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MRSA in Hip Joint Replacement
Started by Vanessa
Posted: April 19, 2007 at 10:25
My dad is 60yrs and a couple of months ago had a hip joint replacement. Everything was going really well and the pain disappeared instantly, then one of the dissolvable stitches didn't dissolve and got infected, they started him on antibiotics but after a while it wasn't getting any better and Dad started feeling a bit unwell, temperature etc. They put him into hospital straight away to open the wound and clean it out but found it to be full of pus to the joint and closed it up straight away to await the result of the blood test to find out what it was. Two days later after the first attempt to clean it out they went back in knowing it was MRSA and cleaned it all out, replacing some of the parts of the hip replacement as well. They had already started him on vancomycin and said that everything was looking good after they had cleaned it all up. Six weeks later Dad is still on the vancomycin (part of the way through they realised they weren't giving him enough! and upped his dose, I only hope that hasn't contributed to the bug not going away)he has a pic line which takes the medicine straight to his heart and wears the medicine in a bumbag around his waist, changing the bottle every night. His blood results have been coming back good but when he saw the infectious disease team today they have said that his symptoms of not feeling well are not down to the vancomycin, that they think the MRSA is getting worse (even though the blood results show ok?) His knee and ankle are swollen. He has gone back to work as he is a hard man to keep still and has it in his mind that he wants a holiday when this is all "over" but he is not feeling well and is not a happy man, my mum bears the brunt of his frustration via his extreme grumpiness and not wanting to talk about the possible long-term future.

This is a long post, but I just cannot imagine him losing his leg to this (worst case scenario, aside from death)and in NZ we have no recourse against medical institutions, no one will take the blame. I fear retirement is coming too early for him and that it will eat him up (metaphorically and literally). I know there are worse things that can happen but I just wanted to put this down in words and if anyone else out there has gone through a similar experience (joint replacement with MRSA) they might be able to give us another perspective.
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Re: MRSA in Hip Joint Replacement
Reply #1 by kris
Posted: April 24, 2007 at 01:08
Tried to write back but coudnt get through testing
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Re: MRSA in Hip Joint Replacement
Reply #2 by kris
Posted: April 24, 2007 at 01:29
brief summary: 2nd attempt.. My dad is 57 years old. He had hip surgery on Nov 11,2007. He got MRSA in wound and in blood. He was on Vancomycin IV antibiotics at hopital. He was sent for rehab at nursing home. Hospital forgot to send orders for antibiotics. He got severly worse, and was in severe pain. 2 months later was sent to hospital were we found out that the mrsa had got in his bones. His hip bone was dead, his leg bone was dead, and half of his hip socket was dead. Amputate they say, but he's to weak for surgery. On March 8, 2007, I held his hand while he died. Complications of mrsa. I dont know much about mrsa, I wish I had known more. Im glad your dad is getting good results on lab work. Thats a good thing. Keep on top of things because sometimes I think doctors dont care one way or the other. Lots of luck!!!
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Re: MRSA in Hip Joint Replacement
Reply #3 by Vanessa
Posted: April 24, 2007 at 04:24
Kris, I am so sorry about your dad. The infectious disease specialist wanted to take the hip joint replacement out straight away (after appointment last Friday) but the orthopaedic specialist said to wait a week, in the meantime his next batch of vancomycin had been forgotten to be ordered and when it did arrive it was the wrong dose (smaller). We are now waiting until Friday to see what the prognosis is. If they take the hip out he will get a temporary ceramic one with slow release antiobiotics and will still be on vancomycin (for about 3months) but he will not be able to put any weight on it so will be on crutches (he is a big man just over 6 foot an ex-rugby player and weightlifter). Mum has had good news in that contracting MRSA comes under a "treatment injury" so he will be covered under ACC (NZ government's accident insurance scheme) and will be able to receive approximately 80% of his wages while off work, which helps Mum's peace of mind a lot as she was worrying how they would cope for those 3 months without his wages.

