Revisit the orthopedic surgeon or not? don't know what to do!

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Carica
New Member


Date Joined Jul 2008
Total Posts : 7
   Posted 2/3/2009 2:39 AM (GMT -7)   
I'll try to keep this brief.  Shattered my elbow a few years ago.  Seven surgeries, best elbow doctors in the country, artificial  pieces of bone implanted and physical therapy but still in a lot of pain!  My ortho can only offer to remove the implanted parts and hope my elbow doesn't dislocate which would mean total elbow replacement right then.  Elbow replacements don't last very long and I'm 42.  They don't want to do one for many, many years if possible. 
 
My problem is the chronic pain!  I don't trust that my elbow won't dislocate.  I had a really rare fracture called the "terrible triad" that basically means I broke everybone that makes up your elbow and holds it together.  Ortho told me to bring in disability papers and he would sign them.  I didn't even mention that.  I love my job and don't want to give in to the pain if I don't have to.  My PCP has been managing my pain because my records were submitted to a pain management clinic and they won't see me because they don't have much success treating injuries like mine.  I currently take 3 (lowest dose) Hydroco a day but it's just not working anymore.  My PCP wants me to visit the ortho again for an update but I know there's NOTHING he can do but another surgery.  My PCP is wonderful and I know he feels terrible that my options are so limited.  I just don't know what to do.  Would you go back to the ortho, wait 2-4 hours in the waiting room to be seen and pay for an office visit if there's nothing he can do?  I'm sorry...I know I said I'd try to keep it short but I'm just so incredibly frustrated!  My husband is wonderful and supportive and I still keep up with my everyday activities as best I can but my daughters are getting older and I don't want the pain to keep increasing to the point that I can't enjoy getting out and doing things with them cry or having to end my career.  This pain is just freakin rediculous at this point.  I have moments when I just want to gnaw my arm off at the shoulder to make it stop!  sad I appreciate any advice or suggestions.

edt
Veteran Member


Date Joined Dec 2008
Total Posts : 773
   Posted 2/3/2009 6:26 AM (GMT -7)   
Carica,
Find a new Ortho Dr., you never know there may be someone that does know something that may help. I was in your shoes as far as wanting to keep my job I loved. I continued working for 3 years after they told me to stop and then I finally gave in. I had been to many Dr.s and Chiro's for treatment, so when the time came to apply for SS, I had documentation of treatments in an effort to eliminate pain. Just because one Dr. says your situation is hopeless, does not mean it is.....2nd and 3rd opinions are a must in my experience.
There are many alternative treatments available, check into Prolotherapy, acupuncture and find someone who treats with the Erchonia Laser. They may not take the pain away 100% but may make it more tolerable, which for us who suffer chronic pain from injuries would be a miracle.
Pain definitely puts a strain on relationships with husbands, children and friends, I used to think they were mad at me because I couldn't do activities like I used to. After many months of me feeling guilty, we had a family conference and it turned out to be frustration on their part that they couldn't do anything to take away the pain. Talk openly about your feelings and theirs, having to deal with your situation is bad enough. Let them help you, in the end it helps everyone.
Good luck to you.
edt

hurtzallot
Regular Member


Date Joined Nov 2008
Total Posts : 30
   Posted 2/3/2009 7:42 AM (GMT -7)   

Nobody can guarantee you anything. Some fancy small print that if you look real closely at will read something like this...No guarantees were implied or given to the patient prior to the tratment or surgery. I, like you have been down this road, now in need of dual/both knees replaced, no ifs ands or butts about it. I'm as screwed as a light fixture.

The chronic pain question, an educated provider will assure you this to will be left to pulling a rabbit out of the hat, even if the surgery is successful. Always get a 2nd opinion, better yet, go to any perspective surgeons office and loiter in the waiting room. Sit and talk to patients of his/hers to find out from their own real personal experience and outcome.

My own "terrible triad" definition is Chronic Pain, Depression and Anxiety. This is a term used by many in the medical profession. Have you tried a sports medicine rehabilitation specialist? Highly touted for any kind of orthopedic injury you can imagine around here.

Disability? He sees more than an single elbow injury, I can guarantee you that. If this is the road you decide to travel good luck, get ready for the long haul even if your doctor supports you claim. In the realm of SSA DI (Disability Insurance) there is an undercurrent and a stigma attached, that you are a malingerer no matter how strong you claim is. I had several doctors support my claim and it STILL felt like an all out assault on MY credibility.


Opinionated and you no what they say about opinions. Simpleton living with chronic pain.


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 2/3/2009 8:36 AM (GMT -7)   
I agree that you should get a second opinion but.......I don't think any doctor is going to allow you to loiter around their waiting room talking with the other patients. Or at least I have never seen this happen. Speaking openly with your family about your condition is a wonderful idea and could give you some insight on how they are feeling about your condition. I realize that your pain is not something that you chose for yourself...hell if someone would have told me 15 years ago that I would have been unable to get a job, defenseless to get disability and hopelessly in pain the rest of my life, I would have told them that they were out of their minds. But as I was saying.....it's not something that you chose I am sure but maybe you need to talk to your PCP about increasing your medication so that your pain will be managed in a more better way. It might help hun.

