My mother is in ICU! After 10 weeks of total knee replacement

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Hey all!

My mother had bilateral knee replacement on 18th Dec 2015, her age is 68. Surgery went well, but after 24 hours of it, due to poor pain management, stomach bloated and she went into icu for 8 days, all her values BP, PR, etc went bad, counting long story short we brought her back home at 20th day after surgery. She started walking few steps, but after 4 weeks, she started falling down during her walk. We went to doctors they said its due to weakness you need to increase her diet. She refused to eat, her electrolytes went down sodium is at 111. Every other report like heart/stool/etc are all fine. Doctors said its due to loose motions of 8 weeks. They have her vancomycin capsules yesterday.

Please anyone out there could help in guiding any further solution. Is this normal?

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  • Posted

    I can understand the weakness. Without any therapy for so long I'm sure not only he legs but arms have atrophied. I'm not sure why the vancomycin is being used unless there is an infection that is being battled.......and if there is an infection" where is it. What is the dosage and frequency. I had a staph which I had to fight twice. The 1st time I was on vanc by infusion. They insterted a PlCC line and I had morning and evening infusion. After 8 weeks they gave me 300 mg 3x's daily and I was expected to be on it permanently. Apparently it failed to work and they had to remove my prosthesis, go back to the infusion and after 4 months install another appliance. I'm thinking this is another type infection that isnt directly related to the tkr itself. Is there a physical therapist working with your mother daily. I don't know where you are and how your system works but if possible, I would seriously consider getting her into a rehab center so she could have full time professional assistance. 3 weeks in a place like that would have her back up on her feet properly. I was 10 years older than her when I went through all of this. Having to deal with a situation like this is very difficult for people with no training and the emotional attachment as well. I'm in the US and our hospitals all have trained social workers to analyze and make recommendations in situations like this. Hope you get son help soon
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    • Posted

      Hey there!

      Thank you for your reply n kind words. According to doctors she is having multiple infections in urine and in stomach (may be, it's till have to figure out somehow). Her upset stomach is the main cause after the mishandling of pain management. Morphine was given in very high dosage within first 24hours. Which causes body to bloat.

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  • Posted

    Hi Baqir!

    Welcome to the Knee Forum of patient.info!

    I am very sorry to hear that your mother has had such a rough time following her bilateral knee replacement in December.

    When anyone of any age undergoes surgery of any kind it is trauma to the body. Although most surgery is successful with minimal issues in recovery, many people DO suffer setbacks. The knee surgery is very complex. When both knees are done at the same time there's two knees to deal with and double the trauma to the body.

    Your mother was stable then took a turn for the worse. It's a good thing that they placed her in ICU. There is around the clock care in ICU. We have had several members in UCU and were very impressed with the careful monitoring.

    Since your mother WAS sent home, she apparently WAS stable. Something went wrong after the fourth week. I'm guessing Vancomycin is an antibiotic. Is that correct? Infections can set in at any time and cause further trauma to the body that is trying to heal.

    How is her blood pressure? Low blood pressure can cause you to feel weak and faint. I experienced this my first day after surgery.

    It is hard to eat when you are feeling sick. Nausea is, unfortunately, all too common with knee surgery, use of PAIN meds, etc. I was nauseated with my first knee replacement but not with my second four months later.

    If your mother has an infection, it is VERY IMPORTANT to get it under control. If she continues to be weak and unable to eat, it makes it harder for her to get up and moving. That brings MORE possibilities of blood clots forming which can be life-threatening. If she is falling, that, too, is quite serious.

    If she was my mother I would take her to the emergency room right away. Sounds like she is suffering more complications.

    I hope that things will be better for your mother very soon!

    Please let us know how she is doing tomorrow.

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    • Posted

      Hey cherry!

      We took her to emergency two days back and they admitted her in ICU. Vancomycin is an antibiotic. She is having very low BP. 95/65. And it varies. From past 14 days she was complete bed ridden. She was unable to stand on her own. We thought she might be having depression attack. So we took her to psychariest. Dr. Explains completely and gave her anti depressants but in that return she kept on sleeping and unable to stand.

      One 10 days ago we went for the cardiac specialist to roll out blood clot possibility. All tests where clear with the grace of God.

      Now she is on medicinal help. They have checked her stool, her urine her. Her TLC was 15. I'm unable to attach the reports. Sodium 111.

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    • Posted

      Hello Baqir

      You mentioned she has stomach pain- does she have any kind of mesh inside her from a previous op? Anything foreign, other than tkr?

      Thinking something , like a mesh, could be infected and docs may be unaware she has it from prev op years ago.

      Have a sit down with the docs involved and have them be upfront with you on what they have ruled out and what game plan. Let us know how she's doing.

      Elaine

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    • Posted

      Hey Elaine!

      No she doesn't have anything before operation in her stomach.

      Now doctors are only trying to maintain electrolytes.

      I'm regretting why I made her do this operation.

      Please pray for her.

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    • Posted

      So glad she is in the ICU! Knee replacements are MAJOR SURGERY, and often the body has a very adverse reaction to the trauma of it all. Add infection, and things get pretty scary!

      Many on this site have experienced complications following knee replacement surgery.

      I'm glad she is being monitored and cared for at the ICU.

      Sending prayers of strength and healing for her today!

      Keep us posted on her progress, OK?

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    • Posted

      Sure! Will keep you posted. You guys can tell me if the doctors treating her right.

      Her vitamin d is < 3. now they asked for ggt lab and test. they fiona check on liver i guess.

      thank you for your prayers. 3.="" now="" they="" asked="" for="" ggt="" lab="" and="" test.="" they="" fiona="" check="" on="" liver="" i="" guess.="" thank="" you="" for="" your="" prayers.="">

      thank you for your prayers. >

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    • Posted

      Don't put yourself on a guilt trip. Just take a step back and give it time for the body to do its thing. It may take a while but as I have said before, focus on the process not on the end result.

      Prayers for your mother

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  • Posted

    I had a UTI while on the 900 mg daily of vanc. Dr's would have added a drug like bactrim but imnhighly allergic to sulpha so they had to go to another family of drugs. They all said vanc wouldnt touch urinary/bladder/kidney. Maybe they will add ano ther for that infection. Actually I'm surprised the don't have her on IV medication. To speed up the med delivery. Cut down the chances of causing the stomach problems and add more fluids. Then again every Dr had his own methods dpending on the situation. Low BP would certainly be a cause for weakness and the inabilitity to walk. Late Nov of 2014 I was feeling I'll one Monday morning and went back to bed. Stopped eating and drinking much and Wednesday morning collapsed in the hall landing squarely on both knees and forehead, splitting the head to the tune of a 6 stitch gash but when the ambulance came to scrape me up off the floor my BP was 88 /50. 5 days in the hospital t o cure a bladder infection and get my BP back up to functioning properly. Found out one thing in the test fall, the tkr sure is a solid, hard to damage, item. 200 lbs full force on hardwood floor, no damage. Of course , like the ER Dr said, with my head, they were sure the fallwouldnt cause any damage. Don't let the Dr's look for an easy way out.
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