1. < Joint Replacements

What kind of mobility can I expect with an antibiotic spacer in my hip

Posted by mrfish @mrfish, Nov 3, 2017

About 11 months ago, I had a total (right) hip replacement. No injuries led me to the decision to undergo that, just arthritic pain that had become gradually worse over 20+ years. Several months after the surgery, I developed an infection at the joint but it took a while to get that properly diagnosed. So, in less than two weeks I'll undergo the first of the two surgeries/stages to elminate the infection and replace the implant. I've read that the antibiotic spacer I'll have for 2-3 months will provide "limited mobility" but I'm struggling with what that really means. I'd apperciate any further information I can get from others who have undergone this same procedure. I expect 2-3 days of hospitalization following the surgery and IV antibiotic infusions several times a day (self-administered).

I'm an (otherwise) healthy 48yo male and I was very happy with how quickly I was able to bounce back from the original hip replacment. I'm sure there will be a week or so of recovery from the surgery itself -- but after that am I going to be mostly home-bound for the interim, or is driving myself and working in an office setting (on a limited schedule) a possibility? What other aspects are there to living for a with a hip spacer?

Thank you in advance for your help on this,
Art in Alaska.

Interested in more discussions like this? Go to the Joint Replacements Support Group.

janelaine | @janelaine | Nov 13, 2017
In reply to @janelaine "I am scheduled for this surgery on Tuesday of this week. I have a fungal infection..." + (show)
@janelaine

I am scheduled for this surgery on Tuesday of this week. I have a fungal infection but won't know about a bacterial infectiion until they do the culture following implant of the spacer. I am told there is to be no weight-bearing on my right leg which means I will be confined to a wheelchair or walker or crutches. I've tried hopping around on a walker with one foot and find it very challenging. I am 78 yo. If you are fortunate enough to get rid of the infection in the first go round, I'd be doing the happy dance for you (yes, on one foot!) I would like to see that outcome for myself but don't want to get my hopes up.

I learned on Friday that I will not be doing PT following the surgery. Maybe down the road but don't know yet. I will be in a rehab center for what I hope is a short amount of time. Also been practicing pivoting on my good leg to chairs, the toilet, etc. and then lifting myself up on one leg. I like to think my body is developing a cell memory that will help make the transition easier. I have a regular wheelchair and a friend gave me a motorized wheelchair. I've used a cabulance to take me to appointments but will try getting into the car unless the pain is too much.

I have a supportive family and have done all the work to prepare myself physically, emotionally and spiritually at the recommendation of my surgeon who incidentally took some of his training at the Mayo Clinic. I will check in asap after the surgery.

Good luck to you.

Jan in Washington State

Jump to this post

Thanks. Don't know if I will have them or not. I'm busy packing. Arrival time at the hospital is 9 a.m. It's gonna happen. Best wishes to you for a successful surgery.

REPLY
mrfish | @mrfish | Nov 25, 2017

I finally made it home last night after a longer than exected 10 days in the hospital. The pain in the first few days following the surgery was something I could never have imagined. Fortunately, my ortho brought in a pain management specialist who inserted a pain block (nerve catheter, pump and bupivacaine) which was a huge improvement. The popping and grinding with the spacer is getting better as I move around more (on a walker), but movement is still quite difficult. For the self-administered IV antibiotics (vancomycin twice daily) I have a PICC line that runs through a vein in my right armpit, so using crutches is not allowed (or at least using a crutch on the right side).

Once I get settled in more at home I'll post more updates. Than you everyone for your advice and guidance. This has been quite an adventure so far, and it's still early.

REPLY
3 replies
lynzze | @lynzze | Nov 25, 2017
In reply to @mrfish "I finally made it home last night after a longer than exected 10 days in the..." + (show)
@mrfish

I finally made it home last night after a longer than exected 10 days in the hospital. The pain in the first few days following the surgery was something I could never have imagined. Fortunately, my ortho brought in a pain management specialist who inserted a pain block (nerve catheter, pump and bupivacaine) which was a huge improvement. The popping and grinding with the spacer is getting better as I move around more (on a walker), but movement is still quite difficult. For the self-administered IV antibiotics (vancomycin twice daily) I have a PICC line that runs through a vein in my right armpit, so using crutches is not allowed (or at least using a crutch on the right side).

Once I get settled in more at home I'll post more updates. Than you everyone for your advice and guidance. This has been quite an adventure so far, and it's still early.

