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

Bob, I was in a immobilizer twice in my early knee surgery days. I had no problem getting my bend back. I think it's a blessing to be in one. It gives the knee much more time to heal before the stress of PT.
 
That's good to know sisters because after that slight twinge I felt yesterday it made me think...oh boy this is going to be wicked painful when it's time to start flexing it again
 
Once you get more healing on that knee, the pain will be less than what you felt yesterday, especially since you have a infection.
 
Can’t they use your PICC for the blood work instead of sticking you? When the immbolizer came off my leg felt very weak and I had to slowly begin not using it. I kept it off around the house, but if I had to go out I wore it for a week or so. It did seem my leg would collapse at times, but it never did.

Once I started bending it was very very gentle, my OS ordered non-aggressive PT and I began talking a pain med again as I had stopped them about 2 weeks after the infection surgery. I concentrated on not walking with a peg leg, bending while I walked around the house. That was December 26 and it was around January 20th when I got a full rotation on the bike. When the immbolizer comes off, don’t push too much or too hard or let anyone else.
 
KarriB said:
Can’t they use your PICC for the blood work instead of sticking you?
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Unfortunately no. From what I'm told, up until recently it was an acceptable practice and the staff in the hospital even said that was one of benefits of having a picc line. In fact they even drew blood from it a few times. But now it appears its becoming a source of bacteria growth and the picc line itself was never intended to be a provision to draw blood from. So now that practice is no longer allowed. When I went to Quest Diag the other day for the blood work, she even said they could no longer use the picc line, not that I expected her to use it.

KarriB said:
When the immbolizer came off my leg felt very weak and I had to slowly begin not using it. I kept it off around the house, but if I had to go out I wore it for a week or so. It did seem my leg would collapse at times, but it never did.
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I'm not comfortable removing it just yet. I feel much more secure with it on and don't want to risk anything, esp considering the stage of improvement I've reached....its that noticeable and I want to continue on that path. Maybe next week I'll try walking around the house with it off. When I'm in the recliner, I do loosen it which is a big relief and increases my comfort. While I was still in the hospital, they had it cranked way too tight and was causing circulation problems...my leg and foot were getting numb. But I loosened it myself and saw instant relief.

The real fear I have with removing the brace too soon is splitting the incision open again. The infection caused a significant amount of skin damage in the incision area and the OS/PA were concerned they wouldn't have enough intact skin to use stitches. Fortunately for me they were successful and the current condition of the incision is remarkable...in fact during my first follow up visit this past Wednesday, they both commented on how well it looked. Their words alone gave me a big boost in confidence. Initially my OS wasn't too optimistic that it would hold.
 
Homeport said:
Hoping all is okay and your catching up on sleep
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OK?..yes. Caught up on sleep?..no! Highly irritable?...absolutely! More on that in a bit.

My biggest gripes so far are the excessive visits and phone calls from the home care staff. Seems everyday I'm getting more than whats needed. However I do understand the seriousness of what happened, and I do know my OS ordered constant monitoring of my condition...he even asked me about it on Wednesdays visit. The problem with the constant visits is it interrupts my daytime sleep episodes which I've happily become accustomed to. It caught up to me yesterday as I barely made it to the recliner late yesterday before the lights went out. Woke up twice during the night but fell back asleep almost immediately. Feeling the jet lag again right now, but it'll have to wait. Currently waiting for a delivery of new meds for the picc line and the nurse is supposed to be here around 11. So time for a quick 'spit bath' and clean clothes. And then let my GSD out for a quick run around...it helps calm her down when I have to crate her. That's another thorn in my side...having to crate her so much which she doesn't deserve. But its in everyone's best interest so it has to be done.

After I'm dressed I'll continue with more updates and probably a rant about the picc line nurse since you folks say its acceptable here. Not that I want to whine about what he did yesterday, but more about getting it off my chest.
 
Keep the immbolizer on until your OS says to take it off. Originally I was to use it only 2 weeks, but that grew to 4 weeks. I slept with it and only removed it to wash or change clothes. At 4 weeks I was given the ok by my OS and took it off while elevating (I elevated 24/7) and just walking to the bathroom/kitchen. But I used it when I left the house because my leg did get achy with too much use.
 
