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Medical Forum / Diseases and Disorders / Arthritis / October 2006

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Update on sister #1

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RoseB - 17 Oct 2006 14:48 GMT
As you may remember my eldest sister had a tkr over a year ago, on
September 21st. In the year since she has been fighting an infection
in the incision, has had a vena cava filter installed, has had several
surgeries to debride the area, and finally had the prosthesis removed
and a "puck" put in.

I believe it is now about a month since the surgery, and she is still
fighting infection. She is developing another cavity and they are
working to keep that area closed. She is on IV antibiotics that she
self-administers and public health nurses come each day or every
second day (I'm not sure exactly) to change the dressing and etc.

At her follow-up appointment the surgeon seemed very concerned that
she is not improving, and he advised that if things don;t change, he
may not be able to put a prosthesis in. That means that she will have
a knee without a joint.
My sister is a very social person, and this forced immobilization has
been very difficult for her. If she is to spend the rest of her life
dependent on someone, she will not do well at all.

She could use your thoughts and prayers.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Harvey R. Stone - 17 Oct 2006 14:54 GMT
Hi Rose,,,,   What your sister is going through is anyone's worst nightmare.
She will be prayed for today.   Tell her not to give up,,, to keep fighting
with a positive outlook and keep use informed on how she is.
Harv

> As you may remember my eldest sister had a tkr over a year ago, on
> September 21st. In the year since she has been fighting an infection
[quoted text clipped - 22 lines]
>
>     Please remove "Ima" to reply.
RhondaM - 17 Oct 2006 19:20 GMT
I Am sorry that you sis has to go through so much. Just when a person thinks
they are going through a bad time you hear about someone worse off than
yourself. Kind of puts things in perspective. I will say a prayer for her.
RhondaM

> As you may remember my eldest sister had a tkr over a year ago, on
> September 21st. In the year since she has been fighting an infection
[quoted text clipped - 22 lines]
>
>     Please remove "Ima" to reply.
ladylove77 - 18 Oct 2006 03:55 GMT
Rose, that really isn't good news!  I know we had all hoped that the
infection would disappear with the replacement that came out.  Will be
praying for that to happen.
Gwen

> As you may remember my eldest sister had a tkr over a year ago, on
> September 21st. In the year since she has been fighting an infection
[quoted text clipped - 22 lines]
>
>     Please remove "Ima" to reply.
d'huit - 18 Oct 2006 07:06 GMT
how disheartening. ((((((((((((((((((you and your sister))))))))))))))))
she certainly has mine, rose.  i'm sorry this has been such a difficult
journey for her.  i'm going to do some healing visualizations for her,
visualizing the ulcerations clearing the infection and healing themselves
closed.  my heart goes out to you both.

kate

As you may remember my eldest sister had a tkr over a year ago, on
September 21st. In the year since she has been fighting an infection
in the incision, has had a vena cava filter installed, has had several
surgeries to debride the area, and finally had the prosthesis removed
and a "puck" put in.

I believe it is now about a month since the surgery, and she is still
fighting infection. She is developing another cavity and they are
working to keep that area closed. She is on IV antibiotics that she
self-administers and public health nurses come each day or every
second day (I'm not sure exactly) to change the dressing and etc.

At her follow-up appointment the surgeon seemed very concerned that
she is not improving, and he advised that if things don;t change, he
may not be able to put a prosthesis in. That means that she will have
a knee without a joint.
My sister is a very social person, and this forced immobilization has
been very difficult for her. If she is to spend the rest of her life
dependent on someone, she will not do well at all.

She could use your thoughts and prayers.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to
understand it. RB

    Please remove "Ima" to reply.
RoseB - 18 Oct 2006 14:39 GMT
>how disheartening. ((((((((((((((((((you and your sister))))))))))))))))
>she certainly has mine, rose.  i'm sorry this has been such a difficult
[quoted text clipped - 3 lines]
>
>kate
Thanks Kate. It has been quite a process.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Cindy - 18 Oct 2006 14:27 GMT
Rose,
I cannot imagine the nightmare this has been for your sister. I do pray that
it is over soon and with a good ending..
Hugs Cindy
> As you may remember my eldest sister had a tkr over a year ago, on
> September 21st. In the year since she has been fighting an infection
[quoted text clipped - 21 lines]
>
>      Please remove "Ima" to reply.
RoseB - 18 Oct 2006 14:38 GMT
>Rose,
>I cannot imagine the nightmare this has been for your sister. I do pray that
>it is over soon and with a good ending..
>Hugs Cindy
Thank-you, everyone. It has certainly been an ordeal. I will pass on
your good thoughts.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
johnie - 18 Oct 2006 18:36 GMT
Rose, was the surgeon able to put a time frame on the prosthesis being
used or not. I cannot imagine how awful this experience has been for
her. She is in my thoughts for a positive outcome.

