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Author Topic: Open Debridement and Proximal Z-plasty  (Read 185047 times)

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Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #750 on: February 27, 2012, 04:26:07 AM »
Pam,

That is really helpful at it is medical knowledge for dummies....which I happily fall into.  I am not pretending to understand more than about 40 percent of that power point explanation, but I will tell you that it connected a large number of very big words with pictures that I could guess the result of. 

I have to admit that I am guilt of what just occurred here.  I am talking about the future of my little girl and if you don't have the stones to ask for multiple opinions, you make the mistake that I made with my previous three (3) OS.  They sound like they know all there is to know about knees.  How am I supposed to know if they are right or wrong?  Of the 3, one was a total butthead, one was like my best friend, and one was somewhere in between.  They all three had no clue what AF was and how to treat it.  I seek out their advice and if I look them in the eye when they give me a diagnosis, I honestly felt if I asked for a second opinion I was disrespecting them.  So, I still see my self shaking my head yes in this replay of a nightmare on my street and next thing I know I am no longer fully mobile and I am being treated for an infection that was never there.

In my daughter's case, I was sitting in the OS exam room who until a couple of weeks ago was my hero.  He does a XRAY and a MRI and wants to do a LR on my daughter.  Maybe that will cure what is wrong with her knee...but listening to Dr. Sanders and researching a few people on KG, I am SURE that she needs to be evaluated much more before any decisions are made. 

The really scary part....is 3 months ago if this OS told me that surgery on my baby was the answer....I would have shook my head up and down and we would be in some recovery room.

I understand what Dr. Sanders is saying about his group of Giants.....they will most likely have the same diagnosis.  I can think of nothing that would make me feel more comfortable than having specialists like Dr. Sanders and Dr. Noyes, and Dr. T all advising the same course of action.  I may have to donate my body to raise the money to get multiple opinions, but at this point nothing will short of that will allow me to sleep.  I finally know why the good Lord has disabled me....If I was working 70-80 hours a week on a boat, I would never have the time to take my girl to see the "Giants".   We would be doing it here and rolling the dice that she is being treated correctly.

I still have to find the money for this epic road trip....but he will provide that is some manner or another.  As always, you keep providing me with information that eases the pain in my chest when thinking about the possible wrong decisions I could make.  If you excuse me, I am going to Craigs List to post my body for sale for medical research!!!!!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline missmyknee

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Re: Open Debridement and Proximal Z-plasty
« Reply #751 on: March 15, 2012, 08:26:07 PM »
Hi All

I Had another round of injections to my knee for nerve pain. I had a total of 20 this time. Two of the injections were blocks. One to the saphenous nerve and the other to the tibial nerve. Much to my dismay, I did not have the same experience as last month. Last month. the injections provided 100% nerve pain relief. I had included 3 extra sites on the lateral side and I think one of those extra sites made contact all the way down to the sural nerve in my foot. This time it did not make it down there. To top it off, my BP was the highest it has ever been at 223/115. My head was throbbing and my hearing was numb , but no pain. They kept me there for an hour til it got down to 170//103, then they let me go.

When I had my appt with the pain management shrink, we were discussing my latest round of injections and my disappointment this time. As tears welled in my eyes, I told him I felt like I've been in pain prison for so long, that I don't remember what it was like, to be on the outside. Then one day, I escaped. I was out for 3 days, enjoying the feeling of freedom, from unrelenting nerve pain. It is more than wonderful, it is pure heaven. I never wanted it to end. Then, I am caught and returned to prison. Only this time, it is very hard to adjust being back in pain prison. I wish I had never escaped.

I hope some day, I will be released permanently. What a celebration, that will be

Pam

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #752 on: March 16, 2012, 01:40:22 AM »
Pam,

I had a bad pain week also.  I don't have a pain psychologist, but I was getting medication from my OS and my pain management doctor.  I take copies of what each writes me so it is in each others chart.  I have an infusion pump implanted in my abdomen that has catheters to my spine.  It pumps hydramorphone, bupivicane, and cholonodine into my spine continuously.  I have asked my OS to do the pump because he doesn't.  If he would than I would only have to see one doctor.  My pain doctor won't treat me in the hospital and my OS (back, shoulder, knee) won't do my pump.  Four weeks ago my pump ran out.  My pain doctor works every Tuesday and Thursday from 10:00 a.m. until 3 p.m.   I tried calling, but no way to get a hold of anyone.  The emergency number I had put in my cell was wrong.  I go five days without this medication so of course I detox.  I go to the E.R. when the alarm goes off.....the wife freaks out because my body starts having alarm sounds!!  E.R. says all they can do is admit me and treat me for opoid addiction.  Of course, $150 a day for five days which I can't afford.  I go home and take my oral meds.

