Knee Update

I thought everything was going fine, my physio was helping improve my flexion (bending) up to 120 degrees and my extension (straightening) was at 0.

Today was my consultant appointment and have shown a different story. He says my flexion is 95 and my extension is only 0.
This has crushed me...

2 days before I go on holiday and I haven't been doing as well as I thought, it seems the Range of Movement (ROM) is based on the amount you can actually move of you own free well rather than being "forced" by someone.

I have been advised told I will need even more physio (I am currently having 2-3 days a week) and if things don't improve within the next 4 weeks, then I have to seriously consider MUA Manipulation under anesthesia before my knee stays like it is... Permanently.
Most people requiring this kind of procedure do so as they have had a total knee replacement (TKR), I can't seem to find anyone that needs a MUA for a "Normal" problem such as mine.

Found a great site about a woman who had MUA, in particular, this post. She couldn't bend her knee past 90 degrees (110 at a push) it seemed to work for her. At least it's given me some hope, if only as a last resort.

I will definately be doing as much as I can over the next 4 weeks, even if 2 of them are while sunning it in Tenerife, who knows, maybe the sun will help too. (I know the large measures of JD & Coke certainly will)

Day 12 - Nothing to see Here
For the first time in what seems like years to me, but only a couple of weeks, I have had a very unevetful day,

No bloodtests, no operations, (not even a CRP test)
Of course I have my daily injection for DVT and my physio "Boot Camp" session, but apart from that, NOTHING HAPPENED.

I even managed to watch Match of the Day to see my beloved Derby get thrashed 4-0 by Tottenham - Pah !!!

The consultant again mentioned "Going home" as long as CRP drops tomorrow and Monday.

Now then, how do I get to watch the matches tomorrow...

• Blackburn v Arsenal
• Liverpool v Chelsea
• Man City v Man Utd

Day 11- PICC Day
The PICC Line is in, the next step in me going home is complete, after several unsuccesful tries yesterday, the reinforcements were called in..

I went down to the theatre at 6.30 *(even missed Hollyoaks)

a few VERY nervous minutes later and we were ready to go, the anaesthetic was injected and I'm not sure about the next 20 minutes or so except

• Taking deep breaths
• The wierd sensation in my arm as the line is thread
• X-rays every so often so the radiologist knows where he's going
• The woman holding my hand had amazing eyes - NOT AS BEAUTIFUL AS YOURS SWMBO !!!
• The uncomfortable feeling as the outer casing is pulled back out of my am

and the most memorable

When the radiologist tells me he "HAS GONE UP THE JUGULAR VEIN* INSTEAD OF DOWN INTO ANOTHER VEIN"

after I got back to my room, it made me feel a little wierd thinking thats theres this long line is inside me, although relieved that he managed it rather than resorting to the Hickman Line (That does use the Jugular vein*)

The first IV was no problem at all.

...Oh, my CRP has dropped again, now we're at 80.

If that same person crosed their fingers again for me - Thank You !!!

*Sorry if you've find this page by googling Hickman, the radiologist did say (when I had a face of fear about the the Hickman) that using the Jugular vein is nothing to worry about, people are scared due to horror movies

Links
- 1 - 2 - 3 -

Day 10 - Good and Bad News

The consultant came to see me this morning, he is happy with my recovery as long as my CRP continues to drop. He actually mentioned going home (for the first time), to continue my treatment, and this may even be as soon as Sunday or Monday. I will need to have the PICC line put in which I had decided on anyway. I should hopefully be starting my physio in the next couple of days.

My CRP results came back - 96 - Yesssss !!!!!

The RMO (Resident Medical Officer - Doctor that Lives onsite) came to discuss the PICC line insertion, it involves a local anaethetic then a little cut where they put a tube in, followed by the line itself, he mentioned this will either be in my groin, my chest or my neck (CHEST PLEASE). These lines can stay in for up to 90 days although they prefer 30 days, either way they should really only need to put one of these in, my veins are saved...

So far the day went well, I even managed a shower - Took ages but I didn't care, I AM RECOVERING !!!