johnie
RoseB - 19 Oct 2006 05:36 GMT
>Rose, was the surgeon able to put a time frame on the prosthesis being
>used or not. I cannot imagine how awful this experience has been for
>her. She is in my thoughts for a positive outcome.
>
>johnie
Thanks Johnnie,
I think they will know in about two weeks. IN the meanitime they have
ordered a device of some sort that will keep the sinus area closed. I
have not seen this so can not elaborate.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Kelly - 19 Oct 2006 18:04 GMT
Rose,
I am sending prayers that everything will work itself out.  Is this a good
doctor or is it time to get someone new?  Is she still dealing with the guy
on the coast?

Can't imagine what she is feeling.  Give her my best please and tell her I
am hoping for a great outcome.

Kelly

>>Rose, was the surgeon able to put a time frame on the prosthesis being
>>used or not. I cannot imagine how awful this experience has been for
[quoted text clipped - 10 lines]
>
>     Please remove "Ima" to reply.
Squirrely - 19 Oct 2006 22:17 GMT
Rose,

I agree with Kelly and what she said. My prayers are with your sister. I
hope this finally gets resolved. She has been suffering with this too too
long.

Signature

  Love and hugs Jo

   (\__/)  .~    ~. ))
  /O O  ./      .'
 {O__,   \    {
   / .  . )    \
   |-| '-' \    } ))      Warning: squirrels.
  .(   _(   )_.'
 '---.~_ _ _&
"> Rose,

> I am sending prayers that everything will work itself out.  Is this a good
> doctor or is it time to get someone new?  Is she still dealing with the
[quoted text clipped - 4 lines]
>
> Kelly
RoseB - 20 Oct 2006 00:52 GMT
>Rose,
>
>I agree with Kelly and what she said. My prayers are with your sister. I
>hope this finally gets resolved. She has been suffering with this too too
>long.
It is so frustrating because she was in better shaper before having
the surgery. Her other knee could be done but of course she won't risk
it now. I really can't imagine what it will be like if they can not
put in a prosthesis. I guess you adjust, it is just that with a knee
that does not bend you are really limited.
With her OA it is not the same as those of us who have been
immobilized for a while. Even in pain she was very much a go-getter,
has always had a spotless house, and was bery busy socially. Mentally
it has been a difficult adjustment. I mean it is for anyone, but maybe
we can be more accepting and go on because we deal with it on an
on-going basis. When you have an expectation that you can and you can
not it is hard to accept.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Squirrely - 20 Oct 2006 18:20 GMT
Rose,

I saw your response to this and must have deleted it. So I am responding
here.

I am sorry that it is so frustrating for her. I would be frustrated too if I
had been better before surgery. I feel for her and my heart goes out to her.

It has to be hard for her with her go-getter ways and now having to be so
layed up with this all.

yes, I agree with you on the statement you made about When you have an
expectation that you can and you can not it is hard to accept.

I will be keeping her in my prayers and hopefully soon and I mean really
soon something will change and the infection will just disappear or the drs
will find something that will really work.

Send your sister my love and thoughts. I truly do feel for her.

Signature

  Love and hugs Jo

   (\__/)  .~    ~. ))
  /O O  ./      .'
 {O__,   \    {
   / .  . )    \
   |-| '-' \    } ))      Warning: squirrels.
  .(   _(   )_.'
 '---.~_ _ _&

>>Rose,
>>
[quoted text clipped - 18 lines]
>
>     Please remove "Ima" to reply.
RoseB - 21 Oct 2006 02:36 GMT
>Send your sister my love and thoughts. I truly do feel for her.

