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Author Topic: Should I seek a third opinion? Really need some help! But my morals....  (Read 1515 times)

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Offline Marantha

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Hi all,

I have been seeing my second surgeon since May 2010 after my first surgeon who did my Lateral Release in 10/03/2010 didn't provide me good care (has been proven in reports) so I got transferred to my current surgeon. He has Been brilliant but am confused more than ever. From what he states in his letter dated 25/10/2010 MRI scan looks almost normal does suggest some thickening of the joint lining. Then states that if symptoms persist he would consider key hole (arthroscopy and debridement). Then when I seen him on the 02/11/2010 he stated that people with what I have can end up in wheelchairs. He said that he can do surgery but id either be better or be disabled. So he wrote a letter to my GP date of letter 09/11/2010 that likely post operative synovits and pain syndrome (CRPS).  Tender in the anteromedial sulcus and across the medial joint line. Quads are diminished in size and tone. he also gave me a cortisone shot in my knee and said he will scratch his head If it doesn't work.

Also my physio discharged me as there is nothing they can do and they want me to have surgery.

11/01/11 I seen my surgeon who discharged me today which was a complete shock he is referring my onto the pain management clinic. He said that he thinks I could improve but it could take years. He said That surgery is tempting but won't achieve anything for me. I explained to him that my knee keeps giving out, locking, I can't kneel, I can't run, walk up down stairs but I think he made his mind up and this was him scratching his head.

I am only 21 I've had knee problems since I was little bit it got dramatically worse since my operation.

He has said different things to what he said on 02/11/2010 there is no mention of CRPS nothing and I still have all the swelling in my knee my symptoms are the same. I am not going to be drugged up by the pain clinic what do I do?

I used to be a semi pro footballer now am nothing.

I am confused to the change of mind he had. I was that gobbled smacked I didn't say anything. Should I ask my gp if I can be reffered to another surgeon? This surgeon was meant to be good but he is I just feel he doesn't know. I can't go years without not being able to walk properly or run kneel and how long is years?
2009 Physio
30/10/2009 OS appointment confirmed patella tilt, very hypermobile, and a rare bone deformity called hypoplastic medial femoral condyle.
10/03/2010 LR preformed and chondromalacia grade 1 spotted

Offline amoler

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #1 on: January 13, 2011, 07:07:45 PM »
You are the "customer". If you think services provides suck, look for a different dr. I have run into far too many docs over the years who don't want to deal with the hassle of someone who isn't an "easy fix". I went thru 4 really awful neurologists trying to find a solution to my migraine problems before I found a brilliant /flexible research oriented guy who actually helped me. (I have all sorts of freaky weird drug allergies)  With my knee problems -I'm about to hit ortho #2 in 2 weeks. If he is as awful as #1 I'll switch again.

I'm a really firm believer in the joke- what do you call the M.D. who graduated at the bottom of his class..... Doctor.   There are vast difference in skill levels in the medical community.
'77- Rt knee menicus tear
'90 -2nd menscus tear
'91 -failed arthroscopy/partial menisectomy
patella dislocation 10/ 2010
Dx = grade 4 chondromalacia + synovitis + Meniscus tear + lax strained medial ligaments
Fall down the stairs 7/20/11 - mcl sprain + 2 meniscus tears

Offline emzobe

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #2 on: January 13, 2011, 07:50:34 PM »
I am a firm believer that if you have a gut instinct that the surgeon or doctor you are working with is either not helping the medical problem, has no plan in place to try to solve the medical problem, has given up in trying to figure out what the diagnosis is, or isn't fulfilling the expectations you have for medical care, switch.

I have had "very uncommon" problems with my hand and knee, which took 7 and 6 different doctors respectively to figure out the problem and treat it.

In the end, it matters that you get better in the shortest amount of time possible and that means you have to be the greatest advocate for yourself. Sometimes, that means communicating your feelings about the medical care you are receiving by walking with your feet to another doctor or practice.

Offline Marantha

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #3 on: January 13, 2011, 08:12:22 PM »
Thanks! I think am too nice and worried that I will hurt feelings if I go somewhere else. My deepest issue is am scared in case they don't believe me xx
2009 Physio
30/10/2009 OS appointment confirmed patella tilt, very hypermobile, and a rare bone deformity called hypoplastic medial femoral condyle.
10/03/2010 LR preformed and chondromalacia grade 1 spotted

Offline smillie

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #4 on: January 13, 2011, 10:35:46 PM »
If your doctor came in and said he wanted to do a new XYZ surgery to fix your problem and it will be a big deal with a difficult recovery and some degree of risk, your first instinct would (should) be to get a second and maybe third opinion to confirm that this big step is the right one to solve your problem. And you should get the second opinion because a big procedure is not to be entered into lightly. So now you have a doctor telling you that there is nothing to fix your problem and that you're going to have to live with this level of disability. Why wouldn't you do the same thing and go for a second or even third opinion? It's OK to see further opinions. You might find someone who will confirm what you have been told or you might find someone who has some new insight into your condition or who is willing to search more to get to the root of your problem. Don't worry about hurting someone's feelings. You're not going to go tell them off. You're just seeking another opinion. It's not personal. It's business! It took me until I was 30 to figure this out. You have the chance to learn it at a younger age and avoid a mistake.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Online vickster

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #5 on: January 13, 2011, 10:54:59 PM »
Are you in the UK?  The system is a little more clunky, unless you have private insurance (and even then it's not plain sailing).  As said if your surgeon cannot do anything else, he should be suggesting you see someone who is expert in your specific issue.  What is the exact nature of your knee injury (if you know) - you should use this forum and the Internet generally to identify experts in that specific area (even knee specialists have their own specific specialisms, complicated joint) and then ask your GP for a referral. 

