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Outline of treatment plan

Posted by Kari B on 11/29/02 at 03:46 (101385)

Hi, 1st of all, let me say I'm sorry for the length of this post, but I wanted to share this here. I'm scheduled for tts surgery on Dec 3rd and on Nov 27 I went to my pre-op appt and was given this treatment plan by my Dr. I'm pretty shocked by the Dr's ideas of the short recovery period for this surgery after all I have read on this board! I'm not 100% sure, but I sort of feel that the reason for this is related to the fact that I am being covered by Workmans Comp because it all started when I broke my foot in June while working. (If anyone is familiar with CA WC and could tell me if this sounds like the Dr is trying to please WC by writing this plan or if it sounds like a standard treatment plan, PLEASE, feel free to jump in here and give me your opinion!! If anyone has had similiar situation, I would be very grateful if you would share any comments on this.)
I have read many posts by people here wanting to know what to expect after tts surgery and what we have been told by our Dr's before surgery about length of recovery etc. so I thought this might help others. Here goes:
Proposed Surgery: Decompression of the posterior tibial nerve at the tarsal tunnel.
You have been diagnosed with a neuroma of the tarsal tunnel of the right lower extremity. Compression and trauma of the nerve at the ankle level causes this entity. The surgery involves the identification of the neuroma and the decompression of the nerve.

Following surgery: Following surgery you will be placed into a short leg splint for your protection. This splint will be well padded for your comfort and will resemble a ski boot. You will also be required to use crutches to prevent swelling.

Post-op Week 1: Wounds will be assessed, will be redressed and a short leg cast will be applied. You may be allowed to return to modified duty depending on your assessment.

Week 3: This visit, the cast and sutures are removed. You will be referred to PT. This therapy will be 3x's a week. You will also be eligible for modified duty if not already working.

Week 6: Your right foot extremity will be assessed to determine the efficacy of therapy. You may be advanced to regular duty depending on your functional level.

Weeks 8+: At these visits your right lower extremity will be assessed to determine its function.

Physical Therapy: 2-4 weeks

Total time of disability: 2-6 weeks projected

I would love to hear some feedback on this if anyone would like to share with me. I'm definitely not believing that I will be back to work after only one week considering he has had me off work since June due to the fracture. It amazes me that the same Dr. could take someone off work for 6 months for a fracture but only 1 week for this surgery!! Please, opinions and experiences greatly appreciated here!!
Kari

Re: Outline of treatment plan

elliott on 11/29/02 at 08:14 (101391)

Kari, it does not sound unreasonable to me at all. I'd even view it in some respects as on the generous side. In a regular case of TTS release, if there are no complications with the surgery, there isn't much need for PT, and two and a half weeks would be enough to return to normal walking to and fro and to function at least for a desk job. Not sure what kind of work you're doing; obviously, if you stand on your feet all day you'd need longer, and your previous fracture is another factor possibly slowing things down. To me the schedule itself is what's tough, as it assumes you'll be able to stick to it no matter what; TTS surgical results can be unpredictable, especially from a nerve pain perspective. Of course, it could take a year or more for the nerve pain to completely settle down.

I find 3 weeks for removal of sutures to be on the long side; 10-14 days is more normal.

[]

Re: Outline of treatment plan

Laurie R on 11/29/02 at 10:43 (101404)

Hi Kari , Frist off , every doctor is different in the way they do things. I had a tt release in May of this year . My stitches came out at 10 days post opp . I agree with Elliott ,3 weeks is a long time . MY Pod told me 10 to 14 days .....I had to into his office three days post opp . He wanted to make sure I was doing alright .

Are you asking if your doctors plan sounds right ? Or do you think he may be doing this plan just for WC ? Your doctor should be working for you , not Comp.

I know your surgery is scheduled for Dec 3nd . Are you comfortable with your doctor ? Also are you comfortable with his plan ?

All I can tell you is about my case . I was off my foot for 6 weeks no weight barring at all .....Then slowing I used crutches and could put about 50% of my weight on my foot for a few more weeks ..... I will say , my recovery was long . But I did everything my doctors asked of me . I was not going to rush anything for anyone.....

PLEASE my advise to you is , take your time with your recovery ... Don't let anyone rush you . After all it is your foot and your pain .....

I am one of the lucky ones , my Pod always listens to me and has never ever rushed me or has he given up on me ...

I wish you the best of luck with your surgery . If I can help to answer any questions you may have , just ask ...