As my veins are now well and truly shot, I had to have one of my antibiotics via an injection (in my arse) this worried me, Gentamicin has to be given slowly by IV, otherwise you can go deaf and it's irreversible - but this is not the case via injection as the muscles soak it up, but also means it's not as effective.

The anaesthatist came to see me at 5.30pm, he explained it goes in via the top of the arm (phew) and I will be going down within the next 30 minutes.

I went down to theatre at 6.00pm got prepped and the anaesthatist started....

Then comes the bad news

... 2 hours and 14 attempts later, he stopped, he had tried every vein he could find using an ultrasound machine but they were all thrombosed (blocked), he was unable to thread the tube through therefore unable to put the PICC Line in.

What is it with me, I had a tiny chance of getting the staphylococcus infection in the first place, then the "easy" procedure of getting a PICC Line is not possible. Apparently being part afro-carribean means my sink and veins are thicker than normal, (great for the aging process, shit for venal work) :-(

I am now waiting until tomorrow for a radiologist to put the line in via a different method. Whoever had their fingers crossed for me before, please do it for me tomorrow,

My arms are killing and full of little cuts, and still I'm having to have the IV antibiotics via a cannula which is red, sore, swollen and hurts like mad.

But Daddy will be home to see Leah and SWMBO - whatever it takes.....

Daddy's coming home

Day 9
WOW - 9 Days...

Good news - my CRP has dropped again to 123, I thought I'd be a lot happier than I was about this result...

I am starting to get very down now, I am beginning feel the world is just passing me by as I lie here, Leah had one of her first giggles yesterday and daddy missed it.

I also had some shooting/stabbing pains in my knee but was reassured by SWMBO that these are my wounds healing (muscles & nerves trying to re-attach etc)

I have decided I need to stay positive though, I am scheduled to have a physio session tomorrow which will also mark the second part of my "road to recovery" (the first being getting rid of the infection itself).

COME ON !!!!

Day 7 - Part 2
Above are some nice gory photos from today, the first one is the hole from my first drain and the second is my bandaged knee still with the drain in and the last is the drian by itself, which was removed today, and hurt like a bitch...

On a plus side, the swelling and pain seems to have reduced, however I have spoken to my consultant tonight, my CRP has gone up to 243 which was to be expected after the operation (and there's only a small increase at that).

I still have what is called "septic athritis" (Which isn't the same as rheumatoid or Osteo- Arthitis), we should get the test results of samples taken yesterday from microbilogy which, along with the blood tests for CRP, will show whats next in the story.

Tonight though, I'm happy...

EDIT 15 August
Looked at my states and someone looked on my site by googling for do doctors put you to sleep when they drain fluid from the knee?
The answer is yes and no, I had a needle drain without any anaesthetic on 2 occasions had 2 washouts under local and 2 under general. needles in the knee quite 'kin hurt...

Knee update - Day 6 - Part 3

I have woken up.

I was again put to sleep, although I did ask if I could just have a local, I was advised against this as a spinal could lead to further infection (in my spine) which is probably not so good. I have had an injection to put a nerve block in my leg, so although I wiggle my toes and move my foot and even my leg from side to die, I can't actually feel it, even if iI i touch it with my hand, it doesn't feel like part of me.

I was back within a couple of hours feeling very drowsy, it was 2.50pm but I thought it was 8.50pm.

My mum was here to greet me, and SWMBO came along shortly after bringing goodies (which I always like). I'll need to wait until tomorrow to see the consutant to discuss the operation fingers crossed though he did mention that the Flucloxacillin is working as it should, but they are looking at adding something to it.

I also managed to get video clips of the operation, I can't upload them yet as my connection here is now down to 56k (remember them days).

I am hoping I am now mended and don't need any more surgery.

Knee - Day 6 - Part 2

The results are in.... and my CRP has gone up again, to 236, this means another operation.

Knee - Day 6 - Part 1

I was woken at 6.00am for breakfast and drugs (sounds perfect to some of you I bet). I also had a blood test so they could get it to the DRI to check my CRP, I'm hoping that it's dropped it's really the only way I know I'm on the mend.

