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tb48
Regular Member


Date Joined Apr 2009
Total Posts : 23
   Posted 4/14/2009 8:58 PM (GMT -7)   
Looks like a great place to be able to talk to others and get more info on dealing with CP.
I've been suffering chronic pain for the past year now.
I'm 48 and this is the first time I've ever had CP in my life.
But I at least know why.
I have an Osteochondral lesion on the talar dome in my ankle (grade 5 , the worst).
Had scope surgery done last Sept. with an ortho.
Went through a month of PT 2 months after the scope (at my own request in hopes of ridding the pain). Only made things worse. Worst part of the PT was them looking at me in disbelief as if, but not saying, "how can you still be in pain, you had scope surgery to fix it".
Well finally after still having never ending pain, the ortho did another MRI 4 months after the scope and told me "the lesion is still there, we tried". But he was at least sympathetic to my pain and even told me on my last visit "I sure emphasize with people with those kind of lesions".
And I was at least relieved that there was a reason I was still in pain, that it wasn't in my head or some other unkown problem. Take that PT lady.
He referred me to another ortho who specializes in ankles.
I've been taking percocet once daily since that first scope (6 months now).
I only take 2 a day. It's a severe aching pain, like a 6 or 7 but it just never ends and I have days when it's even worse, as bad as feeling like a broken ankle.
I've not had 5 minutes without pain in a year now.
Can't run, can't jump, can't be on my feet for more than hour without yet more pain.
Fortunatly I work from home office on PC full-time else I'd surely be disabled from this.
I can tolerate the pain to a point. I don't mind making myself suffer all day knowing that I can at least be provided some relief for the day.
It's the 2 times so far with the new dr. that I've gone a week and a half the past 2 months without any meds that's killed me. With my never ending pain, without any means to relieve it, I tend to lose focus on my work, my family and focus solely on my constant aching ankle.
Anyway to wrap it up (sorry for the long first post), I just had the scope surgery done yet again last Monday and currently in a splint, non-weight bearing on crutches for 2 weeks.
When the Dr. spoke to me 2 minutes before going into surgery I told him my concern for the pain. It was hurting so bad "prior" to the surgery that I serioulsy almost bailed because knowing how much more pain I'd be in scared me to death. The first scope was brutal for me.
Anyway, he then acted as if my pain was already becoming a burden to him and said I should probably go to a pain clinic. I've only been seeing this one for 2 months now.
Having to take the meds heavily the first 4 to 5 days, I only have 4 days supply left.
I have my first follow up in 2 days to get the splint off and stiches out but now I'm afraid to ask for another prescription cause of what he said.
I never liked having to ask for them anyway. Never once had the "how is your pain? do you need a refill?"
Like all of you guys, I'm not into pain meds, I'm just not into pain. After taking them for 6 months now, I barely even get the pain relief any more but it's better than nothing. At the very least it takes the focus away from the pain in my ankle.
Should I brave up and ask for one last prescription (I really don't want to be a burden to them) or should I call some pain management place now? Never had to do this before.
Thanks for listening and I pray for you all!
I'll be sticking around for a while if that's ok. Nice to at least share thoughts.
 
 
 
 
 
 
 
 

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3610
   Posted 4/14/2009 9:49 PM (GMT -7)   
tb48
Welcome to the Chronic Pain Forum, sounds like that heel of yours has sure given you some problems with pain. You have come to the right place, I really think you should talk with your Doctor, if this last surgery isn't helping you then maybe you should ask your Doctor to give you a referral to a Pain Clinic or a Pain specialist! There is absolutely no reason you should have to be in such bad pain that you cannot walk or stand for any length of time! Your Doctor might want to give it some time before referring you to see if the surgery worked, but you should talk with him about it, and if your still in pain tell him so, don't ask for more meds just tell him if your still having pain, and describe it to him. Let him decide what should be done.
Again Wecome to the Forum and hang around as long as you like, there are some really good caring and compassionate folks here, that are more than willing to over you help and support!

