This subreddit is not for medical advice. Our community is intended for medical professionals and interested laypeople to discuss interesting or current topics on the practice of surgery. While I'm sure your concern is important to you, this is not the appropriate venue to address it. Best of luck!
Are you saying nobody asked you specifically if you were allergic or nobody asked you about allergies? It’s your responsibility to self report. And I’m not judging, you may think it doesn’t apply or isn’t relevant or you could have forgot.
I’d think an allergy would have come up far sooner than 5 weeks. Infection is the far likelier source of a warm post op site.
Not once during any interview: with the surgeon, the anesthesiologist, the nurse did they ever ask you if you had any allergies?!?!? Highly unbelievable.
Go see a doctor about your infection.
Yeah as an OR nurse I find this highly unbelievable. Pre-op nurse, OR nurse, anesthesia, and surgery teams all verify allergies with the patient, even if 2 of 4 didn’t it still would have been caught. Plus the pre-induction briefing where the patient is awake and they go over allergies AGAIN with everyone in the OR.
Yeah this situation is not believable. There are too many people in the chain who verify the information before entering the OR. Then there is the chain of people IN the OR who verify the Name, birthdate, patient number & ALLERGIES listed in the safety timeout before the procedure. If ONE person in the chain has a question it goes all the way back to the beginning. OR people do not like mistakes, we have fail safe after fail safe. I feel like
OP admitted that they didn’t disclose their allergy. I know that if they allergy is present and the actual cause of the inflammation then the team in question now has to have a review to see where the mistake was made and how to prevent such a mistake in the future. The whole process & individuals involved will now have a review of the incident: IF this was caused by an allergy.
They asked me about every single allergy on my chart: animal dander, tree pollen, dairy, aspirin sensitivity, pretty much everything I’ve self reported for decades. They never introduced or suggested additional materials or items to consider, they were just reading off my chart.
They all knew this was my first surgery ever. I walked in with the limited knowledge of what patella surgery entails. When they said metal I was under the impression that it was inert and hypo-allergenic, most likely titanium. This can still be true but I specifically can’t tolerate the metal used in acupuncture needles so idk why everyone here is so hostile. Someone should have at least been specific about the metal and we could have switched out to titanium, people do it all the time. I know plenty of people who have titanium.
I just think it’s funny they ask me about every single minuscule unrelated sensitivity in the world and don’t even bring up metal implants. I would have immediately answered that I can’t wear any jewelry or get acupuncture.
They asked you if you had any allergies. You, knowing you have an allergy, did not tell them you have an allergy. You will be in contact with thousands of different items when you go in for surgery. They aren't going to specifically ask you about every single ingredient in every single item that will be on, in, or around you. YOU know your allergies and when they asked you should answer them truthfully and completely. Some people are allergic to bananas and we use different gloves because some are known to be commonly cross reactive. People still tell us they are allergic to bananas. Hell, sometimes people even tell me about the allergies of people they are related to, just in case.
Because you are supposed to be proactive when it comes to your health. You are supposed to say, when they ask about allergies/sensitivities that you have problems with stainless steel.
I have problems with nickel. My surgeons have always known this going in... because I told them.
They aren't psychic.
A lie of omission is not really much better than a lie of commission, despite what you may believe. You didn’t disclose your allergy to stainless steel (let’s be honest, this is extremely rare and nobody is going to ever ask you this) despite I’m sure multiple opportunities to do when asked about allergies. And now your reaction is to be blame that the surgeon will gaslight you? 🤦
you need to bring it up. i really don’t think they will try to gas light you but if they do hold your ground. you know what’s up. i would check and see if the hard ware is titanium bc most of mine (i have a ton) is titanium.
Ok thanks for your kind, indefensible answer. I looked at my chart and I see they’re self-tapping screws which are usually SS. Other people I’ve talked to have had them removed because of similar sensitive reactions but they had to wait a year. I’m taking allergy medicine now to see if it helps.
