Do No Harm

Yesterday was a mixed blessing: on the one hand, I know what has been wrong with my right leg since last Thanksgiving, but, on the other hand, I am dumbfounded that it took until the first of September to know that critical information. The first three doctors I consulted took the “wait and see” approach to my medical complaint, and the fourth doctor used part of an MRI to address the most obvious issue, but totally ignored my questions, my concerns, and my direct confrontation as I tried to make him listen to me when I repeatedly told him that he was not addressing the pain I was expressing. I was right all along, but that is little comfort.

The first doctor diagnosed a “sprain” and recommended ice/heat/elevation. The second doctor ordered an ultrasound to determine if there was tissue damage, but the results of that procedure didn’t show anything. The third doctor ordered a bone x-ray, which was inconclusive. The final doctor ordered the MRI, which clearly showed damage to the meniscus, and did the surgery to correct that issue. What all of the doctors refused to hear was my constant complaint about the very contained, very specific pain in my right knee area. I repeatedly said, “it’s not my kneecap,” as I put my fingers on the side of my right leg to indicate an area about 5 inches in length. The pain was intensely hot, throbbing pain that often felt as if it were bleeding inside my leg. For the first couple of weeks after the meniscus surgery, the pain seemed to be almost gone – but that, I know today, was a false positive sign, the result of both pain medication and staying off my feet post-op.

Yesterday, I took my time line, surgery photos, MRI report, and my personal notes with me. I asked if I could just explain what happened, the treatment options that have not worked, and then describe my very contained, very specific pain issue. This time, the medical professional listened, rather than filling the air with medical babble designed to make me feel foolish. This time, the doctor went back to the original MRI and found the very obvious, very over-looked answer to my medical problem—both the good news and the bad news.

My meniscus was torn, but in the next paragraph was another issue of equal importance that was never addressed: microtrabecular fractures of the right femur. My leg should have been immobilized and given a chance to mend; instead, I have been urged to exercise, partake in physical therapy, rely on pain medication to function, and accept the doctors' repeatedly incorrect diagnoses and treatment plans, including the site injection last week. My repeated expressed concerns about the intensifying pain were ignored, masked with “take more drugs.” My repeated expressed concerns about the specific local pain site were ignored, brushed aside with a ballpark “arthritis” discussion. My repeated expressed pleas for another MRI to show my knee post-surgery were ignored, to be used as a last resort after I completed 4 weeks of physical therapy 3 times a week – a prescription that is contra-indicated by the existing fractures.

Today, I will be fitted for the hinged knee brace I will use for the next 6 months, pick up the walker I will use for the next 6 months, and go for the MRI. Next week, my new medical professional will assess the current medical condition of my right leg and determine how best to proceed. She has warned me that it probably will take 6 months for the fractures to heal, which means wearing the brace unless I’m sleeping; using the walker until further notice; and, perhaps, enduring another surgery. Her examination of the knee area indicates structural concerns that have developed because my fractured bone is not able to support my weight and activity level, and that’s why the knee has been suddenly locking up and/or giving way and I’ve been tripping, stumbling, and falling. Of course, each time my leg has buckled, I’ve basically reinjured the fracture site, so the cycle has been repeating for 9 months!!

What’s done is done. I am literally going to take this one step at a time because I am to stay off my feet as much as possible: no weight-bearing unless it’s necessary. I can continue to work with restrictions: stay on a flat surface, use the walker, sit down. I have different pain meds that I must take as part of the healing process is the absence of pain, which exacerbates stress, and that affects healing, as well as my diabetes.

I’m mentally composing the letter to the surgeon and looking for “Report the Doctor” websites. Perhaps the most discouraging aspect of the entire process is that if he had merely read the entire MRI report, he would have known about the fractures. He went for the obvious, for the quick-fix that pays his rent, and he did it at my expense. The incredible, on-going, ever-increasing pain of the past 9 months will not be easily forgotten, nor the physical limits to what I can do, nor the depression that has come along with the inability to get a medical professional to listen to me.

I won’t finish composing that letter until I have the follow-up appointment next week.