Aa
neeurology and orthopedics question, posted this on orthopedics but a bit quiet over there and no answers
Just looking for some reassurance, or not. I am in the process of pursuing a complaint against a doctor who knew little about me, yet accused me of fabricating some of my problems to aquire controlled drugs. I do not have a problem refuting this allegation, as my medical history is strong and the doctor can clearly be proved wrong. My condition is worsening and recently I saw a neurologist. I know I sometimes limp because of severe hip and leg pain but on this ocassion I was not in pain and thought I was walking normally. The neurologist took all my symptoms very seriously and ordered scans of my back and brain. In his letter to my doctor (a different one), he made a comment about my gait. He said it was normal but I walked in an antalgic way. I was not aware I was doing this. My question is this, can such a gait be fabricated? I need as much evidence as possible to secure my case regarding the allegations made against me and need to know if I can use this as proof? Of course anybody can fake a limp, but surely a neurologist would have recognized a psychosomatic or malingering or hysterical limp, or would they? I have some doctors who are continuing to take me seriously, but the vicious actions of this doctor who made this claim against me have destroyed my relationship with all the local doctors and hospitals in my area. I need as much evidence as possible to get their comments off my notes. The limping issue took me somewhat by surprise, firstly in that I did not know I was doing it all the time, which to be honest upsets me a lot, and also because I have lost trust in myself and wonder if I am somehow inventing this. Anybody with expertise on antalgic limping would be very helpful to me. Apart from anything else this has made me very self concious when walking outside, as I think people are looking at how I walk. Stupid I know, people just don't do that generally. Never thought I would end up like this, or like whatever the future holds. Strange thing is part of me wants to be making this all up, so I can just stop it and go back to normal. Am I?
Let's all treat each other with the utmost respect and be friends here. We don't need to slam each other, even if we disagree with what someone else has stated. This probably should be contained to the PM section and not on the Forum's.
Let's shake hands and all be friends. That's what these Forums and MedHelp are all about. Helping each other and being there for one another.
Thanks so much,
Heather
Let's shake hands and all be friends. That's what these Forums and MedHelp are all about. Helping each other and being there for one another.
Thanks so much,
Heather
I believe your intentions are not true and thats why I am writing these replies.
Why would you go into a forum for a disease or condition you do not have, say you dont have it but vent about you and your hard times anyway.
My mother has MS and I go on forums to read about other peoples experiences and things their doing that could possible help her. Everyone offered you support even though you dont have MS or are even being investigated for it. Obviously they felt fine doing so, but to me you are emotioanlly taking advantage of people who are suffering. Do you know what MS is like, especially when it progresses. You have no idea what it is like to not be able to pick up a pencil and write a quick note or have to be wheeled in a wheelchair through a public place by someone your supposed to be taking care of, not the other way around. Thats like me going on the HIV forum and saying i dont have HIV but can I vent to you all please. Thats just not right. And it makes ME angry. I'm not speaking for anyone else on or off this forum, only for ME.
That is why I replied. Maybe you are suffering, but then why go on to forums you have nothing to do with and use them for support.
Its not as if I pulled your name out of a hat and decided to say something, I have never approached anyone for such a thing. But in this case I'm almost positive that your using this forum for reasons that are not so pure as you make them out to be.
I'm glad you get good feedback for your advice, I didnt say anything about your advice. I'monly commenting on what personally effects me and someone I love.
I have no need to write anything more to you as it seems you like the attention.
I believe I have made my opinion and feelings clear and will not reply to any of your nasy remarks to me. You made your opinions of me clear enough.
Again I am free to state my opinions and feelings.
You dont have to worry about my posts, this is the only one I plan to make.
Why would you go into a forum for a disease or condition you do not have, say you dont have it but vent about you and your hard times anyway.
