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Author Topic: When is it OK to give up?  (Read 228448 times)

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Offline Doc79316

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When is it OK to give up?
« on: April 12, 2006, 05:07:39 AM »
Hi,

I thought after the week I had last week things could only get better. After passing out 3 times at clinic on Monday it happened again at work yesterday, a total of 4 times. No warning, nothing. I've only just  managed to successfully get my own job back after much negotiation and argument with management, personnel and occ health. My job involves a lot of driving so it's not gonna be long before I have to give up altogether if this carries on. I have noticed, though, that it only happens when I'm in more pain than I know how to handle. The problem is, I can't contrrol the pain and my pain management appointment hasn't come through yet. What do I do in the meantime whilst waiting for it? Is it going to happen at every clinic appointment? My next appointment is today, so I'll find out.
The best part is, yesterday was my first day out on site inspecting buildings again - and it p****d down all day. Should've known better really, i suppose.
I can usually laugh about most things but my sense of humour has long since evaporated. Still, at least I'm distracted at work with other things to think about - for the time being anyway.
Sorry for posting this - feeling sorry for myself. Wouldn't you if your knee looked like this 89 days post op??? ???    :'(




Laura x
« Last Edit: April 12, 2006, 06:53:03 AM by laura79316 »
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline UK Girl !

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Re: When is it OK to give up?
« Reply #1 on: April 12, 2006, 08:38:38 PM »
laura
sorry you  are still having a crap time - get back to your GP - he must find out why you are passing out - and get it sorted

Please do not drive until you see your doctor and get the all clear - it's harsh but you could cause a serious accident - not just injuring yourself, your gorgeous little boy or partner but you could kill or seriously injure someone else. Please get this sorted -

I am sorry if this sounds harsh but you dont pass out for no reason

take care and keep us updated
anja
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline Doc79316

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Re: When is it OK to give up?
« Reply #2 on: April 12, 2006, 09:26:51 PM »
Hi Anja,

I have to drive to do my job. I'm not about to give it up when I've just got it back. So now I'm thinking of other alternatives to me driving myself. I suppose I could get a taxi as others have done at work, or I could just do visits that are only walking distance (hobbling distance) away.
There's no way I'd deliberately put someone else at risk for anything. As far as I am concerned, I'm not really bothered any ore.

take care,

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline UK Girl !

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Re: When is it OK to give up?
« Reply #3 on: April 12, 2006, 09:34:03 PM »
laura, I realise that you woulnt deliberately put anyone at risk - but if you have no warning that you are going to pass out.....

Taxi's are a good idea - you do worry me - you are having a really crap time - hopefully you can soon look back on this awful time
take care
anja
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline Doc79316

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Re: When is it OK to give up?
« Reply #4 on: April 12, 2006, 09:35:31 PM »
Hey Anja,

Thanx for that but I don't want to look back on it. I'd sooner it all just went away and I could forget about it. Once I get over one problem there is always another. I don't know why I bother.

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline Doc79316

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Re: When is it OK to give up?
« Reply #5 on: April 13, 2006, 01:01:48 AM »
Hi,

My knee has changed in appearance. It's like it belongs to someone else!   :o  (other than the pain - that's definitely mine).
From the scar, all around has turned a bright red colour, almost as though it's been coloured in with a cerise coloured crayon and there are kind of spindly red tracks coming out from it as though a spider has stepped in ink and walked across paper. It's only at the top of the scar area.
Anyone know what it is? It looks really strange.

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline Doc79316

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Re: When is it OK to give up?
« Reply #6 on: April 13, 2006, 01:56:51 AM »
AND JUST TO TOP OFF THE EVENING WITH STYLE, NOW THE SCAR HAS SPLIT AND ITS DRIPPING. I CAN'T STOP IT. FANTASTIC. BLOOD EVERYWHERE AGAIN NO DOUBT.


Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline kath

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Re: When is it OK to give up?
« Reply #7 on: April 13, 2006, 02:08:36 AM »
Laura....I don't like the sounds of this.  If your incision is not looking better but looking worse, if it has spreading redness, I would  have this checked right away.

Do you have a fever?  Is the incision oozing clear or cloudy liquid?  Do you feel ill?

You have had such a rough time with this.  Sorry, maybe I'm over-reacting, but if it were me...I'd go have it checked.

kath
Bi-lateral unicompartmental Nov 2004

Offline Doc79316

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Re: When is it OK to give up?
« Reply #8 on: April 13, 2006, 02:10:08 AM »
Kath,

Thanks for that. I will get it checked in the morning (it's just after 2am here now). Too tired and can't be bothered right now. Just needed another opinion on it.