Good Luck to You

White Beard
  I'm Retired USAF, went back to school and became an RN, and now am on full disalbility!--Degenerative Disc (affecting mostly the thorasic disc but all levels involved), C6/7 laminectomy/diskectomy& fusion, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications: Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV


Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 4/14/2009 10:56 PM (GMT -7)   
Hi tb48 and Welcome!!

I am sorry you are suffering so much pain. Like White Beard said...you have truly found a caring family here and I feel you will enjoy this place. It's very late and I'm barely awake so I will chat more later. Just wanted to say HI!

Chutzie
Co-Moderator Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, PTSD, dermatitis herpetiformus, osteoarthritis and a few other side dishes.
***************
Happiness is something to do, someone to love, and something to hope for."
(\__/)
(='.'=)
(")_(")


angel8
Regular Member


Date Joined Apr 2009
Total Posts : 109
   Posted 4/15/2009 3:28 AM (GMT -7)   

Welcome TB, I also am new to this forum but not forums in general and I picked this one after lurking for awhile and seeing all the great insight and info generated here not to mention that amount of hugs and compassion here. Sometimes it is all that we need isnt it?

It is a great day to have someone and somewhere to go where you know others have been exactly where you are in this CP life. Understanding all it entails to be a survivor of CP is the most required point I think.

Sorry you have had such a time of it with the pain but hopefully you can take away from here knowledge of others experience that may help you in some way and may actually leave something of yourself that helps someone else along the way.

 


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 4/15/2009 7:04 AM (GMT -7)   
TB and Angel, welcome to both, but as always sure wish it was under better circumstance..
Yes I think you should ask for a referral to a pain management clinic and thought it was
rude of your doc for not telling you before now to seek help from them...Geezee..
soft hugz and lots of them......
(((((((((((((((((((((((TB48))))))))))))))))))))))))))))))))))))))
Can you use Ice on your foot, might help...
will keep you in my thoughts, sure hope you heal better this time around..
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc, Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's and Ocular Migraines

********>^..^<********>^..^<********>^..^<********


tb48
Regular Member


Date Joined Apr 2009
Total Posts : 23
   Posted 4/15/2009 7:14 AM (GMT -7)   
Thanks all! My first post op follow up is tomorrow morning and I am going to ask for one more prescript for the pain. Would be nice to at least allow 2 more weeks healing before I have to make the decision on a pain doc. Never been down this road before. I'm only at 2 weeks post op and still severe pain. Not to mention I'm going to enter a whole new level of pain tomorrow trying to walk on it again in an aircast. I remember the first scope, wearing that boot set me back an entire week of having to ice and elevate again due to the pain.
Prior to this scope he said my only hope of fixing it was an open reduction allograft. They take a piece of a cadaver donor ankle and fill in the crater in my ankle with that. Then he decided to do the scope first rather than just review the previous doc's scope so we'll see what happens.
Anyway, I'll keep you updated on how it goes tomorrow.
Thanks and have a good day!

skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 4/15/2009 6:47 PM (GMT -7)   
Hi tb48,

I also want to welcome you to HW. I am sorry that you have to join us because of pain, but we are always happy to welcome new members! I have a lot of sympathy for you. I've seen multiple cases of osteochondritis in the orthopedic clinic (mostly in the distal femur/knee of teenagers) & watched multiple scopes for OCD. It can be quite crippling. I can't even imaging having OCD in my foot! Wow! You need your feet for support and everyday function, I can only imagine how tough your situation is, and especially now, recovering from surgery. Best of luck to you! I sure hope that this most recent surgery did the tick & is able to repair the lesion and that you will have less pain and a better quality of life! Keep posting & let us know how you are progressing, and feel free to jump in on other threads!

Skeye

tb48
Regular Member


Date Joined Apr 2009
Total Posts : 23
   Posted 4/15/2009 7:58 PM (GMT -7)   

Thanks Skeye! Yep, I'm one of the lucky few. I've done so much research on my ankle OCD and it is mostly common in the knee. Only 4% get it in the ankle and it is very painful.

Got to the point where I could barely even walk for the first hour every day due to pain and stiffness.

So glad to hear from someone who actually knows of the OCD and can sympathize.

