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.

Liked by lynzze

@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

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Hello. I’m one of those people who always forgets to take my pain meds on time. First I set the timer on my cell phone to go off every 4 hours. Easy. Then I started having trouble remembering what I took and how much. So I made a “journal page ” on my computer. I call it Pain and medication journal. Then I typed Time- with a few spaces and below it typed Meds taken with a few spaces and typed Notes. I lined it all up. I did that 6 different times on the same page and printed it out twice. I cut it in half and taped them side by side and copied it 15 times. I cut those copies in half so I had 30 of them which I paper clipped together. At the top I write the DAY and DATE ie. Tuesday December 5th and so on for the month. I found this a lot easier than writing in a bound journal because each page is a new day. And I take notes as I’m taking my meds. For example if I wake up at 4am in horrible pain I write just that “up at 4am, terrible pain in upper hip radiating down to my foot.” Took 2 diluded, 1 Robaxin, 2 Tylenol etc. I keep the pages so I can see if a pattern is developing. Like am I waking up everyday at 4am? Was I able to sleep until 8am before the pain got too bad? This works for me because I feel like when they removed my hip joint, they took half my brain too. I just can’t remember all the meds, exercises etc. Maybe this could work for someone else having a hard time remembering meds and such. I hope so. Robin:)

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@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

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This is a great tip @froggy1. I get the catheter for my pain block taken out this week and that’s really the last thing keeping me from showering, especially with with a trick for the PICC like you suggest here. I was thinking a washcloth under a bunch of wraps of saran wrap and then a little tape at each end would probably do the trick, too. The home-visit nurses who bring my antibiotics and clean/maintain the PICC said to keep it as dry as possible when washing up, but that keeping it totally, 100% dry isn’t really critical; just avoid significant direct water (especially submersion if you’re bathing).

I’ve done plenty of complaining about all the accessories I have had to drag along after this first of two surgeries. I was able to ditch the Active Care leg compression cuffs last week (yay!), and as I just mentioned my pain catheter/pump comes out this week. The last one I’ll still need to pack around for a while is a wound vac. When my joint infection finally presented itself in an obvious fashion, it was as a series of growing abscesses that pushed out via a fistula (channel) from the joint and directly through the scar from my first (anterior) THR surgery. When they did this last surgery to remove the THR and place the spacer, they also did considerable debridement of that wound which resulted in quite a large “crater” on the front of my leg. This wound gets its’ dressing changed twice a week. It’s packed with porous sponge, then covered with a tegaderm-like film and then a tube over the top that goes to a smallish (maybe 10″x6″x2″) vacuum pump. It has been fascinating watching how quickly this has helped this large & deep wound close itself up. I’ve clearly got some more time to stay attached to this one…but at least I can see a significant value to having to pack it along with me everywhere I go.

Has anyone else had to use one of these for wound care?

I guess some doctors like to continue their use through some of the epidermal (skin) formation, while others just remove it once the wound has closed enough and let the scar tissue/skin form on its own? I’m not soo sure about that one, though. It’s on my list of things to talk to my ortho about during our next follow-up.

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5-week update: I met with my infectious disease specialist two days ago and he said that if my bloodwork from this week (drawn yesterday) looks good, he expected to take me offf the antibiotics on Dec 26 (what a great Christmas present!!) Then, it’ll be a matter of waiting anywhere from 3-6 weeks before the next surgery to make sure the infection doesn’t come back. He said infectious disease docs usually prefer to wait a little longer than the orthopedic surgeons for the re-implantation — the extra time, in his opinion, gives more confidence that the infection is gone. I also happen to have a follow up appointment with my ortho on Dec 26, so we’ll see what he has to say. I definitely want to do as much as I can to make sure I don’t have to go through all of this again, so I’d be okay with waiting a little longer before the new THR. At least once I’m off the IV antibiotics, I’ll have the PICC line removed will be able to start using crutches instead of a walker. My pain is still problematic, but reasonably under control with meds, and my mobility is still very limited.

