New to forum...

I have a rather lengthly history so I'll do my very best to make this short and sweet. 

I'm a 34 year old single mom who works full time and suffers with osteoarthritis in many joints but my knees are the worst (large/severe chondral defects). I had arthroscopic surgery in August of last year and there wasn't much my surgeon could do so I've been waiting for a cadaver to have a cartilage rebuild of my knee. I've been in excruciating pain but my surgeon told me months ago I'd be kept comfortable until the surgery, even after I turned down a stronger pain med. I have been on hydrocodone (norco) 5/325 since the arthroscopy. I was only taking a couple pills a day (2-3) but was in a lot of pain...my doctor told me I was in pain because I wasn't taking enough so I was put on 2 pills 3 times per day. And that's the dose I remained at until, all of a sudden, my surgeon's PA told me they couldn't keep me on the meds anymore (April 11). After a week of tramadol, she forwarded me to a pain management doctor but gave me an rx of the norco until the appt. The appt with the PM was this past Friday and it was very seriously the worst appointment ever. I waited for almost 2 hours. I was in a lot of pain by then because I didn't take my meds before the appointment and my blood pressure and pulse were high. They asked why. I said because I hurt! When he finally came in the room, the first thing he did was pop his foot up on the desk (he had a brace on his ankle) and said he can understand my pain since he sprained his ankle and it hurts him too. At that point I didn't know whether to laugh or cry. It went downhill from there. He told me he had a great medicine that was just like "super advil" that he'd put me on. He also wanted me to do this nerve cauterizing procedure but I knew nothing about it so I said I wanted some info before deciding. He said I looked tech savvy so I could Google it. I asked him to write it down so I could Google it...but he didn't. He was visibly not pleased that I didn't readily agree to the procedure. He also said I would get a TENS unit and I should put this on every night. Didn't say anything about what to do during the day. He said to go down to 2 times per day with the Norco but only gave an rx for the "super advil." He also laughed at me when I said I was under the impression my pain was temporary. I also gave him a print out of all my information and history and his response after glancing at it for about 5 seconds was that I repeated myself too much.

I left the appointment in tears. My body is experiencing the effects of stopping the medication I've been on for over 8 months abruptly. I called my surgeon's office about what I should do or what to look out for because my BP is remaining elevated but they just said I needed to talk to the PM doctor. Well, I refuse to call that office...I don't even want to ever go back to that man, let alone CALL them! My boss, who is amazing, told me to contact the patient advocate for the hospital so I did but I haven't heard anything back. I'm afraid to cancel the follow-up because I have heard it isn't good to do that with pain doctors. So I figured maybe the hospital patient advocate can help get me set up with a new doctor that isn't so terrible. I wanted to keep the PM in the same medical system as my surgeon so the records were visible to everyone and so they could see I'm not playing games. Also, the PM came storming in after he checked the pharmacy records and asked WHO is prescribing the Norco. I said my surgeon's PA. He didn't believe that's who it was even tho he could easily look that up being in the same medical system!

I don't know what to do. My surgeon knows I am suffering...they gave me the rx for the handicap placard and filled out the paperwork for work (to get reasonable accommodations) so it's not like I'm making any of this up. I just don't know what to do or where to go to get help! I am frustrated, in so much pain, and I feel so alone. Friday was one of my lowest days ever...I am not suicidal but, for the first time ever, the thought of wanting to go to sleep and never wake up crossed my mind. I really feel like I'm going to lose my mind with this pain and frustration with these doctors.

Do I start over again? With the ortho AND PM? My ortho surgeon said it'd be 6 weeks to 6 months to find cadaver donor but then his PA just said Friday it could be another year! I can't DO this another year! But supposedly I can't have a replacement because I am too young.

Anyhow, thank you for listening...I just needed to find a place to vent where maybe someone understands and could give me some suggestions of what to do.

~Diva

Thanks Judy2, I really appreciate your response.  I have had all sorts of injections, I couldn't even name all the different types, lol.  That's what was started with...cortisone, then something else, then, finally, some gel injection...I had all these from 2008 to last year (before the arthroscopy).  All of them did great...for awhile...then the pain returned and seemed worse than before. Finally, I got an MRI in June of last year and there were some chondral defects shown and meniscus tears...it also showed ACL and MCL tears that weren't actually there. My surgeon went in and there was exposed bone everywhere, cartilage chunks floating around, two menisus tears, etc. So, he cleaned up the floating chunks of cartilage, did the condroplasty, and the menisectomy (sp). He said it's one of the worst knees he's seen in someone my age, ever. He said if I was 20 years older, I'd be immediately scheduled for a replacement but he thinks this allograft is a better option for the damage and my age. From what I understand, theoretically, if this allograft works, I may never need a replacement ever...or for many years. At any rate, when he said the wait was 6 weeks to 6 months, I was more than willing to do it over a TKR. But, as we are going into month 7 of officially waiting (after the measurement x-rays were done and tissue was ordered), I'm beginning to wonder if this really is the best option for me. I haven't gotten a 2nd opinion because I thought this sounded reasonable and I REALLY like him...he's so patient and understanding and he'll sit with me for an hour to explain things if I need him to.  An amazing man and I truly trust him.

I did put a post in the Chronic Pain forum for some options on the PM situation. I hadn't really told my surgeon's office exactly what happened as I was far too upset Friday. I finally sat down and told his PA (who I've really grown close to) what happened and she was horrified. She is going to find me the name of a good PM who won't suggest burning my nerves or sticking needles in them as she understands why I don't want to do that and, also, ensure that the new PM won't think negatively about my cancelling the follow-up with the first PM. I looked the first PM up online and he has horrible ratings on every place I could find. For some reason, that made me feel better...that I'm not the "only" one who had a bad experience.

I really want to stay within this same medical system so there's that continuity of care with them being able to see everything. If the 2nd PM is not able to do anything, I will get a 2nd ortho opinion. I really hate to start over but, well, seeing that I am now looking at waiting another year, I think a 2nd opinion isn't a bad idea.

Anyhow, I am sorry I am so long-winded...I never seem to be able to "really" keep things short.

Thank you for your response!

~Diva

Oh my gosh!!! What a nightmare! I am so sorry you are having to deal with this. I have heard of bad PM docs, had a terrible one myself, but wow--this jerk takes the cake! It's amazing that people like him actually have a medical degree.

What do you call a doctor who graduates at the bottom of his class?

Doctor.

It's sad, but even the worst can still be doctors! My last GI doc must have slept through medical school.

Ok, enough of that. Sorry. I am glad you let the people at the surgeon's office know what happened at your appointment and that they are going to set you up with a different doc. That was going to be my first suggestion. I also agree with the suggestion that you look at getting a second opinion. If your surgeon is a good doc, he will not be offended if you decide to get another opinion. It can't hurt. One last thing, I too have heard that although docs are sometimes hesitant to do a replacement in a young person, many are recognizing that it is necessary to give someone their quality of life back.

I hope that whatever you decide to do, you are able to get some relief soon! Oh, and the chronic pain forum is a busy place full of people who are knowledgeable about meds and different treatments. Best of luck!

Diva, I walked on a leg with two broken bones for over two months; it was nearly healed but crooked by the time it was diagnosed. It hurt but not horribly to me.

I can tell you that walking for more than four years with my knee bone-on-bone was the second most painful thing I've ever dealt with.

If you have a PCP you trust, he or she might be able to give you some ortho suggestions.