Comment by AbraKdabra | Hacker News Reader

Comment by AbraKdabra | Hacker News Reader

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My time to shine.

I had a surgery last January, broken labrum on both hips, left was "ok" and the right was really damaged, still it was an arthroscopic surgery and I could go on with my life 2 weeks after, but... 3 weeks after the surgery my right hip was getting worse, way worse, the pain was like nothing I have ever felt, I couldn't sleep, I couldn't walk, I couldn't even touch my fucking leg that I felt a nuclear bomb going off inside of it. No fever, puncture was ok, nothing that could deemed it as an infection. I was in literal agony, not even the strongest analgesics worked. I did a blood test and the PCR was off the charts, "yup, that's an infection, it's 10 AM, don't eat anything, today at 17hs you go in surgery".

I had a toilette done, infection was cleaned off but still I couldn't even move my leg, I lost all the muscle. Fast forward today, I had the worst 7 months of my life, antibiotics for 6 months but wait, there's more... Both infection and the initial cartilage problem evolved into a septic arthritis, last week I went into surgery again to have my hip replaced by a temporary spacer while the biopsy is performed and I will go in again in a month or so to get my definitive prosthesis.

For those who want to know, the bacteria was a Pseudomona.

So yeah, don't fuck with infections.

I am so sorry you are experiencing all this. I sincerely hope things turn a corner and things improve for you. I’ve had my share of horrific trauma related to my health, and it often felt this would never end. Luckily my issues did end, but it does really change your perspective on how fragile and valuable life is, but in some ways it also made me more accepting of death having fully accepted a number a times death was preferable to my situation. I had people that depended on me though so it was more a recognition of the fact.

I did find places like HN and other outlets really helpful, little bit sized opportunities to nerd out and connect, that were just small enough that I could keep focus during the worst of things.

Good luck.

So what you’re trying to say is the fear is justified. That going in for surgery or a stay at the hospital is as much (or more) risky due to after procedure infections.

I’ve broken my olecranon (the pointy bit of your elbow) and declined surgery. I set it myself. Glad I did. It hurt. It wasn’t pleasant. But to me the risk of infection from being opened up for something so minor was too much of a risk. If I had internal bleeding or something I would have gone for it but a simple broken bone (even a joint) isn’t enough for me.

It's like any medical procedure or drug. There are always risks and possible side-effects. The idea is that the risks of not treating the problem are worse than the risks of the cure.

Yes some people get infections after surgery. Most do not.

The COVID vaccine killed some people. Most were fine.

Don't make your medical decisions based on anecdotes.

I broke my elbow tip as well on a skateboard but figured it would sort itself out like i do with all injuries.

A decade later I can’t do an elbow plank without some pain usually and I can’t put a lot of weight on that part of my elbow. My favorite laptop position is on my belly on the floor so it sometimes hurts too much to do that.

I don’t know if surgery would have helped but it’s annoying sometimes.

if it doesn't work and you didn't set it while it was broken (you let the pieces heal on their own) you probably do need surgery. They'll have to re-break it and set it properly. I did this to myself while it was broken and my arm wasn't useful. A few shots of whiskey, a friend giving me a firm handshake, and a really really strong pull. The broken bone bit slid back into the elbow socket and I could straighten my arm. I couldn't hold it there on my own, but it was straight. A couple of months with an arm sling and it healed ok. There's still a little gap in the bone but it no longer hurts when I hit it against door frames.

IANAD but I know my own body, I know when something is wrong, when something isn't working right, and sometimes kicking your body's a$@ is what it needs. Like doing a purge. Or fasting to shock the system.

I wouldn’t jump to the conclusion that the fear is justified, not every broken bone is “simple” and while most fractures are nonoperative some do require surgical fixation.

Pain reduction isn’t the main reason to operate or the metric of interest, there are many ways to alleviate acute pain including casting.

Functional impairment (immediate and delayed) and reducing the risks of posttraumatic arthritis are far more important.

Joint infections (and pseudomonas in general) are an absolute nightmare as the joint space is not vascular.

Bone infections/osteomyelitis are much rarer and for the most part less catastrophic (although they certainly still can be).

