Antibiotic Prophylaxis for Dental Work after Total Knee Replacement
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And I forgot to mention, I had heart surgery done through a hole in my groin. This concerned the knee surgeon far less than dental cleaning. He said there is all sorts of stuff in your mouth you don't want in your bloodstream with an immature knee replacement!
My hip surgeon said I needed to take antibiotic prophylaxis until I die despite the fact that peer-reviewed medical journals see no reason to take antibiotics after 5 years post-surgery. I stopped taking them after I ended up in the hospital with c.Diff, a major and occasionally fatal intestinal infection that is very contagious. I have never experienced pain like that ever in my life. My suggestion to all of you is to make sure you are taking probiotics prior to taking the antibiotics and after you've taken them. You definitely do not want c. Diff. I'm about to have a knee replacement and I'm already worrying about the antibiotic prophylaxis!
I was surprised yesterday, while playing Bridge, several of the gals say their doctor has told them they need to take antibiotics forever when going to the dentist. I am not sure what type of antibiotics but regardless it really surprised me. A few said they had been told this by their dentists as well.
I was surprised yesterday, while playing Bridge, several of the gals say their doctor has told them they need to take antibiotics forever when going to the dentist. I am not sure what type of antibiotics but regardless it really surprised me. A few said they had been told this by their dentists as well.
The usual problem with anecdotes...no one knows whether these ladies might have had some other immuno-suppressive situations that made this a good idea. For example, if they had ongoing heart problems that would make an infection even riskier. Maybe some other medication that suppresses their immune system. We also don't know whether they might have misinterpreted, mis-remembered what the doc told them, or when they were given this information. If they were told this 25 years ago it might have been more common advice. Nowadays, not so much. Times change. Protocols change. Docs also have personal opinions/biases. A very conservative doc might be convinced that prophylaxis forever was the best protection for that particular person.
Last edited by Parnassia; 01-15-2020 at 06:06 PM..
My hip surgeon said I needed to take antibiotic prophylaxis until I die despite the fact that peer-reviewed medical journals see no reason to take antibiotics after 5 years post-surgery. I stopped taking them after I ended up in the hospital with c.Diff, a major and occasionally fatal intestinal infection that is very contagious. I have never experienced pain like that ever in my life. My suggestion to all of you is to make sure you are taking probiotics prior to taking the antibiotics and after you've taken them. You definitely do not want c. Diff. I'm about to have a knee replacement and I'm already worrying about the antibiotic prophylaxis!
I know there is a concern about c.Diff from taking a lot of anti-biotics. Sorry that happened to you; it must have been a horrible experience. Wondering if you were taking a lot of anti-biotics, or for an extended period before contracting c.Diff? I very rarely have taken ABs in my life and usually get my teeth cleaned 1x every year or two, and will only be taking 2 pills before the procedure - not much. I do take probiotics and know that is important if taking ABs. But I've had a lot of root canals and crowns and there may be more to come (life-long teeth grinder). That will also require ABs. I've become very focused on keeping my immune system strong from this whole thing.
I really hate the constant threat of infection hanging over my head for the rest of my life due to this knee replacement. Just one of the many, many things you have to deal with in getting joint replacements. It was a very hard choice to make, but in the end, there really wasn't much choice. Either that or not be able to walk. One of those "lesser of two evils" choices. Life is full of 'em!
And I forgot to mention, I had heart surgery done through a hole in my groin. This concerned the knee surgeon far less than dental cleaning. He said there is all sorts of stuff in your mouth you don't want in your bloodstream with an immature knee replacement!
I'm wondering, when does a knee replacement become "mature". Does it age like a fine wine?
But seriously, I wonder why many Ortho surgeons recommend this 2-year time frame where you need to take ABs for dental procedures? Why two years, and not three, four, or five? I mean, what's going on in that joint that makes it risky for only the first two years, then you're fine after that? Why is it okay to drop the ABs after two years? I'd really like to know the answer to this.
I really hate the constant threat of infection hanging over my head for the rest of my life due to this knee replacement. Just one of the many, many things you have to deal with in getting joint replacements. It was a very hard choice to make, but in the end, there really wasn't much choice. Either that or not be able to walk. One of those "lesser of two evils" choices. Life is full of 'em!
