Revision TKR Knee replacement is not nice to me...

[Josephine]

Just because they are in a bigger city does not mean they are better doctors.

That's not quite the point. Bigger cities and bigger hospitals mean they have a bigger patient base because people come from far and wide to see them. People with unusual problems that doctors in regular provincial hospitals never get to see but once or twice in their lifetime. And that's what makes them "better" doctors, in this case just meaning they have greater experience of the unusual.

You know the old saying
Q: Can you tell me how to get to Carnegie Hall?
A: Practice, practice, practice!

It's exactly the same in this business.

 

[Jamie]

Coachie, I do understand where you are at this point. I know you're frustrated. I can see that money is an issue for you. However, Jo is right....there are reasons to see someone at a large hospital when you are having unique problems.

Since you are concerned that you might not even be seen by one of the doctors at Mass General until a year is up, I suggest you call and ask that question. A phone call costs you nothing but a little time to see if there are options for you now.

Many times the surgeons in these larger facilities are not so restrictive as a smaller clinic. It is possible they will consider your case before October. If you received confirmation over the phone that one of the surgeons will review your case, ask if you could send images and appointment notes initially prior to any appointment being scheduled. The worst that could happen is that they would say no and you might at some point need to travel to Boston. But if they agreed (and many surgeons WILL do this type of long-distance review), you might have new options open up for you.

I'm glad you understand that these suggestions are offered because we care about you and want you to get the help you need.

 

[Coachie]

I would suggest that you have a note from your doctor about your limit on activities if you need this when you go back. Don't assume you can be in the chair and teach. I don't know how your appraisal system works, but documentation will back you up so no one can come back on you and use it against you. You know what I mean? Good luck, it did take me up to a year to really feel great from the first knee. Hugs, Ann

Luckily for me, I work in a great school where everyone (including the students) are very supportive of each other. It is a small school- typical of rural Maine- we have about 275 students from grades 9-12 so everyone knows everyone else. My principal and I are friends. He was my assistant basketball coach two years ago- talk about turning the tables on authority, haha!! He fully understands my need to sit and teach and they have adapted my classroom to help me out with a document camera that projects onto the white board. I also have a smart board and many other resources that help. My freshmen are always willing to run errands for me, probably to get out of class!

 

[old goat]

Coachie this all sounds great. Smaller schools I think are better in many ways. I work in a smaller country school and have a smart or promethian board as well. All of this helps to run things smoothly. I have worked in bigger districts, and inner city. It is great when you have a supportive environment. I am really looking forward to school starting this year. I do not have the pain before the surgery that I had before. I think this was a good decision even though I am still in a rehab type phase. Our school starts early. I need to be back by August 1st. Students come on August 22nd, but we end in May. It is too hot right now for anything here! 100 plus everyday!

 

[Coachie]

We just got out June 22, and our first teacher day back is August 24th. Kiddos report on August 29th. However, since I coach the girls' Varsity soccer team, I technically start on August 15th as that is the first day of pre-season for all fall sports in Maine.

 

[wanttoride]

Is it possible to find a replacement soccer coach for the season so that you can put your health issues first and foremost and not worry about school schedules? Just asking.....that may give you more time to devote to your knee. I know coaching on the sidelines isn't first choice, but it
might be something you will need to do or have to do in order to get your knee taken care of as soon as you want.
I hope you get answers with Dr. Walsh tomorrow...if you don't, I would heed Jo's advice and start making phone calls and writing letters, as I also suggested. I know first hand that this does work, and Jamie is also correct.
If these options aren't possible if Dr. W doesn't have any answers for you, (which I'm hoping and praying that he will help) I hope you pursue OA in Portland and write a letter with Dr. Walsh's help so that you can stay in Maine and use your insurance. I wish I had more suggestions and answers for you, but I think you will find that you have been given the BEST ones here on the forum. Good luck!

 

[Coachie]

I don't want to put off soccer again. I had to last year because of my recovery issues and I really, really don't want to. If I have to coach from a wheelchair, I will...
I'm off to Bangor with fingers crossed!

 

[Jamie]

Good luck, Coachie.....I'm anxious to hear a report from your appointment!

 

[wanttoride]

me too!

 

[WaterBaby]

Good luck in Bangor!

 

[JennyI]

Good luck Coachie.

