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[THR] Worried I may have infection<<

Discussion in 'Hip Replacement Recovery Area' started by Jws., Apr 6, 2018.

  1. Jws.

    Jws. junior member
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    hi, two part question

    After 9 weeks was grooming groin area with razor and cut myself. Should I worry about infection..(put triple antibiotic ointment on , left w/o bandage to heal..(should I take prophylactic amoxicillin?).

    Read posts and then became more concerned. I have much younger wife. Read about UTIs, dental, and other possible causes of infection to the prosthesis. For the life of me could not find any questions regarding "adventurous oral sex" and bacterial infection risk.

    Sorry, I tried to be as least graphic as possible but my wife and I enjoy "adventurous" oral sex - we can't be the only ones?

    Are there any cases of infections directly caused by the bacteria we may encounter in those situations? Any percentages? Any recommendations. We have many years of sexual enjoyment after THR and don't want to worry.

    Can you please provide the facts on this if you know them or any links. I know we are not the only ones who engage in this so I figured the question had to be asked.

    Thank you
    jws
     
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  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    All of those things you've mentioned are not an area of concern for someone post-joint replacement. However, I would add a small caveat on that in regard to you being only 9 weeks out though not in regard to infection but to do with your activity being more cautious for at least another 3-4 weeks.

    The infection issue in regard to dental treatment is very much a non-starter. Read this Evidence insufficient to recommend prophylactic antibiotics for dental procedures

    I would also advise that you do not ever use antibiotics creams or such unless by a doctor's recommendation. Injudicious use of antibiotics is how we ended up with MRSA.
     
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  3. Jws.

    Jws. junior member
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    @Josephine I am so discouraged and depressed. I had posterior THR 3½ months ago. Prior to surgery wasn't having that much pain walking only getting in and hout of car and bending down.

    Went to 4 best hip OS in LA and 4 back OS and all the hip OS's said prob. was the hip. 2 of the back split hip/back. I did the floroscopy diagnostic shot with marcaine and for 5 hours could more or less do most things without pain. So confirmed hip -so I thought?.

    My OS third visit said my xrays didn't show enough to go forward. "have one more CT and if it looks bad will proceed." He said to me that I looked better off than most of his post op hips during that evaluation.

    I know you're saying why did you do it if you were feeling mostly ok?

    I was having pain bending down , getting in and out of car, etc. and all my friends who had "hips" said it's a snap, best thing, 1-2-3, etc. Had the hip shot with marcaine,etc
    Finally had new CT and OS said ok he was in. There's enough in new CT to do THR.

    3½ months I still have pain walking (no sticks), limp when I first get up from sitting or out of car, hobble and pain when I get out of car , pain on right side (not constant ), can't bend to put socks on or tie my shoes, cant yet sleep fetal, operated leg over good leg, pain every time i get up from sitting and lying).

    Now 3½ months in OS says I have no flexibility in back and I should have new CT scan and schedule a facet block shot for my back.

    I feel so stupid, feel like I went through all of this for nothing - didn't need THR and even the hip component is having trouble healing. Feel like I will be back to where I began or worse. Please tell me I'm wrong. Josephine, I need your help!
     
  4. alexthecat

    alexthecat MODERATOR Administrator

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    @Jws.
    You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
    • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
    • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
    • Having only one thread will act as a diary of your progress that you can look back on.
    So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
    If you need an urgent response to a question, just tag a member of staff.
    How to tag another member; how to answer when someone tags you

    Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
     
  5. honeybeast

    honeybeast member

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    Hi jws

    I have similar symptoms to you. Confirmed arthritis in both hips, painful chondromalacia in both knees and debilitating back pain which is undiagnosed. One doc said it was SI joint dysfunction and suggested RFA (which was unsuccessful). OS said it's more likely spinal arthritis. Or it could be a herniated disc.

    I'e been struggling a lot with "what if I have this surgery and my quality of life doesn't improve cause I still have the back pain"

    I found this online

    http://holycrossleonecenter.com/blog/multiple-hip-knee-back-pain-issues-treat-first/

    And it helped reassure me I'm taking the correct steps. If I still have back pain I'm going to see an OS that specializes in spinal problems. But I can only address one thing at a time.

    I know this may not help your specific situation, except to know that you are not alone.
     
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  6. Jws.

    Jws. junior member
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    Hi honey, thanks for the reply.

    You said it best "what if I have this surgery and my quality of life doesn't improve cause I still have the back pain"....that is what is the most discouraging. We go through this major surgery with the idea that it will "cure" us and we feel like we were either "sold a bill of goods" or we made a long term, uncorrectable wrong choice that got us into a bigger mess than before. You sound like you were really in pain in your hip problem so your choice was more clear.

