Can I get second opinion? 3 months post-op pain; now I'm told cuff was irrepairable.

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Alcie
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   Posted 1/12/2012 3:07 PM (GMT -6)   
3 months ago I had shoulder surgery for bursitis and bone spurs after PT made it worse and another doc did an MRI.  Doc didn't stay around to tell me what he did.  At first appointment he said he did bursectomy, debrided biceps, acromioplasty.  Pain was awful.  I tried everything.  No PT, because he said not to do anything but a couple exercises at home. 
 
2 months - pain still terrible, couldn't sleep, tried taking several sleep meds.  Nothing stopped pain on slightest movement.  Joint crunching, grinding, tendon pain triggering biceps spasms, pain clear down to hand.  Cortisone shot second appointment helped 3 days.  Doc said he trimmed a labrum tear and rotator cuff.  Called over and over to get new appointment.
 
Now 3 months of pain; putting on clothes is still agony.  Doc said the rotator cuff was irrepairable.  Was I supposed to know this from "trimming" it?  He didn't mention the labrum.   I got a cortisone shot in the biceps and am being sent to PT next week. 
 
I'm not getting better.  Can I get a second opinion for treatment after surgery?  I expect PT is going to be unbearable.

Screaming Eagle
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   Posted 1/12/2012 3:24 PM (GMT -6)   
 
        ...sorry, your post is a bit hard for me to understand,.....however if your surgeon has changed his story several times....then I think you might want to seek out an attorney. Generally...some attorneys will send you to a Dr...to get an opinion...and then can tell you if you have a case.
 
        If you want, ...you can always get the second or third opinion on your own first.
 
     I'm really sorry that your dealing with this much trama in your shoulder. Hopefully PT will cure most of your problem.
 
  SE wink
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tmjpain
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   Posted 1/12/2012 3:34 PM (GMT -6)   
Sorry to hear you are still having so much pain after your surgery. I hope you can get the answers you are looking for and that pt helps you.
 
Let us know how you make out.
 
Suzane

Chartreux
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   Posted 1/12/2012 3:49 PM (GMT -6)   
So very sorry about this situation your in and I hope you
can get some relief soon...maybe try ice and heat packs for now....

I think you should get Susie/Straydog opinion on the getting a lawyer,
but it might be something to look into, as a doctor that is changing his
opinion is not sounding good...make sure to get everything down in
writing of what has happened and dates and keep it with your doctor receipts
and make a journal of what you were told and when...

Another surgeon might not even want to deal with you, it might be hard to get that second opinion,
but if you can do it and write done everything this new doctor tells you...
Many well wishes in hopes you can get a low pain day soon, sorry about what your dealing with...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
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straydog
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   Posted 1/12/2012 3:59 PM (GMT -6)   
Alcie first thing I would do if I were you is call the facility where my surgery was done and get a copy of the operative records. You will find out in those exactly what was done and not done. They may charge you a fee for copying the records which is what most places do.

Next, I would look at my insurance and see if they have any shoulder specialists on the plan, if so call and see if you can be seen this soon after surgery. Many times when surgery has been done a dr will not see the patient until a certain amount of time has gone by for healing, usually its around 6 months. Then, I have also seen some drs say oh no you have already had surgery, no the dr will not see you. So this can go either way.

If you can get in with another surgeon I would be very careful in how I presented myself to him-if he thinks for one moment you are wanting to sue the other dr he will bail and run. Drs do not like to hear the words my dr messed up my surgery or the words malpractice. I would just say the dr said surgery was to fix this but then changed his mind and let it go at that. You could ask the dr what he thinks about your shoulder now.

Take care.

I know SE said maybe see a lawyer on this, but the way they work things on medical malpractice, in most cases where surgery has happened there is no 100% guarantee it will work. Also, the dr may think its one thing, but when he actually gets in there and see's what is going on there can be a change in plans and that is not illegal in any way.
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Alcie
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   Posted 1/12/2012 5:01 PM (GMT -6)   
I won't sue. Poor outcome is not malpractice. I did get a second opinion as to whether surgery was needed. Can I get another opinion on treatment?

Screaming Eagle
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   Posted 1/12/2012 7:48 PM (GMT -6)   
….I understand….it sounded like he had changed his story several times. I think of course!... you can get another opinion!…..and I suppose the treatment will depend on the opinion?

Hope the PT works out well for you…that would be the best if it works.

SE wink
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Weekly Quote!

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straydog
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   Posted 1/12/2012 8:26 PM (GMT -6)   
Absolutely, but do not be shocked if you are told its too soon by the dr you are trying to get in with. Like I said above, many times drs will not see someone thats had surgery until its been a good 6 months or more since surgery, then some just will not see someone thats had surgery else where. All you can do is call and see who will take you for a consult. Be sure to get those op records and take a copy with you to the new dr.