I am so sorry for what you went through but in reading everyone's stories I feel a bit better equipped to help support Dad through this time.
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Re: MRSA in Hip Joint Replacement
Reply #4 by Jackie
Posted: April 24, 2007 at 21:25
I am a student nurse in my second year in the UK. A lady who is currently under my care also contracted MRSA in her wound following a THR. Her op failed and she is bedridden for life because of this and has daily fragmin injections. My intention is to find out as much about this "phenomenon"as is possible and I will endevour to keep you posted on this. I myself am trying to prove a link between surgery I had myself and a long- term skin condition I have contracted from a possible dirty cannulation that was given to me whilst I was under.
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Re: MRSA in Hip Joint Replacement
Reply #5 by Jackie
Posted: April 24, 2007 at 21:32
I am a student nurse in my second year in the UK. A lady who is currently under my care also contracted MRSA in her wound following a THR. Her op failed and she is bedridden for life because of this and has daily fragmin injections. My intention is to find out as much about this "phenomenon"as is possible and I will endevour to keep you posted on this. I myself am trying to prove a link between surgery I had myself and a long- term skin condition I have contracted from a possible dirty cannulation that was given to me whilst I was under.
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Re: MRSA in Hip Joint Replacement
Reply #6 by Vanessa
Posted: April 24, 2007 at 22:59
That poor woman Jackie! I will be interested to hear anything you find out. Sorry I don't know what cannulation means but having any medical condition long term must be a drain on your spirit.
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Re: MRSA in Hip Joint Replacement
Reply #7 by D Will
Posted: April 25, 2007 at 17:12
Hoping he gets over it all OK. It is a such a horrid thing to suffer
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Re: MRSA in Hip Joint Replacement
Reply #8 by Vanessa
Posted: April 25, 2007 at 20:46
Thank you D. He commented to my mum that he was feeling a bit better yesterday and the wound was looking a lot better so we may get good news on Friday but we will just have to wait and see, otherwise it's back into hospital to have the hip removed.
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Re: MRSA in Hip Joint Replacement
Reply #9 by D Will
Posted: April 26, 2007 at 12:56
Hoping he doesn't have to go through another hip replacement procedure.
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Re: MRSA in Hip Joint Replacement
Reply #10 by Vanessa
Posted: April 27, 2007 at 01:32
Have just had good news! The orthopaedic surgeon has taken out Dad's Picc line and taken him of the vancomycin. He said that Dad's last bloods were good and the x-ray they took of the hip looked really good. He said that Dad's symptoms of not feeling well will be from the vancomycin and that he has been on it long enough, so fingers crossed now that all stays well because we know that it is a sneeky bug and could return. The patient in before my Dad was a guy who had had his hip done a year ago and had got MRSA as well but they had managed to get rid of his and a year later he was still doing well. Just hoping that Dad is one of the lucky ones because I know how many unlucky ones there are out there and I really feel for you all.
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Re: MRSA in Hip Joint Replacement
Reply #11 by kris
Posted: April 28, 2007 at 03:46
Congrats on the good news. Im very happy for you and your dad.
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Re: MRSA in Hip Joint Replacement
Reply #12 by Vanessa
Posted: April 28, 2007 at 04:22
Thanks for that Kris, Dad knows it could still come back but we will take this good news for now as we know so many people don't get it at all.

I have appreciated everyone's feedback and thoughts and will keep you posted if anything changes.

Thanks again

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Re: MRSA in Hip Joint Replacement
Reply #13 by Maria
Posted: April 28, 2007 at 13:29
Vanessa
Good luck with your dad, my mum was treated for MRSA in her surgical wound site and it spread to her lungs, she had MRSA pneumonia. The Vancomycin did clear up her infection at the time, so it is effective.

Mum didn't survive the year though as she had terminal cancer. You just need to keep an eye on the ball and be aware for the future, as long as you tell any medical teams nursing your dad he has previously had MRSA then at least you will know at the first sign of any problems so that immediate action can be taken.

Fingers crossed that it doesn't come back.
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Re: MRSA in Hip Joint Replacement
Reply #14 by Vanessa
Posted: April 28, 2007 at 21:14
Thanks for your thoughts Maria, I am so sorry about your mum.

Dad now knows what the medicial staff should and shouldn't be doing with regard to hygiene practice and MRSA as well as the procedures with his PICC line (they made so many mistakes with it, forgetting to unclamp line, if Dad hadn't realised he would not have been getting any vancomycin through at all plus other mistakes, plus he got a faulty part once)so if by chance it comes back he will be the patient they all fear to get anything wrong with as he knows exactly what should and should not be happening.
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Re: MRSA in Hip Joint Replacement
Reply #15 by Vanessa
Posted: May 1, 2007 at 20:25
Well it has been about 5 days since Dad has his Picc line out and off the vancomycin and unfortunately he is not feeling any better. He has been taking panadol regularly for the aches and pains and my mum thinks that has been keeping his temp down (it is 37 point something, when normally it is 36 point something), plus he has a hot spot on his wound. It is looking more like he will have to have the hip out and the spacer put in. I suppose it depends if they want to risk just going in to see what is happening with the wound or if they just bite the bullet and go in to remove the hip.

We should find out today what they want to do. At least there was a glimmer of hope for a couple of days.
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Re: MRSA in Hip Joint Replacement
Reply #16 by missy
Posted: May 1, 2007 at 20:54
Did the dr tell you there was no infection before he stopped the vaco.?My husband has MRSA from a back surgery he was on Pic line for 2 months and on 2 other antibiotics his pic line was removed and replaced with another medication ID dr says he will be on meds for 1 yr .
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Re: MRSA in Hip Joint Replacement
Reply #17 by Vanessa
Posted: May 1, 2007 at 22:23
Hi Missy, from what I can tell the Dr was happy with his blood results and from the x-ray it looked like all was really good. His Dr has asked him if he could be sick with anything else (how would Dad know, he's not the Dr!) But Dad has been feeling this way ever since getting the infection. I think he should go to his GP and get full blood tests and a chest x-ray (to rule out pneumonia) before going back in (which will be next Monday if it happens)but Dad will do what he wants, he is stubborn and I suppose it is his body. I think his Dr thought that taking the PICC line out and off vancomycin might do the trick and just took a stab at it. The MRSA just loves to attach itself to the steel parts of the hip joint replacement so maybe taking it out and putting the ceramic one in will be the answer to helping get rid of it before putting a new replacement in (if he still has it?) Who knows? Will keep this post updated. Thanks for all your advice, information and thoughts, I really appreciate it.
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Re: MRSA in Hip Joint Replacement
Reply #18 by missy
Posted: May 2, 2007 at 18:50
Vanessa,
If Iam not mistaken you should have a MRI to see the tissue?
Is he short of breath? Are his legs or feet swollen , cough ? Temp?
Those would be signs of pneumonia? I would get a copy of lab results so you can review.Sed rate is important!
I have learned through this mess that you have to ask specific questions ...
Keep in touch and please let us know how you dad is doing ..

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Re: MRSA in Hip Joint Replacement
Reply #19 by Vanessa
Posted: May 2, 2007 at 20:39
Hi Missy, he had an x-ray on the hip before being taken off the vancomycin. His leg has been swelling up sometimes and his temperature it in the 37 degrees (but he has been taking paracetamol regularly for the aches and pains so that would be keeping it down).

He is booked in for his operation to have the hip out and the spacer in on Monday. His Dr said to ring him on Sunday and let him know how he feels before heading into the hospital.

It is a lot of frustration for my mum as she is hearing what the doctor says second hand from Dad and Dad can be impatient and grumpy when it comes to anything about himself so gives the shortest story possible.

I know that from everything I have read and learned from people's experiences on this forum (and passed onto Mum) Mum feels better equipped to be more demanding about his care when he is in hospital and knows what to ask for and expect. But at the end of the day Dad is the patient and with all the privacy acts etc Mum will have to rely on him to do a lot of the "demanding". We just worry that in his tired and fed-up state, he might not ask the right questions.

Will keep you posted, thanks for your concern.
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