Jump to this post

@mrfish So glad you made it home!! The first couple of weeks will be the worst but should gradually improve. I will be praying for smooth sailing from here on out!!! Thanks for the update!
Lindsay

REPLY
janelaine | @janelaine | Nov 25, 2017
In reply to @mrfish "I finally made it home last night after a longer than exected 10 days in the..." + (show)
@mrfish

I finally made it home last night after a longer than exected 10 days in the hospital. The pain in the first few days following the surgery was something I could never have imagined. Fortunately, my ortho brought in a pain management specialist who inserted a pain block (nerve catheter, pump and bupivacaine) which was a huge improvement. The popping and grinding with the spacer is getting better as I move around more (on a walker), but movement is still quite difficult. For the self-administered IV antibiotics (vancomycin twice daily) I have a PICC line that runs through a vein in my right armpit, so using crutches is not allowed (or at least using a crutch on the right side).

Once I get settled in more at home I'll post more updates. Than you everyone for your advice and guidance. This has been quite an adventure so far, and it's still early.

Jump to this post

Welcome home. Sounds like you had a lot more pain than I did. I was in the hospital three nights and then in What was called a skilled nursing facility for three more nights but it turned out to be a residence for patients with more long-term disabilities. It was not a good fit for me. I am getting home health care with a visiting nurse occupational therapy and physical therapy.

I transition to a walker into a wheelchair. I don’t feel confident using a walker for a any distance. The hospital had an air mattress on my bed that they sent home with me and I have that set up on a recliner.

The pain is manageable. I am not very active at this point except for getting up for meals and going to the bathroom. Having the spacer in is a very strange experience. It feels like it slips around sometimes.

My doctor thought he got all the fungus infection out. He should have. The scar is about 12 inches long. I see him next week for the first follow up. Maybe get the stitches out. I did not have a bacterial infection and I’m grateful for that.

I admit to having been on an emotional roller coaster because I did not expect to lose so much control over my life.

One day at a time.

Please stay in touch and let us know how you’re doing. This support is invaluable right now.

REPLY
mrfish | @mrfish | Nov 28, 2017
In reply to @mrfish "I finally made it home last night after a longer than exected 10 days in the..." + (show)
@mrfish

I finally made it home last night after a longer than exected 10 days in the hospital. The pain in the first few days following the surgery was something I could never have imagined. Fortunately, my ortho brought in a pain management specialist who inserted a pain block (nerve catheter, pump and bupivacaine) which was a huge improvement. The popping and grinding with the spacer is getting better as I move around more (on a walker), but movement is still quite difficult. For the self-administered IV antibiotics (vancomycin twice daily) I have a PICC line that runs through a vein in my right armpit, so using crutches is not allowed (or at least using a crutch on the right side).

Once I get settled in more at home I'll post more updates. Than you everyone for your advice and guidance. This has been quite an adventure so far, and it's still early.

Jump to this post

@janelaine I think you and I are just about in the same boat. I'm quite disappointed at how little mobility I have with this spacer. I knew it wouldn't be anything close to normal but I feel my ortho wasn't as honest (or blunt) up front with me about just how limited it would be. This morning, using a walker, it took me almost 20 minutes to get from my living room to the bathroom...a distance of about 25 feet and I was totally exhausted by the time I'd made the return trip back to my "nest" in the living room. One day at a time is right, one positive I've noted is that the popping/grinding from the spacer has smoothed out somewhat but I'm not able to bear hardly any weight at all on my right leg (post-op instructions said no more than 50% weight bearing, I feel like I can't get much more than 10-15% right now).

REPLY
mrfish | @mrfish | Dec 5, 2017

Well, here I am almost 3 weeks post-surgery and I'm getting around a little better with every day. I'm still using a walker 100% of the time, but I can now get from one end of my house to the other at more than a snail's pace. Pain while walking around is getting better too, but I can definitely feel it when I haven't stayed on schedule with my pain meds. If the meds have worn off, the pain from the spacer's popping and grinding is much sharper as well as more pain and difficulty lifting my right leg to walk (rather than dragging/sliding it along the floor).

I have a follow up with my ortho later today and I'd appreciate other's preferences/experience with their pain meds -- particularly the shorter-term meds. (Moderators, given the sensitive nature of narcotic pain medications, feel free to delete this portion of my post if this is not allowed here.) I have been prescribed 20 mg oxycodone to be taken twiice a day (once every 12 hrs), 50mg tramadol to be taken once every 6 hours. These two seem to work quite well for pain management but depending on how active I am (or intend to be), I also need shorter term meds the help out during the day. So far, I have been given two meds to try for shorter term relief: either norco 5-325 (5mg hydrocodone w/ 325mg acetominophen) 1 tablet to every 4 to 6 hours, or roxicodone15mg 1 to 2 tabs to be taken every 4 hours as needed. I think I find the norco's to be more effective than the short-term oxy's, and I'm guessing this is because they also come with the acetominophen? Or is it a difference between the oxy vs. hydrocodone? I probably should go do some more reading on this subject, but what are others experiences with pain meds intended for shorter/mid term relief? Are there others meds I should be looking into and asking my Dr. about?