Good luck.
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Alcie
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Date Joined Oct 2009
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   Posted 1/12/2012 8:54 PM (GMT -6)   
Thanks to all for the advice! Tomorrow I'll call insurance to make sure about the second opinion.

Thanks to Stray Dog for the idea of the operative report. Reading that would let me know if the surgeon even remembers me. I'm wondering if there's anything about "inoperative" in there. If the hospital doesn't have the report I will request it when I go for PT.

I'm not angry about the actual surgery. It was necessary, and there were some good results - no pain where the bone spurs were and better range of motion, even though I pay with new pain and spasms after moving. The grinding and crunching in the joint doesn't hurt much. The worst thing is not being informed about the pain or that it would go on and on and regular pain meds wouldn't relieve it.

I mostly fault the office staff that keep saying I can't get an appointment when I need it. I think this office, several docs, is too busy. The nurses are OK. This doc's nurse got me in after I told office person I was going to look for another doc. I don't think the doc knows how long his patients have to wait in pain for an appointment. I told him in as nice a manner as I could. Getting nasty doesn't get you treatment.

I'll let you know what insurance says, and I'll ask my pain doc next week if there's a possibility of a nerve ablation if PT doesn't work.

Thanks again.

straydog
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   Posted 1/13/2012 5:44 AM (GMT -6)   
Alcie, depending on what kind of insurance you have, most HMO's & PPO's will require a referral before being seen. This is something your PCP can take care of for you. I really doubt you will have any problem getting your ins to approve a consult.

I am a little confused here though, because you said the dr did not stay around to tell you what he did. Did this dr leave the practice or what? Also, generally when surgery is done the dr see's the patient a couple of weeks after surgery. Did this dr make you wait 2 months after surgery before being seen? Thats an awfully long time.

Yes, I have read many operative records and have seen drs comment that after going in and seeing whatever, they elected not to attempt repairing something and give the reason including if they felt like something was not fixable. The best thing to do is call the facility and ask for the medical records dept. Tell who ever you speak with that you need a copy of your operative records and ask when will they be available for you to pick up. Its always best to call ahead so they can pull the chart.

Well, if this dr is that busy perhaps a new dr should be considered.

I have always heard that shoulder surgery is one of the most painful ones to recover from and the post-op pain is just incredible. I have had friends that have had shoulder surgery and many of our clients had it too and everyone said the same thing. I did something to my right shoulder back in the beginning of summer and I know the pain I am having is something else, especially when I get muscle spasms in it. I am taking Baclofen for spasms and that is the only I have managed to put off seeing the ortho and having a CT done. Several years back I injured this shoulder when I fell off of our motorcycle and there is a lot of scar tissue built up in it and I impingement problems going on.

Let us know how all of this pans out and take care.
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Alcie
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   Posted 1/13/2012 1:57 PM (GMT -6)   
Thanks SD, for the advice. I have a Medicare "advantage" PPO. I called and was told I can have a second opinion for any treatment, no referral. I haven't called Med Records yet, but it's on my list for today.

To clear up the confusion: The doc didn't stay around after surgery to talk to me. He presumably went to the office. I saw him 2 weeks post-op, very briefly, for removal of stitches. That was the soonest I was allowed to hear what he did during surgery. Since then he's changed what he's told me somewhat at every appointment. That's why I want to find out what he really did - so I can understand why I have such severe pain for 3 months. My knee was nothing compared to this!

I've been reading about post-op exercises, and they seem to be recommended by reputable sources. I'll try the PT, but I'm skeptical since the pre-op exercises worsened the condition a lot and the least housework starts up really bad biceps spasms. Housework is nothing to me after many years of driving tractor, changing out plows and mower decks, painting, real work.

For any further conditions I will see my knee doc's group, and I'll see him for a second opinion. It's not about the doc so much, as accessibility of treatment.

Since you are having a bunch of the same symptoms I had before surgery, I recommend getting an MRI ASAP and not putting off treatment. I waited a year because of other conditions from a bad accident that needed to be fixed first, or so I thought. Delay may have contributed to the not-so-good outcome.

spinal soldier
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Date Joined Dec 2009
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   Posted 1/13/2012 2:06 PM (GMT -6)   
sorry you have to go through this and i am sure that you need more than this but after surgery on muscle/ligament/joint you can supplement with amino acids like l-glutamine and BCAA's and alpha-lipoic acid, vitamin E, cal/mag w/ vit. D, vit.K2. some of these type things may help tissue repair.