Thank-you SJ. I will definitely do so.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Nann Bell - 22 Oct 2006 15:27 GMT
> With her OA it is not the same as those of us who have been
> immobilized for a while. Even in pain she was very much a go-getter,
[quoted text clipped - 3 lines]
> on-going basis. When you have an expectation that you can and you can
> not it is hard to accept.

I know just what you mean.  That is why I came here to ask about bunion
surgery rather tahn accepting what my mom had heard from some of her friends.
Our expectations for outcomes are so different, as well as our perception of
pre- and post-operative pain.

I would think for your sister the huge difference in activity level caused by
this ordeal would make the mental adjustment even harder.  We all know how
difficult that change is.  And of course dealing with a chronic infection
affects her whole body and her ability to function.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

RoseB - 20 Oct 2006 00:49 GMT
>Rose,
>I am sending prayers that everything will work itself out.  Is this a good
[quoted text clipped - 5 lines]
>
>Kelly
No Kelly, she went to Kamloops this time, and the surgeon seems very
good. He is one of our South African docs. It is a problem when a job
is botched because sometimes other docs will not touch it with a ten
foot pole. This doc seems to be checking into everything really well.
I will give her your regards.
Thanks.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Harvey R. Stone - 20 Oct 2006 14:50 GMT
>>Rose,
>>I am sending prayers that everything will work itself out.  Is this a good
[quoted text clipped - 13 lines]
> Thanks.
>     Rose   @}>->--

Hhhhm,   One of our South African docs,,,, I bet there is a story there.
Want to tell us why you would have S.A. docs?
Harv
RoseB - 20 Oct 2006 15:04 GMT
>Hhhhm,   One of our South African docs,,,, I bet there is a story there.
>Want to tell us why you would have S.A. docs?
>Harv

In Canada we have many doctors from South Africa. They leave their own
beautiful country and come to work here. In this small town we have 6
doctors, and 4 of them are from South Africa. In general terms these
docs are very well trained.

I can not speak to the political situation that brings them here, but
know that many feel that it is better for them to emigrate than to
deal with whatever is going on there. We seem to have a shortage of
docs so the ones from S. Africa are very welcome.

My doc is from S, Africa, and if he goes away for a bit he gets a
locum from Capetown. I have asked Dr. Wahl if he knew drdoc. He spoke
very highly of him, commenting that he was _the_ best rheumatologist
in South Africa. I thought that was pretty neat. We know how great he
is because of the work he has done here and on his website, but to
hear one of his countrymen confirm it made it seem even more to be the
case.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Harvey R. Stone - 20 Oct 2006 17:18 GMT
>>Hhhhm,   One of our South African docs,,,, I bet there is a story there.
>>Want to tell us why you would have S.A. docs?
[quoted text clipped - 18 lines]
> case.
>     Rose   @}>->--

Thank you for the reply.   I hope drdoc is OK.   I am sure you feel blessed
to have the doctors in your country.   They could take what they are with
them.   The people that had farm and ranches for over 200 years could not do
that as they had to leave their homes in  South Africa.   So it goes.
Harv
d'huit - 26 Oct 2006 04:54 GMT
On Fri, 20 Oct 2006 13:50:02 GMT, "Harvey R. Stone"
<hrstone@swbell.net> wrote:

>Hhhhm,   One of our South African docs,,,, I bet there is a story there.
>Want to tell us why you would have S.A. docs?
>Harv

In Canada we have many doctors from South Africa. They leave their own
beautiful country and come to work here. In this small town we have 6
doctors, and 4 of them are from South Africa. In general terms these
docs are very well trained.

I can not speak to the political situation that brings them here, but
know that many feel that it is better for them to emigrate than to
deal with whatever is going on there. We seem to have a shortage of
docs so the ones from S. Africa are very welcome.

My doc is from S, Africa, and if he goes away for a bit he gets a
locum from Capetown. I have asked Dr. Wahl if he knew drdoc. He spoke
very highly of him, commenting that he was _the_ best rheumatologist
in South Africa. I thought that was pretty neat. We know how great he
is because of the work he has done here and on his website, but to
hear one of his countrymen confirm it made it seem even more to be the
case.
    Rose   @}>->--

i had a young female pcp, just before the pcp i have now, who was from south
africa.  she was incredibly charming, as well as being extreemly  competent.
it was sad for the staff when she went back and she's still very missed.  i
miss her too.

kate

    Being educated means that rather than fearing the unknown, one seeks to
understand it. RB

    Please remove "Ima" to reply.
Nann Bell - 20 Oct 2006 13:20 GMT
Oh no.  I was so certain that once they got that prosthesis out of there
she'd beat off the infection.  This must be incredibly discouraging for her.