Anyway, last week Thursday is my regular monthly appointment to get my oral meds, have the pump refilled, etc.  We don't want to ask for pain meds early or extra pain meds.  I get a call in the morning from PM doc's assistance saying they are overbooked, can I come next Tuesday.  I tell her I am out of oral meds due to the pump being out for five days.  I am on hold for 30 minutes....she has a midterm so wants to leave early.  Anyway, I tell her I have extra scripts left over so I can fill one of those.  So many times I can't get the oxycontin and oxycodone prescribed because of all the laws Florida has past in the last year to try to cut down on the pill mills and illegal scripts where folks are driving in from Kentucky and taking huge amounts of pills back to sell.

So, I go to the PM's preferred pharmacy.  I don't like the guy anyway, but I take in a script that is just over 30 days old.  He refuses to fill it.  Any other pharmacy fills them as long as they are valid.  I leave and drive to the hospital I was at last (65 miles) and fill my scripts....no sweat.  Evidently the preferred pharmacist is made because I didn't fill them with him and calls my PM and tells him I have scripts from two doctors...my OS and my PM.

So, I go to my Tuesday appt. and he tells me he called my OS and he will not give me pain meds again.  I can only fill one kind of med every 28 days per Blue Cross.  I am out of work for two years so I couldn't pay cash if I wanted to.  I was in so much pain as my PM is jabbing me with this needle in my abdomen to fill my pump.  He will never listen to me on its location so he always ends up jabbing me 4-6 times.  I finally lose it telling him I am in pain, I filled the old script I had because I went WITHOUT pain meds, not because I am getting too much.  In Florida, if you get two scripts for the same med, the State now knows and sends a report to both doctors.  The criminals don't care because the pill mill doctors get paid in cash and don't care.  The injured people....( I have had 28 major operations...upper spine..lower spine..both shoulders...knee) give the PM MRI's documenting my pain...same thing...3 years ago I have my GP call an ambulance because my BP is way over 200/over something stupid and tells my wife I am about to have the widow maker.  I have to call in...miss two cruises and a wedding..go the the E.R.....they give me a stress test so stressful I get sick all over myself and then the heart catheter.  The Cardiologist is screaming at me that I am some sort of hypochondriac because I am so healthy....if I wasn't a fat guy I could run a marathon. 

The PM backs off at my first display of any emotion in 18 months and tells me everything is okay......gives me more scripts for the same medication that does not work....Oh...forgot to say...when I could not get him on previous Friday, I call my OS and get a Monday appt.  Monday he gives me Opana ER and Zanax and Flector patches....PM is telling me to tear those up and get the oxy filled that I filled last Friday that his pharmacist called him about which do not work because I have taken them for 10 years.

I went to PM and had the pain pump because they lied their collective backsides off telling me it would take care of my pain.  When I go off on the PM, he tells me I am at a low level (for 4 years) and he can turn me way up.  I have hesitated to tell him how bad it is so that they don't think we are "seeking the euphoria" of opoids.  I had a PM tell me that once.......yes.....I have had all these surgeries just so I can trick these rocket scientists out of opoids that make me bloat like the goodyear blimp, grouchy, emotional, (45 more side effects) but you guys all know what I am talking about.  I am so over trying to make OS who have ruined my knee, Infectious Disease Doctors who ruined my immune system...Physiotherapist who get a thrill feeling the scar tissue tear as they jump on my lower leg....the PM's who act like "I am tough and should fight thru the pain."....and of course, don't forget Walgreens and Walmart who won't carry pain meds, CVS who order less oxy for a month than I get by myself because of the bad people taking it to KY to make a fortune, and than there is the independent pharmacist who is from another country and never had a scratch on him call my doctors to prevent me from getting my pain medication!! 

