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Author Topic: please help!! 4 months since fall and no diagnosis yet  (Read 3092 times)

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Offline sambam

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please help!! 4 months since fall and no diagnosis yet
« on: August 22, 2008, 10:13:53 AM »
Can anyone please help...I am a 42 year old woman, always been fit and have an active job, I'm a postwoman so walk miles each day, my world has been turned upside down after having a fall 4 months ago  :(
I slipped and have injured my left knee...the initial impact was on the top of my tibia but I then fell sidewards my left foot planted under the right leg, my knee was twisted out to the left and took the full force of my body weight.
I went to casualty the next day in severe pain and was told to go home and use the rice method that they couldn't see anything much wrong, I returned to casualty 4 days later as the pain was so bad, I was x-rayed and found that the top of the tibia bone had a break in it, I saw an orthopaedic consultant then and put in a full leg cast for 2 weeks to immobilise my knee and let it settle down.
My knee continued to be very painful, felt wobbly and I was mobilising gently around the house albeit with a terrible limp, the Dr queried a torn meniscus and torn acl and I waited weeks then for an mri scan which did show I had a meniscal tear and possible acl tear too, I was booked in then for an arthroscopy in which the Dr said he would repair the meniscal tear and have a look at the acl at the same time.
I had the arthroscopy done on the !st August, I left hospital in agony and totally in the dark about what the surgeon had done or found, he never came to see me after the surgery and the nurse looking after me couldn't decipher what he'd written in my notes, after 2 weeks I made an urgent appt to see the Dr as I was still in agony, hardly able to walk, I had no idea about exercises etc that I should be doing and had work breathing heavily down my neck asking about re-hab plans and I couldn't tell them anything!  The Dr said that during the arthroscopy he hadn't found anything wrong with my acl, he'd had to dig under my meniscus to find the tear and then decided to leave it unrepaired as it would heal on it's own. He told me he couldn't understand why I was in so much more pain since the arthroscopy as he hadn't done anything and found nothing, I was told he did these every day and to go home and take the tablets and come back in 3 weeks to see him...I left the consultation in tears feeling that he thinks I'm making this up.
My knee is markedly worse than it was before the arthroscopy, I'm in so much pain It's getting to me, I'm off work and still have them asking about re-hab and I still don't know anything...I can describe exactly how my knee feels, apart from the pain never going away it feels so stiff yet wobbly and unstable especially going downstairs, my knee throws out to the left. I can touch the pain! it is on the inside of my knee underneath the arthroscopy incision scar, if I bend my knee heel to bum as far as I can get it it feels like the joint is opening up and that my tibia can rotate outward, I now have quad muscle wastage that is quite noticeable, I'm at my wits end now as I feel I'm getting nowhere with the Dr, I think I've got a mcl injury?
I've put in a formal complaint about my knee being worse and have asked for a repeat mri scan to compare with the pre-op one, whether I get anywhere with this I don't know but I'm losing faith that I will be listened to and get the help I know I need.
I go back to see the Dr on 4th Sept and I'm worried that because I've now complained that he won't take kindly to me saying that I think I've got an mcl injury. Any help, comments would be greatly appreciated. Thanks for taking the time to read my post  :)

Offline Nettan

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #1 on: August 22, 2008, 10:34:49 AM »
Could be just lack of muscles too if you have not done any rehab.
Ask OS for referal to PT and maybe make a second opinion.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline sambam

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #2 on: August 22, 2008, 10:45:11 AM »
I've asked about physio and bracing only to be told to let it settle down as the physio will just aggravate it? but everything I've read tells me that I should have been having therapy, I have thought about asking for a second opinion so I think that's the next step if the hospital doesn't answer the complaint properly, many thanks for replying  :)