My mother has MS and I go on forums to read about other peoples experiences and things their doing that could possible help her. Everyone offered you support even though you dont have MS or are even being investigated for it. Obviously they felt fine doing so, but to me you are emotioanlly taking advantage of people who are suffering. Do you know what MS is like, especially when it progresses. You have no idea what it is like to not be able to pick up a pencil and write a quick note or have to be wheeled in a wheelchair through a public place by someone your supposed to be taking care of, not the other way around. Thats like me going on the HIV forum and saying i dont have HIV but can I vent to you all please. Thats just not right. And it makes ME angry. I'm not speaking for anyone else on or off this forum, only for ME.
That is why I replied. Maybe you are suffering, but then why go on to forums you have nothing to do with and use them for support.
Its not as if I pulled your name out of a hat and decided to say something, I have never approached anyone for such a thing. But in this case I'm almost positive that your using this forum for reasons that are not so pure as you make them out to be.
I'm glad you get good feedback for your advice, I didnt say anything about your advice. I'monly commenting on what personally effects me and someone I love.
I have no need to write anything more to you as it seems you like the attention.
I believe I have made my opinion and feelings clear and will not reply to any of your nasy remarks to me. You made your opinions of me clear enough.
Again I am free to state my opinions and feelings.
You dont have to worry about my posts, this is the only one I plan to make.
Thank you for you clear explanation of my limp. My original question was whether such a limp could be faked. You have shown the reasons why it cannot. That was what I needed to know. As I explained on another forum, this neurologist did spend nearly an hour and a half assessing me (for a 30 minute appointment), and has been thorough to the nth degree in assessing everything I brought to him. And yet here I am still doubting his motives because of some other incompetent physician who had tried to muddy my name. I think another doctor would not have even noticed I limped, I should be grateful to him for his careful observations. I do see your name popping up again and again on this forum so am aware that you are somewhat of a 'veteran' here, and thank and trust your experience. It sounds like life has dealt you a raw deal, and here you are trying to help others. With me, after some years of not being taken seriously, suddenly I am being rethrown into the cycles of tests and scans and all the anxiety that goes with them. With one part wanting results to be found and another wanting all to be normal. To be brutally honest I want something to show up on my scans, to give me a handle on the situation, even if it is something very bad. To go through all of this and then be told 'there's nothing wrong' is a worse diagnosis than anything else. Things are very wrong. Walking with a bit of a limp isn't the end of the world, and I don't know why it has become such a big deal for me. There are many people in wheelchairs who would love to walk with a limp. I agree I need some psychological support with all that's going on, with allegations and medication issues and lifestyle changes and chronic pain. I'm just scared to ask for help as if I do then maybe all my other symptoms will be once again ignored, and seen as part of some psychological problem. To be honest this website is part of my self-help therapy. Here I can vent my anxieties anonymously, feel of use when I can help others, and talk of issues I cannot take to any doctor. I take seriously all responses to me, and think seriously about all responses I send. I do though vent angrily when I feel a respondant is being flippant, thoughtless, or harmful, as happened with Misty1980. I hope for you a better future, and please know that you have helped me today. Be well.
Dear Wish,
Here is a quote about antalgic gait from this website:
http://sprojects.mmi.mcgill.ca/gait/antalgic/intro.asp
"Antalgic gait refers to a posture or gait assumed in order to avoid or lessen pain. The pain itself can be caused by numerous conditions such as diabetic foot, osteoarthritis, joint or limb deformity, degenerative arthritis of the cervical spine, gout, trauma, rheumatoid arthritis. The key concept to keep in mind when dealing with antalgic gait is that the patient will try to minimize the amount of weight applied to the painful limb or joint and the amount of time that weight is applied. The result is a limp, a decreased single support time for the affected limb, a shortened stride length for the contralateral limb, and an increased double support time."
I'm glad a neurologist was asked to give his opinion on your health situation. He noticed your gait was a little off, which is a sign that some abnormality indeed exists that makes your body compensate for some pain you have. It should not be your focus to prove your gait is goofed up. Rather, since the neurologist noted you had an abnormal gait, and he is a qualified specialist, you now have more proof that you are indeed in pain.
