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

[BionicBob]

@liam2015, honestly, up until yesterday I felt fine mentally. I thought my thinking was clear and precise and had no problems posting. In fact I felt obligated to get the thread up to date ASAP since I had started it off with a little entertainment involved. I mostly did that to keep my mind of the pain and discomfort. It seemed to work because I was kinda laughing after a couple member comments...it appeared my intentions were working. My wife did comment a couple times that she could tell when i talked that I wasn't my normal self, but I disagreed. If I was coherent enough to create this thread theme, I was as normal as I could be.

You were lucky with your discharge as I was told I would not be released unless I passed all the PT tests.

There's no doubt I underestimated the recovery phase. I thought the worse I'd have to deal with would be how intense the pain would be and if I could tolerate it. Wed night, the night I got home, I discovered how bad the pain could get. and that was the worst so far. I inadvertently shut off the ice machine when I turned off the light before going to sleep. An hour or so later I woke up with the most excruciating pain I ever felt. Had no idea the ice machine was that critical either. The entire time I was in my private room in the hospital, the nurses kept me well iced 24/7. No complaints from me either as it did help and since that Wed night episode, the ice machine has become my BFF

 

[BionicBob]

Speaking of ice machines...
The home visiting PT told me using it all the time was wrong. He said I should use it 20 mins on and then 20 mins off. I can see that getting old real quick. He also said not to use it at night while sleeping...that's not going to happen for sure.

Comments?

 

[Jockette]

If I have another replacement in the future I will not go to PT or have one come to the house. Not after learning on here that it is not necessary. And not after hearing on here the misinformation some of them tell their patients. Shocking.

While my PT experience was not all that bad, there were some aggressive moments that will not happen in the future.

I will test out my gumption on Tuesday at my 7 month check up when I tell my surgeon he does not have my permission to bend my knee to measure like he always has. He puts it to a painful place to get a number he likes. I had a lot of respect for him until I found Bonesmart’s different approach from his to recovery.

 

[birdwatchr]

I used my ice packs until they were almost thawed out on my knee! And yes, I used them when I went to sleep too. Many times I got up as soon as the one thawed out and changed it to a frozen one to keep the ice ongoing. It was a life saver. I think you will also be told by those here in the medical field, that 20 minutes is not enough. I don't recall being told anything specific on how to use ice by the doctors office.

 

[PoetryChef]

I just visited a neighbor who has returned home after a LTKR. She stayed with her sister for several weeks. I thought I might take her some food from a cookout I went to tonight.

Her PT tells her to ice for 5-7 minutes, to not sleep with the ice machine on because the leg gets stiff. Her leg was so swollen and to tell the truth it sort of freaked me out. Why so much disinformation? They are also telling her to not lie with a bend in the knee and to keep it straight.

When I told her to keep the ice on longer she says doing so makes the leg stiff. I'd think lying straight legged would certainly make it stiff.

 

[liam2015]

i didn't have an ice machine, only a couple of ice packs which, for the first week or so hubby changed them for me in the night when i got up to the bathroom. after a couple of weeks i got up myself and changed them. up until a week or so ago, i kept a larger ice pack on my knee all night; however, it slipped off sometime in the night and i didn't replace it. now, almost 6 months post op, i'm not using one anymore for the last few days. it now feels too cold on my knee even being inside a pillow case. i found the ice pack really helped with pain even though there was also stiffness, but there would be stiffness regardless after sitting for awhile or sleeping in bed.

 

[rubyyarn]

Since HIPAA and the electronic record, nothing is really private anymore. If the OS questions your motives, just tell him it seemed he didn't want to hear about post-surgery issues, so you didn't want to bother him.

Most likely no one will say anything to you about it. It is your body; do what you must to take care of it.

 

[Celle]

Speaking of ice machines...
The home visiting PT told me using it all the time was wrong. He said I should use it 20 mins on and then 20 mins off. I can see that getting old real quick. He also said not to use it at night while sleeping...that's not going to happen for sure.
Comments?

As long as you have some material between your skin and the icing medium, to prevent frost bit/freezer burn, you can ice for as long as you like.
I used to go to sleep with ice an my knee and renew the frozen gel packs when I woke in the night. I think I iced my knee all the time I wasn't up and walking. I experienced no harmful effects.