Thanks,
Art in AK

REPLY
1 reply
janelaine | @janelaine | Dec 5, 2017
In reply to @mrfish "Well, here I am almost 3 weeks post-surgery and I'm getting around a little better with..." + (show)
@mrfish

Well, here I am almost 3 weeks post-surgery and I'm getting around a little better with every day. I'm still using a walker 100% of the time, but I can now get from one end of my house to the other at more than a snail's pace. Pain while walking around is getting better too, but I can definitely feel it when I haven't stayed on schedule with my pain meds. If the meds have worn off, the pain from the spacer's popping and grinding is much sharper as well as more pain and difficulty lifting my right leg to walk (rather than dragging/sliding it along the floor).

I have a follow up with my ortho later today and I'd appreciate other's preferences/experience with their pain meds -- particularly the shorter-term meds. (Moderators, given the sensitive nature of narcotic pain medications, feel free to delete this portion of my post if this is not allowed here.) I have been prescribed 20 mg oxycodone to be taken twiice a day (once every 12 hrs), 50mg tramadol to be taken once every 6 hours. These two seem to work quite well for pain management but depending on how active I am (or intend to be), I also need shorter term meds the help out during the day. So far, I have been given two meds to try for shorter term relief: either norco 5-325 (5mg hydrocodone w/ 325mg acetominophen) 1 tablet to every 4 to 6 hours, or roxicodone15mg 1 to 2 tabs to be taken every 4 hours as needed. I think I find the norco's to be more effective than the short-term oxy's, and I'm guessing this is because they also come with the acetominophen? Or is it a difference between the oxy vs. hydrocodone? I probably should go do some more reading on this subject, but what are others experiences with pain meds intended for shorter/mid term relief? Are there others meds I should be looking into and asking my Dr. about?

Thanks,
Art in AK

Jump to this post

Today is my three weeks post-surgery. The stitches came out last week. I use a combination of the wheelchair and walker to get around. My experience with pain is similar to yours if I get off schedule with my pain melds. I haven't taken anything stronger than 5 MG of Norco and Tylenol as needed but no more than 2000 MG a day. Norco also has Tylenol, so I have to be mindful of that. I am ultra-sensitive to the stronger narcotic pain meds so cant take them.

I am restricted to toe touch only except for hand-washing and brushing my teeth. I have had a couple of close calls with losing my balance with the Walker and ended up putting too much weight on my right leg. Apparently
I broke a small part of the spacer but my doctor wasn't concerned

I have irritating leg cramps. Tomorrow will be my first venture out in a car. I've been using a cabulance for doctor appointments. Continuing to have in-home PT, OT and home nurse visits.

I see my doctor after the first of the year. He said I might be able to do more weight-bearing then which would make this much easier.

My daughter has a neighbor who had to stay in assisted living for seven weeks because of a bacterial infection as she had no one to stay with her at home. She gets her new hip next week so hang in there

And so it goes. Some days are better than others but all in all, I am blessed with a supportive family. There isn't anything I can do to change what has happened so my goal is to accept what I can't change and take charge of what I can.

Let us know what your doctor has to say.

Jan

REPLY
mrfish | @mrfish | Dec 6, 2017
In reply to @janelaine "I am scheduled for this surgery on Tuesday of this week. I have a fungal infection..." + (show)
@janelaine

I am scheduled for this surgery on Tuesday of this week. I have a fungal infection but won't know about a bacterial infectiion until they do the culture following implant of the spacer. I am told there is to be no weight-bearing on my right leg which means I will be confined to a wheelchair or walker or crutches. I've tried hopping around on a walker with one foot and find it very challenging. I am 78 yo. If you are fortunate enough to get rid of the infection in the first go round, I'd be doing the happy dance for you (yes, on one foot!) I would like to see that outcome for myself but don't want to get my hopes up.

I learned on Friday that I will not be doing PT following the surgery. Maybe down the road but don't know yet. I will be in a rehab center for what I hope is a short amount of time. Also been practicing pivoting on my good leg to chairs, the toilet, etc. and then lifting myself up on one leg. I like to think my body is developing a cell memory that will help make the transition easier. I have a regular wheelchair and a friend gave me a motorized wheelchair. I've used a cabulance to take me to appointments but will try getting into the car unless the pain is too much.