Jan @janelaine how are things going for you?

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Hello – I’ve been thinking about you and wondering how you are doing. Good news from your infectious disease doc that the PICC line gets to come out.
And I agree that waiting a bit longer at this point makes sense – we do not want to go through this again. I don’t have an appointment to see my infectious disease doctor yet but do see my ortho doc on January 4 with lab work done next week. I was told they go a “little” longer with fungal infections because they are so hard to get rid of so I don’t know what that means other than every day puts me closer to the goal of THR. Pain is problematic for me as well plus sitting so much causes problems in and of itself. Haven’t been able to find a comfy cushion. I don’t do well on pain meds so use Tylenol sparingly. I might get the go-ahead to use more weight-bearing so I can use the walker more, I totally understand about limited mobility and the precautions we have to take just like having a THR. Sometimes I just want to get up and walk! This definitely challenges my patience. It is very difficult to have to rely on others for help with almost everything.

Wishing you a happy holiday season, My family put up a tree and decorated so we are looking quite festive around here.

Stay in touch – I will check in after January 4. Let me know what your ortho doc has to say.

Liked by Jamie Olson, mrfish

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So sorry for your pain and follow up need for surgery. While I’m thoroughly uninformed of but intrigued by an antibiotic spacer, I have concerns that you seem to have not broached with your surgeon, or a/some of his-her patients that have had this insertion. You might also choose to get a second medical opinion, which is totally reasonable, to grow your information and comfort zone with the decision you’ve made.
I’ve had too many surgeries, including an anterior cervical spine fusion and did a huge amount of research, posed a lot of questions to my surgeon until I felt sure that what was scheduled was in my best interest, all things considered.
You deserve to have every question or concern addressed and if you want feedback from someone who has experienced the procedure, ask your Dr for referrals.
Ask for what you want! Good luck!

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Thank you for your suggestions, @shenriq. I did quite a bit of online research about treatment options once my infection was diagnosed, as well as speaking with my infectious disease specialist. There are a lot of medical journal articles online that looked at this, and it seemed quite clear that non-surgical treatment (antibiotics only) was really only an option if the infection is discovered and treatments began within just a few days of the onset…otherwise, surgical revision is required to address the infection. There were a number of journal articles, particularly from the UK, where they compared single-stage and two-stage revisions for infected hip implants. From what I saw, the two-stage (two surgeries and the antibiotic spacer) had significantly better success rates than just a single surgery to swap out hardware.

As far as mobility, and as my ortho explained, that really varies from patient to patient. For me, it’s now been 8 weeks since they removed the infected joint and implanted the spacer and I’m still needing to use a walker or crutches to get around. I’ve briefly tried using just a cane, but that still puts too much weight (and pain) on my right leg. For the most part, there’s no pain when I’m not moving around, but movement is slow and still always comes with some degree of pain. When I’m at home, it seems the walker is just more convenient than crutches most of the time. Fortunately, I have a job that allows me the opportunity to do some work from home/electonically but I’ve been wanting to get out of the house. So this week I began going into work for 4-5 hours a day and using crutches to get around when there. I’ve been having my wife or son drive me…I’m in no condition to be driving a vehicle for two reasons: my right leg doesn’t have the strength or agility to safely control the gas/brake pedals and I’m also still taking narcotic pain meds. While I’ve been able to reduce the amount of meds I’ve been taking, there is no doubt my judgement and reaction times are still compromised to some degree (especially with our icy roads).

But, after just two days of going into the office, I’ve had a little swelling return and my joint is much more stiff and painful than it had been before. So, I’m home resting it today. Maybe I’ll get a little more mobility if I just keep at it, but I think this is most likely as good as it’s going to get until I get a functioning hip joint re-implanted. Next week, I think I’ll try going into the office every other day (MWF) and see if that works better.