First off, the surgeon didn’t break your kneecap. Secondly, that’s how you fix it. If you’re sensitive to it and you know it, it’s your responsibility to tell them, and if there is an option for an only titanium implant or something else they can try to use that if the fracture pattern permits, but sometimes you have to do what you have to do. If you need to have it removed later, which isn’t uncommon with patellar hardware, then you have it removed later.
Don’t go blaming the surgeon for something that he/she has no real control over. They’re just literally trying to help you get better and most of them care and want you to do well.
And lastly…..it may or may not be infected. But if you wonder whether it is or not, go have them look at it and they can determine that. Warmth isn’t always infection. Infection is usually blatantly obvious.
Implants can be removed if there is an issue. The patella needs to heal first. Nothing you can do right now.
Even in people with know metal Allergies, you have to use the right implant; sometimes that means they will have symptoms.
You seem to have a lot of first and secondhand health anxiety based on the dozens of posts in your history, OP. I’m not saying that as a slight to you.
However … There are things within your locus of control, and things not within your locus of control (or professional expertise, for that matter). I think establishing proper boundaries of what goes in your “box,” (self advocacy about your own allergies when asked), versus not in your box (micromanaging other interactions/procedures you don’t have expertise or knowledge about), would do a lot to ease your anxiety. A skilled therapist could help you with this.
In the meantime, it is 100% necessary to inform your doctor that you did not previously disclose a metal sensitivity prior to surgery. No surgeon wants a poor outcome on orthopedic hardware. An infection would be quite easy to identify and it is up to you to advocate for yourself to ensure that your healing is going smoothly.
Thanks, when the surgeons assistant unwrapped the day of surgery he was pretty taken aback by a superficial wound on the surface of my skin that he hadn’t checked the day before and was concerned he’d missed an open fracture. I told him it was fine, it was a skinned knee.
If you’re referring to my dad being starved to death in skilled nursing because his therapist quit and they never replaced her for 3 months, yes indeed I’m super critical and skeptical about the varying levels of care.
Anon: knows he's allergic to metal.
Anon: has multiple discussions with Dr about having metal put into his body.
Anon: says nothing
Anon: signs consent form for operation to have metal implanted in his body.
Anon: has operation where metal is implanted into his body.
Anon: surprised Pikachu face after this entirely preventable series of events plays out.
Don't be like Anon.
One conversation about having “a plate put in to stabilize the patella”, under extreme duress and pain. Consent forms don’t have the detail of the procedure done, they are general consent forms that you sign to agree to be treated.
Here you go. Completely explained. You obvs aren’t a doctor because this doctor is able to parse out the situation in a perfect way: https://youtu.be/75G5sYmUP4E?si=q7a5k9oAncM6fpio
Obligatory NAD.
Everyone seems to be blaming you but doctors regularly deal with forgetful, elderly, otherwise mentally compromised people. They should have asked specifically about allergies or any hardware in your body and if it had caused issues. My fiancée is having surgery and she has already dry been asked this 3 times, your doctors dropped the ball. Should you have said something anyway, advocating for yourself, sure. Did they still mess up? Absolutely yes.
Thanks, MOD mentioned this sub is for medical professionals. Now I can see the origin of the hostility. My bad. I won’t bother to update when I address this with my team unless it’s pertinent.
Line of questioning: “Allergies to medication?” Me: “not that I know of but sensitive to NSAIDs, aspirin.” “No reaction to anesthetic?” Me: “No but I’ve only had general 38 years ago when I had my wisdom teeth pulled” (thinking there might be some pertinence since it was so long ago and so many things have changed. “Pet dander, tree pollen, etc…?” (reads list of seemingly irrelevant things that wouldn’t be encountered in this setting but I go along with it.) Then reads a list of every medication I’ve been prescribed for the last 19 years. Then nothing. Could have said, “allergic to metal? Because that’s what we’re putting in your body tomorrow”
Let me give you another perspective (insider). There is a very low association with people with skin nickel sensitivity that relates to a deep sensitivity, and in fact, there is really only one reliable test that cost a few thousand dollars and only one center in the US does it. I doubt that a medical allergy is causing the symptoms that you were having, so don’t be worried that you didn’t tell somebody about it, because it is not significant.
