Anyone else experienced frustration with their OS's course of treatment?

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  • #1887 Reply
    Christina
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    The more I read about TPFs and what everyone’s stories consist of, the more my gut tells me I’m not on the right path. When I first landed in hospital, I was only given x-rays, and I didn’t get a CT scan until the next week. For the first week, I was in a knee immobilizer but when the results of the CT scan came back, it was on with a full leg cast. No MRIs were ever done to ascertain damage to the surrounding soft tissues, and no mention of any sort of physio (I had to push and ask to find out what I could and could not do).

    What worries me is both the short- and long-term. I’ve been in a full leg cast now for three weeks with another three to go, and the most my leg’s been bent was at 10 degrees. I understand the NWB part, but is the no-bending part normal, too?

    With my TPF, I had a displacement of 6mm, which was in the grey zone for surgery. So far, it’s not surgery, but do displacements align themselves in the healing process? Or once I get to the weight bearing stage, am I going to be putting undue stress on the meniscus and ACL/LCL/MCL and screwing myself up much later on down the road, and risk a higher chance of osteoarthritis? Is it going to be harming my short-term prognosis, too?

    I’m also worried about the blood supply to my foot, as I don’t think it’s as efficient and strong as it needs to be. Since my July 3rd accident, I’ve only cut two toenails once, and my foot feels cold if I’m moving around on crutches.

    My doc doesn’t seem too concerned about sitting me down and going through all the options with me, and one of the downsides of the Canadian healthcare system is it takes a LONG time to see anyone else, so I’m feeling stuck, frustrated, worried, and a little despaired and hopeless.

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    • #1904 Reply
      Eileen
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      Christina,

      The first OS explained my injury by showing me the x-rays and CT scan. Then, I went to a trauma OS who did not explain what he would do, so I went to another OS who did a very good surgery. After surgery, when I had concerns about swelling and color, I got a same day appointment with a PA who answered my questions. Since then, I had a PA examine and answer questions, and I have seen the OS who explained what I should do to rehabilitate the knee. I am very grateful for the level of care I have received.

      I hope you ask to see your images and learn more about whether your cartilage is in tact.

      Eileen

    • #1901 Reply
      Christina
      Guest

      Hi John

      I am thankful — beyond words — that I live in Canada and don’t have to face sky-high medical bills. But parallel to that, I’m also frustrated at the rushed feeling I experience at going through a fracture clinic where I’m just a number on the OS’s daily chart. But I’m glad to hear the foot thing isn’t just me. Mine turns purple when I get up and move, too, but luckily, I haven’t experienced much peeling.

      Thanks for the tips, Eileen. I think I’m just getting frustrated at the lack of information and progress, and you’re right: ligaments and tendons probably should be addressed after bone union. Did you find your medical team were able to give you the answers to your questions? Or did you have to keep coming back and back? I’ve got an appointment with my family doctor’s nurse practitioner this Friday, and I’ve started to write down a list of questions. It keeps growing, though!

      I’m finding the same thing, Lisa, that different docs have different opinions, based on the medical journals I’ve read online. What frustrates me the most is the waiting time here. It’s not possible (or legal) to get to the front of the line by waving a bunch of money in the air, so the frustrating part is having to wait to both see my family doctor, get referrals, and then see specialists.

    • #1900 Reply
      John
      Guest

      Christina, your leg is in a cast because the knee needs to stay straight for the bone to heal. Any other issues are addressed after the bone has healed. Leave your leg as still as possible, physio will start once the cast comes off. Your foot issue is normal. Mine turns purple/blue when crutching around, skin is dry and pealy. It will get better once the cast comes off and you start moving your leg again. The doctor hasn’t given you a lot of info because there isn’t much to tell you until the bone is healed. Be patient and be thankful you live in Canada and don’t have to pay the doctors.

    • #1897 Reply
      Eileen
      Guest

      Christina,

      I had the same MRI concerns that you have. Numerous nurses, surgical assistants, and, importantly, two surgeons all had the same answer — the swelling must be gone and the bones must be properly aligned before further surgery can be done on soft-tissue. It is a non-issue until they get the rest of it right.

      Again, ask to see your images and have someone show you the damage. Ask about your CARTILAGE because that is what keeps your bones moving smoothly at the knee. Your “gut” reaction may be due to not having enough information to feel comfortable about your treatment. You will have better healing if you understand and are confident in the decisions your medical providers are making.

      Keep working to get the answers you need.

      Eileen

    • #1892 Reply
      Lisa
      Guest

      Hi.

      Yes, I am in America and it is common to shop around for care providers, if you are lucky enough to have insurance that allows that and live in an area that can be done.

      From what I am gathered from this web-sites, different doctors have different views on the most appropriate ways to deal with a tpf. Maybe you doctor have reasons for making the specific decisions he/she did.

      I do wish you well!

    • #1891 Reply
      Christina
      Guest

      Thanks, Lisa 🙂 May I ask if you’re American? There, is it common to “shop around” until you find a doc that really suits you? I’ve not so much found that experience here, I think because the idea of medical consumerism isn’t as strong here. You can request specialists, but you don’t always get who you want. I can’t help thinking, though, that if I were the NHL’s Steven Stamkos or the NBA’s Paul George, both of whom suffered similar and traumatic leg fractures, that I’d be on a different, less passive course of treatment.

      And gosh, thanks for those links, Eileen! The second YouTube video especially gave me a lot of insight. I’ve learned to trust my gut but as I’m not a medical professional, I’m hesitant to tell doctors I want to proceed in a certain way. But I just can’t shake the feeling that I should be working on physio and ROM at this point (4 weeks since the accident). My concern with the MRI though is how it impacts a surgery decision: if there’s damage to the meniscus, then I think I’d want surgery to repair it so that when the bone heals and I start bearing weight, I won’t be doing any (further) damage to it if the tibia stays misaligned.

      At this point, I’m ready to pull out my credit card and hop across the border for better treatment. Living in Canada, I’m thankful beyond words I don’t have to see a single medical bill, but if money means a better short- and long-term outcome, I’ll start knocking down doors to scrape together dollars.

    • #1890 Reply
      Eileen
      Guest

      Cristina,

      I am only a patient, but here are some things I have learned.

      There are six levels of fracture (http://www.youtube.com/watch?v=Vji4F9v7uo4 http://www.youtube.com/watch?v=0sOfB-FET34).

      A 6mm depression can cause osteoarthritis and alignment problems. If your bone is smashed down into itself and your cartilage is also depressed, surgery may be needed to push the bone and the cartilage back into place http://www.youtube.com/watch?v=5hZv_FZhdlc (Also, see images at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852742/)

      Pay attention to your “gut.” Is there any way you can have someone show you your images and explain your problem. By insisting on getting more information, I was able to have someone explain my CT and X-rays. Then, I was able to get a surgeon whom I trusted.

      MRI’s are not needed until the bone is fixed because nothing can be done, with the meniscus, etc., until the bone is mended.

      Keep doing whatever physio is safe. Exercising upper body can and healthy leg can help with circulation and wellness.

      Swelling interferes with blood flow — keep checking the pulse in your foot.

      I hope you are able to get good care and a good outcome.

      Eileen

    • #1889 Reply
      Lisa
      Guest

      My attitude is this: I am a medical consumer. As such my answers better be answered or I go to another health care provider.

      I know it was 2 weeks after my surgery that my ortho doctor said I needed to begin PT and get some ROM going on the knee. The physical therapist actually asked why it too so long to start ROM exercises.

      If it takes too long to transfer care, I would at least make an attempt to seriously talk with your current provider about these concerns.

      Take care!

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