Do you all have full confidence in the doctors who are treating her?  Is
there any chance of her seeing someone else who might be more experienced in
cases such as hers?  I figure such responses to tkrs can't be common.

If they can ever get that blasted infection killed off, she will surely feel
better and be better able to deal with getting out and about without a knee,
but it really doesn't seem right that she should have to do it.

An afterthought - have they investigated the possibility that part of the
infection is a reaction to the surgical materials?  I'm just remembering that
when my dad had his ankle fused in the early days of such fusions, he had
external pins in it for a couple of months and had an ongoing infection
requiring Cipro the entire time.  They decided it was a reaction to the pins.
Sure enough, within two weeks of having the pins out he was infintely better
and having the infection gone did so very much for his overall health.  I
don't know if there's any possibility your sister is even reacting to the
"puck" or what they could do if she is, but it's a thought.  Her system must
be so overly sensitized after this horrible year she's had.

Thoughts and prayers for her are continuing.

Signature

Nann
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Simply the thing I am shall make me live --- William Shakespeare

Harvey R. Stone - 20 Oct 2006 14:53 GMT
> Oh no.  I was so certain that once they got that prosthesis out of there
> she'd beat off the infection.  This must be incredibly discouraging for
[quoted text clipped - 27 lines]
>
> Thoughts and prayers for her are continuing.

Ya know,,,, I had a good friend that compound fractured his leg on a rug on
his stairs that had the same problem with pins.
Harv
RoseB - 20 Oct 2006 14:56 GMT
Hi Nann,
This puck thing delivers antibiotic directly to the site, as far as I
know. She has a new surgeon now and is confident in his skill level.
He is certainly more proactive. He has ordered a device (that i have
not seen so can not elaborate on) that is to keep the wound closed.
Maybe this is what Diane Witt had once for one of her wounds that
would not heal.
I think they have considered all possible reasons about why this has
continued. She gets daily nursing care so that helps. She does her own
IVs.
Thanks for your concern and I will pass on the message.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Nann Bell - 22 Oct 2006 15:27 GMT
> Hi Nann,
> This puck thing delivers antibiotic directly to the site, as far as I
[quoted text clipped - 8 lines]
> Thanks for your concern and I will pass on the message.
>      Rose   @}>->--

It's good to know she has a surgeon who has her confidence.  That makes such
a difference.  I am praying that he was just preparing her for the worst case
scenario, but that the best case option will still be the result.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

RoseB - 22 Oct 2006 18:29 GMT
>It's good to know she has a surgeon who has her confidence.  That makes such
>a difference.  I am praying that he was just preparing her for the worst case
>scenario, but that the best case option will still be the result.

Thank-you, Nann. As of Friday, it looked as though the wound was
starting to close. We just need to keep praying that it continues to
do so.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Ginnie - 24 Oct 2006 07:47 GMT
Hi, Rose,

Pardon me for coming in late on this thread, but I've been "out
of commission" for a few weeks from one nasty fall, then one stupid fall!

Just the other day at the pain doc's waiting room, I ran into a fairly young
woman (she looked about 30) who was dealing with infections like
your sister's, but hers were in both hips!  Yeouch!

For whatever reason, she had both hips replaced when she was
about 25, and did really well until late last year, when she got an
infection (traveled from somewhere else in her body) in her right hip.
She was hospitalized on major antibiotics, and the original device
was removed, and she was either jointless or had some kind of "puck"
for a while.

They were successful in killing off the infection, and then giving her
yet another right hip joint.  But the infection managed to travel to her
OTHER hip in the meantime. (Why they could stop it in one hip and
not the other is a puzzlement to me.)

When I met her, she was a couple of months into a new bunch of
antibiotics, with the old replacement hip still in place.  They had
taken a different tack with the infection in the left side, and briefly
knocked her out so they could get a needle into the joint to biopsy
the infected tissue, and at the same time, inject bunches of antibiotics
directly into the joint area.  I 'think' she said they'd sedated her
and injected the anti-b's twice.  They never removed the fake joint
on that left side, left it in place while they were treating her, and
they were now satisfied that the infection was a done deal.  And she
was about to be sent into surgery again to remove the old one, debride
the area, and if it looked as clean as they thought it should, give her
yet another left knee joint.

