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Old 11-24-2004, 07:17 AM   #1
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Smile HELP! What should I do next? Foot/Ankle Injury

This is a long story but if anyone can over some advice, I would really appreciate it. In August, I twisted my ankle and fell. I was in severe pain and could not walk. First doctor did x-rays of my ankle and said nothing was broken just a slight sprain referred me to PT three days later. PT would not treat me because I had a huge bump on the outer side of my foot, return to Dr. additional x-rays showed non-displaced fracture of the fifth metatarsal and he referred me to DPM. DPM said no surgery and put me in a cast. While I was in the cast, I was having crushing pains on the top of my ankle and numbness in my little toe. Questioned DPM he said everything would be fine when my cast came off in 4 to 5 weeks. Pain was worse and my toes were blue so I went to the ER, they removed my cast and referred me to a different DPM. New DPM (4 weeks after injury) put me in a boot, NWB. After 2 weeks no improvement and in severe pain constantly, DPM sent me for PT say that would make it all better. PT limited on what he could do because of my pain, limited ROM exercises and modalities. No improvement, ankle still swollen and painful and PWB limited to 1-2 hours a day. DPM ordered a MRI because PT asked for one before they would continue treatment. 11 weeks after injury MRI showed original fracture, avulsion fracture and a complete tear of the ATFL and CFL. After DPM gave me the results, he sent me to pain management specialist because he said that I should not be in pain. He wanted the pain and swelling to subside before he could do surgery. PMS said the pain was all mechanical and that there was really nothing he could do but prescribe additional meds. Returned to DPM, he decided that he did not want to do surgery at all and would send me back to PT. So here I sit 16 weeks after my original injury still in pain and swollen with PWB. DPM told me yesterday he wants me off crutches and ready to go back in to regular shoes in two weeks. I know there is know way that I can do this; I donít think my regular shoe would even fit. I am trying to get in to see another Dr. for a second opinion but this is a workers comp claim and I have to wait for approval from the state, which takes 3-4 weeks. So there is my dilemma. What do I do next?

Last edited by klutz; 12-08-2004 at 07:11 AM.

 
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Old 11-24-2004, 10:26 AM   #2
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Question Re: HELP! What should I do next? Foot/Ankle Injury

Quote:
Originally Posted by klutz
This is a long story but if anyone can over some advice, I would really appreciate it. In August, I twisted my ankle and fell. I was in severe pain and could not walk. First doctor did x-rays of my ankle and said nothing was broken just a slight sprain referred me to PT three days later. PT would not treat me because I had a huge bump on the outer side of my foot, return to Dr. additional x-rays showed non-displaced fracture of the fifth metatarsal and he referred me to DPM. DPM said no surgery and put me in a cast. While I was in the cast, I was having crushing pains on the top of my ankle and numbness in my little toe. Questioned DPM he said everything would be fine when my cast came off in 4 to 5 weeks. Pain was worse and my toes were blue so I went to the ER, they removed my cast and referred me to a different DPM. New DPM (4 weeks after injury) put me in a boot, NWB. After 2 weeks no improvement and in severe pain constantly, DPM sent me for PT say that would make it all better. PT limited on what he could do because of my pain, limited ROM exercises and modalities. No improvement, ankle still swollen and painful and PWB limited to 1-2 hours a day. DPM ordered a MRI because PT asked for one before they would continue treatment. 11 weeks after injury MRI showed original fracture, avulsion fracture and a complete tear of the ATFL and CFL. After DPM gave me the results, he sent me to pain management specialist because he said that I should not be in pain. He wanted the pain and swelling to subside before he could do surgery. PMS said the pain was all mechanical and that there was really nothing he could do but prescribe additional meds. Returned to DPM, he decided that he did not want to do surgery at all and would send me back to PT. So here I sit 16 weeks after my original injury still in pain and swollen with PWB. DPM told me yesterday he wants me off crutches and ready to go back in to regular shoes in two weeks. I know there is know way that I can do this; I donít think my regular shoe would even fit. I am trying to get in to see another Dr. for a second opinion but this is a workers comp claim and I have to wait for approval from the state, which takes 3-4 weeks. So there is my dilemma. What do I do next? Is this the normal course of treatment for this type of injury?

