blood test and I was informed I was fine. The # she told me that applies was 51...forgot the details

 

[BionicBob]

btw...for those following still my saga I'll continue with day 3 and a couple other incidents, one of which I think is hilarious, once I regain my senses. Maybe after a shower later. It may be due to all the pills, but I find my memory to be out of kilt and somewhat difficult to keep the timelines in order. It seems after the last few posts of mine I remember something else i wanted to say and forgot. Probably should keep a pen and paper handy and start making notes

 

[PoetryChef]

You are sounding more like yourself. Hang in there. I understand it is perfectly normal to hate your surgeon these first few weeks.

 

[Jockette]

I had trouble thinking straight for a while after surgery. Between the effects of anesthesia and narcotic pain medicines, it was hard to focus. I like to read but would spend way too long just looking at the words before they would register. Same with playing words with friends!

In addition, I had a drastic change in my vision after surgery, over night, but no one knows what caused it. My distance got better and reading got worse, so my glasses were not much help. It never cleared up so at about 7 weeks post op I had to get new glasses.
I never expected that to happen!

 

[Josephine]

By the time PT arrived I was in pretty sad shape

All those symptoms you listed could be a reaction to your pain killers - so what are you taking, how much and how often?

Bleeding?? What's considered normal and when should I be concerned? The band-aid has been blood stained everyday since I've been home.

Well for one thing, I doubt it's actually bleeding. It's more likely just oozing which is very common. Do you know if your surgeon used a tourniquet or a wound drain? You'd know the latter as it would still have been in place when you got back to the ward and you'd have had to have it removed before they discharged you. If the answer to either of these is no then that could easily account for the oozing. In which case, you should keep it covered, especially when you shower.

OS told me to remove it today and leave it open to air. I disagree and would prefer to keep it covered for a few more days due to the bleeding.

I totally agree with you on this. The only time it's right to leave a wound exposed to God's good clean air is when it is dry!

Anyone know here I can find those oversized band-aids?

Whatever you look for, ensure you get occlusive, sterile and waterproof! You can get them easily on Amazon like this one.

Stratasorb Composite Island Dressing

I suggest you contact the seller first to check you can get an appropriate size for your wound as the descriptions are not very clear.

 

[Celle]

Total body ache...flu like feeling. I did have a recent flu shot
The front face of my shin bone was upset and yelling at me almost constantly
My entire knee area felt like a glob of a fresh concrete that's almost cured
My leg felt like it weighed 1500lbs and unable to lift it at all
It's full of pain, shooting throbbing dull sharp constant
Became shivering cold almost teeth chattering at times, outside temps mid 60's
Became so hot had to turn the AC on, glad I left it in the window pre op
Equilibrium was off, felt like a bowl of jello if I stood up.
Vision was blurry with these odd shooting sparkles at times

Bob, I am a little concerned. I know you don't want to see your surgeon again for a while, but I think it might be a good idea to see your own doctor/PCP. That's because your story about feeling "shivering cold" and then very hot could have been due to what's called a rigor, when your temperature rises suddenly.
It could have just been a passing episode, but it could also indicate an infection of some sort. Best get it checked out, I think. I had a bad urine infection that started that way once. Talk to your doctor about it and about your medications.

Pain in the shin bone and that heavy, concrete-leg feeling happens to a lot of us. It does go away, but can last for a while.

 

[liam2015]

@BionicBob ~ sorry you're having a rough time. you are very early in your recovery and i think you're pretty amazing being able to post so soon. i didn't post until 2 weeks post-op. that's awful what the p.t. did to your knee so soon after the surgery and in the hospital. the p.t.'s i had in hospital did not touch me at all, just wanted me to demonstrate the exercises they wanted to "tick off their list" so i could be discharged. i did terrible by the way. the first time they sat me up on the edge of the bed, i vomitted!