 

[Coachie]

He's fairly certain that the knee cap is loose but wants to confirm it so I now have to wait to get an appointment to get a CT Scan. The good thing about him is that he said there are too many risks involved with just "going in blindly" and said he is not willing to take those risks. He said that if I went to 10 different orthopedics, that I would probably find one that would say, "sure, let's go in and operate right now," but am I really willing to take a risk that something could happen.

Yes, it could end up making it better, but without knowing what to look for, it is kind of like taking apart the engine of a car when maybe all it needs is new brakes.

It's frustrating to have to wait, but I understand the reasoning behind his hesitation.

 

[Jamie]

Coachie, this sounds like a reasonable approach. He should know what he's going in for if you are electing surgery. So, I think this was a good result from your appointment. Here's hoping you can get the scan soon.

 

[wanttoride]

I still don't understand WHY doctor's don't order CT scans when there is pain and questions well into the recovery of a TKR!!! Had it not been for Dr. Kelly ordering the CT scan when I saw him 9 months after the initial (botched) TKR, I would not have known until "who knows when". Ugh!!! All those tests you've had, and now the CT scan???? I'd be ticked that this wasn't ordered sooner.
Never EVER would ANY ortho surgeon go into a knee "blind"....which makes me question WHY they don't do a CT scan 6 months out if the patient is having pain and/or problems outside the norm to find a baseline. Probably the answer to that question is the "wait a year" and then see where you are and THEN order CT scans or MRIs...etc. ...or...they want to pass you off to neurologists and psychologists first to give them a piece of the pie! Very frustrating for those of us who have been or are in pain. Did Dr. W mention why he wouldn't do a CT scan when you saw him earlier this year? He could have saved you a lot of money, time and frustration had he done so previously! ...and you just had a corizone shot in your back, too. Ugh...more money spent, right? I'm sorry, but this really frustrates me, as I was you only a year ago and was put on the "merry-go-round" of tests, specialists and bozos. Heck..I even ASKED for a CT scan in Bangor, and I was denied because they were convinced the pain was in my head! You should have had this CT scan several months ago. A CT scan quite literally SAVED MY LIFE and diagnosed my "crooked" implants. No xray ever showed it...ever.
I would not be surprised at all if the knee cap is loose or positioned a bit high or low. It's about time SOMEBODY ordered this test for you. It just really, REALLY ticks me off that this (the CT scan) could not have been done for you several months ago, and I don't understand the hesitation in doing so, as it's not an invasive procedure...just a fancy xray. :hissyfit:

Like I've said before....Bangor is waaaay behind the 8-ball when it comes to diagnosis and techniques. If the CT scan does show the kneecap being loose, you are not obligated to have the surgery done in Bangor or by Dr. W. DO YOUR HOMEWORK and find the BEST surgeon (in Maine) that has done this revision surgery before...and LOTS of them! Just because Dr. W may be able to do it, doesn't mean he's done a lot of them. ASK for the best, and ASK how many he's done! :skeptical: You need a REVISON SPECIALIST! Big difference in doctors who do knee replacements vs ones that are revisionists. I learned that lesson the hard way!
Let's hope the CT scan shows something....oh...ask about "special views" that would show that. Let them know you are doing your homework!!!

 

[Coachie]

I had something else posted, but decided to delete it and write this instead.

People make mistakes. Sometimes the answers are not as easy as they appear to be, and sometimes it takes more time for some than it does for others. Everyone heals differently- so this just happens to be my case.

There are people who don't like my family doctor- while I have never had a problem with her. I wasn't pleased with a certain Emergency room, while others say they'd go back to that one. We all know of these types of stories where one person is pleased while another is not. That's life for you.

No doctor is perfect and they're not miracle workers. There are always going to be the "what ifs" and the "could haves" but I can't linger on that. All I can do at this time is move forward and hope for the best.

 

[old goat]

Coachie I admire your positive attitude. Yes, there comes a time to move on. God bless you, I really hope and pray it works out for the best. Hang in there. Hugs, Ann :wubroses::wubroses:

 

[wanttoride]

I'm glad that you have settled into the mindset that you are now in. There was a time you were desperate for answers and wanted to be "fixed" asap and could not understand why you could not be. Been there.

I don't understand the "that's life for you" comment, but that's ok. I have every right to be displeased as you have also been. My situation is very unique. However, my "displeasure" was very much warranted, as Jo and Jamie can well attest to. Without their support and suggestions, I would not have pursued the avenues I did, nor found the Dr. I did.

