Stupid Orthopedist

I have major patella maltracking, bi lateral. The right's worse than the left, I have tri carpentmental arthritis and pretty significant narrowing of the cartilidge. Since I can't take NSAIDs, I've been trying icing and Tylenol, my PCP prescribed Vicodan...which isn't doing a flipping thing.

When I saw my ortho a couple of weeks ago, he gave me a cortizone injecting and I was totally stoked. First time in two years I didn't have major pain going up and down stairs, let alone riding the bike or trying the elliptical at the gym. But it was short lived, as was possible, so I called to let them know my knee pain returned and was there something else we could try since the other stuff wasn't working. It's really uncomfortable.

His nurse/assistant totally blew me off and said I would have to go through my PCP because of the gastric bypass, blah blah blah. Her tone was really unhelpful...like she didn't want to help, and giving the message to the orthopedist sounded more like a chore than anything else for her. So..I called my PCP's office.

I feel completely stupid, and mildly embarassed. No matter how I word it, I sound like an addict.

My mom has the same issue (she's got generative disc disease and arthritis in various places). She had the same surgery, and has the same problem with the medication.

How annoying.

 Pain Clinic?  One that your WLS Dr. likes, or his other patients have used.  Not all of them just perscribe medication.  That is their job, to treat pain.  That is all they do.  They usually use a combo of stuff to help you manage the pain and work around what cannot be controlled.

I would think a pain clinic would be a little extreme, also I suspect not all options have been exhausted...being that I have knee pain, not all over pain. A lot of aches and pains I had were resolved with what weight loss I've experienced thus far. I knew the knees would be a problem. But being that I can't run right out and take 800 mg of Motrin, I would think there would be something the PCP or someone could recommend.

I don't think pain clinic would be extreme... Those pain clinics really can and do help people deal with chronic pain.  That is their specialty...

However that said, perhaps you could talk to your PCP about something like Ultram (down a notch from Vicodin, lasts longer though and seems to be good for body pains....while not technically a narcotic, is addictive like one....though)... also they have creams that you could rub on the outside that may be quite beneficial.... (even a Toradol cream) without having to swallow anything....perhaps icyhot or aspercreme if you want just OTC cream...

Why is a pain clinic extreme if you are having pain that is really troubling you and your orthopedist and PCP seem unable or unwilling to treat the pain effectively?  Isn't that the kind of thing pain clinics are for?

Sports medicine then?  I get what you are saying.  You know the cause, you want to try other treatment options and the Dr. isn't listening.  That is horribly frustrating.  I hope you can find someone who will.

@Kelly....anyone I've known of who's gone to a pain clinic has been completely dibiliated by their pain with no relief by conventionaly methods through their regular doctor. My orthopedist isn't being helpful, and I'm not certain how my PCP will respond. My WLS doctor doesn't "do" narcotics.

I'm in uncharted waters, for me at any rate. It's like learning to walk again (no pun intended, though that was kind of cute there).

I have found physical therapy to be very helpful with this type of pain.  My orthopod rarely gives steriod injections, but is a great believer in PT.  It works for me, and I've had bad knees for 20 years. (currently have bone on bone arthritis, with no pain meds)

 how did you know you had arthritis with bone on bone?  I've developed a problem recently in the past couple of months where I can't walk up and down stairs for pain in my right knee.  This is one that I've always had a little soreness with but this is rediculous... it's "oouch, oouch.... ouch..." with every step now. 

Good xrays can determine the extent of arthritis and how much of the cartilage you have left.

Lora