On Friday this week, they will draw out (aspirate) and culture some fluid from my hip joint to make sure the infection is/remains clear. My re-implantation surgery is scheduled for Feb 14, if everything contiues to look good. It’s frustrating that it’s still more than a month away (and will be almost exactly 3 months from the first surgery)…but as I mentioned before, longer waits before re-implantation should hopefully provide some more assurance that the infection is truly gone.

@janelaine, I hope you’re doing well. Is your second surgery on the calendar yet?

Best,
Art in AK

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I appreciate your sharing more of the details of your situation and regret not being able to provide more information or support. The complexity of your hip is extremely curious, but I’m sending you good wishes and every success with journey, going forward.
I had an afterthought, since you mentioned having done a lot of research. I’ve learned quite a lot of information on a variety of subjects, from the National Institutes of Health. They are a repository of research and information, that the public has access to, that they will mail to you. I hope this helps.
Best wishes and lots of luck, for a successful healing and full usage, without pain.
Good luck to you!

Liked by mrfish

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Time for an update on how I’m doing.On November 4, 2017 I had a spacer put in my right hip due to a fungal infection. I saw my ortho doc last week The lab work shows the infection levels are coming down which is great news. I see him again in six weeks to see where my lab results are. IF the infection is gone, I will have a four week drug=free holiday. If nothing shows up at the end of the four weeks, I can schedule my THR. That’s a big IF as the fungal infection is hard to get rid of so I’m just doing this one day at a time. I did get permission to do 50% weight bearing on my right leg so that means I can use a rolling walker and get around much better.

Happy New Year to all of you who are on this journey. Thanks for your support.
janelaie

REPLY
@mrfish

Thank you for your suggestions, @shenriq. I did quite a bit of online research about treatment options once my infection was diagnosed, as well as speaking with my infectious disease specialist. There are a lot of medical journal articles online that looked at this, and it seemed quite clear that non-surgical treatment (antibiotics only) was really only an option if the infection is discovered and treatments began within just a few days of the onset…otherwise, surgical revision is required to address the infection. There were a number of journal articles, particularly from the UK, where they compared single-stage and two-stage revisions for infected hip implants. From what I saw, the two-stage (two surgeries and the antibiotic spacer) had significantly better success rates than just a single surgery to swap out hardware.

As far as mobility, and as my ortho explained, that really varies from patient to patient. For me, it’s now been 8 weeks since they removed the infected joint and implanted the spacer and I’m still needing to use a walker or crutches to get around. I’ve briefly tried using just a cane, but that still puts too much weight (and pain) on my right leg. For the most part, there’s no pain when I’m not moving around, but movement is slow and still always comes with some degree of pain. When I’m at home, it seems the walker is just more convenient than crutches most of the time. Fortunately, I have a job that allows me the opportunity to do some work from home/electonically but I’ve been wanting to get out of the house. So this week I began going into work for 4-5 hours a day and using crutches to get around when there. I’ve been having my wife or son drive me…I’m in no condition to be driving a vehicle for two reasons: my right leg doesn’t have the strength or agility to safely control the gas/brake pedals and I’m also still taking narcotic pain meds. While I’ve been able to reduce the amount of meds I’ve been taking, there is no doubt my judgement and reaction times are still compromised to some degree (especially with our icy roads).

But, after just two days of going into the office, I’ve had a little swelling return and my joint is much more stiff and painful than it had been before. So, I’m home resting it today. Maybe I’ll get a little more mobility if I just keep at it, but I think this is most likely as good as it’s going to get until I get a functioning hip joint re-implanted. Next week, I think I’ll try going into the office every other day (MWF) and see if that works better.

On Friday this week, they will draw out (aspirate) and culture some fluid from my hip joint to make sure the infection is/remains clear. My re-implantation surgery is scheduled for Feb 14, if everything contiues to look good. It’s frustrating that it’s still more than a month away (and will be almost exactly 3 months from the first surgery)…but as I mentioned before, longer waits before re-implantation should hopefully provide some more assurance that the infection is truly gone.