Yup....every doctor is liked by some...and disliked by some. I'm sure Dr. M has his "fans" and "atta-boy" patients. I am not one of them.

My life is on a forward, positive path. Not the path I should have been on, but it's the path that I have no choice but to take and make the best of it. I question EVERYTHING...because I have to. I will never go down the road of "could'a, should'a, would'a" and "what if" and "could have" again. I have nobody to blame but myself, and that is what I hope to share and mentor with others here at the forum. It is through sharing information and commenting (like them or dislike them) so that we can laugh, cry, ask questions, get mad...whatever...so that we don't feel so alone.

You seem to be on a good, positive path now with doctors that you like, a PCP that you like and some answers. You certainly have had your share of frustrations. That's life for you....and I sincerely hope that changes. Good luck

 

[wanttoride]

Coachie...I have read through EVERY post on your thread. Back in April, you asked for advice and suggestions, but I don't see where you have heeded that advice. Dr. Becker at OA in Portland was suggested to you before I even posted to your thread....why didn't you pursue him? Also...these orthopedic surgeons are not revision specialists, as it has been suggested many, many times that you find. The suggestions by Jo, Jamie and many others are right on the money.
However...you continue to stand by the "nice people" that you like, but aren't getting anywhere. The advice that Jo, Jamie and others here is "spot on". They are caring people who know their stuff.
It is difficult to continue to support and make suggestions when they are passed by. I have given you tools to get into OA in Portland or to any other REVISION SPECIALIST, but you did not use them. (this was writing a letter on your own explaining what you are going through). Back in April, it was mentioned that your kneecap seemed loose and to seek out a SPECIALIST at that time. One that has done lots and lots of knee revisions...not just "some". No matter how much you may "like" a person for their demeanor, it doesn't mean that they are the person you need to be seeing...whereas you have been in soooo much pain and frustration these past few months. Help is there for you....you just have to decide if you want to go outside your comfort zone to get it. You had the tools and information, along with names of specialists back in April....and the support of many, many people on this forum. Whereas you have welcomed any and all comments, I just can't sit by and let these issues go unnoticed.
You were ready to give up to nerve pain at one point, but didn't. So...I know you don't want to live with this pain. However, needing something done by a "deadline" (as in school starting) isn't helping both the mental and physical healing. If suggestions were taken earlier, I am confident that you would be in the healing process before school. Pain doesn't have limitations, and neither should your search for a diagnosis for your pain. Sorry if I'm being blunt, but I feel this needs to be said. Had I not gone through EXACTLY what you are going through now, and have learned, I would have no basis for my comment. But....I do.

 

[Jamie]

Audrey....I know it's frustrating to see someone you care about in pain. And it's especially disheartening when suggestions that are made seem to go unnoticed.

But the reality for anyone is that they must do what they feel is right for them at a particular time. This is true for Coachie.

None of us on BoneSmart really know our "friends" here online. There are many factors in someone's life that go into making decisions about what to do. Coachie has many tools that have been provided and at some point, if necessary, she will be ready to use them.

I appreciate your caring words. Even if you are a bit blunt, I know Coachie does too. She has been appreciative of the suggestions provided, even though she has made other choices so far.

So please don't get discouraged. All of our BoneSmarties need every bit of support we can give....maybe even more so when they make decisions that, for us, don't seem to make sense. Believe me....for them, it is the right thing for that point in time in their lives.

 

[Greda]

Coachie,
When is your CT scan? Will it be local? I hope it won't be too far it is so uncomfortable to ride in the car. I live in a rural area and we have aMRI truck that comes a few times a month. But for specialized tests we have to drive into "town".
I am glad you like this doctor. I stuck with an oral surgery for my jaw for years at Mayo because of his reputation of being the best and had so many awards. But he was not a nice man...I tried to keep a professional relationship with him but could not because he refused to believe I had pain after his magnificent surgeries. I was in one of his studies as well. If I would have been the norm 99% I probably would have been singing his praises too...but I was the less than 1% that things went wrong. He tried to make it all my fault. I hope this doctor can help you or lead you to someone that can. I have found the majority of my doctors who go the extra mile from referrals from current doctors.
I hope you are having a good weekend.
Greda