As to the warmth, it is not completely abnormal to have increased compared to your other side, because there is healing that is occurring, which causes an increase in blood flow to that side, especially around the wound, causing some increased warmth. Certainly, if it is very hot, very red, very swollen, that is a different story, however, many people get worried when there is a little warmth and redness, around the area of the incision, and this tends to go away.
On top of that with your injury, you injured a bone that is fairly superficial, and you may have some irritation in general with the hardware and some scarring.
Bring up your concerns with your Surgical team, but just know that it may be within the realm normal ✌🏻
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This subreddit is not for medical advice. Our community is intended for medical professionals and interested laypeople to discuss interesting or current topics on the practice of surgery. While I'm sure your concern is important to you, this is not the appropriate venue to address it. Best of luck!
When you were asked by at least three people before your surgery if you have any allergies, that’s when you mention this issue. You were also asked by your surgeon in his office. If you keep that information to yourself, that’s on you.
I found this doctor who explains, in detail, the differences in allergies and sensitivities and what you can do about it. Anyone here who is a surgeon should consider this as a way to put to rest all the questions and fears so that next steps can be taken. This guy nails it: https://youtu.be/75G5sYmUP4E?si=q7a5k9oAncM6fpio
This subreddit is not for medical advice. Our community is intended for medical professionals and interested laypeople to discuss interesting or current topics on the practice of surgery. While I'm sure your concern is important to you, this is not the appropriate venue to address it. Best of luck!
Are you saying nobody asked you specifically if you were allergic or nobody asked you about allergies? It’s your responsibility to self report. And I’m not judging, you may think it doesn’t apply or isn’t relevant or you could have forgot. I’d think an allergy would have come up far sooner than 5 weeks. Infection is the far likelier source of a warm post op site.
Congrats you just make things difficult for everyone
Not once during any interview: with the surgeon, the anesthesiologist, the nurse did they ever ask you if you had any allergies?!?!? Highly unbelievable. Go see a doctor about your infection.
Yeah as an OR nurse I find this highly unbelievable. Pre-op nurse, OR nurse, anesthesia, and surgery teams all verify allergies with the patient, even if 2 of 4 didn’t it still would have been caught. Plus the pre-induction briefing where the patient is awake and they go over allergies AGAIN with everyone in the OR.
every OR I’ve ever been in, whiteboard with NKDA or the like on it. It’s discussed before sterilizing the site too
Yeah this situation is not believable. There are too many people in the chain who verify the information before entering the OR. Then there is the chain of people IN the OR who verify the Name, birthdate, patient number & ALLERGIES listed in the safety timeout before the procedure. If ONE person in the chain has a question it goes all the way back to the beginning. OR people do not like mistakes, we have fail safe after fail safe. I feel like OP admitted that they didn’t disclose their allergy. I know that if they allergy is present and the actual cause of the inflammation then the team in question now has to have a review to see where the mistake was made and how to prevent such a mistake in the future. The whole process & individuals involved will now have a review of the incident: IF this was caused by an allergy.
They asked me about every single allergy on my chart: animal dander, tree pollen, dairy, aspirin sensitivity, pretty much everything I’ve self reported for decades. They never introduced or suggested additional materials or items to consider, they were just reading off my chart. They all knew this was my first surgery ever. I walked in with the limited knowledge of what patella surgery entails. When they said metal I was under the impression that it was inert and hypo-allergenic, most likely titanium. This can still be true but I specifically can’t tolerate the metal used in acupuncture needles so idk why everyone here is so hostile. Someone should have at least been specific about the metal and we could have switched out to titanium, people do it all the time. I know plenty of people who have titanium. I just think it’s funny they ask me about every single minuscule unrelated sensitivity in the world and don’t even bring up metal implants. I would have immediately answered that I can’t wear any jewelry or get acupuncture.