@janelaine, I hope you’re doing well. Is your second surgery on the calendar yet?

Best,
Art in AK

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Thanks for your update. I’m having the same issues with pain. I am delighted to be using the walker and put 59% weight on my right leg, even though I feel like I’m using some muscles that are tight and sore. I save my pain meds until bedtime so I can sleep. Let us know what the aspiration and culture show – hopefully no infection so you can proceed with surgery on Valentine’s Day. What a sweet gift that would be. I have been out of the house several times, primarily for appointments but did sneak in a visit to Costco using one of their carts.

Jan in WA

Liked by mrfish

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Here’s my most recent update: I’m scheduled to have my next (and hopefully last) hip surgery on Wednesday, Feb 14, when they plan to remove the antibiotic spacer and install fully-functional new hardware — just about three months since the spacer was installed.

I had to undergo two hip aspirations a few weeks ago (where a loooong needle is used to draw fluid from the joint). During the first one, they drew some fluid but someone messed up and they weren’t able to culture the sample (it was mistakenly sent for processing to a lab out of state and too much time had passed). So, they scheduled a not-very-happy me for a second aspiration but unfortunately weren’t able to get any fluid that time.

According to the docs, my blood work looks good. It is frustrating to me that throughout all of this there were no successful cultures to figure out what kind of microbe was causing my infection, nor (most recently) to confirm that the infection is truly cleared out. There are only the indirect indicators from blood & lab work. My ortho tells me that during this week’s surgery, samples will be taken — and processed — while I’m still on the operating table. If those indicate that there is still an infection, they will abort the installation of working hardware and instead re-implant another antibiotic spacer. However, he said that they have never had that occur. I guess that gives me some comfort?

But (beside having this blasted spacer in my hip and its’ pain & limitations) I feel good and I have no reason to believe the infection isn’t gone. I’m looking forward to this next surgery and the recovery that will come after that. I’m looking forward to putting the last six (or so) challenging months behind me — I just can’t shake this fear in the back of my mind of possibly having to go through this all again should an infection reoccur.

I’m not driving myself, but for these last few weeks, I have been going in to work at the office for three days a week (M,W,F) and using crutches. While seated at my desk, I need to get up and move around a little bit every 30 minutes or so. If I go longer, it’s much more painful and harder to get things worked out and moving again. Fortunately, I have a motorized stand-up desk that I can put up or down and I’ll also sometimes spend a little time standing and shifting some weight between both legs. I still cannot bear much more than 50% normal weight on my right leg.

At home, I prefer to use the walker, it’s just so much more convenient. The extra activity certainly comes with additional pain. Right now, after being at work all day today, I my visibly swollen right leg elevated and an ice pack on my hip.

I’ll post another update next week after my surgery. Fingers crossed.

REPLY
@mrfish

Here’s my most recent update: I’m scheduled to have my next (and hopefully last) hip surgery on Wednesday, Feb 14, when they plan to remove the antibiotic spacer and install fully-functional new hardware — just about three months since the spacer was installed.

I had to undergo two hip aspirations a few weeks ago (where a loooong needle is used to draw fluid from the joint). During the first one, they drew some fluid but someone messed up and they weren’t able to culture the sample (it was mistakenly sent for processing to a lab out of state and too much time had passed). So, they scheduled a not-very-happy me for a second aspiration but unfortunately weren’t able to get any fluid that time.

According to the docs, my blood work looks good. It is frustrating to me that throughout all of this there were no successful cultures to figure out what kind of microbe was causing my infection, nor (most recently) to confirm that the infection is truly cleared out. There are only the indirect indicators from blood & lab work. My ortho tells me that during this week’s surgery, samples will be taken — and processed — while I’m still on the operating table. If those indicate that there is still an infection, they will abort the installation of working hardware and instead re-implant another antibiotic spacer. However, he said that they have never had that occur. I guess that gives me some comfort?