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline kath

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Re: When is it OK to give up?
« Reply #9 on: April 13, 2006, 02:18:00 AM »
PLEASE BE SURE YOU DO!!  the appearance of your incision, plus the fact you are passing out, is way too serious to shrug off.

It could be your medication causing the fainting spells...sometimes anticoagulants will do that.  BUT...this isn't anything to fool around with. 

Laura...monitor this carefully.  Please take your temperature to see if you are running a fever.  You may not realize you are because you've not been well for so long.  Do you have one of those phone-in health services where you live, like Tele-health?  If so, I would recommend calling them now and giving them your symptoms to see what they say.

kath
Bi-lateral unicompartmental Nov 2004

Offline misshilde

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Re: When is it OK to give up?
« Reply #10 on: April 13, 2006, 02:31:38 AM »
 :o  Laura I agree with Kath, get to a doc asap..A scar should not look like yours..ever...and the passing out...no no... I know women wait a long time to have things checked out when we're in pain, and that's why we die from heart falure and other preventable things...we wait too long....see a doc now......!!

Hilde
born with bad knee
83 patella ligament pierced by iceicle
84 50%  hamstring rip
86 lateral meniscus tear
more dance 
99 menisectomy(finally)
more dance
patellar & quad tendontis
05 LR, bonespur removal, general clean out, stage 4 OA
oct 06 illiophoas release( hip ok) but knee still bad...

Offline Heather M.

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Re: When is it OK to give up?
« Reply #11 on: April 13, 2006, 05:20:53 AM »
You really need to see a plastic surgeon or wound clinic (usually found in places that treat diabetic and elderly folks) AS WELL AS an infectious disease specialist to rule out infection.  Your wound will not close in the presence of infection--I seem to recall that you had one of these.  Perhaps it never went away completely. 

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Doc79316

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Re: When is it OK to give up?
« Reply #12 on: April 13, 2006, 05:45:37 AM »
Hi Heather,

Thanks for that. I'll go to my GP when the surgery opens.

Take care,

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline Heather M.

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Re: When is it OK to give up?
« Reply #13 on: April 13, 2006, 09:16:06 AM »
If your GP decides to send you for testing (swabs used to culture bacteria, usually), then BE SURE to have the swabs done BEFORE you take any antibiotics.  Otherwise they will mess up the results and you won't know if the meds are right for the bacteria you have.  Usually, multiple swabs of the fluid draining from your wound should be taken, then sent off to the lab.  A very thorough doctor will take a blood sample, too.  Teresa can talk about the two types of blood tests they do to look for infection.  I believe these are 'yes-no' tests vs. a culture, which will hopefully tell WHICH bacteria is present.  So both types should be done to be thorough.

Once you've had the blood and swabs taken, then usually you are put on a broad-spectrum antibiotic.  Often the doctors can tell which type of antibiotic is most appropriate based on the wound's appearance, the discharge, etc.  Usually the patient takes the antibiotics while waiting (approx. 48-72 hours) to hear back on the cultures and blood tests.  Then, if the cultures show that the patient isn't on the right type of antibiotics based on the cultures, a new prescription will be issued.

Please remember that if stuff can get OUT of your knee, stuff can also get into it.  Bad stuff.  Keep the incision dry at all times.  Don't put creams or lotions or even anti-bacterial ointments on it unless you have been specifically instructed to do so.  Use STERILE gauze (sheets or squares should be individually wrapped) and hold it in place with a tensor/ACE bandage.  Change your dressings 2-4 times a day--whenever the fluid/blood soaks through.  If the gauze has dried fluids on it, do NOT just rip it off, soak it off with a warm, wet washcloth.  Wash and bleach the tensor/ACE wrap and washcloth after each and every use.  NEVER submerge an open wound like yours in a tub, pool, hot tub, river, lake or ocean.  Try to keep the area dry for showers, too.  When you are home sitting (which you should be doing as much as possible to give the skin a chance to close), then it is okay and even advisable to unwrap the wound and expose the skin to air.  Some docs even recommend taking yourself outside and getting some sunshine on the area, especially if it is in a spot that is covered by clothing all the time.