Now, please understand I am doing much better...Tuesday was really bad but I am trying to be positive.......my Psychology College Class is studying cognitive learning (using your positive attitude to tough thru the pain) so I am self soothing!!  I am the exception (Missmyknee and me) to most of these horrible circumstances and living in Florida, we have millions of elderly Snow Birds who have double TKR's every day of the week that are healthy and last 10 more years than the 10 years promised without complication!! 

I did take my black lab Polly in today for surgery!  She actually is the only member of my family to get good treatment this past year and she came thru the surgery well.  She is still dopey....must be the euphoria from her opoids!!!  She is also wearing a cone and bumping into everything....but doing well and hopefully will be herself in a couple of days.

Pam, I know what your are going thru girl and I also know what you mean about the pain.  The difference when I don't have meds is so intolerable that I can't stand it.  I am looking for a new pain doctor....looking for a new OS.....keeping the same old dog.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline missmyknee

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Re: Open Debridement and Proximal Z-plasty
« Reply #753 on: March 17, 2012, 05:04:31 AM »
Hi Russ

Thank you for posting. I'm so sorry to hear about the horrible time you went thru with your pain pump and meds. I don't know how you did it. It is a shame legitimate pain people can't get treated properly in regards to the pain meds they need. Just another case where law abiding people pay the price for the criminals. You can't even buy a sudafed for a cold, because of all the meth labs.

I'm glad your dog is doing well after surgery. We tend to take care of our furry family members no matter the cost. How can you say no to someone who loves you, no matter what....unconditionally. I'm guilty of that too  ;D

I've read some of your posts on other threads.....I love your sense of humor thru it all.  ;D

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #754 on: March 17, 2012, 07:05:17 PM »
Pam,

I definitely learned a lot off of your blog and reading the Intractable Pain Patients Handbook....that is a must read for anyone who is having surgery!  I am trying to be positive...I unfortunately jumped into several threads where people were thinking about TKR's and I was literally scaring some of them.  I did not intend to, but my situation will make most people do a double take..  I received some advice which was very accurate from the KG, that the vast majority of TKR's are very successful and there are thousands of people much older than I who have two done at once (I personally do not know how), but they do it.

So, other than my post about my day from heck with the pain freak, I am trying to at least make sure fellow knee geeks understand that I represent the group of less than 1/10th of 1% of all TKR's who have complications.  The other side of that coin is only 1/10th of 1% of all OS have a clue what to do when their TKR patient has complications!!  Bad Russ!!

Anyway, my kids say Polly (the mutt) looked like me on muscle relaxers stumbling around the house bumping into things.  The Vet put  a cone on her to keep her from touching the surgery site, but I removed it last night as she was not interested in anything but how to lay on her big pillow with this cone on her head! 

I know it will probably be split into a new thread, but I really believe dogs know what we are saying!!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline Teresa_S

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Re: Open Debridement and Proximal Z-plasty
« Reply #755 on: March 25, 2012, 09:13:33 AM »
Pam, although I do not come here frequently, I was worried about you. Was sorry to hear about the disappointment of the injections. There definitely needs to be something done about these Narcotics and their availablilty. I went in on the 03-05-2012, to fill my 30 day supply of oxycontin, and the insurance company told my pharmacist I could not fill tilthe 7th. I said I had billed it on 02-05-2012, and he agreed I should be able to fill it. The pharmacist at the insurance company said that the day you fill it does not count in your 30 days, then you must wait 30 days after you fill it, and the refill it the 31st day, which doesn t count on th next script. I asked them what meds I was supposed to do with all the days that did not count. They told me that by counting the day you get it, you might get it late and not actually need the meds for that day. BULLSH**.   Neither the pharmacist or I could even think of an answer for that!!!! Then they called back and said that in September I filled the script 2 days early, not counting the first day of course, and therefore that was why I had to wait the extra 2 days. B UT in October, I did not fill it till 3 days late, as my appts were off, using up the 2 days early. PLUS I had dropped two of the tablets down the furnace grate. I told them it was completly ridiculous that I could not be allowed to have at least 7 days of meds at all times, that I had to use up all my meds including the last pill befoe I could refill it. They tried to tell me it was MO law and that too is BS, as law allows for a 3 day early refill. Medicare patients can refill theirs 3 days early. SO I also wanted to leave town, and they would not give me it . I called my dr who then ordered me some oxycodone, at not 1/3 the dose of the oxycontin, and I went to refill it after 5 AS THEY CALLED ME AT 4:50, AND NOBODY AT THOSE PILLS IN 20 MG AND GAVE ME 10 MG TABLETS BUT ONLY HAD 17 OF THE 40, THEY NEEDED TO FILL IT, TOLD ME TO COME BACK THE NEXT DAY, AND GUESS WHAT, NO PILLS CAME IN, TOOK 4 DAYS.
iT IS UNBELIEVABLY IGNORANT THAT SOMEBODY I DO NOT KNOW CONTROLS MY LIFE.