But (beside having this blasted spacer in my hip and its’ pain & limitations) I feel good and I have no reason to believe the infection isn’t gone. I’m looking forward to this next surgery and the recovery that will come after that. I’m looking forward to putting the last six (or so) challenging months behind me — I just can’t shake this fear in the back of my mind of possibly having to go through this all again should an infection reoccur.

I’m not driving myself, but for these last few weeks, I have been going in to work at the office for three days a week (M,W,F) and using crutches. While seated at my desk, I need to get up and move around a little bit every 30 minutes or so. If I go longer, it’s much more painful and harder to get things worked out and moving again. Fortunately, I have a motorized stand-up desk that I can put up or down and I’ll also sometimes spend a little time standing and shifting some weight between both legs. I still cannot bear much more than 50% normal weight on my right leg.

At home, I prefer to use the walker, it’s just so much more convenient. The extra activity certainly comes with additional pain. Right now, after being at work all day today, I my visibly swollen right leg elevated and an ice pack on my hip.

I’ll post another update next week after my surgery. Fingers crossed.

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Mr.Fish. You are very, very brave. I will be praying for your infection to be looooong gone and to NEVER come back. I say you’re brave because I’ve chosen to not undergo another surgery (which would have been a 2 stage and new PICC lines after each stage “just in case”) For me 4 surgeries and 2 staph infections was all I could do. Also, in between dislocation 2 and re-vision of the liner in my pelvis, I had breast cancer surgery. They removed a lump from my breast and 3 lymph nodes from my arm pit (to check if it had spread, and it did not) and a week later I had the revision where I caught the first staph infection. While I was home with the first PICC line, Nurses started calling me telling me they wanted me to do radiation. I passed. Just didn’t have it in me. I did enough research on radiation to make an informed decision and I’ve been talking to people about CBDs, which is derived from marijuana. Not quite there yet either. But at my 6 month mammogram I was cancer free so I’m keeping my fingers crossed:) The end of February will be my 1 year mark of having that hip joint removed. It’s a process getting used to but I’m doing quite well. Everyday is different (they just had to add another inch to the bottom of my left shoe, so now I’m at around 3 inches shorter on that side.) Sitting too long, driving too long and walking too much will probably always be an issue. The good news is I’ve only fallen once in the last 4 months! And it was more like a trip and fall. (stepping into the shower I forgot to grab the safety bar, tried to step in with my right foot first, bad move, it left all my weight on the wrong side and on top of that I didn’t lift my leg up high enough and stubbed all my toes before not so gracefully going down.) It’s a good thing that I can laugh at myself, because it was a laugh or cry moment and I chose to laugh. Plus my dog was standing behind me when I got up looking at me like “not again, would you just get up”? Enough yakking about me. Think good thoughts, take some deep breaths and think of your favorite person or place before they sedate you. I’ve been told that if the last thing you picture before going under is something pleasant, you’ll wake up thinking that same thought and you’ll feel fine. It worked for me 5 times!! You’re gonna do great. I’m always available to talk and or listen if you need to…. Robin

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@mrfish

Here’s my most recent update: I’m scheduled to have my next (and hopefully last) hip surgery on Wednesday, Feb 14, when they plan to remove the antibiotic spacer and install fully-functional new hardware — just about three months since the spacer was installed.

I had to undergo two hip aspirations a few weeks ago (where a loooong needle is used to draw fluid from the joint). During the first one, they drew some fluid but someone messed up and they weren’t able to culture the sample (it was mistakenly sent for processing to a lab out of state and too much time had passed). So, they scheduled a not-very-happy me for a second aspiration but unfortunately weren’t able to get any fluid that time.