The physio came in to give me some more excerices, just imaging you are lying on your bed looking up, and you cannot lift your right leg up or bend your knee, thats exactly what is happening to me at the minute, I can wiggle and move my toes and move my feet, but when it comes to trying to move my whole leg, not a chance, the physio helped me to bend my knee, I can now manage half way (about 30 degrees). After about 30 minutes of trying, I also managed to lift my foot a couple of inches of the bed, it's not a big thing, but to me its massive.
I have a walk in shower in my new room now, I managed to have a proper shower last night too, albeit sitting down.

Now I just have to wait for the blood test results.
Fingers crossed ...

PS - Thanks everyone for taking the piss, especially Uncle "Grant Mitchell" Steve, Bossman Dave and Tao, I knew I could rely on some of you to keep me sane.

The Knee story continues

I managed a nice 4 hours sleep last night between my IV treatments every 6 hours, I must say some of the nurses here are really nice, i know most people expect nurses to be caring, kind and gentle, but believe me they're not always.

I woke up at 5.45am and my treatment started at 6. I was brought a cup of tea... I think, due to the amount and levels of drugs I am taking, I am beginning to lose track of time and the names of the peole who work here.

I had a few visitors today, who always seem to look worried when they see me, I think its due to the fact I look like death, again down to the drugs which make me feel sleepy all day long.
The physio came in with another contracption known as a CPM machine , now this did look like it was going to hurt me, it was good though, basically you have to put your leg in and it spends all of its' time bending and straightening it for you, now I can actually bend my leg to 45 degrees from -5 degrees. I have used it all day and it doesn't hurt that much.

The good news was that my first surgeon was back from his holiday today so I will find out exactly what will be happening. The bad news is that I ound out exactly what is happening
. He came in about 4.00pm straight from the airport (lucky b*stard). Asked all about what had happened and then advised me that;

• My knee, although is still swollen (oh it's swollen alright) has no red marks and is not causing too much pain
• I have a normal (36.4) temperature
• I dont feel flu-like

This shows I am responding to the anti-biotics so it looks like we can totally rule out MRSA. (phew)
but...

• I may need to increase my dose of antibiotics as my CPR has again increased , now its at 212 (up from 206 yesterday), this may mean a stay of another 3 weeks... :-(
• If my CPR is raised or constant tomorrow, they are going to do another drain of my knee, which i basically another flush out using the arthroscopy holes, I don't think I'm scare anymore. - Did I just say that ?
  

All I want to do is go home to my family.....
I do realise that it's better to wait a coupe of weeks and be 100% than go home after a day or three, get the bug back and either have to come back or wore still, erm die..

The good thing is they wheel me out to reception where I can see my little angel and SWMBO so I can now see them every day. I must thank SWMBO for coming twice today xx.

I have also moved rooms now and have the biggest and best room available at this hotel hospital.

I am staying very positive, the pain is better, the drugs are working, I have my internet, my room is nice, the staff are nice and I will go home at some point. I'm also saving a ton of cash.

We shall See what happens tomorrow

Ouch - V2

Thanks to Bossman Dave - I am on the t'internet from my hospital bed, wonderful ah the wonders of vodafone 3G Data cards, It just means I can also "Work From Hospital"

So to recap - I had my arthrospy on 7 July, no problems following that, had the final checkup last Friday (3 August), thc consultant confirmed all was healing well, although I mentioned to him that I did have some fluid leaking from my wound, he assured me this is perfectly normal.

Went out for some drinks on Saturday night, cooked sunday dinner and got up Monday morning for work as normal and had a normal day at work. Approx 2.00pm I felt a slight tightening around my knee but thought nothing of it, 3.30pm came and I tried to stand up but my knee had other ideas and I fell back into my chair . I managed to drive home but as soon as pulled up to my drive, I realised something defintely wasn't normal, I was in severe pain, I couldn't walk through my door as it involved "stepping up" through the door.

I managed to get in, limp to the settee which is where i stayed until SWMBO came home to look after me, I called the hospital who tried to get hold of my consultant, I called again and was told if the pain is so bad to go to A&E, unless the consultant can get back to me.