The last ortho, even though he attempted to fix it and couldn't, at least sympathized with the pain. It's at the medial talar dome so difficult place to get to.

The new ortho seemed to sympathize on my first visit and spent over an hour going over my MRI's and CT's with me but threw me for a loop when he said I need to get a pain clinic involved 2 minutes prior to my surgery. I can't say I disagree really as I've been comtemplating it for the last 2 months anyway but I kinda took it that after only 2 months with him my pain has become a burden to him. I would think he if no one else, he would truly understand the chronic pain aspect of this condition. I just don't know, one time seems sympathetic, next time not so much. Maybe they just see too many people.

Just going to be really upset if they refuse to provide me one last script for pain relief tomorrow until I can have more time to get to a pain clinic. How long does it usually take as a new patient to get the first visit? I called one today and left a message but they didn't bother to call me back. And I know I'm in for yet more pain tomorrow trying to walk on it again after 2 weeks. Then what am I supposed to do if they don't provide me anything a) suffer the pain or b) go to an ER? Beats me. Like I said, I haven't been down this road before and have been able to manage it up til now.

Thing that really sucks is I can't do nsaids cause I have GERD. Heartburn every day. I still think it's an ulcer but the gastro just said GERD and take prilosec daily without doing any tests. I really would have preferred an endoscopy to confirm or deny but who am I to argue (just the patient who knows his body better than anyone else, that's who ;) )

Have a good night all!

 


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 4/15/2009 11:56 PM (GMT -7)   
Yes, the medial talar region certainly is not easy to get to! I watched a surgery of a talonavicular fusion, and it took five hours, just to dissect talus free! Amazing stuff, but I cannot even imagine the post-op pain! Living with CP has made me even more sympathetic & sensitive to other people's pain. I'm actually watching another foot/ankle surgery in the (fast approaching) morning, but I can't remember what the doc told me it is. I think it might be another fusion.

Your orthopedist probably just doesn't want to get involved in long term pain management, hence recommending a pain management specialist. I'm sure he is happy to see you for your orthopedic problems, he just doesn't want to be the one controlling the reins when it comes to long term medications, etc for pain. I can't see why he wouldn't give you a new script tomorrow, as you just had surgery & are still in a lot of post op pain! As the surgeon, it is his responsibility to care for your post-op pain!

Some pain management clinics require a referral before they will take you on as a new patient. That was the case with mine, when I used to see a PM (pain management doctor). You may need to speak with your orthopedist about sending a referral over the PM's office. I don't know if your orthopedist recommended a particular clinic, but what I have learned from others here is that not all PM's are equal. Some only do procedures (nerve blocks, pain relieving injections, etc) and don't prescribe medication (opiods, anti-inflammatories, anti-depressants for pain, seizure medication for pain, etc), while others do both. I'd think you'd want one that does both. Mine did both. He was great in the beginning but once he ran out of procedures to do on me he became very curt & less attentive, and so I decided to switch my pain management back to my PCP (primary care physician), as he had volunteered to take over on multiple occasions, he is quite knowledgeable in the area, & I love him to death.

I can certainly sympathize with having something very rare as well. My pain is in/behind my eye. It began with a trauma nearly 2 1/2 years ago, but never went away. We don't know everything that is going on, but the things we do know are all very rare & so no one has any idea how to treat it, plus they don't know how these "puzzle pieces" fit into the big picture! My doc is actually presenting my case at a seminar of difficult cases at a big national conference this weekend, so we are hoping that someone will be able to help guide us in the right direction!

I hope your doctor's appointment goes well tomorrow! Let us know!

Skeye

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 4/16/2009 12:43 AM (GMT -7)   
Hi, tb48,
I also want to welcome you to the chronic pain forum, but I'm so sorry for all you're going through. Skeye and others have given you some excellent advice. Skeye's last post I would particularly agree with in terms of pain management issues. I had my lumbar fusion over a year ago and my neurosurgeon is still providing my pain meds, although that's unusual. Your ortho shoud be willing to prescribe something for you until you can get into a pain management specialist (Skeye's advice on finding a pm specialist is right on!). Perhaps if your ortho know that you intend to pursue someone else for long term pain management, but that you really need his help until that process is started to manage your pain he might be more wiliing. Regardless, he shouldn't see you as a burden; you're his patient. But yes, doctors may be too busy, have different personalities, etc. He's still responsible for providing your care, and i hope you don't feel guilty asking him to do his job.