According to the docs, my blood work looks good. It is frustrating to me that throughout all of this there were no successful cultures to figure out what kind of microbe was causing my infection, nor (most recently) to confirm that the infection is truly cleared out. There are only the indirect indicators from blood & lab work. My ortho tells me that during this week’s surgery, samples will be taken — and processed — while I’m still on the operating table. If those indicate that there is still an infection, they will abort the installation of working hardware and instead re-implant another antibiotic spacer. However, he said that they have never had that occur. I guess that gives me some comfort?

But (beside having this blasted spacer in my hip and its’ pain & limitations) I feel good and I have no reason to believe the infection isn’t gone. I’m looking forward to this next surgery and the recovery that will come after that. I’m looking forward to putting the last six (or so) challenging months behind me — I just can’t shake this fear in the back of my mind of possibly having to go through this all again should an infection reoccur.

I’m not driving myself, but for these last few weeks, I have been going in to work at the office for three days a week (M,W,F) and using crutches. While seated at my desk, I need to get up and move around a little bit every 30 minutes or so. If I go longer, it’s much more painful and harder to get things worked out and moving again. Fortunately, I have a motorized stand-up desk that I can put up or down and I’ll also sometimes spend a little time standing and shifting some weight between both legs. I still cannot bear much more than 50% normal weight on my right leg.

At home, I prefer to use the walker, it’s just so much more convenient. The extra activity certainly comes with additional pain. Right now, after being at work all day today, I my visibly swollen right leg elevated and an ice pack on my hip.

I’ll post another update next week after my surgery. Fingers crossed.

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Thanks for getting us current on your upcoming surgery.. I can relate to much of what you have to say about the spacer and pain and limitations and the lingering fear that you might have to go through this again. This is a challenging journey. I see my ortho doc on Thursday to see what my lab work is. I’m not expecting the fungal infection to be gone but hoping the numbers are coming down. I know my THR is somewhere in my future but don’t know when. Wishing you a totally successful surgery and recovery. Stay in touch and let us know how you are doing.

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@mrfish

Here’s my most recent update: I’m scheduled to have my next (and hopefully last) hip surgery on Wednesday, Feb 14, when they plan to remove the antibiotic spacer and install fully-functional new hardware — just about three months since the spacer was installed.

I had to undergo two hip aspirations a few weeks ago (where a loooong needle is used to draw fluid from the joint). During the first one, they drew some fluid but someone messed up and they weren’t able to culture the sample (it was mistakenly sent for processing to a lab out of state and too much time had passed). So, they scheduled a not-very-happy me for a second aspiration but unfortunately weren’t able to get any fluid that time.

According to the docs, my blood work looks good. It is frustrating to me that throughout all of this there were no successful cultures to figure out what kind of microbe was causing my infection, nor (most recently) to confirm that the infection is truly cleared out. There are only the indirect indicators from blood & lab work. My ortho tells me that during this week’s surgery, samples will be taken — and processed — while I’m still on the operating table. If those indicate that there is still an infection, they will abort the installation of working hardware and instead re-implant another antibiotic spacer. However, he said that they have never had that occur. I guess that gives me some comfort?

But (beside having this blasted spacer in my hip and its’ pain & limitations) I feel good and I have no reason to believe the infection isn’t gone. I’m looking forward to this next surgery and the recovery that will come after that. I’m looking forward to putting the last six (or so) challenging months behind me — I just can’t shake this fear in the back of my mind of possibly having to go through this all again should an infection reoccur.

I’m not driving myself, but for these last few weeks, I have been going in to work at the office for three days a week (M,W,F) and using crutches. While seated at my desk, I need to get up and move around a little bit every 30 minutes or so. If I go longer, it’s much more painful and harder to get things worked out and moving again. Fortunately, I have a motorized stand-up desk that I can put up or down and I’ll also sometimes spend a little time standing and shifting some weight between both legs. I still cannot bear much more than 50% normal weight on my right leg.

At home, I prefer to use the walker, it’s just so much more convenient. The extra activity certainly comes with additional pain. Right now, after being at work all day today, I my visibly swollen right leg elevated and an ice pack on my hip.