Do what you feel is right for your knee.

 

[sistersinhim]

I iced the whole time I was sitting or sleeping. I had 2 ice machines, one for my recliner and one for my bed. I kept about 6 plastic glasses filled with ice all the time so I could refill the cooler part of the ice machine. I had no ill effects of icing all the time and was able to cut way back on the narcotics. I called myself an ice addicted instead of a drug addict!

 

[BionicBob]

The unit included numerous warning labels warning about the risk of freezer burn, so I was sure to heed those warnings. I ended up cutting an old pillow case down to size and used that, which resulted in a double layer of sheet between my skin and the ice pad

 

[BionicBob]

I'm going to try and post a pic...not sure if the size is appropriate for the forum though. Nope too big so I cut it down by 50%. Hope it shows what I want.

Does this require medical attention or is it normal oozing? Hope its the latter but I'm prepared to contact my PCP first thing in the am if its not. The pic makes it look worse than it really is, but that's just my opinion

on edit...this pic was taken after 16 hrs in my recliner. Maybe 2 or 3 trips max to the kitchen or bathroom otherwise zero activity

 

[SusieShoes]

Hi Bob, I'm just catching up with your thread after a busy weekend. Overall, you sound like you're doing better. Am I right? The whiplash of emotions, feeling better then worse, and all the ups, downs, sideways of recovery can be unsettling. Normally even-keel people start to wonder if they've lost their minds, or if there's something terribly wrong with them. Usually there's nothing wrong; recovery just feels like holding on for dear life in a rollercoaster sometimes.

Do you write on a Mac? I ask because I do and losing sentences and even paragraphs while replying on BoneSmart has happened to me. I believe it's connected to bumping/brushing the keypad/mouse thingie. Bear with me, I'm not technical. But what I do is remember that BoneSmart saves replies while I'm writing them. When my writing disappears, I exit that thread, go read someone else's thread or browse the titles for just a few seconds, and go back in. Usually most, if not all, of what had vanished is there waiting for me. I happily continue my post.

I don't know if your oozing requires attention, so I'll tag @Josephine to look at your picture.

I iced for an hour or more at a time for the first two months of recovery. It really helped with the pain. I also elevated while sleeping at first and think that's one reason my swelling went down quickly.

Your activity levels sounds just right. Bathroom trips. Get water or a snack. A few bends or stretches. You have to do PT for your WC, but try to direct it as much as you can. If your pain is going down, you're doing it right.

 

[sistersinhim]

You don't have to do anything at home but ADL. That will be a plenty! Very easy does it when you go to PT.

 

[Josephine]

Bob, I edited your image as it had too much contrast. Now you can actually see it's a leg!

4 hrs later I woke up. Blood stained again. Not heavily but enough that it seeped through the bandage.

If that's all there is in the way of oozing, it's nothing. Leave it alone completely. It's nothing to worry about. And once you get one of your big Bandaids, thereafter stop changing the dressings.

Definitely no drain.

Thought as much. Very often patients who get a lot of post-op drainage have had no drain so there is a lot of free fluid floating around in there!

I complained about severe thigh pain, shortly after I left recovery

Yes, that's a sure sign! But it would also account for the tendency to have post-op oozing for a few days.

Excuse me for saying this, but my thoughts at the time were..it was none of her business.

Well no. I think your PCP needs to know all this if they are going to be providing you with after-care. It's not like it's going to the local library or something! In this digital age, if a doctor has access to the hospital records, then they can see it all. Why not?

The home visiting PT told me using it all the time was wrong. He said I should use it 20 mins on and then 20 mins off. I can see that getting old real quick.

You visiting PT was wrong - very wrong! Otherwise, why would powered cryo-therapy machines be okay to use?

Wow...not exactly what I expected or wanted to hear. I'm fully aware of the infection risk

To be honest, Bob, I really don't agree with that comment. None of what you described sounds anything like infection, much more what I said - a temporary reaction to your pain meds.