    I was in pain doing certain things, in and out of car, sitting and getting up pain - general getting older pain but nothing really debilitating.
     
  7. GrannyC

    GrannyC post-grad

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    I also had lower back pain prior to THR. I really thought it might be from my hip so I asked my OS and he said it was not and the surgery would not help my back. I had THR one year ago and my hip is now fine. I did find that it helped my back a little bit but did not eliminate my back pain. I’m sure my improved gait is part of the reason it helped my back a little but keep in mind that each and every one of us is quite different. We are dealing with different issues and we all recover st different rates. If you feel you are having problems, the first person I would consult was my OS and see what he/she has to say about it. You might consider making an appointment if you don’t have one coming up in the not too distant future.
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    You need to read this again and again. It's key.
    It happens.
    Not at all. It happened that you had a duff hip AND a bad back. I can assure you the surgeon wouldn't have done the hip if he didn't believe it to be necessary. The fact that you ALSO had a bad back was serendipitous and wouldn't alter your need for a hip replacement.
    Would you expand on this?
     
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  9. Jws.

    Jws. junior member
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    @Josephine (need your help and wise advice!!)

    I am 4 months (Feb 1) post posterior hip replacement. The first two months I was healing nicely, walking 45 minutes a day no sticks , no pain, driving, wound healed perfectly and everything ok.

    Only problem was the usual sitting or driving too long (15 min) would hobble and limp on getting up and would walk it out and get back to gait. Usual healing pains, groin occasionally, thigh, but nothing constant. Recently, was still hobbling on getting up (4 months) . OS first said possible psoas, recommended more PT and facet shots for back, X rays normal. PCP also chimed in and 2nd opinion OS diagnosed trochanteric bursitis.

    My concern of infection is I am not healing as fast as before. My recovery slowed. I also had sore throat (took prophylactic course of amoxicillin - cultured for strep-negative) and then three weeks after the sore throat and course of antibiotics, woke up at 4 am with chills and needed extra blankets and clothes. Went to PCP, temperature of 100.3. Again, immediately started course of Augmenten, bacterial culture came back negative for bacteria.

    Felt like everything was aching thigh, groin,muscles for two days. Felt better after two days. Went back to walking for an hour a day and PT. Then began having groin pain like it wasn't attached two hours after and day after walking. Groin pain was during time I was getting over non bacterial infection when I was feeling sick.

    Presently no groin pain during walking, no groin pain at night sleeping, no redness wound, no pain while sitting or laying down.

    Here is latest email from OS:
    "What you’re telling me is a little concerning, on a couple of levels. Let me try to break it down:

    1) While I wouldn’t necessarily expect you to feel like a 20 year-old right now, I would expect your hip to be feeling better. I don’t like the groin pain, but it’s not raising serious alarms. I would like the groin pain to be getting better, not worse. Plus, you had a posterior approach and not an anterior approach, right? That would mean less groin pain. Let’s be vigilant. While it’s rare to have an early post operative infection, it’s not unheard of. Groin pain could be an indication of benign processes like just tendinitis or something.

    2) I hate that you developed an infection (upper respiratory) in this near post op period. Let’s see how you’re feeling after you complete the antibiotics. Any bacteria in the blood stream can pass by your hip and make hay. And FYI, total joint infections don’t always act like regular infections. They don’t always get red and hot and drain. They can be a little more indolent.

    (* I am feeling fine after antibiotics, there was no bacteria in cultures)

    3) I don’t like overall, that you’re just not feeling up to snuff. Do you have any calf pain or sudden increase in leg swelling? As in a DVT? Important. If you do, it’s off to the ER.

    (*no calf pain, no sudden increase in leg swelling)

    Keep me posted.

    And take it slow on the walking. Don’t get yourself tired out. And too much exercise can strain muscles and tendons, like the flexor tendons in the groin. How about a stationary bike?

    Oh...and did I ask you if you have calf pain."
    (* no calf pain)

    Why am I not healing? I am concerned an infection is holding everything up? my blood tests showed creac 2.5, wbc 11.3 and ESR 11.

    Please thoughts and advise needed here. Don't want to worry about infection. Thanks
     
  10. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hi @Jws.
    You'll notice that I have merged your newest thread with your original recovery thread. This is the second time your threads have been merged. Please don't keep starting new threads.