Offline Mookie11

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #3 on: August 22, 2008, 12:24:05 PM »
Hello there,
I know how worried you are and how frustrated too. I had a similar experience where I felt I'd been brushed under the rug by the medical experts. I have a thread that I would encourage you to read called Lamenting My Left Knee. What I would like to say to you is that if your knee feels it is thrusting out to the left when it wobbles, it may be an LCL issue. Briefly, what happened to me was a ball injury where I was mowed down by another player. At the hospital emergency, nothing was found to be inherently wrong other than perhaps a hamstring issue. I too was put in a cast. Time passed and the pain was unbearable. My knee was unstable and definitely felt like it wanted to collapse either sideways to the outside or even backwards now and then. The wobbling caused me to fall on occassion. I too was eventually seen by an OS, about 6 weeks in who went in arthroscopically and who felt that the only issue I had of any consequence was a ruptured PCL. I was told to get strong and everything would be fine. By the time another 6 or 7 months had passed and I'd done more therapy and exercises than I'd ever imagined I could do, things were not getting any better. I finally fell into a plate glass partition at work and was very nearly cut to shreds. That prompted me to get mad and demand a few answers. I saw the OS again who finally  ordered an MRI. The MRI revealed all kinds of issues and I was then scheduled for what was expected to be a 2 or 3 hour surgery to fix me right up. As it turned out, once he got in there it turned out to be even more complicated than what was revealed on the MRI. In the end, it was a 6+ hour surgery. It turned out to have been a complete LCL tear, a PCL rupture, issues with the posteriolateral corner and the posterior capsule and I'd managed to damamge the ACL between the time he'd last seen me prior and the big surgery.  In conclusion, if you are still in this kind of pain and experiencing these kinds of wobbling experiences, you need to DEMAND some answers and some action. Your knee doesn't wobble unless there is something seriously amiss. It seems that when the surgeon's go in to do a look see, they seem to focus on the ACL and PCL but not the LCL, the PLC or the MCL. I don't know if that is because they aren't viewed well with the arthroscope???

You need your knees, that much is obvious. Please let us know how you are doing.... we care around here and have all been there, where you are, confused, worried, scared...

All the best,
Candace
Who knew knees were so complicated!

Offline eslteach

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #4 on: August 22, 2008, 03:19:37 PM »
Check out the "bone breaks around the knee" posts under the Specialists office.
ali
5/27/08 - Fall (dog chased cat)
6/4/08 - TPF diagnosed (crutches/NWB)
7/9/08/08 -  Surgery L.leg - tendon/meniscus repair
7/14/08 - PT - NWB
7/31/08 - PWB w crutches
8/7/08 - WB w crutch/cane optional
8/28/08-Released by OS
3/2009- R.leg - meniscus tear/fragments/cyst 4x7cm
4/7/09-surgical repair

Offline sambam

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #5 on: August 27, 2008, 09:42:29 AM »
Many thanks for your replies...after reading what others have been through my problems don't seem to feel quite so bad, I've turned into a demented mad woman this week  :( I think I've been trying to justify to myself that there is definately something wrong with my knee...I've laid here with knee anatomy diagrams up on the computer, with my knee angled how I fell trying to work out where the pain is in relation to the diagrams and the forces involved, the Dr hasn't ever asked or really looked at how i fell he's just assumed it was acl trouble and then as he found a healthy acl on arthroscopy that seemed to be enough for him and therefore says nothings wrong.
I've done so much reading this last week that my heads boggled  ;D I was interesting to read that the mcl can't be viewed on arthroscopy so that made me hopeful that he could have missed something as he has never mentioned an mcl injury, his focus has been the acl all along. He did say that there was something on my mri scan that he wasn't sure what it was and was going to re-refer my scan for inspection by whoever looks at these things?
When I go on the 4th I"m going armed with a list of questions and hopefully will get some answers...I want to know if I have a medial meniscus tear firstly, my thinking is that...if I have a mcl injury that he's missed, could he have made that injury worse or aggravated it by digging about in my knee trying to find a medial meniscus tear, hence the agony I've been in since the arthroscopy. I might be barking up the wrong tree completely????
Saying all this the pain has lessened over the last couple of days so I decided in my wisdom to get the exercise bike out of our outbuilding and try doing a little bit of cycling to try and build up my quads as my leg is really skinny compared to the other one and this can't be helping with the instability of my knee...but Grandma passed away recently and all her furniture was stored in there too so I've been moving things to get the bike out and I've obviously over done it and I'm in pain again and sat with my leg up feeling I couldn't cycle even if I'd managed to get the bike out.
Still had no answer from the hospital about the complaint yet but will let you know if I hear anything, I'm hoping that it will make the Dr look into things a little more deeply but we'll see!


