"Scars can do weird things"

Posted by mrfish @mrfish, Jan 25, 2019

First of all, I really want to thank Mayo Clinic Connect for the community you've developed here. I have learned so much and have been able to share my experiences with others. Thank you.

I've been on a rather long road after my right THR became infected. I first went through a 2-stage revision with an antibiotic spacer that I posted my initial questions about here, and chronicled some of my additional troubles: https://connect.mayoclinic.org/discussion/what-kind-of-mobility-can-i-expect-with-an-antibiotic-spacer-in-my-hip/

In any case, I feel confident my joint infection is behind me. It's been almost 11 months since my last surgery, and 7 months since I finished the last course of antibiotics.

However, about three months ago, I had a scare that made me fear the infection might be back. I had a lot of swelling, redness, and sensitivity immediatly adjacent to the posterior THR scar (and only on one side of the scar, the posterior side). This flare-up began to show on a Friday night when I couldn't get in to see my ortho or infectious disease (ID) doc and had mostly settled down by the time I was able to get in with them the following week. My ID doc ordered the regular blood work and while some of the numbers were elevated, none of the indicators were wildly out of place.

My ID Doc (who I totally respect) was rather puzzled about what this might have been and, among other things, offered this: "scars can do weird things".

Last weekend, the same thing happened again (it's ironic how almost all of my episodes seem to happen on a Friday night). There was the same swelling, redness and localized pain symptoms and this time it later developed a "rashy" look, as well. Once again, this manifested on only the posterior side of my scar and it was mostly gone by the time Monday rolled around. I didn't bother to go see either of the docs this time. I'm still paying off the last of my hip-related medial bills and I'm very reluctant to rack up another hundred or two $ in out-of-pocket costs for an office visit and possible lab test costs for something that might not be (?) very conclusive.

As of today (Thursday), there are no signs of the flare-up from this last weekend and I still have all of my strength and range of motion in my right leg.

Has anyone had experiences like this? If cost wasn't an issue, I'd be chasing things with a specialist, but I don't even know where to begin with something weird like a scar-related complication.

@mrfish your hip problems really do sound odd, especially so since even the doctor seems bewildered by them. Is there anything you do during the week that could result in that pain, swelling and rash? Sometimes it takes a few days for symptoms to appear. It sounds as if there could be a problem from something, especially since it recovers after the weekend. My husband has a recurring problem with his ankle that he has traced to a certain activity.
When you have the problem again try to think hard of anything you did differently in the days preceding it, or something you did more of. I hope you can figure it out, and if it is something you are doing you will need to be more careful of it. Do you think it could possibly be something you are doing?
JK

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@mrfish – Hi! Don't you just HATE it when you get sick on Friday… maybe not bad enough to call the doctor but in that place where you can't decide? I'm sorry you are going through this. I'm wondering about your work/play schedule. Could it be that you are just so exhausted by Friday night that your body is just screaming "Rest Me!"? It sounds like you've been through more than your share of discomfort. Hoping it goes well from here out.

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@contentandwell sorry for the delayed reply and thanks for your ideas. I do need to focus in on what's going on immediately preceeding these "flare-ups". So far it's (still) only happened twice. It has only seemed to be a superficial/dermal issue, but it's proximity to my hip issues always get me paranoid after all I've been through with the hip infections. My leading hypothesis is that it's a skin irritation brought on by the fact that that we let our dogs sleep in the bed with us and, like dogs, they shed hair and/or dander — but we do change & wash our bedding very frequently. Kicking the dogs out of the bed might be harder than the 5 hip surgeries, though. Haha.

@debbraw you are sooooo spot-on with the suggestion that fatigue might have something to do with the timing of these issues. With the hip infections that kept popping up in the past…it ALWAYS seemed like troubling symptoms would manifest on a Friday when it was diffucult to get in with the regular docs. I tended to think that it was just a Murphy's Law kind of thing, but your work schedule theory is right on the mark. My (mostly office) job isn't anything wildly out of the ordinary, but for the most part anyone's work schedule would lead to times when you're more stressed, tired, and more susceptible to health issues. That could make an interesting thesis/research project for someone (perhaps it's already been done).

I'm hoping that it's just some weird hyper-sensitivity brought on by the (repeated) surgeries and the scars they left behind…and that it will become less of an issue as time goes by.

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@mrfish

@contentandwell sorry for the delayed reply and thanks for your ideas. I do need to focus in on what's going on immediately preceeding these "flare-ups". So far it's (still) only happened twice. It has only seemed to be a superficial/dermal issue, but it's proximity to my hip issues always get me paranoid after all I've been through with the hip infections. My leading hypothesis is that it's a skin irritation brought on by the fact that that we let our dogs sleep in the bed with us and, like dogs, they shed hair and/or dander — but we do change & wash our bedding very frequently. Kicking the dogs out of the bed might be harder than the 5 hip surgeries, though. Haha.

@debbraw you are sooooo spot-on with the suggestion that fatigue might have something to do with the timing of these issues. With the hip infections that kept popping up in the past…it ALWAYS seemed like troubling symptoms would manifest on a Friday when it was diffucult to get in with the regular docs. I tended to think that it was just a Murphy's Law kind of thing, but your work schedule theory is right on the mark. My (mostly office) job isn't anything wildly out of the ordinary, but for the most part anyone's work schedule would lead to times when you're more stressed, tired, and more susceptible to health issues. That could make an interesting thesis/research project for someone (perhaps it's already been done).

I'm hoping that it's just some weird hyper-sensitivity brought on by the (repeated) surgeries and the scars they left behind…and that it will become less of an issue as time goes by.

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@mrfish you make a few excellent points here. I hope you can pinpoint the cause of the problems and manage to avoid them in the future. I am going through a totally different problem now, not TKR related, but trying to determine what is the root cause is very difficult.
JK

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