I’ll post another update next week after my surgery. Fingers crossed.

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Froggy1 – you are an inspiration to have gone through so much and still have a sense of humor. Sounds like you have accepted your condition and are coping quite well under the circumstances. You are very brave! Wishing you the best!

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Thanks for your well-wishes, it really meant a lot to me as I headed into this last surgery, and my anxiety was running high.

Things are going very well for me so far. I spent two nights in the hospital after my surgery on Feb 14. My surgeon said everything looked great while he was "in there" during the surgery and the rapid cultures they took during the operation showed no sign of infection. They still administered a few precautionary doses of IV antibiotic while I was in the hospital, and my ortho said they also sprinkled in some kind of slow-release/dissoving antibiotic into the joint area before closing things up.

The biggest change for me is that the joint pain of the 3 months with the spacer (the popping and grinding) is completely and immediately gone. Of course, I have some pain from the incision but that's secondary to the considerable weakness and loss of flexibility that's due to the past three months of very limited mobility. I started physical therapy this week, and will go out for that 3x a week for up to 7 weeks. I've already noticed improvement from the home exercises and the PT sessions.

I'm still using crutches or my walker, but I've also been trying to spend more time playing around with a cane over the last few days — but, I have a bit more strength I need to regain in my right leg before I feel I can switch completely over to the cane (maybe one more week). I have no restriction on how much weight I can bear on my right leg, but it's definitely not back to "normal" yet. I can stand normally with weight ditributed evenly between left and right feet (without any pain), and can shift some more weight over to my right but I can't fully support my weight on my right leg alone as you would while trying to walk normally. It's really not an issue of pain so much as strength and not feeling stable/safe quite yet.

@janelaine and @froggy1, thank you (and others) for your support. Janelaine, I'm hoping your infection clears soon and you might be able to get your new hip. I'm so sorry that it seems to be taking so much longer for a fungal infection to clear out. Froggy1, its quite flattering to be called brave by you. After getting to know more about you and your long road to where you are today, you are truly the brave one here (but thank you). And, to be able to find humor among the challenges is a testament to your strong character and willpower. I can only begin to understand your frustration and possible disillusionment with what medicine has been able to offer you so far. But I want to sincerely say "hang in there", perhaps new technology or procedures might give you a shot at something closer to normal.

My next challenge is going to be getting off the narcotics. My pain levels are already way, way down–I could probably manage with ibuprofen now–and I've begun to significantly reduce the dose and frequency of my tramadol and oxycodone…but I've already noticed the beginning of withdrawal symptoms from just this. I've done some reading on the topic and asked my ortho for advice or possible medical help, and was very disappointed with his response. He did say I shoud talk with my normal doctor; perhaps that's the correct protocol. So, I do plan to speak with my normal doc this week and see what she may have to suggest and if we can develop a plan/schedule—but I don't think she has much experience with detox treatment (maybe I'm wrong). But again, since the orthos are the ones who prescribe so much of the pain meds, you'd think they'd devote the effort to help you get off of them. Since I'm alrerady back at work full-time, I probably need to find a 3 or 4 day weekend to carry out the initial cut-off to deal with the worst of it. I do have experience with opioid withdrawal after my first hip replacement, but that was only after 4-5 weeks of pain pills, while this time it's been about 4 months of the stuff. I remember sleeplessness was a huge problem last time so I was going to inquire about short-term sleeping medication, and I've also been reading a little about buprenorphine as something that might help lessen the withdrawal symptoms. Recreational marijuana is also legal up here in Alaska and I've had some experience with that, but that was mostly in college a few decades ago. Maybe there's no real medical way to make it meaningfully easier and I'll just need to tough it out — which I'm fully prepared to do in the very near furure. But, any advice would be appreciated.

Moderators, is there a discussion thread on the topic here on connect.mayoclinic?