At my last dr visit, I had told him, that I really disliked the fact that my body was controlled by my pain, and more than that the meds I needed to be able to do normal actvities, and even more than that the fact that he controlled those. He just laughed, but that lack of control over my own life, makes me furious and causes my bp to rise. He tries to be accomodating, but somebody who has not lived it just does not get it. IT IS BAD ENOUGH TO BE IN PAIN, but to have the pain meds be controlled by insurance, not even the dr. is beyond belief.  I know drs have put off by insurance companies making so many health care decisions like if somebody needs hosiptalization, or not, but this is baaaaaaaaaaaaaaadddddddddddddddd.

I do not personally like taking oxycontin, first for the stigma attached to it, and second, it does not work well for me and has too many side effects, especialloy during hotter weather. It was the drs drug of choice for me. Guess I will ask to go back to the fentanyl patch. It has been over 5 years since I used it.

The insurance pharmacist tried to tell me that I would only have to take my script with me on vacation, and present whereever I was and they would fill it. I told him, that was not so. THat drug is so controlled and not available that some pharmacist who did not knwo me would not fill it.
I m sick of it.  BUT the alternative is pain beyond functioning. I know your prison well. I hope , once again, you find relief, if only for those 3 brief days. Keep in touch. Teresa
On going instrumentation failure, chronic infection,
Arthroscopes Left 11 Right 2, MRSA, L TKR  ,  Revision, LR x5, Medial and lateral meniscus repair, Broken prosthesis
Osteochondral Fracture,untreated 6 mths. Revision new tkr 01-07 awaiting new hip and right knee
R TKR pending

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #756 on: March 26, 2012, 04:49:10 PM »
Teresa,

I have the same problems.  Most of mine stem from the pharmacists trying to play doctor and decide if "I really need this much medication" despite the fact that a pain management clinic has ordered it. 

I had an appointment 2 wks ago and my pain doctor was overbooked (what's new) so I had to wait for the following Tuesday (this was Thursday) for his next day.  He only works 2 days a wk.  I told his assistant I was out of meds.  After being on hold for 30 minutes, I just took one of my old scripts to the PM preferred pharmacist.  I  only have extra scripts because with the new Florida Laws, I cannot get oxycontin most of the time.  It was from February of this year.....45 days old.  Not only did the pharmacist refuse to fill it, he called my pain doctor at home, told him I was trying to fill old/possibly stolen scripts. 

This guy was the same way.  Must fill every 30 days.  All other pharmacies are 28 days.  My insurance allows every 25 days, but you have to find a pharmacist without a deity complex.

I honestly agree, how can a doctor know what is necessary to treat my pain if he has absolutely no frame of reference on pain???  I also hate the medication as it makes me grouchy...I carry about 40 pounds of water....always dry mouth.  I hate it but cannot function without it.

I hate the feeling as I go into a pharmacy and they look up at you when reading your script and shake their heads.  Let them walk in my shoes once.  I don't go for disability and we pay for our own insurance. 

