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Work comp case with tts help!!!!

Posted by Moneyt on 9/20/01 at 22:41 (061116)

I hurt my ankle ta work when one of my clients step on my foot during a basketball game. I'm a mental health worker, and at first i went to the doctor, he took xrays and determined that i had a serverly sprained right ankle. But after about 3 months, the swelling was still there, and i went to a ortho, and he said that i needed an mri (which proved to be neg), and scheduled one. But in the meantime he
sent me to pt, and the exercises made my ankle worse. I just couldn't believe it, and told my employer that i want to pick my
own doc, they agreed, and i went to a sport medicine specialist, he did a background, and scheduled an EMG, we did this and found out that i have a nerve blockage in my right foot (tts)! He told me that this was very seroius, and that surgery might not
work, and really didn't recomend it. So the insurance comp didn't kwon what this rare injury entailed. So my doctor wrote in his
final report that i cannot stand or walk fro more than 30 mins without an 1-1/2 rest. The insurance comp was furious, and wants
me too see another doc, my doc said i was 75% disabled, and my lawyer said my case is worth $98,000.00 dollars. I was wondering if anyone has had this happened to them at work, and what the total outcome of their case was. No one understands
the pain that this type of injury has, it's a lifelong battle, and i'm glad to have found a room like this one for support.
We are in the process of the second opinion, i have not seen this doc yet, but will keep all of you informed of the final outcome!

Thanks,
TEE!

Re: Work comp case with tts help!!!!

wendyn on 9/20/01 at 23:06 (061119)

Wow.

No, I haven't heard of this before. We know that the surgical results usually aren't great - but with a positive nerve conduction test - I'm surprised that the doctor doesn't think it's worth it. What type of doctor will you see next?

Re: Work comp case with tts help!!!!

moneyt on 9/21/01 at 13:13 (061171)

well i will see the doc that the insurance comp will send me too, probally an ortho of somekind! this is a lond draged out game
and i'm the one who has had to suffer over the past two years. I will keep all of you informed of where it goes from here!

Thanks!
Tee

Re: Work comp case with tts help!!!!

Ed Davis, DPM on 9/21/01 at 18:30 (061205)

Carpal tunnel is a well understood work related injury and few insurance companies will challenge the legitimacy of a claim for that diagnosis. The relative rarity of tarsal tunnel syndrome leads to a situation in which insurers have little experience in adjudicating such claims. Such claims can be just as legitimate. Your attorney may need physicians with expertise in this area for use as expert witnesses or consultants on the claim.

Your doctors concerns about surgical treatment of TTS are logical but one must weigh the alternatives carefully. If I had the choice between living with TTS and the option of a procedure with a 60 to 70% success rate, I would choose the latter. Consider an opinion from a doctor who is comfortable with tarsal tunnel surgery.
Ed

Re: Do you have any nervy pain?

elliott on 9/24/01 at 13:25 (061430)

You make no mention of nervy pain (numbness, burning, tingling, electric shocks, etc.) but rather that you were informed you had TTS after a nerve conduction test. If you have no such nervy pain, I'd be hesitant to jump into a TTS release. It could be you have ligament damage or other such (after all, you have swelling, and something is causing it) that may just take a year or so to heal, or perhaps something necessitating surgery or some other approach but that was missed by the MRI. While exact stats on false-positives are not to be had, nerve conduction tests are not completely foolproof (nor are MRIs for that matter) and, in the absence of clear nerve pain, should be viewed with extreme caution as an exclusive determination of a nerve problem.

Re: Do you have any nervy pain?

moneyt on 9/26/01 at 01:33 (061600)

Yes i have and had all of the above symptoms so i know it tts, and it continues to get worse, so i am thinking about the surgery
as the last option, but this is workers comp and my attoney has told me to wait until the case settles. I'm am taking neurontin,
and it makes me drowsey, and zombie like, so he has put me on a drug called zonegram, has anyone tried that ( let me know)!

Thanks!
Tee

Re: Do you have any nervy pain?

Susie on 9/26/01 at 17:14 (061662)

I have taken both of those drugs. The zonegran I didnt have the zombie side effects but I only took it at night 200mg. I had to stop taking it because it didnt mix with the codene I am taking for planter F. So I went to Dr yesterday and he gave me elavil to try. He said
it does seem to calm the hyper nerves so we will see!!.

Re: Do you have any nervy pain?

Ed Davis, DPM on 9/26/01 at 22:50 (061699)

Waiting until your case settles before considering TTS surgery may or may not work in your favor. Did your attorney explain his rationale for that to you?
Ed

Re: Work comp case with tts help!!!!

wendyn on 9/20/01 at 23:06 (061119)

Wow.

No, I haven't heard of this before. We know that the surgical results usually aren't great - but with a positive nerve conduction test - I'm surprised that the doctor doesn't think it's worth it. What type of doctor will you see next?

Re: Work comp case with tts help!!!!

moneyt on 9/21/01 at 13:13 (061171)

well i will see the doc that the insurance comp will send me too, probally an ortho of somekind! this is a lond draged out game
and i'm the one who has had to suffer over the past two years. I will keep all of you informed of where it goes from here!

Thanks!
Tee

Re: Work comp case with tts help!!!!

Ed Davis, DPM on 9/21/01 at 18:30 (061205)

Carpal tunnel is a well understood work related injury and few insurance companies will challenge the legitimacy of a claim for that diagnosis. The relative rarity of tarsal tunnel syndrome leads to a situation in which insurers have little experience in adjudicating such claims. Such claims can be just as legitimate. Your attorney may need physicians with expertise in this area for use as expert witnesses or consultants on the claim.

Your doctors concerns about surgical treatment of TTS are logical but one must weigh the alternatives carefully. If I had the choice between living with TTS and the option of a procedure with a 60 to 70% success rate, I would choose the latter. Consider an opinion from a doctor who is comfortable with tarsal tunnel surgery.
Ed

Re: Do you have any nervy pain?

elliott on 9/24/01 at 13:25 (061430)

You make no mention of nervy pain (numbness, burning, tingling, electric shocks, etc.) but rather that you were informed you had TTS after a nerve conduction test. If you have no such nervy pain, I'd be hesitant to jump into a TTS release. It could be you have ligament damage or other such (after all, you have swelling, and something is causing it) that may just take a year or so to heal, or perhaps something necessitating surgery or some other approach but that was missed by the MRI. While exact stats on false-positives are not to be had, nerve conduction tests are not completely foolproof (nor are MRIs for that matter) and, in the absence of clear nerve pain, should be viewed with extreme caution as an exclusive determination of a nerve problem.

Re: Do you have any nervy pain?

moneyt on 9/26/01 at 01:33 (061600)

Yes i have and had all of the above symptoms so i know it tts, and it continues to get worse, so i am thinking about the surgery
as the last option, but this is workers comp and my attoney has told me to wait until the case settles. I'm am taking neurontin,
and it makes me drowsey, and zombie like, so he has put me on a drug called zonegram, has anyone tried that ( let me know)!

Thanks!
Tee

Re: Do you have any nervy pain?

Susie on 9/26/01 at 17:14 (061662)

I have taken both of those drugs. The zonegran I didnt have the zombie side effects but I only took it at night 200mg. I had to stop taking it because it didnt mix with the codene I am taking for planter F. So I went to Dr yesterday and he gave me elavil to try. He said
it does seem to calm the hyper nerves so we will see!!.

Re: Do you have any nervy pain?

Ed Davis, DPM on 9/26/01 at 22:50 (061699)

Waiting until your case settles before considering TTS surgery may or may not work in your favor. Did your attorney explain his rationale for that to you?
Ed