As always patient autonomy is paramount and we all value risks differently. For myself as a young healthy adult (not an orthopaedic surgeon) I would rather accept the minimal risks of surgical reduction and fixation for a fracture needing one than risk needing complex reconstruction or joint replacement in 10-20 years which has much higher complication rates and longer recovery.

Statistics is your friend here. You will be able to get stats for morbidity (fancy word for oopsey rate) for the procedure and the hospital.

there will be a point where the risk of infection is far outweighed by the reward of surgery.

> So what you’re trying to say is the fear is justified. That going in for surgery or a stay at the hospital is as much (or more) risky due to after procedure infections.

Short answer: What? No, no way.

Long answer: It depends, If you can avoid being opened sure, avoid it like the plague, I've learned that the hard way that no matter how much sterilization is done, bacteria is there, and if your body is cut there's a chance bacteria could get in, but there are cases when you have no other road, like my case. Last December I couldn't walk a single complete street, the labrum was damaged to the point that the only solution was an arthroscopy, there was no option for me to say no. My surgeon told me "patients get infected, shit happens", but on top of that I got extremely unlucky, I got the worst fucking bacteria in the universe, I had no fever and the needle that was inserted in my hip to test for bacterial growth yielded negative results.

> Pseudomona

Fucking Pseudomonas.

Wife had appendicitis, or what looks like it. She had given birth a few months before and it didn't really go well. She had to have emergency surgery, and was pretty close to snuffing it.

Anyway, that healed, but she had some persistent pain, but that could just be scar tissue being a dick.

fast forward a few months, she has text book appendicitis symptoms. Now, as she's a doctor, she knows what it is, I know what it is, but she refuses to actually go into hospital. I drag her arse to the GP, who looks at me and says: "why haven't you taken her to A&E" I told the GP, that the patient knows too fucking much and won't listen to a muggle.

The GP turns to my wife and says: "you and I both know you need to go to hospital"

She goes in for assessment. Cant see much on the ultrasound. Go for a slice and dice to section the appendix.

Puss drained, appendix Yeeted, lots of IV antibiotics. Looks like a rampant infection rather than a swollen appendix.

Important note: men, topology wise, you are a doughnut. There is a tube from face to arse, and everything is mostly sealed(lungs are excluded for simplicity).

Women, are not doughnuts, There is a gap between the ovaries and the fallopian tubes, which from what I recall is only really sealed with "mucus".

This means that bacteria can get in from the outside. The hypothesis is that either when my wife was being professionally fisted by the midwives, or when she was being crash sewn up to stop her bleeding to death after the baby was born, is when Pseudomonas got in.

Thus, in conclusion, Pseudomonas can get to fuck.

It sounds like things didn't end well. I am sad for you.

She's much better, but it wasn't fun.

It genuinely touches my heart that even on HN there is concern for strangers.

Is she better now?

aye, that was about 5 years ago. much better now

Glad to hear that

Good Lord, all of that sounds horrible. More power to you for whatever else you face ahead on this.

Thank you for your testimony.

I'm wondering if this was pseudomonas aeruginosa.

https://en.m.wikipedia.org/wiki/Pseudomonas_aeruginosa

Yup.

This is the thing of nightmares. I hope things improve and you get a working hip back.

I'm really sorry to hear that. That doesn't sound fun at all :(

my question with this kind of thing is how does it not almost immediately infect the rest of your body? is it just WBCs or?

The hip joint is pretty isolated from the rest of the body I assume, I had the same question for my surgeon and he told me there was no way for that to happen.

Aren’t there any antibacterial sprays or devices they can leave behind? What if antibodies were extracted from the patient’s blood before surgery then sprayed on at the end of the operation?

You wash, irrigate, and provide prophylactic antibiotics but shit happens, this was a very unfortunate case especially as there was no implant.

Pseudomonas infections are rare in healthy patients and few antibiotics work.

any part of your body - besides hair, nails and bones, I suppose - need to be supplied with nutrients, water, etc

Bones are live tissue and are constantly being remodeled. About a tenth of the heart's output flows into the bones.

okay not bones then, but it makes my question stronger

how can you have a bacterial infection in your hip that doesn’t make it to the rest of your body?

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