    For several reasons, we prefer that you only have one recovery thread:
    • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
    • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
    • Having only one thread will act as a diary of your progress that you can look back on.
    So please post any updates, questions or concerns about your recovery here.
    Don't worry that we won't see your question because, between us, the staff read all new posts every day.
    If you need an urgent response to a question, just tag a member of staff.
    How to tag another member; how to answer when someone tags you

    If you prefer a different thread title, just post what you want and we'll get it changed for you.

    Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
     
  11. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I see that you haven't been given the post-op reading that we give to everyone, so here it is:
    Hip Recovery: The Guidelines
    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)​
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
    4. PT or exercise can be useful BUT take note of these
    5. At week 4 and after you should follow this

    Pain management and the pain chart
    Healing: how long does it take?
    Chart representation of THR recovery
    Dislocation risk and 90 degree rule
    Energy drain for THRs
    Pain and swelling control: elevation is the key
    Post op blues is a reality - be prepared for it
    Myth busting: on getting addicted to pain meds
    Sleep deprivation is pretty much inevitable - but what causes it?
    BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

    While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
     
  12. Jws.

    Jws. junior member
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    Hi @Celle, Josephine, got it, sorry. Will write all questions on the one thread.

    Is there a way someone preferably Josephine can respond to my concerns regarding "infection" of the prosthesis.

    It is really troubling that I all of a sudden had a halt in my forward progress and "is it normal " at four months to have on and off groin pain (btw after not walking for two days I have not had any groin pain)..if it was infected would the groin pain be constant (even when I sleep) and would it be severe? Are there any other major indications of infection other than redness and pain at the wound site (which I don't have).

    Please respond , I want to go on with my PT and walking but am hesitant to trigger the groin pain?

    I don't feel sick or have flu like symptoms. The concern that I may have an infected prosthesis stopping my progress is obviously depressing. Could it just be normal groin pain off and on after walking and not associated with infection? From reading most of these posts groin pain seems to be gone and healed after 4 months. Also, I have read in most of the infection posts that the groin pain is "sudden and severe" during infection.

    I would appreciate the help . Thank you.
     
    Last edited: Jun 10, 2018
  13. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi there,
    I'm really sorry you're suffering pain. I understand your concern and why you're seeking answers.
    I hope you soon find them as well as a solution to remedy the pain. I noticed you tagged, Josephine, a couple posts up. She is very busy as I'm sure you understand and she resides in the U.K.
    so there is a time difference. I know she'll get back to you as soon as she's able.
    Prayers for your comfort and peace of mind as you wait.
    @Jws.
     
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  14. Jws.

    Jws. junior member
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    @Layla..thank you layla...
     
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  15. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    @Jws. I'm here!

    Having carefully read your posts, I have to say that I think you are worrying unnecessarily. What you are describing is a) a strep throat and b) some tendinitis. Neither connected with the other.

    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?
     
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  16. MammaT

    MammaT supremo

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    Hi @Jws. I am four months out from second hip replacement and if I over do things, I can still get some groin pain. I really have to make myself listen to my body. If it kicks in after I try to lengthen my walk, I back off the distance.

    Are you still icing when things act up? I didn't use ice as much with my first replacement, and I think it has made a big difference this time.
     
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  17. Jws.

    Jws. junior member
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    @Josephine,
    I am appreciative of all the advice I can get now.
    Yes , of course , ask me any questions you feel are necessary...
    I am looking forward to your help!!!!
     
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  18. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

    1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

    2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    4. are you icing your painful area at all? If so, how often and for how long?

    5. are you elevating your leg. If so how often and for how long?

    6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    7. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  19. Jws.

    Jws. junior member
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    1. posterior
    2. 0-2 pain level (none sitting, sleeping, laying down, walking (stiffness-1-2) and-just getting up and down from sitting,car bed and first 10 steps thereafter-2) - couple of hours after walking 2 hobbling again
    3. no pain meds ( OS month ago prescribed celebrex 500 mg 2x day when he felt PT wasnt going as well as it should)..none now..
    4. no icing
    5. no elevating
    6.go to work at office, drive, sit for 8 hours, get up two -3 times per day (15 minutes each time)
    7.I try to do one hour of walking every day ...last couple of days cut it down to 30 minutes a day (groin pain feels better 0-1)
    20 minutes of stretching (3reps x 20 secs each leg runners calf stretch,3 reps x 20 secs each supine piriformis stretch, 3reps x 20 secs each leg standing quad stretch, 3 reps x each leg 20 secs each hamstring stretch with towel) (one session)...
    8. 3 times per week PT , 10 minutes walking, 30 minutes of the same sets of stretching as above.

    hope this was accurate enough for you. thanks again josephine
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    hmmm ..
    okay
    okay
    okay

    Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.
     

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