I would be most concerned about the oozing you're having and perhaps your family dr. could advise. i was miserable for the first 5 weeks, due to the narcotics which made me nauseous and unable to eat. i felt cold all the time (highly unusual for me); therefore, some of your symptoms can be explained. i quit the narcotics and all meds at 3 weeks so i could get back my life, but i don't recommend that for others. i did visit my family dr. at 3 weeks and had blood work done, resulting in most everything being normal. i think i was probably lucky that the p.t. that was supposed to phone me to arrange in-home and outpatient p.t. never did call. i've heard of many patients that were pushed too far too soon by p.t. and like you, suffered for it.

time will heal and the recovery will be individual to every person. some get their r.o.m. faster than others whether they work on it or they let their knee heal with activities of daily living (a.d.l.'s) and appropriate walking. i agree with Celle that you should have a professional look at your incision and advise. i hope you can rest, ice and elevate before trying anything too strenuous. looking forward to day 3 of your dialogue.

 

[BionicBob]

@Josephine

so what are you taking, how much and how often?

Methocarbmol 75O mg 1 every 6 hrs
Senexon-s (?)mg 1 twice a day
Meloxicam 15MG 1 once a day
Pantoprazole SODDR 20mg 1 once a day
Aspin-low EC 81m 1 twice a day
Oxycodone hcl 5MG 1 every 4 hrs as needed for pain
Tylenol extra strength 500mg 2 every 6 hrs (have skipped a dosage at times)

Well for one thing, I doubt it's actually bleeding. It's more likely just oozing which is very common. Do you know if your surgeon used a tourniquet or a wound drain? You'd know the latter as it would still have been in place when you got back to the ward and you'd have had to have it removed before they discharged you. If the answer to either of these is no then that could easily account for the oozing. In which case, you should keep it covered, especially when you shower.

Oozing would be a better description as its not actively bleeding. Earlier this afternoon we change the bandage again. Dry blood stain on the bandage and around the 8 staples on the lower part of the incision. My wife couldn't stomach looking at it...wish she could have though. But I trained myself early on and am familiar with what different stages of healing look like. Looked fine to me from what I could see. New bandage and feel asleep in my recliner. Never moved from it and about 4 hrs later I woke up. Blood stained again. Not heavily but enough that it seeped through the bandage.

Definitely no drain. I'm almost certain I heard tourniquet mentioned by one of the nurses after I complained about severe thigh pain, shortly after I left recovery. But by the time I got to my room and was alert enough for the need to know, all I had was the oversized bandaid covered with an ace bandage...one of those stretchy wraps

Thank you for the link for the bandaid things. The center one looks exactly like I'm talking about

 

[BionicBob]

Bob, I am a little concerned. I know you don't want to see your surgeon again for a while, but I think it might be a good idea to see your own doctor/PCP. That's because your story about feeling "shivering cold" and then very hot could have been due to what's called a rigor, when your temperature rises suddenly.
It could have just been a passing episode, but it could also indicate an infection of some sort. Best get it checked out, I think. I had a bad urine infection that started that way once. Talk to your doctor about it and about your medications.

Wow...not exactly what I expected or wanted to hear. I'm fully aware of the infection risk and feel I've done my best to prevent it. I'll heed your advice though and contact my primary Dr Monday. However I do have a concern with doing that. It appears all my medical records are available to everyone involved with this TKR. I say that because a couple days after my pre op physical, I saw my primary for my annual physical. It had been previously scheduled, so didn't see any reason to cancel. Plus it also gave me an opportunity to have him review the EKG report that indicated I may have a problem. Anyway, a day or so later the Nurse who did the pre op called to inquire about the stress test. She also mentioned: "I see you saw your PCP on Thursday" and I replied: "yeah, so?"

I told her why I saw him, and that was the end of it. But she acted like it was a prison record or something and left me with the feeling that I was supposed to let her know before I went. Excuse me for saying this, but my thoughts at the time were..it was none of her business.

So with that said, if I see my primary next week, I have to wonder if someone involved with the TKR will notice I went to see him and then tell my OS. Who in turn will question me why I didn't contact him instead of my PCP. Kind of a touchy subject and may not even happen, but I wouldn't be surprised if it did.