Furious!! Breathing fire, even

A while back I posted about my ongoing pain from a severe ankle fracture and surgery. I said it was wearing me down day by day. Many of you great people offered good recommendations along with your wonderful support.

I was buoyed by that, and resolved to confront the orthopedic surgeon at my next appt., which I wrongly thought was the following Wednesday. It was today. Dumb me, but I got it right and went today.

Once again I told him that the pain is bad. It has improved somewhat but it's still way beyond what I expected. And so on. What he said is that the ankle has healed, the hardware isn't getting in the way, and if it hurts, it's something else. What the @&^%$? How crazy of me to think that a swollen, discolored, hot-to-touch ankle that was broken in multiple places and is full of metal could hurt, 3 1/2 months later. My PT thinks my situation is quite normal, considering what I've been through, and will keep on working at it. At least I've got him.

Furthermore, the ortho-dufus asked me if I've heard of gabapentin (hah!) and suggested it was all neuropathic. Wrong! How come when I sit down and rest, or ice and elevate my leg, the pain lessens? Ever heard of that from neuropathic pain? I sure haven't, and I've had plenty of neuropathic pain. If someone here has had other experience, please let me know.

Well then, the discussion moved to meds. I told him that the Tramadol I had would have been gone in a week if I'd followed dosing instructions, but instead I stretched it out to 3. Didn't really matter because it didn't help much anyway. What followed was a lecture on narcotics and how some people just go nuts and abuse meds like mad. Hell, I've never even smoked pot---just not the type. But he gave me a prescription, so that seemed good. Also, he brought up the subject of pain management, and actually wrote a referral. So there was the first decent thing to come out of the appt.

On the way out I read the prescription and saw it was for hydrocodone + acetaminophen. Well holy moley, that's what he gave me during the whole post-surgical, cast-wearing phase, for 8 weeks, for several weeks of which I took up to 8 a day (per dosing instructions). I was careful, never went wild, never did the Charlie Sheen stuff that the doctor implied was almost inevitable. Did he not remember that he'd given me that before? From the way he worded things, he was going way out on a limb and giving me something akin to Dilaudid.

Nevertheless, I went to have it filled, stopping on the way to find some mild compression stockings that may or may not exist the way he described them. Then I went to the supermarket/pharmacy. I had to wait 45 minutes, and filled the time by doing some needed shopping. When I went to pick up the script, they told me they couldn't fill it because---now get this---the dosage he prescribed doesn't exist! There's a stronger and a weaker, but not that one! Furthermore, because it's a narcotic, they couldn't call him to correct, and he couldn't fax anything. I have to go back to this jerk and get a corrected prescription. Will do that sometime tomorrow. I called. his office and his very nice secretary apologized and said it was very unintentional. (The pharmacy had called first.) Restraining myself mightily, I still couldn't help muttering, 'I wonder.'

Now this is a prominent surgeon in a huge practice with a bunch of offices. The hospital is highly rated, in a city noted for its outstanding medical care. We're not talking about Outer Mongolia, medically speaking. So I have a right to expect better than this.

A final sour note to the encounter. The doctor told me that the big masses and streaks of brown on my foot and leg will disappear within 8 months. That is, if they disappear at all. Maybe not. It's iron from the bleeding that took place while my leg was confined. Wonderful.

Well, at least I can try the pain management route now. Will call tomorrow. This evening I'm exhausted and in severe pain.

Ah, a good vent does a body good!

ess

[rendean]

Aww Ess,

I am so sorry you are in such pain and have such an idiot surgeon treating you!  My kids' pediatrician once told me surgeon s go into that field because they are not "people persons" . sounds like he was right.

Except for the heat aspect of your ankle , it sounds like complex regional pain syndrome. I would certainly follow-up on the pain management appointment.

I so wish you could find a pain-free moment in all of this mess. You have endured much more than you should have had to and more than most could tolerate. I will dedicate my glass  of chocolate wine to you tonight.  You should feel better around 8 pm :-)

Hugs,
Ren

[crwriter]

The US gov has gone wild recently on pain management meds.  It's almost like everyone who needs any type of pain management just has to either be a drug addict or will become one.  As a result, any type of narcotic prescription registers in a database.  If a doctor prescribes too many narcotic prescriptions, he or she can lose the license to practice.  So any type of addictive substance can bring a doctor into the limelight.

