Penicillin Challenge

Yesterday I went through a "Penicillin Challenge" test at the Epworth Allergy Clinic in Richmond.

I had a reaction possibly due to penicillin 30 years ago and haven't had it since so my doctor and I decided to do the test, given the superbugs out there nowadays means there are less things that are effective.

I posted this pic of my forearm on Facebook in the morning when we were just getting started. My skin reacted to the alcohol wipes and the pen but that's pretty normal for me, but it meant we had to wait for that to subside before we could get started. I had a few questions from Facebook friends, and I'm sure when it comes back up in "Memories" next year I won't remember either, so I thought I'd document!

The letters down the left stand for: H - Histamine and C - Control. You're meant to react to H and not to C (which is saline). If you don't react this way the test might not work on you. (My H SPT spot spread outside the box and is still red and itchy today).

The rest on the left are various types of penicillin. The SPT column is "skin prick test", which is a drop followed by a skin prick through the drop. The 1:100, 1:10 and 1:1 columns are needle-under-the-skin injections. One of them (I think it was BPen?) stung like a bitch but the rest only stung a little bit.

They did injections in all rows in 1:100 but only 2 in 1:10 and 2 in 1:1. They measure each spot when they've done the injection and again 10-15 minutes after and if it's grown by more than 3mm they stop the test. After 1:10 my head and hands started itching like crazy and I got really hot, but I didn't have more than +2 on anything so we decided to keep going (with a layer of clothing removed). The lady next to me got a +3(ish) and they decided to keep going too. After 1:1 (and in a t-shirt) I was OK so we kept going. Apparently if there is going to be a severe reaction, most people are going to have it at the SPT or 1:100 stage, and "itchy head and hands" isn't on their list so I guess I'm weird. 😀

Then there were 2 oral doses of increasing strength. Now I'm on a 5-day penicillin course to test "tolerance".

I haven't gone into anaphylaxis or anything severe which is excellent, although I have a mild rash on my forearm today from wrist up to where the drip was, my head and skin still feels randomly itchy and I feel a bit nauseous, so it's fair to say while I'm not fully allergic to penicillin, I'm still not totally fine with it and if I have a choice I'll get something else in future. But at least I know now I won't die if I do need it.

I have a clear set of instructions for signs and what to do in case of "mild to moderate" allergic reaction (take a photo and email it to them, stop taking the penicillin and take an antihistamine). If I have breathing difficulties or any of the severe signs we have to call an ambulance.

I arrived at 9am and left at 3.40pm, several hundred dollars lighter. The lunch was surprisingly good and the doctor and nurses were fantastic. While I was sitting there I helped one set up a new Instagram account for her pet, and I was kept well-caffeinated with biscuits, so I guess it wasn't a bad day all up. :)

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Hip Reconstruction - 4 years on

A couple of weeks ago I received a call from Mr John O'Donnell, the surgeon who performed my ligamentum teres reconstructive surgery in May 2015. He was doing follow-up calls on everybody who had received the surgery to find out where they were up to, which was frankly amazing to me and totally unexpected.

Today is 4 years since my surgery so it's a good time to add a follow-up post to the series.

The first thing I want to say is - I'm so glad I had this operation. It turns out I have a fairly high pain tolerance but when I think back to how totally uncomfortable I was, all the time... this is so much better. I've never had a single day of regret in the last 4 years.

In general today, I have full mobility and no problem with things like stairs, sitting, standing etc. I've previously attempted jogging but I'm terrible at it so these days I see a personal trainer in a gym with experience in old ladies' hips(!!), use a cross-trainer and/or exercise bike at home, and I swim. Some of my movement is limited but that's mostly preventative, not because I can't do it.

The main ongoing issue has been muscular. I'm not sure how many years I favoured that left hip, but when I started seeing the PT in October 2018, and despite doing all the physio after the op, I was still favouring it, to the point where my left quad, hamstring and calf were visibly smaller than the right leg. I could stand on my right leg for several minutes, but on my left leg for only seconds before I started wobbling. This made me "crooked" and caused pain in lower back, knee, neck and a bunch of other aches and pains. My lovely PT has spent considerable time "evening things up", and now I'm starting to feel much more aligned.

I do have some ongoing issues with my left knee and in 2016 I went back to Amir, who sent me for an MRI and subsequently referred me to Dr Jane Fitzpatrick. Initially I thought the pain was due to the ligament being removed from there to use in my hip, but the MRI showed it was missing cartilage inside the patella (knee) which was causing that pain. Again, I don't do things by halves and apparently the hole in the cartilage is around 2cm, so now I visit Jane annually and have an injection of Durolane which helps fill the hole for the upcoming year.