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline missmyknee

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Re: Open Debridement and Proximal Z-plasty
« Reply #757 on: March 26, 2012, 08:52:49 PM »
Hi Teresa and Russ

It is horrible that law abidding pain patients can't get their pain meds. It's not just from pharmacies, it's in the hospital as well. Teresa, I know how you suffered with your revision with no pain meds and I went thru the same thing in Oct 2010 when I had a revision of my ankle fusion with bone graft from the pelvis/hip. That was one of the most painful surgeries I've had, because of the bone graft and I only got oral meds, no IV or IM drugs. To top it off, I had terrible post-op vomiting. I got nowhere with the ortho resident and nurses, pleading for better pain control. They actually told me to think happy thoughts and my pain would go away !!!! I found out my OS was out of town after my surgery. They also were saying I was to go home the day after my surgery when my OS's nurse said 5 days in. I hope I never have to go there again. The time before that, I developed pulmonary edema in the recovery room and had to beg to the nurse I couldn't breath. Thank God an anesthesiologist was checking the patient next to me and came over to listened to my lungs. He said my lungs were wet and started ordering IV meds and breathing tx's, STAT.

Last week, I had to call my PM doc who handles one of the narc drugs and my PCP who does the other, for renewals. It was my PCP idea to put me on that one drug. I go to PCP first to pick up the script then over to PM office to pick up my other script, but this time, they call me back to the exam room. The nurse tells me because of gov regulations/crack down, I need to have one doctor writing both scripts. I refreshed their memories that it was my PCP idea to put me on the other med, not my request. They said either they write both of them or PCP, but it made more sense for them to do it, since they were PM. I said I would have them do it. I told them I had just picked up the other script. I was feeling like a drug addict at this point even though they kept assuring me they did not think that way. I said maybe you guys would feel more at ease if I gave you the script from my PCP. They also handed me a cup for a urine test. I just had a test in December. They said they have to do 3 urine tests in a yrs time. I said the one I had in December was the 2nd one they've done since I started here in 2008. My first one was done after I had been here a year. I also had to sign a new contract with them. They said they had to update all this for the government. So far, I have not experienced my pharmacies reluctance to fill the script, however I have to pick up a new script each month, no call ins.

All this because of the law breakers.

Pam

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline missmyknee

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Re: Open Debridement and Proximal Z-plasty
« Reply #758 on: April 03, 2012, 12:30:58 AM »
PROUD OF MY KU JAYHAWKS !  GO KU JAYHAWKS


GO KU   ROCK CHALK JAYHAWKS  GO KU   ROCK CHALK JAYHAWKS  GO KU   ROCK CHALK JAYHAWKS  GO KU

4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #759 on: April 07, 2012, 03:42:00 AM »
Pam,

I so know where you are coming from.  I am so frustrated with the new Florida laws.  They do nothing to stop the pill mills because not one of the doctors writing the scripts cares if their cash patients are getting scripts from another pain doctor.  My PM rapes Blue Cross to fill my pain pump each month.  I just found out it has a recall.  I also find out that it will hold twice as much pain medication as I am currently getting which would allow me to have it refilled every three months instead of every four weeks.  I could actually get stuck in the abdomen with a large needle four times a year instead of twelve, but the PM will not do that because he gets $4500 to scan, empty, and refill my pump each month.  I understand Blue Cross does not pay what is billed, but a portion of this is getting paid each month.  I am also getting drug screened every month....instead of every four months because I was written scripts by both my PM doctor and my OS.  My PM will not come to the hospital for my surgeries because he has no privileges to practice at each hospital and my OS will not fill my pain pump because he does not have the scanners, etc.

They drug screen me to make sure I am not doing illegal drugs and that I am taking the drugs they give me.  What does it say about our system when illegal drugs are more readily available than prescription drugs.  My PM works two (2) days a week from 10 a.m. until 3:00 p.m.  I have had my pump quit working so I detoxed for five (5) days.  I went to the ER and they would put me on an I.V., but costs $150 a day to lay in the hospital.  I can't afford that.  I sure gained a respect for pain when I detoxed as it makes my knee pain seem insignificant. 

First they operate on you and then they ignore you because they have no clue why I have complications.  They have multiple MRI's and CT scans stating I am in pain...yet they won't treat the pain.  Wow....time to go postal.  I am hearing voices......do you hear the voices....????

OK....you KG's are my witnesses that I  heard voices!!!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline missmyknee

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Re: Open Debridement and Proximal Z-plasty
« Reply #760 on: April 21, 2012, 07:43:43 AM »
Hi All

Last week I had another PM appointment. I had the usual 20 injections to the knee. BP once again was high, but getting 20 injections, purposely in a nerve, does tend to raise a persons BP. They kept me there for an additional hour in a half because of it. PM doc is changing the compounded lotion by changing the lidocaine to tetracaine , to see if I will get more numbing from it. It should be delivered, any day.