They asked you if you had any allergies. You, knowing you have an allergy, did not tell them you have an allergy. You will be in contact with thousands of different items when you go in for surgery. They aren't going to specifically ask you about every single ingredient in every single item that will be on, in, or around you. YOU know your allergies and when they asked you should answer them truthfully and completely. Some people are allergic to bananas and we use different gloves because some are known to be commonly cross reactive. People still tell us they are allergic to bananas. Hell, sometimes people even tell me about the allergies of people they are related to, just in case.
Because you are supposed to be proactive when it comes to your health. You are supposed to say, when they ask about allergies/sensitivities that you have problems with stainless steel. I have problems with nickel. My surgeons have always known this going in... because I told them. They aren't psychic.
Yeah, that's on you OP.
Stainless steel is also inert and hypoallergenic. You just have an infection
A lie of omission is not really much better than a lie of commission, despite what you may believe. You didn’t disclose your allergy to stainless steel (let’s be honest, this is extremely rare and nobody is going to ever ask you this) despite I’m sure multiple opportunities to do when asked about allergies. And now your reaction is to be blame that the surgeon will gaslight you? 🤦
you need to bring it up. i really don’t think they will try to gas light you but if they do hold your ground. you know what’s up. i would check and see if the hard ware is titanium bc most of mine (i have a ton) is titanium.
Ok thanks for your kind, indefensible answer. I looked at my chart and I see they’re self-tapping screws which are usually SS. Other people I’ve talked to have had them removed because of similar sensitive reactions but they had to wait a year. I’m taking allergy medicine now to see if it helps.
You have an infection. Go to the doctor.
Congrats - you played yourself!
First off, the surgeon didn’t break your kneecap. Secondly, that’s how you fix it. If you’re sensitive to it and you know it, it’s your responsibility to tell them, and if there is an option for an only titanium implant or something else they can try to use that if the fracture pattern permits, but sometimes you have to do what you have to do. If you need to have it removed later, which isn’t uncommon with patellar hardware, then you have it removed later. Don’t go blaming the surgeon for something that he/she has no real control over. They’re just literally trying to help you get better and most of them care and want you to do well. And lastly…..it may or may not be infected. But if you wonder whether it is or not, go have them look at it and they can determine that. Warmth isn’t always infection. Infection is usually blatantly obvious.
Implants can be removed if there is an issue. The patella needs to heal first. Nothing you can do right now. Even in people with know metal Allergies, you have to use the right implant; sometimes that means they will have symptoms.
Since you know about this allergy, did YOU bring it up to THEM?
You seem to have a lot of first and secondhand health anxiety based on the dozens of posts in your history, OP. I’m not saying that as a slight to you. However … There are things within your locus of control, and things not within your locus of control (or professional expertise, for that matter). I think establishing proper boundaries of what goes in your “box,” (self advocacy about your own allergies when asked), versus not in your box (micromanaging other interactions/procedures you don’t have expertise or knowledge about), would do a lot to ease your anxiety. A skilled therapist could help you with this. In the meantime, it is 100% necessary to inform your doctor that you did not previously disclose a metal sensitivity prior to surgery. No surgeon wants a poor outcome on orthopedic hardware. An infection would be quite easy to identify and it is up to you to advocate for yourself to ensure that your healing is going smoothly.
Thanks, when the surgeons assistant unwrapped the day of surgery he was pretty taken aback by a superficial wound on the surface of my skin that he hadn’t checked the day before and was concerned he’d missed an open fracture. I told him it was fine, it was a skinned knee. If you’re referring to my dad being starved to death in skilled nursing because his therapist quit and they never replaced her for 3 months, yes indeed I’m super critical and skeptical about the varying levels of care.