Damaged knees are a classic sign of wear for old netballers - "Netball Knee". Nowadays Netball Australia has a whole program around preventing knee damage, but in my day you ran out on the bitumen courts wearing Dunlop Volleys and there was no thought to correct landing technique or anything else. I played netball from age 10 until my mid 30's so it almost certainly came from that.

This has made me consider the chicken/egg scenario - was I uneven before and this caused left hip/knee problems, or did a structural hip problem cause everything else? Did the bad knee cause the hip wear? Did the hip cause the knee? I have orthotics now - was it feet that caused it all? Who knows!

Anyway, back to the hip. If you're considering the surgery - do it! It was a long road and lots of pain and hard work but ultimately absolutely worth it. I can't imagine what I wouldn't be doing now if I hadn't had it.

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Oliebollen and appelflappen

My Dutch Opa used to make these every year on New Years Eve, and I've done them a few times since. This year, my son and I made them together for the first time.

Ingredients:

500 g of self raising flour
0.5 litre of milk
1 teaspoon of salt
1 teaspoon of sugar
1 egg
100g raisins (or currants/sultanas)
1 litre of cooking oil (all the recipes online say 1l but we use a 2l bottle in a bigger saucepan so we can do more at once)
Icing sugar

Preparation:

1. Sift the flour into a bowl, make a hole in the centre and pour in half of the milk, the salt and the sugar. 
2. Stir with a wooden spoon to create a smooth batter. 
3. Next, beat the egg together with the rest of the milk and stir into the batter. 
4. Stir in the raisins so they are relatively evenly-spread.
5. Cover the batter with a damp tea towel and leave in a warm place for about an hour. 
6. After an hour you are ready to begin frying. The batter will be quite sticky. (Do not stir the batter any more). 
7. Heat the cooking oil in a large saucepan or deep fryer – you will know it is hot enough when smoke begins to rise or when you dip a spoon into the oil and it forms bubbles. (If the oil is too hot, the first oliebollen will cook fast on the outside but still be uncooked on the inside - if this happens, turn the oil off for a few minutes).
8. Create round balls using two tablespoons of the batter and drop one by one into the pan of oil. 
9. Fry for about 6-8 minutes or until a light golden colour. If the oil temperature is right, and the size of the ball is right, the oliebollen should automatically turn themselves over.
10. Drain on paper towel to remove any excess oil. 
11. Sprinkle the oliebollen generously with icing sugar and serve hot or cold.

Appelflappen

Use the same dough minus the raisins. We made a double-batch of dough and split it, then only added the raisins to one batch.

Additional ingredients:

6 Granny Smith (green cooking) apples
Sugar
Ground cinnamon

Preparation:

1. Prepare the batter as above.
2. Peel and core the apples and cut each into 4-5 slices.
3. Sprinkle with sugar and cinnamon and leave for 15 minutes.
4. Coat the slices of apple with the batter and fry them, a few at a time, until golden brown.
5. Drain on paper towel to remove any excess oil. 
6. Sprinkle with icing sugar and serve hot or cold.

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Recommended Read: High score, low pay: why the gig economy loves gamification

Really interesting #longread on how industry is using #gamification to "incentivise" workers - I'm more inclined to describe it as "manipulate" but anyway...

https://www.theguardian.com/business/2018/nov/20/high-score-low-pay-gamification-lyft-uber-drivers-ride-hailing-gig-economy

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Recommended Read: What's an arts degree really worth?

For me, it's been incredibly valuable.

"Increasingly, the business world is realising that the skills of most value in the new economy will be those of critical and analytical thinking, communication and interpersonal skills – skills that humanities subjects deliver in spades."

https://www.theage.com.au/business/the-economy/what-s-an-arts-degree-really-worth-200-000-just-for-starters-20181107-p50ej7.html

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Recommended Read: Say no to meetings! And 3 other ideas to keep your workplace happy and healthy

Some good ideas here. I like reading stuff like this to remind me that it's OK to shut the phone off and just focus on one thing at a time.

"There are lots of ways to slice 60 minutes.

1 × 60 = 60
2 × 30 = 60
4 × 15 = 60
25 + 10 + 5 + 15 + 5 = 60

All of the above equal 60, but they’re different kinds of hours. The number might be the same, but the quality isn’t. The quality hour we’re after is 1 × 60."

https://ideas.ted.com/say-no-to-meetings-and-3-other-ideas-to-keep-your-workplace-happy-and-healthy/

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