Man, what an ordeal!  Your sister's problems are just as mind-boggling
as this girl's, and from talking to her, I got an idea of just how hard
this has been on your sister.  But I wanted to pass along this chance
encounter to you, so that it might help you or your sister, because
it actually helped *me*!  I've got a THR and a TKR coming soon,
and, instead of grossing me out, her story woke me up to problems
that *I* might face, that I had been blithely ignoring.  These surgeries
are no walk in the park.

So give your sister my very best wishes and a BIG hug, and tell her
that there IS a light at the end of the tunnel, and it ain't the train. :-)

Hugs to you both,
Ginnie     >^..^<
__________________________________

>> It's good to know she has a surgeon who has her confidence.  That makes such
>> a difference.  I am praying that he was just preparing her for the worst case
[quoted text clipped - 7 lines]
>
>      Please remove "Ima" to reply.
d'huit - 26 Oct 2006 05:05 GMT
Hi, Rose,

Pardon me for coming in late on this thread, but I've been "out
of commission" for a few weeks from one nasty fall, then one stupid fall!

Just the other day at the pain doc's waiting room, I ran into a fairly young
woman (she looked about 30) who was dealing with infections like
your sister's, but hers were in both hips!  Yeouch!

For whatever reason, she had both hips replaced when she was
about 25, and did really well until late last year, when she got an
infection (traveled from somewhere else in her body) in her right hip.
She was hospitalized on major antibiotics, and the original device
was removed, and she was either jointless or had some kind of "puck"
for a while.

They were successful in killing off the infection, and then giving her
yet another right hip joint.  But the infection managed to travel to her
OTHER hip in the meantime. (Why they could stop it in one hip and
not the other is a puzzlement to me.)

When I met her, she was a couple of months into a new bunch of
antibiotics, with the old replacement hip still in place.  They had
taken a different tack with the infection in the left side, and briefly
knocked her out so they could get a needle into the joint to biopsy
the infected tissue, and at the same time, inject bunches of antibiotics
directly into the joint area.  I 'think' she said they'd sedated her
and injected the anti-b's twice.  They never removed the fake joint
on that left side, left it in place while they were treating her, and
they were now satisfied that the infection was a done deal.  And she
was about to be sent into surgery again to remove the old one, debride
the area, and if it looked as clean as they thought it should, give her
yet another left knee joint.

Man, what an ordeal!  Your sister's problems are just as mind-boggling
as this girl's, and from talking to her, I got an idea of just how hard
this has been on your sister.  But I wanted to pass along this chance
encounter to you, so that it might help you or your sister, because
it actually helped *me*!  I've got a THR and a TKR coming soon,
and, instead of grossing me out, her story woke me up to problems
that *I* might face, that I had been blithely ignoring.  These surgeries
are no walk in the park.

So give your sister my very best wishes and a BIG hug, and tell her
that there IS a light at the end of the tunnel, and it ain't the train. :-)

Hugs to you both,
Ginnie     >^..^<

bummer about the falls, sweetie. hope you're doing much better now.

you're absolutely right.  we shouldn't be cavalier or blithe about any
surgery, even minor ones.  i remember how, at 23, i didn't think my first
leg surgery was going to be a big deal--until many surgeries and many years
later, to heal up from it all, changed my mind.  now, i have to warn any
surgeon, even for minor surgery, about the dormant infection in my body that
could be disasterous if it was activated again by a surgery.  and too, now i
always have to go through a preventative course of abx before any surgery.
major infections are no joyful experience.

kate
__________________________________

RoseB wrote:
> On Sun, 22 Oct 2006 14:27:30 GMT, Nann Bell
> <hanbellGOGATORS@earthlink.net> wrote:
[quoted text clipped - 13 lines]
>
>      Please remove "Ima" to reply.
RoseB - 26 Oct 2006 14:35 GMT
Hi Kate,
It's great that you are knowledgeable about your own body and can be
proactive with the abx.

I think that many of us do carry infections without knowing it.

I think my sister is starting to make progress and the wound vac
really helped.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
 
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