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I apologize for the length of this post but I am really upset - barely slept last night. I am hoping that those of you who have gone through this (and those that haven't) can provide some insight and advice.
I have been in alot of pain (with swelling) since my TKR in May of last year and subsequent MUA in August. Even pain management has not been 100 % effective. While I have always felt the implant moving in my knee for the last couple of months everytime I move it I feel/hear it "thudding" - the only way I can describe it. The pain has also increased and I also developed numbing in the lateral part of the knee and the toes on the outside of my foot. In addition for the past week or so I have had burning in the joint area and sometimes over my entire knee.
Given the above I made an appointment with a new ortho surgeon because I was not especially happy with my original surgeon. After examining my knee he felt that the implant was loose but ordered blood work (sed rate and C reactive protein) and a MARS MRI to rule out infection and for a better picture of the implant prior to scheduling revision surgery. I was able to view my lab results online which indicated the below:
Sed rate 46 mm/h - high ( in range is <OR=30 mm/h
C-reactive protein 11.3 - high (in range is < 8.0 mg/L
So I called the dr. to make an appointment after June 1 for insurance reasons and asked if it was ok to wait this long given the out of range lab results. I was told that he wanted to see me sooner rather than later. So I went to see him on May 24th.
At the time of the visit he told me that I had an infection which would require the two stage surgery - the first to implant a cement spacer with antibiotics followed by at least 6 weeks of IV antibiotics via a picc line and the second for the actual revision. He also told me that he would not aspirate at this time to determine the type of infection because he did not feel it prudent to do so and that this would be done at the time of the surgery at which point the type of infection would be identified and the proper antibiotic prescribed. He also said that I must have a really good immune system as he was surprised that the infection has not caused sepsis. I should mention that he had not yet received the results of the MARS MRI which I found really surprising given that I had had it a week and a half before my appointment and while he may not have had the CD of the images the hospital where I had it should have faxed the report. He did not seem too concerned that he did not have this report but did say he needed it prior to surgery.
He did not feel I should wait 6 months for the first surgery but also did not feel it urgent enough to get it done a.s.a.p. When the surgical coordinator came in to schedule my first surgery I got the first available date of 7/6. At that time she told me that if the doctor felt the infection was really serious he would have immediately sent me to the ER as he had done with other patients,
I was telling one of my friend about this and she got really angry telling me that the doctor was full of crap. That while my labs were slightly elevated that this was not indicative of an infection and that if I really had one the results would be in the thousands. She was basing this on what her lab results were regarding a thyroid condition that while elevated was told by her doctor that they would have had to have been in the hundreds to correlate to this particular condition. She also said that there was no way my immune system had anything to do with me becoming septic and that there was no danger of that because she went through it with her husband who had a brain aneurysm and after his last surgery developed it and subsequently died when he went into septic shock. She thought the doctor was using this as a scare tactic and that if he really felt that I had an infection he would not allow me to wait 6 weeks for surgery, She then said that while she thinks I do have a problem with the implant that she does not think I have an infection or I would be really sick and that the only reason he wanted to do the two stage revision was to make money not caring about what I would have to go though. Lastly, she said I need to get a second opinion.
I just think that she is projecting her experience with her husband onto my condition which is comparing apples to oranges as her husband's was extremely dire from the start. I also think she has a general distrust for doctors which is further clouding her judgement,
I know none of us are doctors but I was hoping someone could answer my below questions based upon their experience:
If you have gone through this did your doctor aspirate your joint to confirm that you actually had an infection before scheduling surgery?
If not were you placed on any type of antibiotic before surgery to try to eradicate the infection prior to having the surgery to insert the spacer with antibiotics?.
Did you have the above labs and do you recall how high your results were and whether the results would have been extremely high if in fact an infection was present.
After the first surgery were you mobile with just a spacer in your knee - could you get around with a walker or crutches?
Were you in alot of pain afterwards?
Did you have a picc line for the antibiotics to be administered or did you have a regular IV?
Anything else I should know about the first surgery and then the actual revision surgery?
Laslty, do you think there is ANY validity in what my friend is saying and should I listen to her?
Thank you so much for any input on this, I really appreciate it!
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