I think many of us bite our tongues and have learned to catch more flies with honey than vinegar when it comes to how we approach our docs, but you deserve help with your current pain.

Let us know how it goes!

Again, welcome.

PaLady

tb48
Regular Member


Date Joined Apr 2009
Total Posts : 23
   Posted 4/16/2009 7:41 PM (GMT -7)   

Went well at first post op follow today. Told her (it was his PA I saw) I was going to see a PM doctor just in case and if they could refill my prescription one last time and no problems there.

Thank god too cause I've just entered a new level of pain with the comfort zone of a splint off now. Feels like walking on a broken ankle right now. Using the boot and crutches so not putting full weight on it yet. Also need to make an appt for a month of PT again.

I really like this doctor too and his PA. They spend the time to go over everything, even gave me the scope photos and surgery report. Lesion is 11 mm x 5 mm deep. They removed a flap of scar tissue and a good size chunk of loose bone that was sitting in the crater.

With the last doctor I was on my own to figure out what to do after surgery and he never informed me of anything. Amazing how they can differ so.

Was always hoping I wouldn't need to see a PM doctor but guess I should just to get in the door for now. I'm still in the unkown zone as to whether this scope will diminish the pain or not and I need to have a plan if it doesn't. Only time will tell now.

There is still hope for me but after being in constant pain for a year now, I can't even imagine those of you that have been in pain much longer and those with pain of unknown cause.

I will forever feel for all of you and pray for you and support you!

Thanks for listening!


Post Edited (tb48) : 4/16/2009 9:01:14 PM (GMT-6)


White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3610
   Posted 4/16/2009 8:18 PM (GMT -7)   
tb48
You would probably be much better off if you see a pain doctor and started his evauation process, and let him manage your current pain, that way if the surgery turns out to be successful he can just let you go! But if it turns out that it isn't then you are already in his care, and you will be that much ahead of the game! so to speak, Obviously your ortho surgeon must have thought that your pain issues might not go away or be taken care of by the surgery, other wise why would he recommend you to see one so soon? I mean from what you have said it sounds like he might think that you will be in need of having pain management! Please don't be put off by the idea of going to a pain cliinic, chronic pain can in its self cause a host of different problems that need not have to happen if the pain is controlled! You have a legit medical problem that causes you a great amount of pain, and if they can do no more for the medical problem, then at least go to somebody that can help you live at least semicomfortably with the pain!
 
Good Luck to You!
White Beard
  I'm Retired USAF, went back to school and became an RN, and now am on full disalbility!--Degenerative Disc (affecting mostly the thorasic disc but all levels involved), C6/7 laminectomy/diskectomy& fusion, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications: Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13455
   Posted 4/16/2009 11:05 PM (GMT -7)   

Hi TB48,

Welcome to Healing Well. Hate to always see another new face pop on here, so sad so many suffer. I can't fathom your surgery on the ankle, its truly a delicate area as far as I am concerned. I won't bore you by repeating what the others have already said. But, one thing I will mention too, most pain mgt want a dr to refer you to them. I don't think you will have any luck getting in the door without one. If your ortho did not make a referral, then I would call and ask for one. He may very well know several good ones and thats much better than trying to just pick one out of a phone book.

You may not know this but, some pain mgt drs do not give medications. Instead they like to do procedures and different kinds of blocks, all mostly done by injections. So, you don't want to go there to that kind of dr.. Now, other pain drs will do procedures if they feel its necessary, but they also give medications. Not sure if you knew this. Granted no one wants to take medication but sometimes there is just no other option other than suffering.

Since its so soon since this last surgery who knows it may be the one that works and gives you the relief you need. Keep us posted in your quest for a pain mgt dr.....Susie


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