Anyway I hope this helps.

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.


hurtzallot
Regular Member


Date Joined Nov 2008
Total Posts : 30
   Posted 2/3/2009 1:26 PM (GMT -7)   
The best way, I repeat the best way to find information pertaining to a doctor about their bedside manners and surgical outcomes is to personally talk to patients current and former. Yes maybe loiter ("interview") could be misinterpret and I should of inserted a better word in my limited vocabulary. This is what I did several times before I found a doctor that provided adequate care for my disabilities and was never once shown the door, quite the opposite, as my doctor now says it showed him that I was most interested in assisting with my own care and achieving my main priority of healing well and getting better. The irony of the story is you're the employer and the doctor is the employee and I would want nothing less than the best employee working for me, no matter how many interviews I had to conduct.

Opinionated and you no what they say about opinions. Simpleton living with chronic pain.


Dagger
Veteran Member


Date Joined Apr 2008
Total Posts : 1522
   Posted 2/3/2009 7:56 PM (GMT -7)   
I wouldn't talk to any doctor that kept me waiting for more than 2 hours. Is this the same doc that did your original surgery? I'd be a little nervous about the ortho being so willing to sign the disability papers without even seeing you. Maybe there is a problem with your implanted bone.

I agree with the others. Get a second or third opinion. Ask for a referral to another pain clinic and another physical therapist.

Carica
New Member


Date Joined Jul 2008
Total Posts : 7
   Posted 2/3/2009 9:06 PM (GMT -7)   
Thank you so very much for the supportive comments and suggestions. I have had several opinions. The doctor held in the highest regard in the US for elbow reconstruction, from the Mayo clinic, consulted on my case. The second best, up and coming elbow ortho from Brown University saw me in a problem cases conference. I've also spoken to the elbow specialist in the ortho office that treats the local professional baseball and football teams. They all agree that there isn't anything that will really help and the treatments I've had are what they would have done as well and comment that the first and second surgeons are fantastic. I guess sometimes you just break something beyond repair. My ortho suggested disability after my total elbow reconstruction failed to relieve much of the pain and didn't restore full range of motion. I'm not ready to go down that path yet but it was almost like a kick in the gut to hear him even suggest it. It left me feeling a little helpless about a good outcome.
I will take everyone's advice and just keep exploring every option I can find out there. I'll follow up with any new ortho I hear anyone speak highly of. Last night was rough but today was a little better. My husband and daughters are wonderful about supporting me but you have another great point in reminding me that I need to talk to them when I'm having a difficult time and keep the lines of communication open!
Thanks to all of you!

SmurfyShadow
Veteran Member


Date Joined Dec 2008
Total Posts : 2386
   Posted 2/3/2009 10:29 PM (GMT -7)   
Just a wild shot, but they put steel and metal in ppl, on some replacements. You'd set off every metal dector, but if your willing to live with not bending ur arm, couldnt u get a metal replacement in ur elbow? Only other solution I can think of would be getting the arm amputated. But I'd personally try to find a way to deal with the pain first before I ever did that. Maybe heat, ice, compression. Maybe an anti inflamatory (with doc supervision). Or do what I do and let the doc know you mean business by saying "shoot me and take me out my misery." Ive been told every time they couldnt shoot me but I've gotten better meds LOL
 
Smurfy Shadow
 
DX: Wegener's Disease, Migraines, Diabetese Type II, PCOS, Lactose Intolerant, Benign Heart Murmer, Depression, Asthma, Asperger's Syndrome, Necrotizing Gramultous Inflamation in eye, A.D.D., Acid Reflux
 
Medications: CellCept, Prednisone, Tri Nessa, Percocet, Metformin, Prilosec, Protonix, Zantac, Advair, Cingulair, Albuterol, Calcium + Vitamin D


Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 2/4/2009 1:59 AM (GMT -7)   
So then Carica the doctors are basically telling you that your options of surgery are no longer feasible? That there is nothing more in the surgical aspect that they can do that will allow you to gain any more relief from your pain. Am I correct?

If this is so, then your best recourse is to seek the advice of a Pain Management Specialist and see what they can do to lower your pain through medications and other things that they have access through. There are many things that they can try to ease your pain and I would not consider amputation as the last poster suggested unless that is something that you have really thought about quite seriously and have spoken with your family about as well as your doctor about too. All hope is not lost just because surgery is not an option to resolve your pain. There are still quite a few options open that can relieve your pain. PT.....medication regiments.....aquatic therapy......injections and other things are viable options that might bring down your pain enough to bring relief for you in this case.

Anyway, I do hope that you will think about this. and I hope this helps.

Your friend in pain

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.

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