 
Old 11-24-2004, 11:25 AM   #3
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Re: HELP! What should I do next? Foot/Ankle Injury

Wow, and dealing with Worker's Comp too! Sounds like your DPMs dropped the ball unfortunately in initially diagnosing your injury. I'd like to know how you are going to get back into the shoe in two weeks.

Anyway, need some clarrification, has the two fractures healed, it has been 16 weeks. The torn ATFL and CTL probably require surgical repair. You say you are PWB, do you have a brace or anything to help support your foot and ankle?

Are there any orthopedic foot and ankle docs in your area as an alternative to a DPM? Your are going to have to fight for the care it sounds like you need. Wish you all the best! -eko
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Old 11-24-2004, 11:37 AM   #4
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Re: HELP! What should I do next? Foot/Ankle Injury

I am not sure if the fractures have healed DPM has not done any x rays since the MRI at 11 weeks and doesn't seem like he plans to either. Currently I am in a walking boot, so I can walk with crutches. If I try to walk without the crutches I have sharp pains from my foot/ankle to my hip.

As far as seeing a OS I am trying to see someone else however I have to wait for approval from the insurance company and the state. I talked with the Insurance company earlier today and they told me that since the DPM did think I need surgery they might not be able to send me to anyone else. So I don't know I think my Dr. is quack!

 
Old 11-24-2004, 03:36 PM   #5
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Re: HELP! What should I do next? Foot/Ankle Injury

I can understand your frustration when something is wrong and you cannot get a plan of resolution. You may have to fight with the Worker's Comp to see the Dr. you want to see. The OS was a suggestion because I really like and have had good success with my DPM, others have had better luck w/ an OS.

Keep us posted and good luck!
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Old 11-24-2004, 04:40 PM   #6
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Re: HELP! What should I do next? Foot/Ankle Injury

Wow, that sounds miserable! I can understand the doctor not wanting to do surgery right away, but instead waiting until the pain and swelling have gone down. It seems that a lot of people with pain get stability from the surgery, but not much pain relief. But really, it's been 4 months, and that seems like it is long enough after the injury that pain from torn ligaments should be greatly reduced. There is either something else going on there, or your injuries are not healing and you need surgery. Either way, fight for a competent doctor! Good luck.

 
Old 11-25-2004, 09:11 PM   #7
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Re: HELP! What should I do next? Foot/Ankle Injury

Hi Klutz,

Boy, can I relate to your problems. I'm almost at the 2 year mark with my ankle/foot injury. Stubborn stupid Dr's, miserable WCB's and the worst, a bum leg.

What's been the most important issue is to stay strong and DON'T give up. Insistance will pay off, eventually.

I knew from day one I had some serious under lying problems with my severely sprained ankle. It took 7 months for the bruising and swelling to subside, the pain remains. I have so far been diagnosed with, Bone Bruise, Plantar Faciitis, and two torn deltoid ligaments, suspected nerve damage, and some issues with the lateral ligaments which are unknown. Orthopod refuses to use arthroscope in fear of damaging more nerves which = more pain. Can't repair the PF because of the pain caused by nerve damage. WCB is saying all the damage didn't show up on my first MRI so I musta done the damage after my accident, therefore they are not responsible.

If I made it through this mess, so can you. The road is long but hang in there and don't let them tell you it's in your head. You walk on your feet, not your noggan, if it hurts, something is wrong!

 
Old 12-03-2004, 02:24 PM   #8
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Wink Re: HELP! What should I do next? Foot/Ankle Injury

Well I still haven't heard if I got approval for a second opinion. I have to wait for my employer, then the said it will take 1-2 months to get in. But what the hell it has been 17 weeks with partial weight bearing on a broken foot and grade III sprained ankle so what difference does it make. I guess they figure I am at work everyday, on drugs ,but there so they can take as long as they want.

I tried walking/limping without crutches in the walking boot just around my house so I can grab on to the wall or furniture. That didn't last long I tried for 15 minutes 2 days the 3rd day I tried 20, took one slightly wrong step and almost fell because of the burning pain. So now it is as swollen/bruised/ painful as when I first sprained/broke it.

