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Reflex Sympathetic Dystrophy (RSD) (CRPS) Message Board
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Old 01-22-2013, 06:00 PM   #1
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Scheduled for FCE

I haven't been on here in a while. I was diagnosed with CRPS in Aug of this past year. I've had several nerve blocks that did not help much and so my doctor wants me to get a spinal cord stimulator.

In the meantime, my wc has sent me to my 2nd IME and the doctor was a jerk and said I don't even have RSD, among some other crazy things he put in the report. So, today I got a letter in the mail saying that this IME doc has requested that I get a Functional Capacity Exam. What should I expect? Any advice?

The IME doc said I was displaying "pain behaviors" which evidently means I was trying to act like I was in pain, but really wasn't. What do they expect? Now I am afraid to even let them know I am in pain during this exam.

 
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Old 01-22-2013, 06:18 PM   #2
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Re: Scheduled for FCE

I'm sorry that you're going through this too. I am in the SAME EXACT situation as you. I was injured last March and finally had a diagnosis of CRPS (RSD) in my right ankle/foot this past August. I've been to 4 IME's, 1 FCE and an electrical nerve test (VERY PAINFUL). Do you have an attorney? If not you need to get one. I was FINALLY allowed to see an orthopedic surgeon that I was referred to 4 times AFTER I got an attorney. He is the one who diagnosed me.

All of the IME's done by the WC doctors all said the same thing "he's faking" the amount of pain is not in line with the injury". In an FCE you will get a physical examination by the Doctor. Then they will take you into a room and have you walk steps, put you in front of a machine and have you pull up while standing and sitting, pull down while you're standing and sitting, push in and pull out both again while standing and sitting. Then they had me go to a wall and move pegs in a board from the left to the right and back to the left.

In my case it didn't matter how poorly I did (I simply could not do most of the exercises) the stupid WC doctor still said I passed and was normal. The best advice I can give you is to NOT trust anyone associated with WC. Only trust your doctors, your attorney and your family. This is so hard to live with and the nerve blocks aren't working for me either.

Thanks and good luck.

Last edited by moderator2; 01-22-2013 at 06:23 PM.

 
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Old 01-23-2013, 05:32 PM   #3
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Re: Scheduled for FCE

I totally agree with getting the attorney!!! I am in the same boat with both of you. My injury was on May 16th of this past year. I have been dealing with work comp on many issues. First off, let me say, with it being this early in the game DO NOT let them put a stimulator inside of you!!! That is something that should be considered last...like years from now, not five months in to this!!! Do not hold back in telling a doctor of your pain level. I know they make you feel like you really arent in that much pain but that is what CRPS/RSD is....your body is overreacting to an injury causing more pain than what the injury should be!!!
Question: What types of symptoms do you have? That is the beginning point to it all.

 
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Old 01-23-2013, 05:42 PM   #4
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Re: Scheduled for FCE

I agree totally. I just had the 3rd nerve block today. It's been almost 12 hours since the injection and pain went from a 10 to about a 7.5 which is good but if its anything like the other 2 injections it will only last a few hours. I curious about your statement about implanting the stimulator. My doctors (not the WC doctors) have told me that's the next step for me. Injections not working, meds aren't helping so they wanna try tat but I've read horror stories online about the implants and I've heard other stories where it's helped them some. Have either of you heard the same thing?

My symptoms are incredible sharp pains, burning, tingling and about 10 times a days really sharp pain like your stabbing my leg/foot/ankle. It's excruciating.

 
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Old 01-23-2013, 07:24 PM   #5
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Re: Scheduled for FCE

I do have an attorney. I got one even before I was diagnosed.

My symptoms are excruciating pain, almost like my leg is in labor. It feels like my muscles are being shredded. I have alot of sensitivity and can't even wear long pants even though it's winter. It started in my left knee after I slipped on ice on the sidewalk on my way into work. Now it has spread from just my knee to the top of my thigh down to the bottom of my foot. I am concerned in the past week or so that it is moving up into my hip. My leg is also usually different shades of blue, purple, red, pink, and sometimes even a weird orange color.

I did question my doctor about getting the stim so soon, but he said that since other treatments are not effective, the sooner I get the stim, the better the chances are of stopping this in its tracks.

As of now, work comp is denying it anyway. They have been "voluntarily" paying me and paying my medical so far, but this last IME has stated it is not necessary. My attorney says they can and probably will stop the payments, but throwing the FCE in the mix doesn't make sense even according to her.

 
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Old 01-23-2013, 07:38 PM   #6
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You're lucky they're paying you or have been. I've not been paid and we just had the first hearing about it. 10 months after the injury. It's a slow process. And just so you're aware the stim doesn't stop it in its tracks. There is no cure for this. It can reduce the pain or even make it go away fora time but it comes back

 
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Old 01-23-2013, 08:00 PM   #7
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Re: Scheduled for FCE

Jonathan is right, it is a temporary thing! By the sounds of it, you have RSD. All of the symptoms are there. I would try and bring in something off the internet that shows what the symptoms of RSD are and explain to him that you are having just about all of the signs. If he says he doesn't agree, ask him about possibly doing a triple phase bone scan. They show if there are changes in blood flow. It doesn't validate it, nor does a negative scan prove it's not...but if it shows changes in blood flow, it just backs up the first diagnosis all the more! I still question doing the stim so soon into this. I have had the nerve blocks and the first one was fantastic and the other two caused more problems. Things vary from person to person. One med may not work for you but does great relief to somebody else. There is no definite in this! All treatments are pretty much trial and error. You want to have a combination of meds to help and there should always be some type of anti-convulsant medication like Neurontin (Gabepentin) or Lyrica to help with the burning pain. If all else, you should go on your own to an orthopedic to have it checked out on your own. Even though it's out of pocket, it would be worth it to get a back up diagnosis. I have been very blessed in the fact that work comp has paid for everything...including the days that I have had to leave early for doctor appts, physical therapy, and the nerve blocks. I am on temporary disability and getting paid from work comp part of my salary and they are still paying for all my meds and doctor appts. I pray you will be able to get the help you need.

 
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Old 01-24-2013, 06:03 PM   #8
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Re: Scheduled for FCE

I have tried both neurontin and lyrica. The neurontin was ineffective and the lyrica made me so loopy and panicky I couldn't even remember how to answer my cell phone.

The first doctor to suggest that I had crps was my ortho. He got the ball rolling for me. I have had a consultation with a neurologist who agreed with the diagnosis. The first IME also agreed at that time that this was more than likely crps and that I needed treatment. Also the neurosurgeon that I was sent to for the consult for the trial stimulator agreed with the diagnosis. So, I've got way more physicians on my side than against me. That is probably why, despite the last IME saying that I don't have this that they are still sending me for the FCE.

I really like my pm doctor and I feel really bad that this IME doctor made him sound incompetent. I don't think that is going to go over well with any of my physicians who see the report. The neurosurgeon for the stim said that I have had excellent care and that he rarely sees anyone, especially if they are workers comp, at this point in my illness have this great of care.

 
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Old 01-26-2013, 09:27 PM   #9
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Re: Scheduled for FCE

Have you tried using a TENS unit? If an external stimulator doesn't work, I dont know how well an implanted one will....but, I'm not a doctor so I don't know. :-)
I hope it all goes well and I'm glad you have more doctors on your side! Your lawyer should be able to help you then with workman's comp if they start giving you a hard time!

 
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