Many people suffer with pain that many doctors do not know precisely why they have that pain. Since there are strict laws in place in "the war against drugs" to monitor abuse of controlled substances, a lot of docs are understandably reluctant to overprescribe pain medications. This is especially true if the doctor perhaps has no diagnosis and thus no reason to believe you, or if you are a new patient, or if you ask for an ever-increasing change in dose.
If I were you, I'd (a) stick with one family doctor, (b) persistently find out through tests why you have pain in your left hip, (c) if the source of pain cannot be shown on an MRI or otherwise, then consider the following possibilities, (1) you mentioned weight, and many overweight people have an array of aches and pains due to the stress on their body, in which case a complete overhaul of your diet and exercise program needs to be addressed, (2) this sounds simple, but a goofed up foot or footwear can cause all sorts of problems with the hip, so visit a podiatrist, (3) the website I gave you refers to a variety of things that can cause pain that creates a compensating limp, so all those things should be investigated as a reason for your pain.
The kind of pain you have, you should break it down as best you can in as ways as you can. For example, did it come on all of a sudden, have you had it a long time, it is sharp or does it ache, does any other part of the left side of your body hurt also, did you hurt yourself severely anytime during your lifetime that might cause pain in your body, have you had an MRI done of everything below your waist? Then you could always visit a pain clinic in a larger city in your state, bring any documentation that would give clues as to why you have pain, and let them work on you for a while.
If this whole situation is overwhelming, it wouldn't hurt to visit a counselor for a while at a mental health clinic, so you will have someone to talk to about your frustrations, and who can act as an impartial compass for what to do next about your health problems. I have chronic pain from an accident, my back was broken in three places, my X-rays show deformity in my spine, I have no disks in between several vertebra, I limp and I am only comfortable when I lay down, I am on three controlled substances as a result and have been for years.
Every now and then, when the pain I have changes or if I move to a new town, just like you I sometimes run into resistance about the medications I take, I run into people who doubt my discomfort even with irrefutable evidence, and I myself sometimes worry about the life I used to have and how it will never be the same again. I regularly see a family doctor, a neurologist, and a psychiatrist, and anytime my pain gets worse, I have a new set of scans done by an orthopedist, to see how things are going, because the risk of paralysis exists in my case.
I hope you will soon get the relief you need, try not to worry about what other people think of you, rather think positive, move forward with getting at the bottom of all this, do whatever it takes to get the help you so desperately need, and learn to live with what you have as best you can.
GG
.......
Here is a quote about antalgic gait from this website:
http://sprojects.mmi.mcgill.ca/gait/antalgic/intro.asp
"Antalgic gait refers to a posture or gait assumed in order to avoid or lessen pain. The pain itself can be caused by numerous conditions such as diabetic foot, osteoarthritis, joint or limb deformity, degenerative arthritis of the cervical spine, gout, trauma, rheumatoid arthritis. The key concept to keep in mind when dealing with antalgic gait is that the patient will try to minimize the amount of weight applied to the painful limb or joint and the amount of time that weight is applied. The result is a limp, a decreased single support time for the affected limb, a shortened stride length for the contralateral limb, and an increased double support time."
I'm glad a neurologist was asked to give his opinion on your health situation. He noticed your gait was a little off, which is a sign that some abnormality indeed exists that makes your body compensate for some pain you have. It should not be your focus to prove your gait is goofed up. Rather, since the neurologist noted you had an abnormal gait, and he is a qualified specialist, you now have more proof that you are indeed in pain.
Many people suffer with pain that many doctors do not know precisely why they have that pain. Since there are strict laws in place in "the war against drugs" to monitor abuse of controlled substances, a lot of docs are understandably reluctant to overprescribe pain medications. This is especially true if the doctor perhaps has no diagnosis and thus no reason to believe you, or if you are a new patient, or if you ask for an ever-increasing change in dose.