Just know I don't have a Dr. to go to my PT approval ran out, can't get that approved until I go back to the Dr. which will be never by the way it feels. At least I have percocet to get me through the days.

Well sorry to vent, but I need to get it out somewhere and at least everyone hear understands the frustration.

How do you manage?

Last edited by klutz; 12-03-2004 at 02:45 PM.

 
Old 12-04-2004, 04:13 PM   #9
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Re: HELP! What should I do next? Foot/Ankle Injury

Klutz,

It's really hard, but keep yourself together, keep trying. I have found that if you do what they (WCB) want it will go much further than if you fight them. Like I said, I knew right away into my injury that something bad was going on inside my ankle, nobody would listen. Listen to your body, it's telling you things! Eventually someone will sit up and pay attention to what you are telling them.

WCB's are paid to distrust and manipulate you and your doctor, be smart, and read EVERY word they say. There mandate is to reduce payments!

I am now looking for 3rd opinion, I might consider whatever that is. I'm not giving up. Your mobility is everything, take every avenue you can to make sure you can reinstate it.

 
Old 12-06-2004, 11:08 PM   #10
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Re: HELP! What should I do next? Foot/Ankle Injury

hi klutz.. this may be a long shot but my story is similar to yours, i had a fall accident and they thought i just had a sprain .. so i tried crutches etc... but pain got worse and swelling, they did an mri and found some tendon tears, but couldnt find what they thought must be an underlying reason for all the swelling and pain.... finally sent me to a good orthopedic surgeon who suggested doing a CT Scan.. have you done that? becuase my results gave me the explanation.. and apparently sometimes it only sows on ct scan, not nri or x rays.. it turned out that my fall had uncovered a genetic condition know as tarsal coalition, where your tarsal and calcaneous bones are partially fused together by bone and the joint is deformed.. once you have an accident and have this underlying it can essentially mean that you need an ankle fusion, which i am having dne right after christmas, my doc says it is the only way to get rid of the pain and swelling, although it will limit the side to side motion of my foot.. check it out it could be something like this underlying all your other problems.. good luck

 
Old 12-08-2004, 06:43 AM   #11
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Thumbs up Re: HELP! Foot/Ankle Injury

Thanks for all your reponses.

Good news, I got a call saying I got in to a sport med MD that specializes in ankles! The doctor they are sending me to is suppose to be one of the best in the area, my friends dad who is a GP told me to see him. At first they told me no, but they finally gave in. I have a three week wait before my first appointment but they said that I can stay with him and not have to go back to the DPM. So hopefully, the end is near. I will keep you posted. Thanks again for the support.

Last edited by klutz; 12-08-2004 at 11:14 AM.

 
Old 12-08-2004, 06:44 PM   #12
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Re: HELP! What should I do next? Foot/Ankle Injury

Great news... Hope it works out for you. Be sure to write down your history up to this point and make sure that all of your records and test results get sent to the new doc. Also, make a list of all your questions so you don't forget anything during the appointment. Good luck and let us know how it works out.

 
Old 12-10-2004, 07:24 PM   #13
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Question Re: HELP! What should I do next? Foot/Ankle Injury

Since everyone is on the subject of severe ankle pain and workers comp. I broke my ankle in three places a year and a half ago. Most significiant I had a fragment come off of my posterior mallelous. They opted not to do surgery, because the fragment never moved (it sewlled so bad, it kept it in place). I was in a non walking cast and the a boot for more than 3 months. I went to physical therapy for week, and never regained any more movement or range of motion in my ankle. After all this time and numerous x-rays and a MRI. The bones have healed perfectly (thank goodness), but I still can not move my ankle anywhere near as far as the other one, and there are sharp stabbing pains in the side of my ankle. I also get cramps in my calf muscle and my big toe stands straight up in the air when the cramps are bad.

Does anyone have any ideas about what my be going on with my leg???

Thanks!

Last edited by awolford; 12-11-2004 at 10:29 AM.

 
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