[addicted2harleys]

Ess-  I hear you loud and clear!  What a mess for you.  :(. I have to admit that I did have a couple chuckles when reading your message.  Ortho-dufus cracked me up.  Never did the Charlie Sheen stuff....now that was pretty good, too.  I tend to find the humor in things.  

But, on the other hand, WOW!   You sure have been through the ringer with this ankle.  I didn't realize it was as bad as it is.  I feel for you and am truly sorry you are going through this.  :(

I wish I had a magical wand or something.  Or at least some good advice.  But, I don't.  But, I can definitely be counted in on your sounding board and shoulder.  

Hugs,
Addi

[jensequitur]

There's a big sign in my doctor's office that says if you're in for a refill on narcotics, then you have to have a blood test.  Presumably it's to cut down on that sort of abuse.

It sounds to me like you've got some hidden damage in your ankle, that hasn't been addressed yet.  Reminds me of Quix's ankle that was actually broken, but they didn't diagnose it as broken for a couple of weeks.  So maybe the specialist was right, but he's still an idiot!  Problem is - how do you convince him that maybe there's something else going on in there?

Iron staining - yeah, it does take a while to go away.  When I broke my toe I had a lot of that.  Thing is, it does take about four weeks to go away, but you should be seeing some improvement.  It makes me think that there's still some bleeding in there.

I know Quix is dealing with her own troubles, but I would drop her a line and ask her - I think there's something hinky here.

[Sumanadevii]

No one deserves to be left in pain and not treated.  And, I like you, think there was no mistake in the dosage.  He had to know better.  He just doesn't want to treat the pain...easy for him as he goes about his day pain free.  

I think some doctors play god like figures making snap decisions about if a patient is or is not in real pain.  I have a dear friend that had her knee cap replaced and hasn't been able to walk since.  Her doctor will not treat the pain.  He thinks she should just get up and move and it will disappear.  He has no idea of the kind of woman he is treating.  She is one of the strongest I know!!!   Strong or not, her pain is real and she doesn't deserve this any more than you.

I hope the pain clinic works out.  Another thought is have you considered asking your neuro to treat it?  It just seems so wrong to me.  I fear it could put you into a flair...untreated pain I believe would have the power to do it.

[Sarahsmom46]

What can I say that would begin to help you other than this guy is beyond the dufus category.  

I have had ankle surgery and had a dufus ortho as well. I can tell stories about him too.  Like you said, the only good thing he did for you is give a referral to pain management.  Try to get in ASAP so you can get this pain under contro. We heal so much better when we aren't fighting with the pain.

I love my physiatrist - pain manager.  She does not mess around with the pain issue all the while keeping an eye that I don't stay on a drug any longer than necessary.  Wish you lived up my way because she'd get you all straightened out.  

So, do you have to see this guy again?  Hope your follow ups are over with him. He's not an academic uni guy is he?  

Hang in there, it will get better.  

Hugs,

Julie

[crwriter]

I'm beginning to think people, including doctors, do not comprehend pain unless they have been attacked by it.  I had excrutiating back pain last year.  It actually kept me from sleeping so I would wake and have to sit in a chair.  The pain was so severe I ended up just being able to keep myself from screaming, because screaming made it hurt.  I have seat belt injuries.  I would go to ERs and my son even threatened to call an ambulance on one occasion - but for pain.  He berated one er doc for his attitude saying that I had raised kids and what was the deal?  He had walked in with an attitude.  I would have given up if not for my son.  I was furious.  I knew I was dying slowly from not being able to sleep enough.  So I went into a major hospital and told them I would rather die than face one more minute of pain.  They threw me into one of those "special" hospitals, and they started me on neurontin, flexoril and the lidoderm patch.  My bp was starting to bottom out, so I really didn't have much time left.  I cannot thank those people enough.  They saved my life.