It’s totally acceptable to rant here we have all done it and we are here to support each other
 
The nurse is supposed to be here any min now, so I have to be quick...I forgot to say something with my last post:

I want to give a big shout out of thanks to @Jaycey again and equally important to @Josephine for the link about self administering the Lovenox injection. Having been given minimal instructions I knew nothing about how the alcohol swab would affect the sensory nerves. Especially the part about putting a little extra pressure when using the swab. Knowing what I know now has relieved all the tension that I was experiencing just prior to the injection. The last 2 injections were an absolute breeze to do with zero anxiety present. And with 16 more injections still remaining, I no longer cringe at the thought of doing it. So thank you both for the info!!
 
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No problem @BionicBob ! Glad the link helped you through this process. I know it was daunting for me until I too found the information in the Library.
 
Every day I wake up I keep hoping to find that this was all just a bad dream...wishful thinking! Lately, at least for the last several days, irritable seems to be the flavor of the week. Not sure if its just another side effect or a mood swing that I have no control over. Started last Thur and reached a climax yesterday afternoon.

Yesterday about noon, my nurse shows up to check vitals and change the bandage for my knee. Typical visit with the typical casual conversation ensuing. As she's cleaning/dabbing the wound with a dampened gauze pad, something caught her attention and she briefly looked away. At that exact moment, a single thread of the gauze pad caught one of the stitches in the worst possible place...where the infection was located. As she lifted the pad it also tugged on a stitch and I literally saw stars. It about ripped the stitch right out the skin. Shes darn lucky she didn't get kicked in the head as my entire body lifted and my leg jerked upwards uncontrollably trying to loosen the grip the gauze thread had. I had to yell at her several times to leave it alone and finally barked "just cut it off!!!" as she frantically tried to untangle it. The pain peaked like nothing I've experienced, which is saying a lot considering what I've recently been through. Tears in my eyes overcame the anger I had.

She couldn't apologize enough and I kinda felt bad for her, but still...her attention should have been 100% focused on what she was doing. I can still clearly remember that exact moment seeing her look back over her shoulder at 'what I don't know'. After she cut the pad free, I had to literally yell at her to 'LEAVE IT ALONE' so I could recover. Took several mins and then I let her remove the piece of thread from the stitch. At first I told her to leave it alone but she didn't want to leave it fearing further risk of infection. I was like "what!?!" but then allowed her to proceed. Gawd that ordeal was brutal and yet just another one of those horrific events that I had to suffer through. This pain stuff is getting old...REAL OLD!! She finished up, picked up her mess and got ready to leave, all the while apologizing. I told her it was OK and things happen...yet my inner self was screaming tell her what you really think.

Took a couple pills, laid back and somehow fell asleep through the pulsing pain that shot through my knee.
 
double post so I deleted it...
 
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Last Thursday the nurse who tends my picc line showed up for the weekly visit. Basically just a bandage change along with 2 new extension lines and to make sure all is going well. The first sign of trouble...as he's removing the bandage, I comment 'let me put this towel under my arm' on the arm rest for the recliner, "I didn't want the mess all over the chair". He replied "its ok, I'm just about done with the worst of it" Which was baloney as he continued to place **** on the chair and stick pieces of tape everywhere...should have spoke up again, but I let it pass. Then I notice the speed he was moving while flushing the new lines with saline. So I comment about it and he replies its ok to give it a somewhat aggressive flush...which is the exact opposite of what he initially told me during the very first visit. These people need to make up their mind...it's either one or the other! Whatever, and I let it pass as well.

He packs up and heads out the door. As I let my GSD out of her crate, I notice through the window that he took off abruptly, kicking up stone from his tires. My driveway is gravel and topcoated with 3/4" crushed stone. Perfect for a rural setting and as I have better things to do with $30K than spend it on asphalt. I should also mention that my driveway is 600' long by 18' wide with a 25* sloped section leading up to the house. As he's sailing down the driveway at a ridiculous speed, when he gets to the bottom of the slope there is a slight curve in which his car slides a bit. I'm watching all of this from my house and was very tempted to call him and rip him a new one...apologies for the expression! I can only imagine the mess he made of my driveway, but decided to let it pass...once again.

