KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: dragonwoman on July 18, 2012, 05:42:59 AM

Title: Please give me some advice!
Post by: dragonwoman on July 18, 2012, 05:42:59 AM
I fell at work on 11/03/2010.  I was walking out the front door going to lunch when the rug at the front door slipped out from under me and I fell and landed with my right knee on the threshold of the door.  I filled out the paperwork on the accident and my husband came and got me and took me to the ER.  They x-rayed me from head to toe, said I was ok and sent me home to rest.  I had to see a Workers Comp Doctor before I could return to work.  I went in to see Dr. A.  He gave me meds, told me I had bruised my knee and to take it easy and come back in two weeks. I had had a conflict with Dr. A in the past so I switched Doctors.  I Switched to Dr. B.  By this time my knee had started to hurt worse.  Dr. B put me through 2 weeks P.T. that only made it worse.  Then he sent me for an MRI.  The first line of the MRI said “Image is degraded due to the patients in ability to remain motionless.”.  When I went in to get it done the tech told me she had to do it twice because I couldn’t hold still because of the pain.  After the MRI, Dr. B sent me back in for two more weeks of P.T.  All the time the pain was getting worse.  By this time I couldn’t walk on it.  Dr. B was not giving me anything for the pain that worked.  So I went in and talked to and Attorney.  He suggested that I switch Doctors.  So I switched to Dr. C.  Dr. C put me on some meds and put in a request for me to go see an Orthopedic Doctor.  I went in to see Dr. D.  He said there was nothing that he could do.  Then Dr. C requested for me to have an EMG done.  I was never able to get that approved.  The insurance company sent me in for an MMI/Impairment Rating with Dr. E.  He found that I was not at MMI.  Dr. C then did an FCE.  Then the insurance company sent me in for another MMI/ Impairment Rating with Dr. E.  He sent me for a CT.  It showed nothing.  I was still not at MMI.  Then Dr. C put in a request for another MRI with sedation.   Then the insurance company sent me in for an RME with Dr. F.  He said I was at MMI.  The next time I went in to see Dr. C, they said they wanted to do and Impairment Rating.  They took a flex rating of my knee, I saw the Dr. C and then they sent me home.  I then received in the mail the approval for the second MRI.  I call Dr. C office to set an appointment and they tell me I can no longer see Dr. C.  I ask why and no one will tell me.  I then received a letter in the mail from Dr. C telling me that I am at MMI.  On the report he lied about some things and I called his office wanting to speak with him about this and they will not let me speak to or see him to ask why he lied on the report.  It took me three months to finally get another Doctor. When I went in to see Dr. F, he put me on the Butrans 10mcg/hr pain patch. It does not help with the pain. It is like I have no pain meds at all. A month after I started seeing Dr. F, I was sent to Dr. G for an MMI/Impairment Rating. Before I got the report from Dr. G, I had another MRI done. It shows that I have my patella that is tracking slightly laterally, but does not appear to be dislocated and mild cartilage loss in the medial compartment suggesting chondromalacia. I sent this report to Dr. F. Dr. F said that I was at MMI even with what the MRI showed. Dr. F ordered for me to go through 20 days of Work Hardening. This did help slightly with my ROM but not with the pain. Dr. F tells me that he believes that surgery will not help me but he has referred me to see an Orthopedic Surgeon.  On my next office visit, Dr. F sees a bulge on my right thigh. He thinks that I could have a torn/ripped Quad muscle. This MRI comes back normal. Every time I go in to see him I tell him how much I hurt and that the meds are not working but he keeps putting me on the same thing. When I went in to see him today, I tells me that by what the MRI shows I shouldn’t be hurting like this and in not these exact works “I don’t believe you that you are hurting.” He even cuts my meds down even more to Butrans 5 mcg/hr patch. By what I am reading, I have done everything that I can to fix the problem without surgery. I have done R.I.C.E., PT and Brace. I can’t bear all my weight on my right leg, I can’t straighten my right knee, I have swelling from my toes up to my hip and I have muscle twitches around my knee. I’m at my wits end. Does anyone have any advice for me?