Then I had my last terrible fall last October.  After that fall I realized that it was my falls that were exacerbating my annular tears from the seat belt injury.  I had fallen six times in 18 months.  Started me thinking - two things going on not just one.  I finally dropped my whole group of doctors at the urging of friends and family.  They had been at me for years to do so, and I kept defending my PCP.  So silly of me.  Always listen to those who love you.  Now looks like my PCP had a stranglehold on my care as he covered his back because of a miriad of mistakes.  Discounting test results in lieu of the easiest diagnosis.

These days of large groups of physicians/hospitals connected by computer at a second's notice is not a good thing in some cases.  I moved on to a whole new group of doctors - new hospital.  The last straw for me was an MRI suggesting I get inhanced images to rule out neoplasms and demyelinization.  My doc said we would wait and see what happens.  Hah.  Seeya.

But I was worn out and did not follow up quickly.  If I had had brain cancer...  Anyway - looks like my care is getting better and being careful about falling has really helped my back lots.  Pain still wakes me but I can sleep long enough to actually get rest.  And my son bought me a nice highback desk chair that I can slip into and sleep if I can no longer lie down.

I hope you can get this resolved, and better still I hope it heals quickly.

[Guitar_grrrl]

Ess, I'm going to suggest something that's floated around this forum over the last year and some...have you had your leg examined with ultrasound/doppler?  Has DVT been ruled out?  Call me suspicious....

In the mean time, I'm having a glass of wine for you, since you're on pain killers (don't mix 'em!).  Sorry you had to go through such sh!t!

[supermum_ms]

OUCH! So your in pain, got a pretty good reason for the pain, got a pretty good visual of abnormality, got a common medical intervention (RICE) technique that temperarily brings some relief etc and because your not healing as you should be, the only thing the doc can come up with, is the pain must be all in your head, WTF! Did you look like a boiling kettle?

I dont think anyone would dispute that pain meds are responsible for the majority of perscription addictions but clearly your issues and the pain causation is different. Your continued visual sx are they not indicating that there is objective evidence that its physiological and not psychological?

Go see the pain specialist, at least you'll get help with the pain and as a bonus you may get someone (besides you) pointing out to your orthopedic sugeon that the pain is coming from the injury and not your head. Seeing if DVT is happening, doesn't sound far fetched, so worth investigating.

Hugs.........JJ

[crwriter]

Anyone know if the restrictions on doctors is a blanket policy?  He sounds nervous to me.  And the field he is in must require lots of pain meds.  When I went to the paindoc, even he tried to dismiss my pain.  I did have cortisone shots for my back.

There is a time release Tramadol called Ryzolt.  It's new and can be very effective.

[Sparkysarah]

Words fail me and once again we hear of a familiar story of a patient being severely let down.

Addi's post said it al for me and I just love the fact that even though you are so obviously suffering..and not someone to make a fuss, you retian your wonderful sense of humour.

Sending love and hugs and pain free days ahead.

Sarah xxx

[Cre8_it]

Sorry to hear that you're having so much pain.  

I was just wondering if your dr just felt your ankle or if you had some good x rays on it to see the hardware and where it is etc.  My sister had the same thing after she broke her ankle.  After complaining about the swelling and pain for a long time, the dr finally sent her for x rays and found a loose screw!  They fixed it and then she was a lot better.  Of coarse she still had some pain if she overdid it, but was pretty good.  I hope you get some relief soon!

Hugs

[sllowe]

Holy Cr ap Essy!!!!!!!

No wonder you are exhausted. He treated you like a rookie w/no knowledge, hmmm Maybe it was just standard protocol for all patients? I just don't know.

I'm glad you'll go the pain doc, however, neuropathic pain? Definitely concerns me that you are not in the best of hands w/him despite the practice's reputation. And, he should know dosing, and if not, if he were good he would of looked it up before the pen hit the pad.

Troublesome all around. Wishing you less pain my friend.
-Shell

[Lulu54]

:-(  this stinks.

on vacation and  recharging my words   LOL

hugs, L

[michelleric]

Ess,
I am frustrated for you!!!  The whole scenario is awful and inhumane.  You know if you were this docs wife, sister, mother, cousin etc., you would not be left in pain or at least give you something, anything for it.  