If I were you, I'd (a) stick with one family doctor, (b) persistently find out through tests why you have pain in your left hip, (c) if the source of pain cannot be shown on an MRI or otherwise, then consider the following possibilities, (1) you mentioned weight, and many overweight people have an array of aches and pains due to the stress on their body, in which case a complete overhaul of your diet and exercise program needs to be addressed, (2) this sounds simple, but a goofed up foot or footwear can cause all sorts of problems with the hip, so visit a podiatrist, (3) the website I gave you refers to a variety of things that can cause pain that creates a compensating limp, so all those things should be investigated as a reason for your pain.
The kind of pain you have, you should break it down as best you can in as ways as you can. For example, did it come on all of a sudden, have you had it a long time, it is sharp or does it ache, does any other part of the left side of your body hurt also, did you hurt yourself severely anytime during your lifetime that might cause pain in your body, have you had an MRI done of everything below your waist? Then you could always visit a pain clinic in a larger city in your state, bring any documentation that would give clues as to why you have pain, and let them work on you for a while.
If this whole situation is overwhelming, it wouldn't hurt to visit a counselor for a while at a mental health clinic, so you will have someone to talk to about your frustrations, and who can act as an impartial compass for what to do next about your health problems. I have chronic pain from an accident, my back was broken in three places, my X-rays show deformity in my spine, I have no disks in between several vertebra, I limp and I am only comfortable when I lay down, I am on three controlled substances as a result and have been for years.
Every now and then, when the pain I have changes or if I move to a new town, just like you I sometimes run into resistance about the medications I take, I run into people who doubt my discomfort even with irrefutable evidence, and I myself sometimes worry about the life I used to have and how it will never be the same again. I regularly see a family doctor, a neurologist, and a psychiatrist, and anytime my pain gets worse, I have a new set of scans done by an orthopedist, to see how things are going, because the risk of paralysis exists in my case.
I hope you will soon get the relief you need, try not to worry about what other people think of you, rather think positive, move forward with getting at the bottom of all this, do whatever it takes to get the help you so desperately need, and learn to live with what you have as best you can.
GG
.......
Believe me I will look out for your posts on the site and ignore them. Find a psychology dicionary and look up the word 'projection'. You know nothing about me or my background or experience. I never comment on a condition or experience I am unfamiliar with, it doesn't always have to be something I am personally suffering from. I have messages in my inbox where respondents have thanked me, and posts also responding positively. Unlike some, I do not think this website is all about me, or some free doctor's surgery. It is for people to share their knowledge and offer support. I have a large bank of knowledge gained through life, work and education, and it is one of my pleasures to help people where I can. It is you who is commenting abusively on a person who's problems you know nothing about. If you did read my posts you may have picked up that I am currently vulnerable, insecure, in a great deal of pain, and fighting with a situation which is beyond my strength to cope with. There have been some respondents who have been so supportive it makes up for any crass comments such as your own, one of them as above, a doctor herself. This may be a low point in my life but I am not easy fodder for you to take out your own frustrations on. All you are doing is increasing your own suffering, both now and in the future. Look beyond yourself and you will see a world of people here, some diagnosed, some not, some disbelieved by their doctors, some simply wanting acknowledgment that they matter. If your reason to be here is only to talk to doctors or to bully others, you are not just 'speaking your mind', you are harming people. I hope you find something else to do with your free time.
Well I am allowed my opinion. After reading the initial post I read through some of your other posts and saw how all over the place you are. You have said that you have mis taken your medication and that all you care about is sleeping and taking your pills. That your life revolves around when you can take your pills. Then you are upset that a Dr. has shown his concerns that you may have a problem.
Seems you thought yourself that you could have a problem. And you are all over the place for things you do not have. Another opinion of mine is that these forums are for people to connect with others suffering from the same problem. But there are also Dr.'s offering help if you would like it. I have just been diagnosed with a condition for which I want support from people who can understand because they live it too. Some people probably appreciate your advice from a spectator's distance. But I would prefer help from those who live with the same problem. That is why I commented on being all over the place for things you do not have. You cannot expect every one to appreciate help from someone who does not understand what it is like. Bottom line, my opinion. Accept it or do not. But if you dont want to accept it do not attack others for there own observations.