I found out from a reliable source that my first OS was strongly advised to retire. This doctor had more than 11 lawsuits, including mine. He left a trail of destruction with patients lives. Finally, he'll do no more harm. I bet those malpractice ins rates, just got too high for the practice to absorb. The other 4 ortho docs I've used since, have all been competent, class acts.

P
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #761 on: April 22, 2012, 03:02:47 AM »
Pam,

Go get the putz!  I have been doing research on malpractice and over 85 percent of all cases, good cases, get punted by the judge.  Only 15 percent see a jury.  I have had multiple joints ripped out and my leg bones sawed off because three OS and three infectious disease doctors said I was infected.  I have not found anyone to take my case yet.  I am just interested to know if this qualifies as not the standard of care.

I went to my PM Friday.  I have an infusion pump that puts hydramorphone, colonodine, and bupvicane in my middle and lower spine.  I have been getting hassled because I am on the DEA watch list now because none of my OS will fill my pump.  I have to see a PM for that.  But, having more than 8 surgeries in the last 2 years, none of my PM have what do you call it...priveleges at the hospitals.  So, I have such a tolerance to pain meds after 28 major surgeries and how many other minor surgeries that they have to give me more pain meds when I have surgery.

I am being investigated because Florida has a new law that if you get medications from more than one doctor, they think you are going to pill mills and taking the drugs back to Kentucky to sell for lots of money...don't I wish.  I can't get my pain meds most months because no one in Florida carries the strength and numbers I get.  So, I was reported to my two doctors that the DEA and State of Florida are investigating to see why I am getting pain medication from two doctors.  I took in 15 unfilled prescriptions for just oxycontin to my PM Friday.  I am getting less now from two doctors with 8 major surgeries in the last two years than I was from one doctor 3 years ago. 

I had the pain pump implanted to allow me to cut DOWN on the oral pain meds because the make me fat, me me a grouch, and keep me awake.  Now I am getting less and they are chasing me like I am some dang criminal.

I go Friday and I went to the PM I am with now because one, he is close, but two medtronics, maker of the pump says he is the best.  It took me 6 months for the old fart to review all of my MRI's and X-rays from my two surgically repaired shoulders (4 left side-5 right side) multiple back surgeries (6 lower & 2 upper) and two of those were anterior and posterior at the same time......I am at 12 knee surgeries....and none of that was what I suffered with when the telephone pole I was on broke. 

Well, my PM doc tells me that even though he approved my insurance which is pretty much very good...Federal Blue Cross (Until Obama puts all federal employees on the government option in 2014) that he is not Blue Cross approved and he has not been paid anything in 15 months!  A pump refill and computer calibration is usually billed out at 2500-4500 plus the cost of the medication per month.  He tells me he cannot be Blue Cross provider because he is only one doctor and cannot treat me anymore unless I get different insurance (which pays 60 percent out of network) and pay the difference.

I really don't think my pump is working....I had the Catheter into my spine replaced two years ago because it broke some time before that when I fell of the side of a boat.  All the medication was going into my back, not my spine.  I have been complaining to this guy for months, but he has no surgical clinic to check the catheter.

I then find out because my wife is so worried.  I spent time in the hospital several times because my heart rate and bp go so high because of my pain.  If they knock me out, it goes down.  Well, my $1 million life insurance came due a year ago last christmas.  I was out of work and she wanted christmas...thought I would live forever and let it lapse.  Now with the transfusions, anemia, infection, pneumonia I was turned down.

I have to come completely off pain medication for two weeks.  I have not taken oral meds for 3 weeks and had my pump turned down 45 percent.  I had withdrawls from the orals, now I am in withdrawals from the pump and still have 55 percent to go next week.

I just can't bear having my wife and 3 kids who need college without life insurance.  I am not sure I am going to make it thru this, but can't take a chance not being insured.  I have my blood work done, my heart rate checked....must have colonoscopy and drug screen to get the life insurance approved.

I have the medication but can't take it.  The law they passed in Florida has done nothing to change the people coming to Florida and paying cash for meds to take to KY.  I have been out of work for 2 years...could not afford to pay for meds if not for insurance. 