Also, and this is VERY important since you have a toddler, be sure to THOROUGHLY wash your hands repeatedly throughout the day, and especially before any dressing change.  It would be a good idea to use disposable medical gloves as well.  Don't let your boy touch the skin on your leg unless he has just come from his bath...it sounds harsh, but he's likely on the floor and in contact with a lot of stuff you don't want anywhere near your knee.  Of course, when you start to change your bandage, any toddler would be interested in seeing what you are doing--and exploring.  So just keep that in mind until you can get the wound closed up and the skin healthy again.

There has to be a reason your wound has never closed properly.  When I had two post-op knee infections within a few months of each other, I was told by the infectious disease doctor that bacteria could live in the bloodstream, joints, and various parts of the body in a semi-dormant infection state for YEARS.  Years.  So that's why it's important to do a variety of tests to look for indications of infection.  And to keep anything else from getting into the area with broken skin, because that skin is your body's main defense against any other bacteria that would like to make themselves at home inside you.  We all have bacteria that live on our skin/bodies all the time--it's a fact of life.  But when they get into an area without any natural defenses--like an open wound--then you can have disastrous results.

The cherry red color you are describing is definitely cause to sound the alarm.  And really, you should see a specialist...GP's of course have basic experience with minor infections, but for you to be having this level of problem at this point post-op says you are far from a normal case.  Best to see an expert whose practice focuses on skin and wound problems, infections, etc.

Keep us posted.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline Doc79316

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Re: When is it OK to give up?
« Reply #14 on: April 13, 2006, 01:40:54 PM »
Hi,

I went to my GP this morning. Couldn't get to see the doctor I usually see but saw someone who doesn't know my history and couldn't be bothred to flick through my notes before I went in. What a waste of time!

I wasn't tested for any infection, I wasn't sent to hospital to be tested or haveblood taken and I haven't been put on antibiotics. I don't really mind that so much as I'm taking so many different meds anyway.

I have kept the whole aera clean and dry from day one. That in itself isn't really a problem, but a pain in the backside when I have to think about covering my leg EVERY time I want a shower. I use post-op dressings which stick themselves to my leg. I usually change them about 3 times a day unless it's particularly bad, then it's more often. The only time I really allow air to get to it in the hope that it will dry out is either when I'm on my own at home and I can relax without Oscar jumping on it, or at night when I'm up anyway because of pain and the whole world is asleep!
As far as exposing the area to sunlight is conerned - NO CHANCE. It hurts as it is and my scarsalways getburned regardless of what protection has been used. Apart from which it's too cold here right now. I don't mind going out in the fresh air to get UV rays to my leg, but I won't directly expose it to sunlight.

As far as Oscar is concerned, don't worry. I have always washed my hands before having contact with him. Maybe a little over the top at times, but not a bad habit to get into I don't think. So long as it doesn't become obssesive. I always wash my hads both before and after and nappy changes for him, getting him dressed or any dressing changes for me. I never let him touch my leg at all. I don't want him catching anything fom my knee. I know I could pick up something but my main concern is Oscar - he comes first no matter what. He likes to watch me dress my knee, but he never comes anywhere near it. He stands across the room pointing at it usually and babbling at me in baby speak. So no worries there.

As far as not closing properly is concerned - could it be that it's because the cut that was made was particularly deep? I know it should've closed by now anyway but could this be a contributing factor? Or could it be related to an accident I had at work 10 years ago (ish)? Since the accident I have taken a long time to heal with some wounds - never after surgery though!

The red colour around the scar keep changing. It still looks as though a spider has walked through red ink but it seems to change position and direction. THis probably sounds stupid to those of you who're medically qualified, but it's almost as though there are tiny vein just under the skin right next to the scar and it's spreading. I don't know how else to describe it. My GP wasn't too concerned by this but I've never seen it before. I would've posted a photo but it didn't come out/show up too well. It's quiet distinctive to see it though.

I see my OS next Friday afternoon. Maybe he can shed some light on what's going on. My kneecap is still dislocating, even whilst wearing the brace so do I assume surgery was unsuccessful?

The meds/doses I'm taking now just to take the edge off the pain are spacing me out. I fell asleep in a group meeting last week. Not a problem and every found it amusing for a day or so but if I don't take the meds then I can't get out of bed because of pan. I just can't function. What do I do? I'll wait and see what my OS says. Maybe he can refer me back to physio too seeing as they discharged me without good reason. Hopefully, it'll be someone who knows about RSD too - if I'm licky!

Take care,

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation