A New Development

I’ve been spacing my posts out as nothing new is happening daily. A back-to-back post isn’t good right now, but I feel we need a lot of prayer on this development. Amanda didn’t do well overnight. She’s had stomach issues for a few days and has been hurting badly since last night. Her temperature before I left was 99; this morning, it was almost 101. She has an infection; it’s just a matter of where it is. She had a lot going on; she had a foreign body implanted with a filter and dialysis catheter, tons of wounds and holes draining, all with a low white count while heavily immunosuppressed. This is an excellent breeding ground for an infection to brew. Her shoulder, where the tunneled dialysis catheter is, was pretty sore. They had to do a little digging, and it took a bit, so they were thinking the pain was from that. She has been weak and tired since the biopsy, followed by dialysis, then the filter, followed by a round of dialysis. So I was assuming it was that.

The new development is her knee, the one she had a replacement done on. To catch our newer followers up, about 13 months after her first transplant, she had a fall on a ministry trip in New Mexico. She fell down some stairs and injured her knee. All of the high-dose rejection medication she was given early after transplants wreaked havoc on her joints and bones. She now has osteopenia and is monitored by an endocrinologist to follow up on her bone health. The damage was bad and never got better, leading us, after 18 months of injections, to make the decision for a knee replacement. That replacement eventually never fixed the problem completly and wasn’t stable and led us to seek a redo after the year mark. We found a surgeon who specialized in redo knee replacements. In May of last year, she had a second total knee replacement. She did much better after the redo, and in three months, we hiked to an Alpine lake in Colorado. That trip was only a year ago, and it seems we’ve lived five years since then. I feel like I’ve aged that much for sure. Here are some pictures from that hike, just because I wanted to see them!

So, back to the current problem. Yesterday, she said she was having terrible pain in her bad knee. She could hardly stand on it. Her weakness since the end of last week has only gotten worse, too, but the knee pain was new. We didn’t think much of it; my bad knee was hurting, too. The change in weather kind of hurting, so I was thinking the same with her. I don’t have as much hardware as she does, so I figured hers was the same. It was hard for her to stand on it in the evening when I got her up. During the night, it was worse. The nurses were barely able to get her up to go to the bathroom; she couldn’t even walk to the restroom.

During rounds, I was quick to note the joint pain and the new knee pain. They assessed her, saving the knee for last. Her left side lung didn’t sound so great, he said. Other than that, there were not too many concerns. Then they pulled the covers off to look at her knee. It was splotchy down on both sides of the incision scar. It was warm to the touch and hot compared to the other knee. I could tell in the doctor’s quiet tone of voice when he gave the NP orders, it wasn’t good. He looked worried, and a soft tone wasn’t going to hide it. I was worried the minute I saw it, too my heart sank. The last thing we need is a hardware infection of the knee replacement. 

The type of replacement she has now has stems that extend into her femur and tibia. This type provides better stability and lasts longer, but has plastic liners, which don’t last a long time. It’s a simpler process to swap the liners out, though. The liner replacement surgery doesn’t involve saws and drills like a full-blown replacement.  All that to say, there is a lot of hardware to get infected if that’s what we are looking at. It would be a huge setback to try to recover from a heart surgery and a knee replacement both. I’m praying that nothing has to come out and they don’t need to open her knee up for anything. Also, they can get a specific antibiotic regimen that will whoop the infection down without surgical intervention. I’ve wanted to whoop someone’s ass for a while, at the very least, I can ask for the antibiotics to do that for me!

We have an orthopedic consult later today. We should know more after that, and hopefully they shed some light on things. She also has dialysis today. I have her explicit instructions to make sure she doesn’t take to ortho without me or they call me. There is a lot to cover on the knee. Amanda has been super groggy, and I want to make sure they get the entire story. I’m worried, Amanda feels like crap, and is concerned, as well. We know that there is a purpose in this all, and God’s got things, but we sure could use some prayers right now.