Thank you for your taking your time to read all this.
Title: Re: Please give me some advice!
Post by: ConcernedGal on July 18, 2012, 06:01:50 AM
Hi. I completely sympathize with you. First, I want to clarify a major point:
- I am not in the medical profession thus anything I write may not be completely accurate from a anatomical/physiological perspective

If I were in your situation,
1) I would see a GP and see if we can get an x-ray done first to determine if there was any fracture to bone or dislocation which should be visible in an x-ray. Moreover, the x-ray usually has an accompanying report for some conclusion on what is going on.
2) Next I would work with my GP to assess if an MRI needs to be done. If there is no fracture or major bone defects, then MRI will enable one to see the soft tissue to understand if there is a tear in ligament etc etc - in my case, I have cartilage fragments due to patella misalignment.
3) Once the MRI is available along with the MRI report, I think a referral to an Orthopedic Specialist is in order to determine the next steps since they are the experts in this area and can advise if a surgery or physiotherapy is required.
4) I would of course also check web sites to better understand what certain medical terminologies are and whether there is anything I can do to alleviate the pain/problem.

Hope this helps. Sorry its not much but basically what I wrote is actually what I myself did in my own case.

ConcernedGal
Title: Re: Please give me some advice!
Post by: dragonwoman on July 18, 2012, 06:20:47 AM
Hello ConcernedGal,
I have had 3 MRI, 1 Ct and many x-rays. What the MRI shows is that my patella that is tracking slightly laterally, but does not appear to be dislocated and mild cartilage loss in the medial compartment suggesting chondromalacia. My present treating Doctor has referred me to an OS. I'm just waiting on an appointment.
Title: Re: Please give me some advice!
Post by: silver14 on July 19, 2012, 06:23:47 AM
Dragonwoman,

I'm not a dr. but, I am suffering from CRPS, has anyone suggested that this might be the problem? I had a medial tibial plateau stress fracture in my knee and have pain and swelling completely out of proportion to the injury.  My knee is now locked with a 40 degree lack of extension. I have been fortunate enough that my OS did think, about 2 months after the injury, that I had CRPS and put me on pain meds and neurotin.  These helped but I only have gotten worse, again at my OS's  suggestion I am seeing a PM dr. who has changed my meds, but still not doing better, so I am scheduled for lumbar block.  Through this I have had x-rays, ultrasounds, MRI and triphase bone scan.  Don't have results yet of bone scan but all have not been conclusive on the reasoning for my pain, swelling and lack of extension.  I have also been to VS who was a complete idiot.  So all in all my suggestion is try and see PM dr. they should be more familiar with the reasons for pain and may at least be able to better treat and dx your pain.  Don't except MMI until you are positive there is nothing else wrong! Good luck and keep us posted on your situation.

Silver14
Title: Re: Please give me some advice!
Post by: dragonwoman on July 19, 2012, 06:38:35 AM
Silver14,

I have never heard of CRPS. I will have to talk to the Doc about that. Thanks for the info.
Title: Re: Please give me some advice!
Post by: emm10161301 on July 19, 2012, 10:22:46 AM
I would love to say I'm shocked they can't find anything but honestly I'm not, I had both my knee caps dislocating regularly, knees locked, and tilts as much as 20o in my knees and for 8 years they told me it was my legs aren't strong enough go to physio, oh maybe u have arthritis (this started when I was 10) oh I also just had a build up of fluid. A dr also told me that (I was 18) when I turn 18 it would fix itself? They felt my knees at least once a month. It wasn't until my new physio therapist felt my knees and said oh do you know you have such tilts in your knee caps! She wrote for me to get an mri and sure enough my knees are soo badly damaged as the knee caps have tilts and the groove they sit in are too small and they are rubbing on the bone. I had to have mpfl and LR surgery to fix this. In my opinion if this as been going on for soo long for you, firstly I would keep pushing at them, telling them the pain is worse than it is usually helps, tell them its affecting your life. Maybe go to a completely other doctor and begin the process again. It could be something soo small and simple. But its worth another advice.