REPLY
@mrfish

Thanks for your well-wishes, it really meant a lot to me as I headed into this last surgery, and my anxiety was running high.

Things are going very well for me so far. I spent two nights in the hospital after my surgery on Feb 14. My surgeon said everything looked great while he was "in there" during the surgery and the rapid cultures they took during the operation showed no sign of infection. They still administered a few precautionary doses of IV antibiotic while I was in the hospital, and my ortho said they also sprinkled in some kind of slow-release/dissoving antibiotic into the joint area before closing things up.

The biggest change for me is that the joint pain of the 3 months with the spacer (the popping and grinding) is completely and immediately gone. Of course, I have some pain from the incision but that's secondary to the considerable weakness and loss of flexibility that's due to the past three months of very limited mobility. I started physical therapy this week, and will go out for that 3x a week for up to 7 weeks. I've already noticed improvement from the home exercises and the PT sessions.

I'm still using crutches or my walker, but I've also been trying to spend more time playing around with a cane over the last few days — but, I have a bit more strength I need to regain in my right leg before I feel I can switch completely over to the cane (maybe one more week). I have no restriction on how much weight I can bear on my right leg, but it's definitely not back to "normal" yet. I can stand normally with weight ditributed evenly between left and right feet (without any pain), and can shift some more weight over to my right but I can't fully support my weight on my right leg alone as you would while trying to walk normally. It's really not an issue of pain so much as strength and not feeling stable/safe quite yet.

@janelaine and @froggy1, thank you (and others) for your support. Janelaine, I'm hoping your infection clears soon and you might be able to get your new hip. I'm so sorry that it seems to be taking so much longer for a fungal infection to clear out. Froggy1, its quite flattering to be called brave by you. After getting to know more about you and your long road to where you are today, you are truly the brave one here (but thank you). And, to be able to find humor among the challenges is a testament to your strong character and willpower. I can only begin to understand your frustration and possible disillusionment with what medicine has been able to offer you so far. But I want to sincerely say "hang in there", perhaps new technology or procedures might give you a shot at something closer to normal.

My next challenge is going to be getting off the narcotics. My pain levels are already way, way down–I could probably manage with ibuprofen now–and I've begun to significantly reduce the dose and frequency of my tramadol and oxycodone…but I've already noticed the beginning of withdrawal symptoms from just this. I've done some reading on the topic and asked my ortho for advice or possible medical help, and was very disappointed with his response. He did say I shoud talk with my normal doctor; perhaps that's the correct protocol. So, I do plan to speak with my normal doc this week and see what she may have to suggest and if we can develop a plan/schedule—but I don't think she has much experience with detox treatment (maybe I'm wrong). But again, since the orthos are the ones who prescribe so much of the pain meds, you'd think they'd devote the effort to help you get off of them. Since I'm alrerady back at work full-time, I probably need to find a 3 or 4 day weekend to carry out the initial cut-off to deal with the worst of it. I do have experience with opioid withdrawal after my first hip replacement, but that was only after 4-5 weeks of pain pills, while this time it's been about 4 months of the stuff. I remember sleeplessness was a huge problem last time so I was going to inquire about short-term sleeping medication, and I've also been reading a little about buprenorphine as something that might help lessen the withdrawal symptoms. Recreational marijuana is also legal up here in Alaska and I've had some experience with that, but that was mostly in college a few decades ago. Maybe there's no real medical way to make it meaningfully easier and I'll just need to tough it out — which I'm fully prepared to do in the very near furure. But, any advice would be appreciated.

Moderators, is there a discussion thread on the topic here on connect.mayoclinic?

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Hi, @mrfish — glad to hear things are going well for you so far.

You'd asked about threads on withdrawing from pain meds. You might want to check out these two:

http://mayocl.in/2ENZ66U (on withdrawing from fentanyl and oxycodone)

http://mayocl.in/2EQHzLA (on withdrawing from morphine)

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