I have a supportive family and have done all the work to prepare myself physically, emotionally and spiritually at the recommendation of my surgeon who incidentally took some of his training at the Mayo Clinic. I will check in asap after the surgery.

Good luck to you.

Jan in Washington State

Jump to this post

YES! The raised toilet seat has been super helpful. In fact, I wish I would have had it back when I had my original hip surgery. My insurance wouldn't pay for a shower chair/transfer bench that would make it easier & safer to get in and out of our tub/shower, but with my PICC line, and other wound dressings that can't get wet I really can't shower yet unless I use a full-body ziplock bag to keep all those other parts dry, lol. So it's all sponge baths so far and having my wife wash my hair in the kitchen sink with the sprayer. BTW, Walgreens sells a no-rinse shampoo that works surprisingly well (not the dry shampoo spray). It must be the same stuff that's in the shower cap-things they give you in the hospital to clean you hair.

REPLY
janelaine | @janelaine | Dec 6, 2017
In reply to @janelaine "I am scheduled for this surgery on Tuesday of this week. I have a fungal infection..." + (show)
@janelaine

I am scheduled for this surgery on Tuesday of this week. I have a fungal infection but won't know about a bacterial infectiion until they do the culture following implant of the spacer. I am told there is to be no weight-bearing on my right leg which means I will be confined to a wheelchair or walker or crutches. I've tried hopping around on a walker with one foot and find it very challenging. I am 78 yo. If you are fortunate enough to get rid of the infection in the first go round, I'd be doing the happy dance for you (yes, on one foot!) I would like to see that outcome for myself but don't want to get my hopes up.

I learned on Friday that I will not be doing PT following the surgery. Maybe down the road but don't know yet. I will be in a rehab center for what I hope is a short amount of time. Also been practicing pivoting on my good leg to chairs, the toilet, etc. and then lifting myself up on one leg. I like to think my body is developing a cell memory that will help make the transition easier. I have a regular wheelchair and a friend gave me a motorized wheelchair. I've used a cabulance to take me to appointments but will try getting into the car unless the pain is too much.

I have a supportive family and have done all the work to prepare myself physically, emotionally and spiritually at the recommendation of my surgeon who incidentally took some of his training at the Mayo Clinic. I will check in asap after the surgery.

Good luck to you.

Jan in Washington State

Jump to this post

I missed out on the shower cap/shampoo treat but thanks for passing the info along about the dry shampoo at Walgreens. I can see how the PICC line really complicates everything you do. I got a good giggle out of the giant Ziplock bag. My first trip by car today to see the doctor was a little more difficult and painful than what I thought but it was a treat to ride in the car and not in a cabulance. I need to get on track with my pain meds as I wait too long to take them.

One day closer to the goal line even tho I don’t know when that will be.

REPLY
Anonymous122054 | @anonymous122054 | Dec 7, 2017
In reply to @janelaine "I am scheduled for this surgery on Tuesday of this week. I have a fungal infection..." + (show)
@janelaine

I am scheduled for this surgery on Tuesday of this week. I have a fungal infection but won't know about a bacterial infectiion until they do the culture following implant of the spacer. I am told there is to be no weight-bearing on my right leg which means I will be confined to a wheelchair or walker or crutches. I've tried hopping around on a walker with one foot and find it very challenging. I am 78 yo. If you are fortunate enough to get rid of the infection in the first go round, I'd be doing the happy dance for you (yes, on one foot!) I would like to see that outcome for myself but don't want to get my hopes up.

I learned on Friday that I will not be doing PT following the surgery. Maybe down the road but don't know yet. I will be in a rehab center for what I hope is a short amount of time. Also been practicing pivoting on my good leg to chairs, the toilet, etc. and then lifting myself up on one leg. I like to think my body is developing a cell memory that will help make the transition easier. I have a regular wheelchair and a friend gave me a motorized wheelchair. I've used a cabulance to take me to appointments but will try getting into the car unless the pain is too much.

I have a supportive family and have done all the work to prepare myself physically, emotionally and spiritually at the recommendation of my surgeon who incidentally took some of his training at the Mayo Clinic. I will check in asap after the surgery.

Good luck to you.

Jan in Washington State

Jump to this post

Hey to those of you who need a better way to shower without getting your PICC line wet. Go to the nearest feed store that sells horse and cow feed. There are long plastic see through gloves that vets use when they have to stick their whole arm up a horses rear. They cost around 11cents each and they work great. I would tape a wash rag around the PICC line and pull the glove about 6 inches above it and tape it to your arm. Just to be safe and sure I would fold the rest of the glove over the taped area and tape it again. You will have full use of your arm without getting water on your PICC line.I was still careful not to let water run directly on it but it solves that problem really well. Let me know how it goes......

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