I am allowed my opinion on anything I wish to comment on. That is the great thing about a internet forum you do not have to take the advice of anybody else. You wanted feed back you did not specify that the opinions had to be only what you wanted to hear.
I was also expanding on something already stated in an earlier post. I also said that it may be real fake or subconcious.
I am allowed my opinion just the same as you.
But I do like myself just fine and even more for speaking my mind and not being afraid to give my opinion. You can say anything you would like about me. But why attack someone if an opinion has no basis in truth or reality. Just ignore it if that is the case.
Be well and good luck in your efforts in dealing with your doctor.
Seems you thought yourself that you could have a problem. And you are all over the place for things you do not have. Another opinion of mine is that these forums are for people to connect with others suffering from the same problem. But there are also Dr.'s offering help if you would like it. I have just been diagnosed with a condition for which I want support from people who can understand because they live it too. Some people probably appreciate your advice from a spectator's distance. But I would prefer help from those who live with the same problem. That is why I commented on being all over the place for things you do not have. You cannot expect every one to appreciate help from someone who does not understand what it is like. Bottom line, my opinion. Accept it or do not. But if you dont want to accept it do not attack others for there own observations.
I am allowed my opinion on anything I wish to comment on. That is the great thing about a internet forum you do not have to take the advice of anybody else. You wanted feed back you did not specify that the opinions had to be only what you wanted to hear.
I was also expanding on something already stated in an earlier post. I also said that it may be real fake or subconcious.
I am allowed my opinion just the same as you.
But I do like myself just fine and even more for speaking my mind and not being afraid to give my opinion. You can say anything you would like about me. But why attack someone if an opinion has no basis in truth or reality. Just ignore it if that is the case.
Be well and good luck in your efforts in dealing with your doctor.
Just a comment on your response, which says more about you than myself. If you bothered to check most of the other forums I am on I am there helping others where I can, with the training and experience I have. I do not see the purpose of your response to my query other than to make me feel bad. I am sorry you are such a person and you must hate yourself a lot to want to hurt others.
Thank you for following me up on this. I have actually had this same doctor who threw the drugs claim at me also talk to other consultants re Munchhausen's, and I was on the verge of pulling myself out of the whole healthcare system because of this one ignorant person who knew nothing about me or my history other than that I took controlled drugs. There have been a couple of doctors since then who have taken me very seriously, both in prescribing for me and ordering tests, yet I can't let go of the paranoia, and it took the few words of the previous respondant to bring it all back. I am actually in tears while I am writing this. I've become so sensitive to the whole issue of the changes in my health and the reactions of those I turned innocently to for help. I can no longer judge whether a physician is genuine or not. I think that's why the whole limping thing became such an issue for me. It is another thing I cannot control and for doctors to make assumptions about. I agree that if I was trying to fabricate it I would have made it more pronounced. I also know that when I am at home, alone, my walking is even worse as I am not even trying to look normal. I need to hold onto furniture to walk round my flat and have fallen. Why would I be pretending when I am all alone? I worry a lot about what doctors think of me, because of the drugs I take and the complexity of my symptoms. I don't believe they take the changes in me seriously. Part of me has given up, and accepted being disabled compared to what I once was. It is hard to remember that just a few years ago I was climbing, running, doing martial arts, a regular at the gym, dancing, yoga. I have led a lifetime of activity and now just hobble around. And all doctors can see now is a woman in her early forties who has just let herself go and got unfit. Whatever the results of my tests show, be it nothing or some pathology, there is a big part of me now that has just had enough. Unless there is some blindingly simple problem which can be cured by a couple of tablets and a minor op or something, which is hardly likely, I now wonder what is the benefit of getting a diagnosis. Is it just to stop physicians treating me like a fraud? To get back to the point, thank you for returning some self respect to me, it has meant a lot, particularly as you are a physician yourself and can see things from their perspective.
My take on this subject is that faking a gait is pretty easy.especially for a short time in your Dr's office.