Soon after I notice my arm where the pic line was starting to ache. Felt like the picc lines were under tension and pulling. I then remember that during the bandage change he mentioned he was adding another piece tape to help keep the picc lines secure and in place. No doubt that was a mistake and was the cause of the discomfort IMO. I did plan to call him later or the next day if it didn't improve. Couple days passed and I finally decided to just tough it out...wasn't a constant pain...and wait for the next visit. Probably just as well because if I saw him during those few days I would have most likely gave him a piece of my mind. In the end it was clearly obvious that for whatever reason he was in a hurry that day and I paid the price of admission for it. Most likely when I see him again in a couple days, I'll politely mention to not place the extra piece of tape and to slow down when he drives through my driveway. If he gives me any grief about the driveway, I'll just reply "fine, just park down at the street and walk up" otherwise you can bring a rake and straighten out the mess you left me. Hopefully it won't come to that, but f it does...

Oh yeah...forgot about the mess he left me after he washed his hands in my kitchen sink. Jeez...my 4 yo grand sons aren't even that messy! some people...

Now to some of you, you might think I'm being fussy or maybe it's my OCD, but whatever it is, there is no valid reason for a professional to do what he did. In my book, this guy is an idiot...simple as that. Unfortunately I have to deal with him for the next 4 or 5 weeks so no sense in creating hard feelings. If he crosses the line much more, I will have no choice but to speak up...out of control or not!
 
So now it's Friday and the nurse is here...she visits 3 days a week. During our casual conversations, she mentions my driveway and will it get plowed after a snowstorm. I have a New Holland tractor with a front end loader that I use and explain I plow it myself. Well she decides that I may not be well enough to do that if it snows an anytime soon. She also suggests that I consider hiring someone to plow so that she can get up my driveway. I abruptly replied "FAT CHANCE THAT"LL EVER HAPPEN" I'm not about to pay someone to make a mess out of my driveway and then plow all the stone into my lawn. It's not difficult to plow a crushed stoned driveway, you just need to know the tricks. Not sure if she accepted my answer, but too bad!! If she cant get up m driveway...park on the lower level and walk! Not trying to be rude to think that, but it is what it is...this is my place and my rules.

Once again, here's another individual that I have to deal with for the next ?? of weeks and no sense in making it difficult. But I will draw the line if need be.

Next the conversation changes to my eating habits...what am I eating, how often, etc bla bla bla. She then states my recent hospital records show my eating habits are not acceptable. >>>Here we go...

I don't want to go off on a tangent, so I'll do my best to be brief. As a young child I had a miserable time when it involved food. By miserable I mean I was forced to eat what I was served, like it or not. My father was a military officer and his strict military habits were also enforced on us kids at home. Many a times I couldn't stomach what was served for a meal. Even though my father insisted I had to eat it, my mother usually came to my aid. Well one particular night my father was over the top and insisted I had to eat what was on my plate. If I didn't, he would feed me himself. So I attempted to eat and swallow but it just wouldn't stay down. After getting yelled at repeatedly...keep in mind I'm only about 8-10 yo...I kept eating and swallowing until my stomach said enough!! And then in a mild explosion, I sprayed the entire table with undigested food. Sorry to be so graphic, but I wanted it to be clear why I was scarred for life at a young age when it came to food. From that time forward, if I didn't eat what was served, I went without...per my father. After I left home and went out on my own, I vowed to never again let someone force me to eat what I didn't want. I and I alone would decide what and when I ate, and not a soul on this planet would force me to do otherwise. To this day, 50 yrs later I still live by that vow. Fortunate for me my wife fully understands my past and supports me 100%.