As for your meds, I make the following suggestions

Oxycodone 5mg 1 every 4 hrs as needed for pain
Tylenol extra strength 500mg 2 every 6 hrs (have skipped a dosage at times)
Meloxicam 15MG 1 once a day

At one week out, you should be taking the oxycodone regularly as prescribed which is probably 1 OR 2 tablets every 4 hours. Never 'as needed'. Did you read the recovery articles left you in post #3 by Celle? The very first one in the list was this one Pain management: importance of managing pain after a TKR and the pain chart which fully explains how pain meds work and the proper was to manage your pain. There is even a chart. Even if you read it before, do read it again so you can understand better how to deal with this.

As for the Tylenol, first you need to check if your oxycodone has any in it, usually under than name of acetaminophen. If it doesn't have any, then you can quite safely take the 2 tablets 4 times a day (6hrly).
Meloxicam is an NSAID and a pretty poor pain killer. It is an anti-inflammatory but isn't so effective with this kind of swelling. Plus NSAIDs have side effects you should be aware of so read this Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers.

The other drugs you mentioned are of no consequence to pain management.

 

[BionicBob]

I apologize for abruptly vacating the forum. But all things considered, it was in my best interest. The side effects of the meds hit me like a ton of bricks and the effects from them are serious business. Combined with a few other issues, I lost interest. Unfortunately, until I regain my composure and a sense of sanity, along with a drastic reduction in pain, I prefer to avoid reading/seeing anything knee related. This entire week has been pure unadulterated agony. 2 sessions of PT...nothing aggressive mind you... only made me worse. Wednesday afternoon and all night left me in total misery dealing with these electrical(?) zingers. Some of those jolts were so severe I about jumped out of my skin...THAT BAD!! I am in full blown regret mode right now and wish I never did this. Nothing could have prepared me for what I experienced this past week...NOTHING! Sure I read a ton of experiences from many members here, but they didn't prepare me for what I'm going through. I'd rather have a mouth full of root canals with no numbing agent than go through this again.

PT is supposed to return today and he's getting the boot. Without getting sidetracked...not so sure I care for this guy anymore. He isn't really aggressive, but I don't believe he understands where I'm coming from. And to add to that, he said I should toss the lounge doctor. He only recommends it for people with heart issues. He also doesn't believe in using ice to the extent that I am. I'll deal with the consequences of booting him, no matter what they are. I'm done torturing myself. These people...PT, OS, PA, etc...expect you to do this, that and what not, and then they go home and enjoy life. Meanwhile I'm left to deal with the suffering. Even the pain pills are worthless when the severity is that strong. Thank god for ice! I felt obligated to at least come back and explain my absence. After all I've learned here and all the support the members so willingly give, it would have been rude to just bail.

Monday will be 2 weeks and then next Friday I get the staples removed. I'm hoping and remaining optimistic that I've seen the worst, and after next week I'll start to see improvement.

I especially feel guilty not responding to Josephine's reply right now and I do thank you Josephine! But I need to deal with this on my own, in my own way. I'll get through it or way or another, there's no doubt there. I committed myself to this so I'll see it through til the end.

Take care everyone, and I do promise to return.

 

[sistersinhim]

Oh Bob, I am so sorry you are having all this pain. I believe when you get your staples out today, your knee pain will reduce. Mine did. Every time you bend or your knee swells, those staples pull. Getting them out gets rid of that awful, painful sensation.

Please hurry back and let us know how you are doing. We care!

 

[Dianna_WA]

Honestly, don't despair, it really does get better. Very soon you will notice small improvements - the pain you're feeling now is nothing compared to the joy that's coming! You will get through this. Unfortunately the pain medications do mess with your head.

 

[SusieShoes]

Once you have the staples out, that will help. As will Time. These first few weeks of TKR recovery are rough! The pain and inactivity can drive anyone to just want to crawl into a closet. Take good care of yourself.

 

[rubyyarn]

Oh, @BionicBob, hang in there! You are in the worst part of pain and regret. My suggestion is lay off the PT entirely for now. tell the therapist you will call him in a couple of weeks. I waited 3 weeks before starting therapy.

Take care of yourself. If it helps to rant & rave, no one will judge you in here.

 

[Celle]

Hang in there, Bob!

I think that you've made the right decision about telling your PT not to come any more. It sounds to me as if at least part of your pain is directly caused by too much PT.
My surgeon doesn't allow any PT at all for the first month post-op. He says that your knee needs that time, to start on its journey of healing. All his patients do well, as I did.