thanks for reading my ramblings, Samantha

Offline Mookie11

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #6 on: August 27, 2008, 10:43:31 AM »
Hang in there Samantha, and don't settle until you know what is wrong. I doubt you are a demented person as it seems most everyone who thinks something isn't right just KNOWS. MRI's don't necessarily show everything, especially if there is scar tissue built up. I hope you find some answers soon!!

Candace
Who knew knees were so complicated!

Offline luckygrandma6

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #7 on: August 27, 2008, 01:11:02 PM »
The first thing I would clearly do if you go back to this doctor and are still getting the run-a-round as that is exactly what is going on here. You need to get a second, third, or even 4th opinion if necessary. I've been getting the run-a-round with my OS for 3 years until 4 knee surgeries later and he still cannot give me a diagnosis as to why my knee is not stable. I am now in the process of going to my GP and getting a new referrel and I won't quit until I get the answers. We are nothing but a number to these doctors and unless everything goes according to their plans then it has to be in our heads. I started out with an arthroscopy and it's been down hill since. I was in worse pain then when I started. Regardless of whether he found anything, he  poked around in there and stirred things up. He couldn have even torn something while he was doing the exploratroy. Did you have arthritise that he debrided. That alone would cause more pain. Don't waste 3 years on this guy when you could go to someone who could help you. I regret the time I've wasted on r him to figure it out. What it really boils down to is he doesn't want to admit that he did anything wrong or the surgeries failed. He's sending me to a Neurologist for the 3rd time as he is so sure it is a Neurological problem. All tests have been negative but he can't accept it as that would be admitting he is wrong.
Right knee (arthroscopy) 2004
Right knee (PKR)) April 5, 2005
Right elbow (Bursectomy)1998
TRKR 2006 Failed)
Left knee (arthroscopy)
Left knee (arthroscopy)
THR 1992
2 back surgeries (Feb 2007 & March 2007
Right knee spacer exchange (Failed) 2008
TRK (Hinged Prosthesis) Jan 2009

Offline itsbeenayear

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #8 on: September 02, 2008, 05:50:56 AM »
Hi Sam

Read your post with great interest - just wanted to wish you all the best for Thursday - ask every question you need to and make sure you get the answers you are looking for before you leave!!!

Sure we will catch up before then

Take care


Em
Its Been A Year

Offline Mookie11

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #9 on: September 03, 2008, 10:10:41 PM »
Hey, don't forget to update us!! We will be wondering how you make out!

Candace
Who knew knees were so complicated!

Offline sambam

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #10 on: September 04, 2008, 07:26:33 AM »
Well today's the day! going this morning to see the Dr at the hospital, I've been feeling so miserable this last week I really don't know where to begin to put into words how I feel, one thing that cheered me up is that my partner has been able to swap things at work so he can come with me today, big relief that I haven't got to face the Dr alone  :)  I'm really nervous that the Dr will be angry that I've made a complaint.....this isn't like me at all! My younger son has a genetic condition that has disabled him slowly and he's now a wheelchair user, he's had so much orthopaedic surgery over the years and I've always been so strong and fought his case vehemently if I wasn't happy about things yet I'm being like a wet lettuce about my own care...I know I need to find some strength from within to stand up for myself today. I'm truly grateful to everyone for your encouraging words you're all so kind and supportive and i'm going to write down all the questions I need to ask him shortly so that I won't forget anything and I'll definately let you all know later what he's said.
At the moment I'm still in pain all the time, if I stand and put all my weight through the bad knee it goes backwards first and then twists inwards so I look knock knee'd, whether this is because my muscles are now so weak I'm not sure? In answer to Grandma he didn't do any debridement etc. just had to "dig about" to find the tear which he said would heal itself over time so didn't do anything with it, I swear he's done more damage in doing that as I've been in a much worse state since the arthroscopy. I was stuck in the shower the other day as I daren't step out for fear my knee would give way and I'd slip and fall, it's so frustrating!
I'm going to write my questions now so I'll say bye and catch you later,  many thanks once again...Sam x

Offline Mookie11

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #11 on: September 04, 2008, 12:05:24 PM »
Good luck Sam, at least be romaine instead of iceburg.... more to it haha!!
Candace
Who knew knees were so complicated!