Look, when something changes our "baseline" health situation (like a join replacement, being diagnosed with some chronic but manageable condition, some other major repair of something that has lingering effects) your whole view of your future shifts in response to it. You have a new group of fears, a new learning curve, things to get used to. What seem like insurmountable threats NOW will gradually recede into background noise. You have to learn to file them away. At first, they seem "urgent and immediate" but as time goes on and nothing horrible happens, you learn to gradually shift them into "not urgent but don't forget" as appropriate.
I've had a joint replacement...it was over 20 years ago. I've been to a dentist for routine cleanings, exams, occasional fillings every year since. Never did I ever end up with an infected joint. You learn to take the precautions that make sense to you, and you learn to lay the fear of it aside. When people hear that I've been through cancer diagnosis and treatment twice, they ask me how anyone gets through it. They say they don't think they could. How did I survive the constant fear that it would come back? You learn what you need to learn, face what you need to face as it comes up, do the followups and the monitoring that makes sense for you, and you adjust. At first, like most patients I was consumed with fear that another tumor would be found every time I felt a twinge, a lump, at every followup exam. Didn't happen. Gradually I found myself forgetting to indulge in my daily fear fest. Nothing happened. Year after year, exam after exam, nothing happened. Eventually you learn NOT to fear what cannot be predicted or completely controlled. Then you suddenly realize you are looking back over decades...during which nothing happened. Until it does. A 5% chance and you ended up one of the 5 out of 100. Fandangtastic. So, you face it all over again. But each time you have mastered the technique a little better.
I had a heart attack in December. Out of the blue, a blood clot in a coronary artery. I am not the poster child for a heart attack; no heart disease, no atherosclerosis, cholesterol problems, no genetic clotting factor problems, arteries are clear and healthy, valves and blood pressure are fine. All the diagnostic testing they did couldn't determine where that clot came from or why it formed where it did. They cleared the clot, no problems since. A Medical Mystery. Arbitrary one-off. However, now I have this little new fear that it could happen again just because they couldn't find the reason and thus know how to prevent another. I have to learn how to file this nagging anxiety where it belongs and go on with living. As the years pile up so does the practice. You realize that life is basically risk management. This risk is higher than that risk. This risk is acceptable, that one isn't. Over and over again. Every person has to make those decisions for themselves, with help from MDs, counselors, your own research, common sense, listening to your gut.
Right now, facing joint replacement, your mind is full of all the "what-ifs". They all seem awful. The reality is, once you get used to the new status quo you won't be filling your mind with them 24/7. You create a new normal. If you don't, you'll drive yourself crazy.
Don't drive yourself crazy.
Last edited by Parnassia; 01-15-2020 at 09:14 PM..
Very good advice, Parnassia! I AM a worrier by nature and have had to learn to mitigate that aspect of my psyche as I grow older, since I'm now facing more and more physical issues that involve some measure of risk - during and after. I'm getting better at it. This joint replacement has been the biggest physical issue in my life so far, so has provided plenty of opportunities to work on the chronic worry thing. Your reply really put things in perspective for me. So far so good - and that's good enough for now!
Look, when something changes our "baseline" health situation (like a join replacement, being diagnosed with some chronic but manageable condition, some other major repair of something that has lingering effects) your whole view of your future shifts in response to it. You have a new group of fears, a new learning curve, things to get used to. What seem like insurmountable threats NOW will gradually recede into background noise. You have to learn to file them away. At first, they seem "urgent and immediate" but as time goes on and nothing horrible happens, you learn to gradually shift them into "not urgent but don't forget" as appropriate.
