Question: 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.
2. I have a primary care Dr. but no ortho will see me w/o insurance. I have sent letters to over 22 orthopedic Dr's in my area.
3. I was finally able to see an ortho at a "low income" clinic type hospital. He had no answers and reccomended I get and MRI. Of course, I have no $$ for that. (he also had some very inapropriate comments for me and the other patients)
3. My primary is unwilling to provide pain management for me. I understand her problem. I have ulcers from NSAID's and I can not take Tramadol b/c of it's interaction with my Adderal. The tramadol is very ineffective anyway. I took narcotics for almost 6 months after my 2008 TKR and was able to taper off with my Dr's supervision.
4. 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 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 and has limited me in my DLA and the type of work I can take. I have gained 40 hard lost lbs because I can not move around. I can't even do my laundry. This is ruining my life.

Any advice?

Thank you for your answer---though bit shocked. I have spoken to nurses at two facilities where I have been for this problem. I have been told even without asking that hospice provides services to the terminally ill ONLY and medicaid foots the XXXXXXX I am currently seeing a primary care and I saw an orthopedic Dr. through "low income" health services. Neither could refer me. Can you? Do you know of any volunteer pain Dr?? Not even drug dealers work for free!

By the way, i checked for an answer to my question this AM and this PM. It was not here, so I made several complaints. I suppose it was just a computer problem so please do not take any of those remarks seriously.

I only wish I had an answer. I am becoming seriously depressed.