New Zealand
I'm going to ask @Josephine to answer this question, and also to advise you on some of your other comments in your post, above.
Revised PKR to TKR 12 months later but can’t find my thread
- Thread starter shelli22
- Start date
Josephine
NURSE DIRECTOR EMERITA
Of what, exactly? Different things prompt different symptoms
Of course you can - dependent upon the cause of course!
Certainly not!
Not exactly - the rash is usually a symptom of the allergy.
OP
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shelli22
senior
@Josephine thanks for your reply. I was talking about metal allergies. I can't wear jewellery other gold. I have now developed a rash three years later. After I fell, I bruised the patella and have tendonitis. The physio taped my knee. The rash first developed outside of the area taped. We stopped taping and after a week of phenergan the rash started to go. However, after we taped again for less than 24 hours the rash has spread throughout my knee.
I assume it's the tape causing the rash, even though it began where there was no tape and I have never had issues with any tapes before.
I have had pain in this knee since it was done, originally it improved to bearable and I returned to work a year after the TKR (revision) was done. It has gotten worse after each fall (3) but really bad after the last fall. I can only last 1/2 an hour before the pain becomes unbearable and I have to stop and sit. If I do nothing all day the pain is bearable unless I stay in one position for too long. I'm off work (nurse) as I cannot tolerate 8 hours on my feet.
I have previously asked about metal allergies but the surgeon isn't convinced it is that and wants to do an arthroscopy to remove scar tissue as he believes that is the cause of the pain. He will send off samples for testing. He doesn't believe it is worth doing allergy testing as he thinks blood and patch testing is inconclusive (according to research). I don't agree and have read the articles on this forum.
I take tramadol slow release at night. I have tried lyrica and gabapentin, neither worked. Nor did meloxicam.
The worst of the pain is at D LF 3 and 4, however the pain radiates into my shin and thigh as well. It feels like bone pain. It is also in D LB 3 and 4 using your knee chart.
The pain is at 3-4 if I do nothing. At its worst I get to 7 when I go shopping or do housework.
I have ceased all exercise and just go to the physio twice a week. He has only massaged the knee prior to taping and started knee bends in an attempt to build up tolerance to enable weight bearing. When we do that , by the end of the day the knee hurts at about a 7.
I can't work like this for the next 17 years and I don't want to work in constant pain. It's so tiring. I can't even go walking everyday like I did before the last fall.
Anyway, that's what I meant re allergy. Thanks again for your reply.
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I assume it's the tape causing the rash, even though it began where there was no tape and I have never had issues with any tapes before.
I have had pain in this knee since it was done, originally it improved to bearable and I returned to work a year after the TKR (revision) was done. It has gotten worse after each fall (3) but really bad after the last fall. I can only last 1/2 an hour before the pain becomes unbearable and I have to stop and sit. If I do nothing all day the pain is bearable unless I stay in one position for too long. I'm off work (nurse) as I cannot tolerate 8 hours on my feet.
I have previously asked about metal allergies but the surgeon isn't convinced it is that and wants to do an arthroscopy to remove scar tissue as he believes that is the cause of the pain. He will send off samples for testing. He doesn't believe it is worth doing allergy testing as he thinks blood and patch testing is inconclusive (according to research). I don't agree and have read the articles on this forum.
I take tramadol slow release at night. I have tried lyrica and gabapentin, neither worked. Nor did meloxicam.
The worst of the pain is at D LF 3 and 4, however the pain radiates into my shin and thigh as well. It feels like bone pain. It is also in D LB 3 and 4 using your knee chart.
The pain is at 3-4 if I do nothing. At its worst I get to 7 when I go shopping or do housework.
I have ceased all exercise and just go to the physio twice a week. He has only massaged the knee prior to taping and started knee bends in an attempt to build up tolerance to enable weight bearing. When we do that , by the end of the day the knee hurts at about a 7.
I can't work like this for the next 17 years and I don't want to work in constant pain. It's so tiring. I can't even go walking everyday like I did before the last fall.
Anyway, that's what I meant re allergy. Thanks again for your reply.
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Josephine
NURSE DIRECTOR EMERITA
He's right!
There is a lot of misunderstanding about adhesives and so-called allergies to them. Most modern surgical adhesives are hypoallergenic so shouldn't cause issues. However, with some the tendency or temptation is to apply the tape under tension which means the operative sticks one end down and then applies a degree of traction before the rest is stuck down. This creates a reaction more commonly known as traction blisters. These can be quite painful, quite bad and cause widespread rashes as well. So if your PT is applying any traction or tension to the tape during it's application, this can be the cause of your rash. And this has nothing to do with any allergy.
Perhaps you would post me a photo of this rash so I can see it for myself. It needs to be good resolution and either a close up or high definition.