Did you call pain management?  I hope they can get you in pronto!  No one should have to suffer in pain.  I am so sorry.

How you doing today? Thinking of you,
(((Hugs))))    ~ Michelle

[candy158]

Oh Ess, that is such a horrible story, and hard to believe the we people have to go through so much BS before we actually get to the point.  It is like people don't listen to us, and have there own agenda.

I' sorry that you are having such an awful time, and tht you are in so much pain, it is awful for sure.

I agree that maybe an ultrasound would be something good to ask for from your Dr..... does he listen to you, or just tell you what he is going to do???

I have had that so many times, and it is frustrating and maddening too..........

I will pray that you get into another appt. quickly,

Thinking and praying for you,
*HUGS*
Candy

[HVAC]

I am so sorry lets weenie roast him!  What really stinks is he gets paid the most of any Specialty while Neurologists are dead last! But he only gets paid for procedures not check ups or consults so they just could careless.

Alex

[summerluvr]

I had a major foot reconstruction surgery to fix my severe bunion.  It involved three breaks and fusion up around the ankle.

My doc told me at six weeks the bones are  just barely healed, so to expect pain and swelling to continue.  He said at about three months I should be back to moderate activity (like walking) and normal shoes like runners. but he said it would take up to year for the pain to go away, and to expect some swelling off and on. I have three screws in my foot, so he said that holds the bones until the fusion takes, but the fusion took about 5 months for me so I had noticeable pain until it fused.

Hope that gives you more realistic timelines!

[summerluvr]

oh one more thing, the more swelling I had the more pain, so elevating and icing it was my friend for a long while.  I kept a few ice packs in the freezer and wrapped them around my foot with a bandana.  I still find the scars are sensitive to pain from pressure (ie. the shoe is rubbing the scar).

I can not tolerate pain meds well (sensitive stomach) so the icing helped me alot

my friend had ankle surgery three months ago for a ruptured tendon.  She found, the doctor only really addressed the bone healing (6 weeks, should be healed less pain etc) but failed ot prepare her for the task of a recontructed tendon, that she has to train her foot to work again.  She only started going to physical therapy because she insisted on it, and the therapist was sort of surprised the surgeon had not organized it earlier.  

She started back at work now on reduced hours but still has alot of swelling, and can only wear sneakers or crocs, not work boots like she is supposed too!  I wor crocs for nearly 6 months to accomodate swelling. and also had a pair of sneakers a size bigger that I didn't lace up all the way on my surgery foot.

Good luck!

[essdipity]

Thank you all once again for your kindness, and also for your ideas. It's wonderful knowing I have such good friends here, and knowledgeable too.

I did get the hydrocodone straightened out and am getting some relief from pain, which of course I wouldn't if it were neuropathic! So much for that. But this is a holding pattern until I see a pain management doc. The red tape for that is underway.

My PT told me they will be looking for Reflex Sympathetic Dystrophy, newer name Complex Regional Pain Syndrome (as Ren alluded to). Not something I want, that's for sure. I looked it up here and on the web---whew. But maybe that's not it all, so no borrowing trouble.

The PT said the pain isn't in the right place to be a clot. The ortho said the hardware is fine, though he didn't do x-rays this round. He didn't even touch my foot, for that matter.

Like summerlvr, I have had other foot surgeries, 4 in fact, for correction/reconstruction, and I know things take time. (Hers sound much worse than mine, though!)  I have 4 ice packs in the freezer and do a lot of elevating, also exercising. I really do think I am getting better, but it's at such a snail's pace, with mostly just plateaus. What I'm looking for from a doctor, ortho or pain, are ways to make me more comfortable while I go through a tough healing process. That doesn't seem too much to ask.

Feeling exhausted today and it's 8:30 in the moring. Will go back to bed.

Hugs to you all,
ess

[shermay]

Hi Ess,

I can here the frustration in your voice, and your right to try and get sort of good pain management.

Pleased that you got the right hydrocodone sorted, and hope that gives you some relief.

This has been going on for such a long time now, I'm not surprised your feelingfed up, and just want some relief from the pain.

Hugs,

Debs x