So now fast forward to the present....my first tour in the hospital for the TKR was uneventful for the most part as far as food went IIRC. Ate a couple things...along with the few things my wife brought. However tour #2 for the emergency surgery wasn't so pleasant. I believe I previously mentioned it...after admission and upon arrival to my room pre op, the attending nurse brought me some pain meds and said I had to eat something first. Well, considering I had absolutely no appetite, I declined the food. Wrong answer...the nurse stated "no food, no pain pills" And I replied "fine...keep your stupid pills!! I'm not hungry and not about to force myself to eat" and she left. Well, one of the other nurses just outside the room overheard the exchange and moments later someone else brought me the pills. Over the next week it was a constant battle over me not eating enough to satisfy their requirements. Early on I did manage to eat a couple burgers and they were ok. But next time I had one it caused me to spit it out the instant I took the first bite...NASTY is an understatement!! in describing that moment. From that moment forward, I refused anymore hospital food.

At one point the dietician for the hospital paid me a visit. So now I had to explain what was behind my stubbornness. I was fully aware that the need to eat was to prevent an upset stomach, but more importantly the need for nutrition for my healing knee was a priority. Again a few of my attending nurses went to bat for me and clearly stated that I had proved over and over I didn't need food to counter the effects of the strong meds. A few of those nurses were real sweethearts when it came to defending me and looking out for my best interests. So then sometime during the last couple days in the hospital, the PA for my OS came into my room and mentioned that I wasn't eating...grrr...here we go again! What part of the english language don't these idiots understand!? Well...I cut him off by telling him to go see the dietician as she knew the whole story and that I had no intention of repeating again. After some brief discussion he then suggested to at least drink some Ensure. So I did, and honestly it wasn't bad. I then asked if there was such a concern over my eating, why wasn't this Ensure stuff brought to me sooner? Heck I would have drank 50 gallons of it by now. Naturally no answer...

>>>I did my best not to go off on a long winded tangent and that was the result of my efforts.<<<

So now we're back to last Friday with the visiting nurse. After she questioned my eating habits I told her if she saw my medical records from the hospital, there should also be record of my discussion with the dietician. You want specifics, go see her. I forcefully had to explain to her that no one on this planet would force me to go against my will when it came to food. Don't think she liked that response, but too bad!! Fortunately she dropped the subject as I surely didn;t need the stress she was giving me and I think she realized it too.

I fully understand the concerns but these people need to understand when they cross the line when it comes to invading ones privacy. The alst thing I want to do is prevent them from doing their job, but they need to respect that its a 2 way street and some things need to be left alone.

Sorry for getting so carried away...what I said needed to be said. Not even going bother to go back and proof read as I'm ready to fall back asleep. I'm doing my best to keep this thread updated, but have failed miserably from what I originally intended. As time allows, I'll clarify a few other things that I was brief about. Trust me when I say it...there's more!

I shall return...:)
 
Hello @BionicBob it’s got to be really frustrating for you at this time you will eat when your ready I find that I want strangest things at strangest time last night about 11 30 pm already in bed and having earlier not kept down dinner I really had urge for fried egg sandwich not even healthy option but my husband made me one and removed crusts as that is another quirk at moment I don’t eat crusts and I loved it even slept better last night
It’s your body your home and that should be respected take care
 
I don’t have your same aversion to being told what to eat, but I also ran into having a diet I didn’t like forced on me in the rehab hospital. I’m type 2 diabetic controlled by diet. The surgical hospital was fine; they had an extensive menu for me to choose from and only gave me grief over my desire for extra snacks (for taking with pills at off-meal times), which we came to an understanding on. But the rehab hospital kept changing what I ordered and substituting horrid, wretched soup and kale. I’m sorry, but I don’t eat kale. I hate kale. And I will not eat food I don’t like. I had my husband sneak in things for me to eat.

I hope at home you have an ample selection of foods you like and that are good for you. It is important to give your body something to work with as it heals. But yes... you do get to choose what you eat!

One thing to keep in mind: pain medication and other medications might mess with your system a bit and make many foods unappetizing. I developed aversions to some of my favorite foods for a while. I found protein drinks very helpful during that time.
 
@BionicBob @SusieShoes I agree the meds have done that with both knees I find I have to just have something I fancy when I fancy meal times have gone out window
nausea and light headeness does not help either protein drinks is good idea I glue lucozade when I go out in car just for sugar boost again not healthy
 
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