Leftleg says it all - Pain Management Message Board

leftleg · 08-20-2005, 11:50 AM

Hi all,
My name is Chad and I live in Iowa. I've had cp for 14 months. It started with a simple foot sprain. I went through pt for several months afterwards and since the injury was work related I was continually under the microscope.
The company doctor told me he was finished with me and informed the company that I was not injured. He stated that the foot sprain was healed and the symptoms that I continually informed him about were probably not realistic. The company said "you're on full duty as of today" I told them it was not possible

. At this point I still had extreme difficulty walking, sharp shooting pain that ran up my leg (but stopped at the knee), hypersensitivity on the outside of my lower leg, strong burning sensations all over my foot and at this time the worst pain was on the outside area of my ankle. The pressure was so intense that I was sure the first couple sets of x-rays had to of missed something. I told the company I needed to see a specialist not a family practioner. They said OK

I explained all my symptoms to him and he order an MRI and a lower leg x-ray. The MRI results showed a break at the talo-navicular joint. The doc said I'm not sure how to go about getting the center of your foot. It would involve a lot trauma just to get there but I think I can do it. Thinking you might be able to wasn't the right answer, either you can or you can't. I informed the company I needed a second opinion. Once again the agreed. The next doctor said he didn't have the skills to get to the break and he felt the trauma to the rest of my foot may not be worth it. He referred me to the University of Iowa. Six months after the original injury and more specifically after the MRI results I wasn't under suspicion any more. Well guess what. The MRI was invalid. No break and no soft tissue damage was discovered after the arthroscopic procedure. I continued PT with no positive results and was told by my company "look, when a doctor writes 'work as tolerated', he is basically stating there is nothing wrong" I told them there was. After several more meetings and a strong increase in all symptoms I was sent to a different PT. After several different approaches over the next few months we finally hit the jackpot. The pt used a machine called a STS (sympathetic therapy system. Using electrical stimulation on different parts of my body the symptoms lessened

I could finally walk for ten minutes before I had to set down. Unfortunately the effectiveness platued after a month. Then a strong jabbing pain started on the top of my foot right where the incision was made. I swear, it felt like someone had jammed a screwdriver in there and every once in awhile gave it a good twist. The pain was crippling. I went to see the doc again and he was going to give me a disability rating. He told me I was at MMI. I wanted to cry so bad. He then asked how my pain management was going. I told him "you havent' sent me to PM" His response was OH. Within one week I was at the PMC. They did two sympathetic blocks with no results. The next step was a Bier Block. If anyone has had this procedure done you know it's not fun. The first one produced wonderful results. My pain was reasonably acceptable and for the first time in 13 months I was able to take a walk with my family. It was only three blocks but hey, who's complaining. This lasted 4 days

My second block was a disaster. The doc believes they punctured the vein and the meds stayed localized in my foot instead going into my lower leg. I returned one week later for my third one. This only lasted three days. A week later I returned for my fourth and it lasted one day. I go back to the PMC on the 25th and I have no clue what's next.

I'm curious to know if anyone else has cp in a localized area and if they expirience extreme cold in that area. When I go to the PMC they monitor the temp difference in my feet. The left one is always colder than the right. Typically by 5.5f

Well that's it for now. Sorry it was so long but it felt good getting it all said. May God Bless Everyone. Job 2:10 "if we are to accept the blessing then we are to accept the sufferings" I know this is easier said than done but always keep the faith.

trowftd3 · 08-20-2005, 01:00 PM

I can sympathize with you on the work related injury scenario.
My husband broke his heel 10/04 and had a major 9hr surgery to repair it. He was in a wheelchair for 5 months and now has a considerable limp and lots of pain. The doc gives him ibuprofen tells him it will get better. Anyway, they're trying to get him back to work(he wears stilts on the job) soon. I know what you mean about under the microscope. You have to watch everything you say and do. They look for any excuse to get you out.

Just my opinion....it sounds like you have some nerve damage. Nerve pain is really hard to control and because it's been awhile since you injury it might be permanent. Is your pm clinic at the university? Do you know anyone with pain issues who could point you in the direction of a good pm? Or someone with a previous foot injury who know a good foot doc? We were lucky and ended up with a really good sugeon(we know of at least one major league baseball player that goes to the clinic). And we're lucky that it was covered by workman's comp as the treatment is over $100,000 so far!