At about 8.00 I couldn't take any more, I called NHS Direct in agony (and tears) and they immediately sent for an ambulance that came around 9.05PM. I was rushed into a stupidly bisy A&E department where I waited in a side room, in the time of my wait I went through 3 bottles of Gas and Air,

Eventually a doctor came to see me and examined my knee, took some blood and a gave me a shot of morpheine, (the morpheine had no effect whatsoever)

I then waited for a couple of hours before another doctor came and attempted to take a sample of fluid from my knee, using a 4" needle he stabbed into one side, tried again (with the same needle), tried the other side (with the same needle) and tried again(with the same needle) , he apologised for being unable to get a sample and left, bearing in mind, each of these "attempts" caused me to scream so loud that
a: My cousin recognised my "Noise" from a totally different part of the hospital b: The "rude boys" in the bay opposite were wincing at my scream. Eventually a Senior doctor came and after one attempt, got about 50ml of "fluid" from my knee, which he sent away for testing.

This was to establish if it was infected, inflammed or I had gout, all of which are treatable by drugs or operation .

After another couple of hours of gas and air, morpheine and waiting they came back to say there was nothing wrong and sent me home .... at 3.45am

The following day was spent wit my leg up trying to get into see my consultant, during the day, my knee had swollen up to twice the normal size. I managed to get into the Nuffield (private) hosptial at 7.00 where the consultant took another 100ml from my knee, took one look and said it looked einfected, however sent it away for further analysis.

By 8.00pm he had it confirmed it was indeed infected and I needed an operation STRAIGHT AWAY. It also meant I needed to stay overnight so they could monitor it.

I was fine with this, it was basically another arthoscopy, nothing too bad there, I have been there, done that etc. I was in a room by 10.00 resting.

The following day however was a different story however. All was fine until 2.15pm at which my knee was in so much pain I was screaming louder that I have ever done before , so much so that the staff kept calling the consltant for advice, at 5.15 3 consultants and 2 aneasthatitsc came along and had no idea why i was in so much pain, however suggested nother operation so they could take a further look into my knee, however this time under a general anasthetic, this is something I was not happy about (i was actually more scared than unhappy as I have never had this done before).

I went under for what seemed like 2 seconds and woke up without pain. The nurse explained something to me that I cant remember, mind you, I can't remember much of anything that was said that night.

The consultant came to see me on Thursday morning to explain the "Holes in my knee" 2 were for another arthocscopy and to clean all of the fluid out with 5 litres of fluid, and the massive one was so he could "get his fingers under my skin to feel for anything unusual". I'm glad I was put to sleep now.

They have confirmed I have "Staphylococcus Aureus" which is bascially M.R.S.A. without the MR.

I have had a couple of days laid up bed now trying a little bit of physio and walking etc, they are treating me really nice, I am on a drip for IV antibiotics (Flucloxacillin), taking paracetamol, diclofenac, tramadol and codeine for pain and inflammation, and have found out today I may now need to stay in for another 2 weeks to "ensure they hit the infection hard"

I have also been give my Blood CRP results which show as follows

• Monday - 5
  
• Tuesday - 126
  
• Wednesday - N/A
  
• Thursday - 168
  
• Friday - 206
  

While they are still increasing If anyone reading this knows what these mean or how they went from a normal "5" at the DRI to 126 after a day, please let me know. basically is this someones fault !!!

as Cookie and Goona said. "you can cut my balls but leave my knees alone"

Knee Update

3 weeks on, I am still in agony with my knee, luckily thanks to my company healthcare, I managed to get referred to a consultant at the local private hospital, a 2 week wait and today was my appointment.

8.45am - appointment with the consultant, who advised I would need an MRI Scan as he thinks it may be lose cartilage in my knee (Meniscus Tear), he doubts it is ligament issues or "I'd know about it".

MRI scan arranged for 12.30 TODAY - now that is fast

I have now had the MRI scan and although not obvious from the scans, the consultant believes it is what he first thought, so I have to have some keyhole surgery (Arthroscopy) to sort it.


Booked in for next Saturday.

I must say I am very impressed with private healthcare, and nervous of having my first ever "operation".