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shelli22
senior
@Josephine. Thank you for replying. He is applying traction to the leucoplast tape but there is hyperfix or fixamol (not sure what you call it) underneath which isn't applied with any traction. It's just used as a'liner' as protection, so the other tape isn't stuck to the skin. It is extremely itchy and hot to touch but the rash itself is not painful.
As you can see it isn't where the tape is. Nor has that area been under any kind of traction
As you can see it isn't where the tape is. Nor has that area been under any kind of traction
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shelli22
senior
Honestly no there hasn’t. Regardless the whole knee is now covered in the same rash as is the back of my knee. At no point was the leucoplast applied directly to the skin. Hyperfix was always underneath the leucoplast. I then put the hyperfix on my arm and my right leg. The leucoplast on my arm and my right leg and the two together on my arm and right leg. I left it on overnight. No reaction at all. Not even under the leucoplast that was directly on my skin.
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shelli22
senior
Thanks @Josephine and @Celle. I saw the surgeon and it was decided that after no improvement in pain and swelling, an arthroscopy is the next option and histology sent. He had lots and lots of scar tissue to remove. This has now been done. I woke in excruciating pain worse than any I have experienced so far.
Thankfully everyone just kept adding pain relief until something worked. I was crying (I don’t do tears) the pain was so bad. Have now got on top of the pain and it’s one in the morning. So the surgeon came to see me and showed me photos of all the scar tissue he removed. Then I interrupted him politely.
I asked him if we could lay off physio and do nothing initially but ice and elevate and just walk to kitchen and bathroom. I said last time we were in a rush to get me back to work which caused overdoing and probably caused scar tissue formation. Falls didn’t help, adding insult to injury. He agreed. Then two corticosteroids injections one in a fortnight, then the other a fortnight later.
Then the physio came to see me and I told him the plan I discussed with the surgeon and I said I would be going to the physio I had been using as they were going to drive my recovery progress and are five minutes from home. This hospital is an hour away. They work with the surgeon and form a recovery plan that we all agree on. This will be no exercise until it doesn’t hurt. If anything hurts stop doing it. Ice and elevate. Monitor progress.
I did discuss what would happen if this failed. He said then it is time for a second opinion and move forward from there as that may require lawyers etc. being a work injury. But I will take it one day at a time. Wait for histology results. Take time to recover and monitor progress. Other options can wait. I’ll cross that bridge if or when I need to.
Ps the staff are fantastic
Thankfully everyone just kept adding pain relief until something worked. I was crying (I don’t do tears) the pain was so bad. Have now got on top of the pain and it’s one in the morning. So the surgeon came to see me and showed me photos of all the scar tissue he removed. Then I interrupted him politely.
I asked him if we could lay off physio and do nothing initially but ice and elevate and just walk to kitchen and bathroom. I said last time we were in a rush to get me back to work which caused overdoing and probably caused scar tissue formation. Falls didn’t help, adding insult to injury. He agreed. Then two corticosteroids injections one in a fortnight, then the other a fortnight later.
Then the physio came to see me and I told him the plan I discussed with the surgeon and I said I would be going to the physio I had been using as they were going to drive my recovery progress and are five minutes from home. This hospital is an hour away. They work with the surgeon and form a recovery plan that we all agree on. This will be no exercise until it doesn’t hurt. If anything hurts stop doing it. Ice and elevate. Monitor progress.
I did discuss what would happen if this failed. He said then it is time for a second opinion and move forward from there as that may require lawyers etc. being a work injury. But I will take it one day at a time. Wait for histology results. Take time to recover and monitor progress. Other options can wait. I’ll cross that bridge if or when I need to.
Ps the staff are fantastic
I'm glad your surgeon is on board with your plan for no PT and gentle treatment, Shelli.
When did you have the arthroscopy and removal of adhesions? I'll add that to your signature, if you let us know.
Also, I don't see a date for a revision. Have you had one, or is that possibility still on the cards?
I hope your pain lessens now and your medications keep it under control.
When did you have the arthroscopy and removal of adhesions? I'll add that to your signature, if you let us know.
Also, I don't see a date for a revision. Have you had one, or is that possibility still on the cards?
I hope your pain lessens now and your medications keep it under control.
OP
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shelli22
senior
Hi @Celle i had the arthroscopy yesterday 6/11/17. I have not got a date for a Revision. We are going to wait to see what the results of the histology determine and how the pain goes in the next few weeks. If the issue isn’t resolved with this procedure then he will have me go for a second opinion to keep the return to work people informed and go from there. I have photos of yesterday’s removal of adhesions and he did say there was a lot there causing impingement. So I guess it’s just wait and see.