Assuming you have an understanding GP, there should not be an issue - I think the ability to be referred to any named specialist still exists (extended choice) even in this age of austerity.  At your age, you should be fighting to see whoever it takes and however many specialists.  It may even be worth considering a private consultation if you can, and then get the specialist to transfer you to their NHS list

Where do you live (I am assuming the UK given how you write dates, apologies if not)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline KW

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #6 on: January 13, 2011, 11:28:29 PM »
If ANY Dr even mentioned CRPS to me that would be the 1st thing that I would be focused on getting evaluated.  The possibility of CRPS is not something you want to ignore or "wait and see".   
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline fischbein

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #7 on: January 14, 2011, 04:23:53 PM »
After 12 knee surgeries, and waiting for a total complex revision of loose prosthetic knee, I have learned that a person should see at least three or four specialists, not just local orthopedic surgerons, but those who specialize only in knee and hip surgery.  You shaou see others that are hopefully affiliated to a University medical school.  I suggest avoinds over for consults as you can get overloaded, but sfter four specialists you should get a consensus, and then pick the one you feel is best for you and stick with him/her.
A doctor that one person feels is fantastic may not be right for the next person as personality area of specialty number of patients he/she has seen with similar issues all play into quality of care.  Always aske questions and if you don't get an answer or the doctor brushes you off go to another doctor.  Pain management although necessary never solves a problem, it makes the pain go away a little, but the knee could actually get worse since pain tells you something is wrong and if pain is masked you can over do it and do more damage.  Best to you.

Offline Silkncardcrafts

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #8 on: January 15, 2011, 05:19:00 PM »
Don't feel bad. I felt like that when I got a second opinion on my shoulder. The second opinion surgeon was actually better for me. So, I went with him and has stuck by me.

I would actually be asking your GP to a referral to a sports physician on the NHS. They tend to take more of a holistic approach.

Seeing 4 specialists is not necessary. You will just get more confused.

I think you are near Bristol. Dr Eldridge is meant to be very good and works privately and in the NHS. He specialises in knees and takes on difficult cases.

Good luck !
11/1996 - RK LR
07/1997 - LK LR
11/1998 - LK MPFL Reco
12/2005 - RK LR Repair
07/2006 - LK MPFL Repair
11/2006 - LK LR Repair
22/05/08 - LK Trochleoplasty
11/02/10 - RK Trochleoplasty
07/03/11 - RK Chrondroplasty

Offline Marantha

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #9 on: January 16, 2011, 11:46:29 AM »
Thank you all! Yes am seeing my GP on Tuesday I just can't accept the whole you'll be like this for years! It's not good enough when imam hardly independent already and from beig a very fit person to nothing is a hard thing. I suppose I am scared in a way just of the whole not knowing and am scared cause I am bein labled with many problems I mean i can't have them all right??? He said I have CRPS but yes my knee is painful and swollen but it's bit discoloured in anyway am even questioning this.

I am in the UK near (Wiltshire), can my GP reffer me to someone out of my area?

Also I can't stop thinking about this it's a big part of someones life, I never knew knees were so vital.

Thank you all xxx
2009 Physio
30/10/2009 OS appointment confirmed patella tilt, very hypermobile, and a rare bone deformity called hypoplastic medial femoral condyle.
10/03/2010 LR preformed and chondromalacia grade 1 spotted

Offline clarky_vl

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Re: Should I seek a third opinion? Really need some help! But my morals....
« Reply #10 on: January 16, 2011, 05:33:09 PM »
Hey Marantha!

I completely understand how you feel, I was with the same surgeon for years right through my injury and for multiple surgeries, and when I reached the point where I knew I should change surgeons because the relationship with my surgeon had totally broken down, I still felt bad about it and the potential hurt feelings, which doesn't really make sense given how things were I know, but I couldn't help it!

Anyway, I went through my GP to get a referral to another (specific) surgeon and that involved a move from the Devon Trust (where I live) to another NHS Trust (Cornwall) which my GP was totally fine with. She said something about having to apply for funding but whatever happened didn't really involve me, I just got an appointment a couple of weeks later so I assume it was fine. she said that she didn't see that being a problem because it was a complicated case and I had already used the surgeons within my own trust, so you should be the same I imagine.

I had the same fears that the new surgeon wouldn't be able to help me either, or would see me as some unreasonable person who changes surgeons when she doesnt hear what she wants to etc (also because my old surgeon kind of made me believe that) but it was the best decision I have made, and I am very glad I did. I would also advise you to research exactly who you would like to be referred to, like someone else had said about surgeons who take on difficult cases, careful choosing will make it more likely you will end up with someone who can really help you.

Best of luck!

Vicky
11/10/07 ACLr-hamstring, lat meniscectomy, microfracture
29/7/08 ACL revision-hamstring/LARS
7/7/09 ACL revision-quad/LARS
20/2/10 Screws out, bone grafts, arthroscopy.
6/7/10 ACL revision-BPTB allograft
14/3/11 Screws out, bone grafts, arthroscopy.
Then: ACL revision + extra-articular repair















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