Gaits can be improved some of the time or if it can't they would want to know why your walking in that way. I guess it could be subconcious, fake or Real or maunchsusens. You do seem to belong to and post in a lot of differnt forums including substance abuse. Seems a little strange that you would belong to a forum of a problem you don't have.
Good luck in your efforts and be well.
Gaits can be improved some of the time or if it can't they would want to know why your walking in that way. I guess it could be subconcious, fake or Real or maunchsusens. You do seem to belong to and post in a lot of differnt forums including substance abuse. Seems a little strange that you would belong to a forum of a problem you don't have.
Good luck in your efforts and be well.
Hi, I'm certainly not a neurologist, but it has been my experience that neurologists comment on gait as normally as generalists comment on whether the patient seems in any distress, "The patient was a 40 y.o. female, who appears her stated age and was in no acute distress..." It is merely a part of their normal description of your gait. They are finely attuned to small changes in gait and will comment if the rhythm or pattern is abnormal. "Antalgic" means "as affected by pain." I don't think you need to place any more store in that description than if he said you were pleasant and appeared well-educated.
I have been in your position in other circumstances and it's easy to view everything with a little paranoia, at least I began to. The neurologist's comment was very likely an obeservation. If you sometimes do have pain, then it is also likely that your normal gait has changed subtley. Perhaps you slightly favor the hip all the time, the gait feels fine to you, but a trained eye will see the real story. As a physician, I will tell you that people "out for drugs" do not fake things in a subtle way. Typically they make a big show of it.
I don't think you need to be seeing your regular doctor to be ruling out Munchhausen's (elaborate faking of illness for the secondary gain of attention). People with that disorder to not seek treatment and know very well what they are doing. Somatiform disorder is the experiencing of symptoms as the expression of fear, anxiety or depression. I'm not sure how that applies here, as we are speaking of why a neurologist would comment on your gait. The reason is that they are taught to and to describe any variations they see.
Does this help?
Quix
I have been in your position in other circumstances and it's easy to view everything with a little paranoia, at least I began to. The neurologist's comment was very likely an obeservation. If you sometimes do have pain, then it is also likely that your normal gait has changed subtley. Perhaps you slightly favor the hip all the time, the gait feels fine to you, but a trained eye will see the real story. As a physician, I will tell you that people "out for drugs" do not fake things in a subtle way. Typically they make a big show of it.
I don't think you need to be seeing your regular doctor to be ruling out Munchhausen's (elaborate faking of illness for the secondary gain of attention). People with that disorder to not seek treatment and know very well what they are doing. Somatiform disorder is the experiencing of symptoms as the expression of fear, anxiety or depression. I'm not sure how that applies here, as we are speaking of why a neurologist would comment on your gait. The reason is that they are taught to and to describe any variations they see.
Does this help?
Quix
Thanks for answering, much as it has depressed me. Basically you are saying it is possible in the eyes of a doctor that I could be fabricating such symptoms, and apparently it would not be obvious to the neurologist. I wonder if in my case it will be ultimately a story of giving a dog a bad name and hanging them. This neurologist was told by me the concerns I had about the allegations of this doctor who initiated the drug allegations, so would he have then put in this comment about my limp to show that indeed I was pretending to walk badly, or was it just an observation? It's just got me thinking. I'll go back for the results of my tests and then drop the whole trying to find the source of the problem mission. Whilst one insecure practitioner has decided to assasinate my character I cannot continue with any further humiliation. Now I just want the results to satisfy myself and even if something does show up on the scans, will not be returning for any treatment offered. Can't tell where the next insecure and spiteful doctor will turn up, so best to stay away. Shame I can't seem to control my gait, but as there is to only be one more visit they only have to comment on it once more, and we're done.
Sorry about that drug charge against you. It is unfortunate that your gait has caused you so much embarrasment. Is it that you started noticing about your gait more seriously after your neurologist mentioned this? As you suggest, this could also be in the mind (I stress here again to say that you maynot be making it up) Some disorders like Munchaussens syndrome, somatoform disorders can present with similar symptoms. Visit your doctor and ask him to rule out these disorders.
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