Just curious though @Celle. I had the arthroscopy and I expected a little pain as it is surgery and surgery equals pain. But.... when I woke in recovery I honestly believed they’d cut my leg off at the knee with no pain relief. I have a high pain tolerance. The TKR was bad but bearable. However, the pain on waking from the arthroscopy yesterday went way past my tolerance level and was excruciating and unbearable and they kept getting all different drug alternatives to alleviate it but for ages and ages nothing worked. I cried and cried and cried and I don’t do crying . Why the pain at that level? What was that??
Just curious though @Celle. I had the arthroscopy and I expected a little pain as it is surgery and surgery equals pain. But.... when I woke in recovery I honestly believed they’d cut my leg off at the knee with no pain relief. I have a high pain tolerance. The TKR was bad but bearable. However, the pain on waking from the arthroscopy yesterday went way past my tolerance level and was excruciating and unbearable and they kept getting all different drug alternatives to alleviate it but for ages and ages nothing worked. I cried and cried and cried and I don’t do crying . Why the pain at that level? What was that??
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shelli22
senior
Wow. I just saw on the news they are advertising that nurofen and other anti inflammatory drugs work just as good as opioids for injuries, broken bones and the like and that people are becoming addicted to opioids like morphine when after two hours they work no better than paracetamol and anti inflammatory drugs. It’s no wonder it’s so difficult to get effective pain relief when they promote this.
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Much of the public will believe everything they see on TV or read in the paper, even advertisements. It's a shame. People that really need the pain relief can't get enough because of a few bad apples.
Don't believe the advertising! It sounds like "fake news" to me.
Nurofen is Ibuprofen, which is a non-steroidal anti-inflammatory (NSAID). These are much less effective pain killers that the opioids because their primary purpose is to reduce inflammation.
In addition, there are dangers associated with their use.
- They make you bleed more easily and can cause serious gastric bleeding - never take them on an empty stomach and stop taking them if you experience any gastric symptoms.
- NSAIDS may delay healing.
- A recent study has shown that NSAIDS increase your likelihood of developing heart disease: NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study
The NSAIDs aren't the harmless little wonder pills the manufacturers would have you believe.
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shelli22
senior
I know. I’m astounded as this was a documentary by researchers and supposedly evidence based. The anti inflammatory side effects are awful. I am a nurse so I watched this with skepticism however if you didn’t have this knowledge the way it is portrayed makes anti inflammatory medications the gold standard. They are considering not offering opioids for breaks and injuries but prescribing anti inflammatory agents and paracetamol instead
Josephine
NURSE DIRECTOR EMERITA
Not so long ago I reported the manufacturers of Nurofen to our Trading Standards because of that claim. They said mine wasn't the only complaint and that it had been upheld, they had been fined and required to remove the text.
For medical reasons, I can't take NSAIDS.
I've had 3 knee replacements and I can honestly say that not being allowed to take NSAIDS has made no difference at all to my recoveries.
I think NSAIDS are over-prescribed and I wish they weren't available as over-the-counter medications. They're dangerous!
I've had 3 knee replacements and I can honestly say that not being allowed to take NSAIDS has made no difference at all to my recoveries.
I think NSAIDS are over-prescribed and I wish they weren't available as over-the-counter medications. They're dangerous!
OP
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shelli22
senior
Well I think it’s around five weeks since my arthroscopy. I’m still taking a lot of pain meds as I’m still in a lot of pain. I have done no exercise or PT since the arthroscopy and the only exercise I get is walking however I can’t walk for longer than 20 minutes and then I pay for it that night with what feels like bone pain in the centre of my knee and then sharp catching shooting pain from the side into the back of my knee.
The aching bone type pain is the worst and makes me nauseous. I have no idea what is going on, where I will go from here or when I will be returning to work though I’m supposed to return on the 28/12.
The histology that was sent was inconclusive as it just noted that it was fibrous tissue. What kind of report is that? They also sent off to check for infection but he hasn’t received anything back.
I’m totally at a loss as the pain is still worse than before the arthroscopy yet I know it’s still early days. I still have a nagging feeling that it is the nickel in the replacement knee that is causing all my issues.
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The aching bone type pain is the worst and makes me nauseous. I have no idea what is going on, where I will go from here or when I will be returning to work though I’m supposed to return on the 28/12.
The histology that was sent was inconclusive as it just noted that it was fibrous tissue. What kind of report is that? They also sent off to check for infection but he hasn’t received anything back.
I’m totally at a loss as the pain is still worse than before the arthroscopy yet I know it’s still early days. I still have a nagging feeling that it is the nickel in the replacement knee that is causing all my issues.
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Josephine
NURSE DIRECTOR EMERITA
Well, self-evidently you are walking too much! Walk less!
I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