I've had a joint replacement...it was over 20 years ago. I've been to a dentist for routine cleanings, exams, occasional fillings every year since. Never did I ever end up with an infected joint. You learn to take the precautions that make sense to you, and you learn to lay the fear of it aside. When people hear that I've been through cancer diagnosis and treatment twice, they ask me how anyone gets through it. They say they don't think they could. How did I survive the constant fear that it would come back? You learn what you need to learn, face what you need to face as it comes up, do the followups and the monitoring that makes sense for you, and you adjust. At first, like most patients I was consumed with fear that another tumor would be found every time I felt a twinge, a lump, at every followup exam. Didn't happen. Gradually I found myself forgetting to indulge in my daily fear fest. Nothing happened. Year after year, exam after exam, nothing happened. Eventually you learn NOT to fear what cannot be predicted or completely controlled. Then you suddenly realize you are looking back over decades...during which nothing happened. Until it does. A 5% chance and you ended up one of the 5 out of 100. Fandangtastic. So, you face it all over again. But each time you have mastered the technique a little better.
I had a heart attack in December. Out of the blue, a blood clot in a coronary artery. I am not the poster child for a heart attack; no heart disease, no atherosclerosis, cholesterol problems, no genetic clotting factor problems, arteries are clear and healthy, valves and blood pressure are fine. All the diagnostic testing they did couldn't determine where that clot came from or why it formed where it did. They cleared the clot, no problems since. A Medical Mystery. Arbitrary one-off. However, now I have this little new fear that it could happen again just because they couldn't find the reason and thus know how to prevent another. I have to learn how to file this nagging anxiety where it belongs and go on with living. As the years pile up so does the practice. You realize that life is basically risk management. This risk is higher than that risk. This risk is acceptable, that one isn't. Over and over again. Every person has to make those decisions for themselves, with help from MDs, counselors, your own research, common sense, listening to your gut.
Right now, facing joint replacement, your mind is full of all the "what-ifs". They all seem awful. The reality is, once you get used to the new status quo you won't be filling your mind with them 24/7. You create a new normal. If you don't, you'll drive yourself crazy.
Don't drive yourself crazy.
This is a great post and oh-so-true. I have been an anxiety filled person my ENTIRE LIFE. I have worried over all sorts of physical ailments, small, large and non-existent. And I am 70 y.o. and STILL HERE. I too had a blood clot "out of the blue" last summer - always active no known health issues, etc. etc. All my other anxieties got pushed to the back burner after this. I am on medication, but want to get off. I really do not want to live what is left of my life worrying "what if". I want to take it as it comes. I am back riding my bike and dancing, but I always have that nagging little worry when my bad leg bothers me or my other one feels a "twinge" that something may be happening. And the doctors don't help this at all because they are actually the ones instilling the fear!
Anyway, we just have to live our lives the best we can, find plenty of things that fill us with joy so that we are not constantly focusing on our issues. Frankly, there are so many things that can "go wrong" with our bodies it's a wonder any of us make it to older age at all!
And the doctors don't help this at all because they are actually the ones instilling the fear!
Hmm, I don't see it quite that way. I view doctor-provided information as just that; information. Like a mechanic or home inspector making me aware of things that affect this object I own and use. How I choose to internalize that information is up to me, not them. That being said, I do have a biological background so I don't flip out when presented with complicated biological information. I understand that there are no absolutes, black or white answers, and understand what statistics and probabilities can provide and what they can't. There are irrefutable facts and there is an overly of carefully cultivated opinion and judgment constructed over a medical career's lifetime. Just as you know you have to be discerning about what you hear, any doctor is allowed to do the same. I know how to ask questions and can tolerate the reality that there may not be an answer.
Sure, a doctor can scare you with information...but don't forget that same expertise and information can also result in a longer life than you might have had without it. Knowledge OF potential threats to health is counteracted by more treatments FOR them.
I just had a followup with my cardiologist. Never has he tried to instill any fear. No gloom and doom, no telling me to accept my new role as a "cardiac case". He's given me information, a quick background explanation of cardiac physiology and thrombosis, explained all the procedures they were going to do and why. Gave me all the test results, explained what parameters they searched for, and how that might have played into the whole odd event and why it was atypical. I didn't get any finger-wagging lectures about protecting my heart better...well, OK, because it was healthy to begin with. Some unknown thing went mechanically wrong. Then he gave me a big smile, said everything they could measure looked great, shook my hand, and said he hoped I'd never need or see him again.
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