Alcie
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Date Joined Oct 2009
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   Posted 1/13/2012 5:09 PM (GMT -6)   
Good suggestion, SS. Where can I find K2? It's not on the shelves in any local stores, and I know I'm short on it. I can tell when I start bruising, like the half palm-size one from a cortisone shot in my biceps yesterday. I could eat more leafy greens, but I don't like them and have a hard time talking myself into eating them often enough. Frankly, I just don't like preparing vegetables. I do supplement with most of the rest.

straydog
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   Posted 1/13/2012 6:08 PM (GMT -6)   
I hear ya Alcie on the accessability with the drs office, which is not good from any standpoint. When a person needs to be seen they need to be seen. The staff can make a good dr bad because of their behavior. People do complain to their drs about the staff and if he is not willing to do anything about his staff then he is not much better.

If its possible I really think an ortho that specializes in shoulders only or even a sport medicine dr would be a good one to consult with. If you get into someone you like and have confidence in him/her you may want to consider asking if this dr will take over your care. You have nothing to lose and perhaps something to gain by it.

You are so right knee surgery is a breeze compared to a shoulder, I have had 6 knee surgeries so I have some experience there, lol. I have had people tell me that had back surgery that their shoulder surgery was much more painful after surgery than the back surgery. So, what does that tell you, it tells me a lot. Another reason I have not jumped right up & gone to the ortho that my PM dr has recommended. This ortho is her personal dr as well, so I can trust her judgment on him. I know a little about the ortho and its been good so far. I injured this same shoulder from a fall on a motorcycle several years ago and have so much scar tissue built up. I had a dr that injected it back then after a few months of horrible pain, he hit that scar tissue and I just about came unglued and I was yelling for him to stop and he said I am almost done, I yelled you are done and was trying to pull away from him. I came very close to hitting that guy that morning, lol. I was not prepared for what he had planned to do that morning, lol.

I know I have done something to my shoulder, the wrong movement with that arm and stuff is moving around in there that should not be and then the pain that blinds you right after that wrong move, lol. The bad part is its my right shoulder and I am right handed. I have learned to use my left hand a lot more than I ever thought I could. My PM dr is really on my case every month when I go in and I have not had the Ct done. I would prefer an MRI over the Ct and I know I can have one done even with my pump. The facility has a machine that will work with my Medtronic pump.

I hope you can get into someone good soon and also be able to look at the op report to see what was done. Take care.
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CRPSpatient
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Date Joined Mar 2011
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   Posted 1/13/2012 6:25 PM (GMT -6)   
Alcie, sorry to hear what you've been through. All the best with getting hold of your medical records... do you have your GP or someone who could sit down and go through them with you if need be? I have just googled K2, which led me to a lot of stores - online and off (albeit Australian ones) where K2 is available. That might be your best bet - I'm thinking it's probably something that you will need to go to a bigger health food shop for.

Do you always bruise like that? What about if you cut yourself? How long does it take to stop bleeding? Just wondering if your doctors have ever checked your platelets or your clotting times overall. The cortisone itself can also cause bleeding and bruising at the injection site.

I hope that your pain settles - is the cortisone helping?

Take care,

Laura
Moderator - Chronic Pain Forum

Full body CRPS with spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bursitis, CTS, osteoporosis, multiple compression fx, disc bulges.

Oxycodone ER/IR, Topamax, Mobic, Somac, Cipramil, Midodrine, Vit D & C, SCS, baclofen/bupivacaine pump

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 1/13/2012 9:10 PM (GMT -6)   
Hi Laura. I have had K with a scrip, but it's really expensive. There are no coupons or cards we can use if we are on govt insurance, including any Medicare-related insurances. I hadn't looked for online pharmacies until you mentioned it. I thought it was Rx only. I'll talk to my PCP about dose. It's sure cheaper online than Rx!

No, I bruise and bleed only if I'm not eating K vegetables, which I don't like, nothing serious. I make sure to eat some before any surgeries or procedures. My blood gets checked for platelets and lots more every 3-6 months to monitor cancer indicators. Breast cancer 3 years ago, no mets, but I don't tolerate any of the meds.

I didn't know cortisone could cause bleeding. I'm on NSAIDs for the biceps too. I guess I'd better hit the spinach and broccoli over the weekend. It only takes half a cup to a cup a day with the highest K foods. I have a nerve conduction coming up Monday, maybe cortisone spine injection too. My PCP called to say my lumbar MRI showed a new disc bulge. I'll go over it with the pain doc who ordered it Monday before he does the other procedure(s). Cortisone may be helping. I haven't had such bad biceps spasms, but then I didn't do any work to trigger them either. I'll find out when I try to get to sleep. Lying down is when they always hit bad.

Thanks for the hints. I get a lot out of the forum!
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