Wednesday, 5 June 2019

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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Saturday, 25 May 2019

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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