So like, back in January of this year I injured my knee. MRI showed tear of ACL and LCL and also a moderate sized full thickness cartilage defect of the medial femoral condyle. My surgeon recommended a staged approach with 2 surgeries, one to fix the ACL and measure the defect, and the second to repair the defect. I had my first surgery in March, an ACL reconstruction using quad tendon graft. Recovery from that was rough but it went okay with minimal pain and good PT but always in the back of my mind was the knowledge that I had to go through it all over again, and of course my actual function was still severely limited by the cartilage injury. I had to put off the second surgery until the fall (semester-long research/coursework block) since I would be on clinics from mid May until mid August and obviously couldn't really have a surgery then. The surgery to repair the osteocondral defect was an allograft surgery (from donor cartilage) a little over 3 weeks ago and honestly, recovery as far as my knee goes has been going great! I'm further along than expected, able to start bearing weight 3 weeks earlier than they had originally projected. And I'm in better spirits because I know as long as this surgery was successful and I work hard at PT, the light at the end of the long tunnel is finally near and I may be able to run and hike and play hockey and do agility and all that fun stuff again. That's obviously not my rant. Those are below.
They used a closure device that I was pretty impressed by at first on the main incision. It was basically 2 adhesive panels with zip tie closure in between. I looked it up online, everything looked pretty cool and their evidence that it improved scar aesthetics while maintaining a good closure was good. Like 3 days before I was scheduled to have that and the other sutures removed, the whole thing started to itch intensely. I debated taking it off myself since the incision looked okay to me but friends persuaded me to just wait until I saw the doctor. Well, when he took it off there were basically huge blisters over the whole area that it was on top of, some ruptured when the adhesive came off. Great. So I had to do some dressing changes, etc, and though infection was pretty unlikely, he started me on clindamycin since a few of the blisters were open and well, obviously an infection around the area where an open knee surgery was performed and a donor graft was put in is suboptimal. They put a steri-strip on the smaller port incision which started itching 48 hours later so I just pulled that stupid thing right off, and it still left a big red rectangular raised area where it previously was.
Remembering to take clindamycin 4 times a day was not easy but I did it, even when I thought I was going to get some nasty esophagitis because I had to take it right before bed and didn't have a lot of water with me and was not in a position where getting up and getting water was something easy to do and I felt like my throat was on fire for hours and couldn't sleep. My recheck earlier this week was good, the blistering has resolved and everything is healing great. He said I could stop with the dressing changes but just finish out the course of clindamycin (basically another 3-4 days worth). So 2 days ago I forgot the bottle of clindamycin on campus and didn't take any doses after noon that day. Later that afternoon, I started itching intensely. All over my back, and then chest, and then arms. I thought maybe it was just the weather change or dry skin or something. I could barely sleep because of it, so I took some diphenhydramine which helped a little. I woke up the next morning and hopped in the shower and noticed that I had basically broken out in a rash like everywhere but my face. I did some of my own research, confirmed that clindamycin can cause maculopapular exanthema 7-10 days after starting it in previously unexposed people, and called my doctor's office. The nurse told me that it was really weird that it would cause it this late instead of right away, and I explained that I had never been exposed to clinda before so this is exactly what I would expect from a reaction to it. She talked to my doctor who basically just said stop the clinda, which I already had - because of my own forgetfulness I missed 2-3 doses that I would have probably taken before I put two and two together and realized what was up. So I bought some steroid cream and a couple different non-drowsy antihistamines for the daytime and now I'm sitting here with skin that feels like it's on fire and I am really annoyed that apparently my immune system is freaking out over everything. THANKS FOR NOTHING IMMUNE SYSTEM!!