I also have cp issues with undiagnosed lung pain after a bout with pneumonia 02/03. I tried all sorts of treaments but without a diagnoses no one knows what to do with me.

What is a Brier block?? I've had trigger point injections and a facet block but haven't heard of this one. I hope it continues to help you.

Welcome to the board. There is a great group of supportive people here who really understand what you're going through. Take care. ~Mush

leftleg · 08-20-2005, 02:14 PM

Hi Mush,

I'll try my best to explain the procedure. There are two cathators, one in the arm and one in the foot (ouch!)

1. A large blood pressure cuff is placed on my upper thigh
2. Starting with my toes, a strong plyable rubber wrap is then wrapped extremely tight all the way up to my knee. This forces all the blood out of my lower leg.
3. The cuff is then compressed until the blood pressure at my thigh is greater than on my arm. This is to ensure that absolutely NONE of the medicine can get into any other part of my body. I'm unsure of the names of the medicines but it's a concotion of numbing agents and anti-swelling. I know one of them is called lydocane. The idea is for the medicines to remain in the affected area for 30 minutes. This allows the muscles and nerves time to absorb everything. Believe me, the cuff is tight and certainly can work on the mind after about 25 minutes. After the injections are complete the worst part for me is an insane amount of burning on the bottom of my foot. I can't possibly describe how hot it gets. Luckily, it lasts no more 20-30 seconds.
4. The cuff is then released and I get what is called a "washout" It's a combination of displacing the extra blood that was forced out my leg back into my leg and any medicine not fully absorbed by the muscles and nerves.
First there is a terrible metallic taste which is soon forgotten about as I become extremly light-headed and start having difficulty in breathing. This is followed by sharp pains in the chest and an overall feeling of disorientation and vertigo. My typical recover time has been 30 minutes or so. For the rest of the day my lower leg is reasonably numb but functional. Then it's nap time. For me the procedure is very tiring. If your husbands pain is concentrated to the lower leg area I would there would be no reason this procedure couldn't be done unless the damage done to his heel area would be traumatized by the wrapping process.

Unfortunately the last BIER block wasn't effective. So the 25th will be a turning point. And yes I have a great PM doc. He is very expierienced and treats me like a person. Luckily the significant temp. difference is proof positive that there is something wrong with the nerves and blood vessels. Since the first temp differences were relayed back to insurance and my company I haven't had any problems. Finally this was the concrete proof I needed.

I feel for your husband. One month ago was the first time they dared give me anything for the pain. Ibuprofen and tylenol are a joke if you're in serious pain. I truely believe if your husbands heel can handle the wrapping it would be benifical to look into it. And yes my PM does believe the damage is permanent and he is persueing avenues of pain relief because there is no repair.

Thank You for replying to my post. It's good to hear from other dealing with the same problems. I'll keep you posted on the work-comp. Somewhere along the line I'm sure they'll wave a check and say "we're done" I don't want the money I want all medical expenses covered. That's not asking too much considering the company knows I sprained my foot because of an unstable platform.

Thanks again for returning a post,

leftleg

painterinlegoff · 08-20-2005, 06:39 PM

for 7 years i hve been through hell, every doc ii been to telling me there was nothing postivitly wrong with my back, well this past thursday all those docs were made liars, the test i had done shown 3 discs very badly destroying maybe 4, i go wednesday to talk over options for treatment

leftleg · 08-21-2005, 03:58 PM

I have a prescription for percocet and this weekend I definetly needed some. Unfortunately, I hate the side effects.

This makes taking the meds barely worth it.

Do the side effects lessen as the meds are taken more often? Side effects I have are light-headed, kinda fuzzy feeling, tingling sensations and the worst for me is the inability to concentrate. Are other pain meds just as effective with less symptoms?

I also take Amitryptilin (10mg) x1 daily and Nuerotin (600mg) x3 daily. Do these meds and dosages seem normal for someone that has only recently been diagnosed with crps.

Thanks all and God Bless

Sincerely,

Leftleg