Offline sambam

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #12 on: September 04, 2008, 05:35:12 PM »
That made me chuckle Candace  ;D

Well I've been this morning and I've asked all my questions and had no joy at all...the Dr basically I feel is
out of his depth and has agreed to refer me for a second opinion, he could see how much pain I was in but still can't say what is wrong, he sat there looking through my pre-arthroscopy mri scan and kept saying that he couldn't see anything wrong apart from the tear that he left but I'm in more pain since the arthroscopy so I don't think that that mri is relevant anymore. He said that my twisting knee is due to me compensating for the pain...what a load of twaddle! it's more painful now it's twisting so why would I do that on purpose? His only solution was to give me an injection of local anaesthetic and steroids into the joint, he injected so much but I ended up crying and he only got a little of what he'd drawn up into the joint as it was so painful, I'm laid here and my knee is thumping  :( I thought at least the local would take the pain away for a while.
He agreed to refer me to another Consultant at the hospital but said that if I preferred another to let him know so I've looked on the list of kneeguru approved consultants nearby and have rung their offices and they can see me within 2 weeks if the referral is marked urgent so I've just rung and asked to be referred so hopefully I should hear back soon with another appointment. Although I'll have to travel further I feel so much better now that I've taken positive action.

The worrying thing was that when I asked him who was the head guy at the hospital he said "I am, I've been here the longest.", then as I was leaving the sister came over to me and said, "He's not the head guy at all Mr. Ali is and if I or any of the staff here needed surgery we would all ask for him." I found that rather shocking coming from a member of staff and to think that your care could be subject to ego-power struggles of Doctors/surgeons who you trust to do the best for you is frightening. If he is out of his depth he should be man enough to admit it, I wouldn't mind so much if he had said that he would speak with the other consultant about my case but I get the impression that he would see that as admitting that he is at a loss and be a slight on his own ability.
I'm guessing this probably isn't such a big shock to many of you from what I've read here but I must say I'm rather taken aback by it all.

Anyway, chin up I guess and lets hope I know more soon  :) Sam x

Offline Mookie11

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #13 on: September 04, 2008, 06:11:10 PM »
Hi Romaine,
Yep, they have some iceburg sized egos, for sure, these doctors, the depth of ice below the surface of the water out of view until it is crashed into. It's incredible the lenghts they will go to to bamboozle us with their years of experience and knowledge. I am so glad  you've asked for another opinion. What a frustrating situation!!! I'd go with one of the KneeGuru docs if you can get in to see one. The amount of time they put into their professional arena in the maintenance and information provided in this site alone indicates a desire to really help people and to delve deeply into the issues.

As for how you are feeling at the moment, rest the best you can. Ice your poor knee and elevate it. There isn't a whole lot else you can do, other than pain medication, until you've found out what the real issues are.

Hang in there! You will get the answers you are looking for eventually. Not every doctor is an egocentric god-like figurehead!!

Candace
Who knew knees were so complicated!

Offline itsbeenayear

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Re: please help!! 4 months since fall and no diagnosis yet
« Reply #14 on: September 07, 2008, 11:16:03 PM »
Helooooo Sam

Well, at least you asked the questions you wanted to ask, those steroid injections are bar stewards !! - i nearly forgot where i was there and swore. I would love to send you me of my pain killers, they really are fantastic, although slightly addictive.Keep me updated - and wishing you lots of luck sweetie, try and swim - seriously even if you cant do the leg strokes it is amazingi just being in the water

catch up soon

x x
Its Been A Year