Anon: knows he's allergic to metal. Anon: has multiple discussions with Dr about having metal put into his body. Anon: says nothing Anon: signs consent form for operation to have metal implanted in his body. Anon: has operation where metal is implanted into his body. Anon: surprised Pikachu face after this entirely preventable series of events plays out. Don't be like Anon.
One conversation about having “a plate put in to stabilize the patella”, under extreme duress and pain. Consent forms don’t have the detail of the procedure done, they are general consent forms that you sign to agree to be treated.
Here you go. Completely explained. You obvs aren’t a doctor because this doctor is able to parse out the situation in a perfect way: https://youtu.be/75G5sYmUP4E?si=q7a5k9oAncM6fpio
Doctors have a license to practice medicine….practice is the key word here and nobody knows your body like you do.
There’s a whole documentary on how metal is bad for us in our bodies.
Obligatory NAD. Everyone seems to be blaming you but doctors regularly deal with forgetful, elderly, otherwise mentally compromised people. They should have asked specifically about allergies or any hardware in your body and if it had caused issues. My fiancée is having surgery and she has already dry been asked this 3 times, your doctors dropped the ball. Should you have said something anyway, advocating for yourself, sure. Did they still mess up? Absolutely yes.
No, this isn’t how it works. They went over allergies with OP, OP never disclosed a possible metal allergy.
Thanks, MOD mentioned this sub is for medical professionals. Now I can see the origin of the hostility. My bad. I won’t bother to update when I address this with my team unless it’s pertinent. Line of questioning: “Allergies to medication?” Me: “not that I know of but sensitive to NSAIDs, aspirin.” “No reaction to anesthetic?” Me: “No but I’ve only had general 38 years ago when I had my wisdom teeth pulled” (thinking there might be some pertinence since it was so long ago and so many things have changed. “Pet dander, tree pollen, etc…?” (reads list of seemingly irrelevant things that wouldn’t be encountered in this setting but I go along with it.) Then reads a list of every medication I’ve been prescribed for the last 19 years. Then nothing. Could have said, “allergic to metal? Because that’s what we’re putting in your body tomorrow”
Let me give you another perspective (insider). There is a very low association with people with skin nickel sensitivity that relates to a deep sensitivity, and in fact, there is really only one reliable test that cost a few thousand dollars and only one center in the US does it. I doubt that a medical allergy is causing the symptoms that you were having, so don’t be worried that you didn’t tell somebody about it, because it is not significant. As to the warmth, it is not completely abnormal to have increased compared to your other side, because there is healing that is occurring, which causes an increase in blood flow to that side, especially around the wound, causing some increased warmth. Certainly, if it is very hot, very red, very swollen, that is a different story, however, many people get worried when there is a little warmth and redness, around the area of the incision, and this tends to go away. On top of that with your injury, you injured a bone that is fairly superficial, and you may have some irritation in general with the hardware and some scarring. Bring up your concerns with your Surgical team, but just know that it may be within the realm normal ✌🏻
Unfortunately your comment has been removed because your Reddit account is less than 5 days old **OR** your comment karma is less than 5. This filter is in effect to minimize spam. Moderators will review your comment and put it back up if it is appropriate. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/surgery) if you have any questions or concerns.*
Thanks this is good info. And will help with my attitude when I talk to my team.
This subreddit is not for medical advice. Our community is intended for medical professionals and interested laypeople to discuss interesting or current topics on the practice of surgery. While I'm sure your concern is important to you, this is not the appropriate venue to address it. Best of luck!
When you were asked by at least three people before your surgery if you have any allergies, that’s when you mention this issue. You were also asked by your surgeon in his office. If you keep that information to yourself, that’s on you.
I found this doctor who explains, in detail, the differences in allergies and sensitivities and what you can do about it. Anyone here who is a surgeon should consider this as a way to put to rest all the questions and fears so that next steps can be taken. This guy nails it: https://youtu.be/75G5sYmUP4E?si=q7a5k9oAncM6fpio