I have to wonder when it stops.

But...on the brighter side my doggie has recovered from her bladder surgery and sat at the table with my last Thursday and had birthday cake. 

Just have to keep on pluggin.....3 more weeks.
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #762 on: April 22, 2012, 03:13:04 AM »
Pam,

There is one thing I found with my last surgery.  I can't get the anesthesiologists to do a correct nerve block.  They either miss or get in a hurry and don't find the nerves.

My last OS put something called ON Q into my knee.  It has 2 catheters that go right into the surgical site (knee) and are connected to two bulbs that hang around your neck.  They put pain medicine right into the knee (surgical site) for thee days at a time.  I actually had them for 9 days (maximum) and then yanked out the catheters at home....kind of like removing a drain.  I guess you are not supposed to go more than 9 days at a time because the medicine will burn the tissue.  That was the best pain relief post surgical that I have ever had.

I would think they could implant the catheters into your knee and let you go on and off it.  It is not a permanent solution, but would give you days of relief at a time.  It did not mess up my mind or make me nauseated.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline missmyknee

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  • From the Land of OZ
Re: Open Debridement and Proximal Z-plasty
« Reply #763 on: April 24, 2012, 04:52:59 AM »
Hi Russ

I don't know how you stay sane with everything you have to deal with, concerning your pain management. I once asked about a pain pump , but my Dr said no , he felt if it got to that then I should have the spinal cord stimulator. He's brought up several times to at least try it out for 5 days and see if I like it. I keep telling him I am petrified to get scar tissue in my spine.  My OS for my leg below the knee wants me to do the peripheral nerve stimulator.

Each time I had my ankle fused, they did a popliteal nerve block. This involved placing a catheter in the popliteal nerve. I had medication continuously infused. When I was sent home they place a medication bulb on the catheter that I would squeeze every few hours to infuse more medication. The bulb would deflate as it was used and would last about 4 days, then I would pull the catheter out. I've asked my PM doc if he could do one of those or even a femoral nerve block ( I am desperate) , but no go. I wouldn't mind a numb leg.

I hope you get all your PM issues worked out so you get some much needed pain relief.

I'm glad your dog is better and had some birthday cake with you. I just had a birthday yesterday  ;D

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline captainruss

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Re: Open Debridement and Proximal Z-plasty
« Reply #764 on: April 24, 2012, 07:20:49 PM »
Pam,

Happy Birthday!!  The picture we took of my dog with icing stuck on the roof of her mouth are hilarious! 

Have you ever looked at the On Q system?  It is similar to what you had, but it is not for the nerve.  I had it with my last surgery.  The catheters are placed right in the joint.  I had two bulbs of meds that hung around my neck.  I believe the put bupivicane into the bulbs.  They are programmable to put med continuously into the wound.  They would only let me keep it for 9 days, but it was 9 days of relief.  They are also patient adjustable so you would be allowed to adjust it yourself.

The stimulator and the pumps are fantastic if working correctly.  These are patient programmable also.  Mine puts a bolus into my spine every hours with a steady infusion continuously.  I get a big bolus right before my bed time.  The trial period is easy.  They put in catheters and hang the pump around your neck.  If you get relief after a week, they bring you back and implant the permanent pump.  It is all outpatient.

These pumps are outstanding.  I have a cocktail of hydramorphone, bupivicane, and cholondine.  They told me I had to take 8 days off for the trial, but I worked 12-14 hours every day working on and driving boats.  I have not tried the stimulator because I have not had luck with Tens units yet.  I have also had electrical stimulators implanted in my body and then removed after each spinal fusion.  The last one they cut out after 14 months without anesthesia, only a local.  They were put in to stimulate the bone growth on a spinal fusion.

As for scar tissue in the spine, I new nothing about the scar tissue complication throughout all of my back and shoulder surgeries.  I am curious how it is that I get no scar tissue (that I know of) in my spine but after my first TKR I am a scar tissue farm!  I had 5 knee surgeries at 17 and no scar tissue.  No scar tissue with the 9 rotator cuff surgeries and 7 spinal fusions. 

Any idea how I get scar tissue in my knee and not my spine or shoulders?

The Medtronic infusion pumps are outstanding. 

Try that On Q thing.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?