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Had major accident. Damaged knee. Needed LTKR. Again damaged knee by falling. Suggested torn tendon. Suffer pain. What to do?

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Dear Dr.
I am particularly medically savvy and I have tried everything to get help with this issue. Some quick background: I lost my state job of 14 years last year after a major car accident. Aside from extra knee damage I was very lucky to have survived. After the accident,I had a much needed L TKR. My recovery was slow and difficult due to the other injuries I incurred. I was healing nicely until may of this year I damaged the knee by falling. It hurts everyday and gives out occasionally. It has a constant bluish tint and is effusive. It hurts as much or more than it did before surgery.

I had a R TKR in 2008 so I have something to compare.

Here are my MANY barriers to treatment:

1. I am unisured.

I have a primary care Dr.through a local clinic but no ortho will see me w/o insurance. I have sent letters to over 22 orthopedic Dr's in my area.

I was finally able to see an ortho at a "low income" clinic type hospital. He had no answers and recommended I get and MRI. Of course, I have no $$ for that. (he also had some very inappropriate comments for me and the other patients). I reported this extreme unprofessionalism.

My primary is unwilling to provide pain management for me. When did primary care doctors stop providing pain relief for their own patients? I truly don't get that.

I have been to 4-5 "urgent care" centers and ER's when it is just so bad I have to be on crutches. I tell them I fell recently. Most all have said that I likely torn a tendon or "pushed" the kneecap out of alignment. I know I still have some tendons even after TKR.

5. I have also conatcted pain Dr's. No insurance, no visit.

6. I am currently self-employed and I am not eligible for medicare.

7. I need a PC Dr. who can help me along with pain management until I am insured through ACA or I can afford to get an MRI. I have not been able to find one.

8. My injury is obvious (swollen all the time) and has limited me in my DLA and the type of work I can take. I have gained 50 hard lost lbs because I can not move around. I can't even do my laundry or housekeeping and I a starting to give up. This is ruining my life.

Any advice?
Posted Sun, 6 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. Shanthi.E 8 hours later
Brief Answer:
Analgesics and steroids would give pain relief

Detailed Answer:

I am sorry about your current health status, and about your pain.

You have definitely done some damage to the left knee after you fell again in May this year.

Yes, there seems like an effusion and inflammation that is on-going in your left knee. You need pain medicines at this time in the form of analgesics and steroids to reduce the inflammation.

As you do not have medical insurance now, the MRI can wait for some time. Please get back to your prescription at least.

Primary care providers do provide pain relief for their patients. They are eligible to do so. Even, I do not understand why your doctor is not helping you with this. I am sorry about this.

A better option would be to go to a new primary care physician.

Meanwhile, you can take Motrin or Panadol for pain relief as and when required. Both these drugs are available over the counter in the US. This would help you with pain temporarily.

I wish you quick recovery.

Above answer was peer-reviewed by
Follow-up: Had major accident. Damaged knee. Needed LTKR. Again damaged knee by falling. Suggested torn tendon. Suffer pain. What to do? 35 minutes later
Thank you. I find ibuprofen helpful but i have ulcers because of them and steroids increase my weight. Unfortunately, finding another pcp is Dr. Shopping in my State. Especially if you come in asking for pain relief. They want to know why your previous Dr. would not help.
I was hoping for perhaps an online referral for PC--I know some Drs are doing online consulting and treatment.
Your reply is what every Dr. tells me. Seems like there is a huge problem regarding the medical profession and it's attitude toward pain.
Best regards XXXXXXX
Answered by Dr. Shanthi.E 15 hours later
Brief Answer:
detailed below

Detailed Answer:

I am sorry but I tried to do the best I can for you.

You are right that Ibuprofen causes ulcers, and that steroids make you gain weight.

Yes, I do hear about Dr. Shopping here and there.

Yes, online consulting does happen in the US. However, none of the prescription drugs could be prescribed on online consulting. This is against the FDA.

If you could let me know your current location, I could perhaps help you with some PC referrals.

The so called 'doctor shoppers' received a total of 32 opioid prescriptions per year from 10 different prescribers. A recent study says this. Hence the US FDA has come up with strict rules on the doctors for prescribing drugs of any sort.

Perhaps the problem is more huge than we think.

Take care and regards to you too.

Above answer was peer-reviewed by
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