Laurie R

Re: Outline of treatment plan

Kari B on 11/29/02 at 10:56 (101405)

Elliot,
Thank you for taking the time to read my post and reply. I've noticed that others on this board tend to seek your opinion and trust it so I am grateful for your answer. I've got to ask though because I can't remember with all the posts I've read whether or not you have had a tts realease? If so, what were your experiences with it as in recovery time, time before walking again etc.? I am still left feeling as though my dr's idea of recovery time is quite short, although, he did leave room for change with stating that 'return to modified duty will depend on the assessments during the post-op visits'. And this is assuming that my employer will allow me to return to duty with restrictions. I am a property manager and do so many different things in my job I couldn't begin to name them all. Some days I have alot of desk work, others I have alot of walking and stair climbing to do. I am the 'one and only' at my job site (although I am employed by a large cooperation that has offices all over CA) with the exception of an assistant who is on duty every other weekend for 3 days. I also suspect that after being off work for 6 months my employer will not look kindly on having to take time off 3 x's a week for Physical therapy. One thing that has left me feeling bothered by all of this also is that when I first made an appointment with this Dr. I explained to the receptionist that it was a workmans comp case and was immediately asked if I had an attorney because this Dr would not accept patients that have lawyers involved before seeking treatment from him. Well, at that time, I had not, it wasn't even a flicker in my mind that I would need to hire an attorney to protect my rights. And, I'm sure you have guessed already that I have had to hire an attorney since then just to deal with my pay amount. So, what I'm wondering is this; Does anyone think that there is a possibility that he is trying to cut things short now that I have hired a lawyer? I'm not one of those money grubbing people you see about on the news all the time faking injuries, suing people for no reason etc. As a matter of fact, this is the first time in my life I have ever been injured on a job, had no idea what workmans comp was or did, and have never hired an attorney prior to this in my life. I'm not trying to get rich, I just want to receive the benefits I'm entitled to from the employer who thinks it's ok to under report wages. My attorney is not a malpractice attorney or personal injury... she is strictly a workmans comp lawyer and has only contacted my Dr one time and that was to request copies of his reports and findings so she could make sure that what the WC insurance company has is the same as the Dr and herself. It did seem somewhat stinky being told he wouldnt treat me if I had an attorney but I didn't think about it again after seeing him the first time until just recently. This is really bothering me because up until I recalled that statement I had implicit trust with my doc but now I'm having doubts. Why would a Dr refuse to treat if someone is represented by an attoreny for a matter that doesn't even include malpractice in the case... nothing other than being the treating Dr. Hhhmm... I think I will ask this on the ask the Dr. board. Hope to get some insight from you all. Again, thank you Elliot.
Kari

Re: Outline of treatment plan

Kari B on 11/29/02 at 11:19 (101407)

Laurie,
Hi, thanks for sharing your experience. That seems to be what I read most on here is that taking time to heal has been more successful than rushing any kind of recovery. I just responded to Elliot and included in there that I have trusted my doc implicitly until I remembered a statement his receptionist made when I called for my 1st appt stating that he doesn't take patients that have retained an attorney, even though the case is WC and shouldnt bother him if he is treating the patient correctly. My thought is that the only thing that should bother him about patients with attorneys is if he has doubts in his diagnosis and treatment of his patients. Am I just feeling this way due to anxiety over the surgery or does anyone here think that there is some merit to how I'm feeling? The funny thing about my doubts with my Dr are the nagging feelings I have that he may have written that treatment plan based on what WC wants to hear and the fact that he wasn't even appointed as my Dr by WC... my employers WC medical care is provided by Kaiser and there is no Kaiser within 150 miles of where I live so the VP of the company told me to pick a doc and go to him. I had been initially treated at my local ER and the Dr I'm seeing was recommended by the ER doc to follow-up with. So, how would I find out if the Dr is working for WC or if he's working for me? I can't seek another opinion without approval from WC (and with their track record on my case, it could be months before I could get that approved... my surgery is scheduled for Tues.) I haven't mentioned this to my attorney, by the way, as I just remembered the receptionists statement on Wednesday... and the doubts started trickling in LOL. I have called my attorney's office and left a message for a return call but I am not even sure if she is working today since most people take 4 days off for Thanksgiving. And to top it off... she is located about 4 hours north of me and I can't just drive there to see if the office is open today. Wow, this sure got alot longer than I intended but I hope someone can help me. I am hoping that this isn't just a case of pre-surgery anxiety creeping up on me. Thank you for giving me some advice and direction Laurie! Hope you are having a good day!
Kari

Re: Outline of treatment plan

elliott on 11/29/02 at 12:28 (101419)

Kari, not too familiar with WC, but a back PT I went to recently told me that it is all too common that a WC attorney unfortunately does not always work in the best interests of his client; in particular, he often tries to dissuade the client from returning to work in order to get a bigger $ettlement, this even when the client desperately needs money and is capable of returning to work much sooner in at least some capacity. Also, I'll ask you, if the surgery does not go well, might there then possibly be trouble to the doctor coming from the WC attorney? Even if surgery is a success, is there a hassle of paperwork and the necessity for the doc to voice messy opinions (e.g. it definitely came as a result of work, you must stay out for such-and-such duration, etc.)?

Well, fortunately your job capacity does not include lifting boxes or assembly line work. Again, I claim with a basic TTS release (no tendon or bone work) and no complications, stitches should be out in 10-14 days and normal getting-around walking in two weeks. Ther are others on this board who had longer nonweightbearing periods even for a standard TTS release, so one can't say it's wrong.

I had bilateral TTS releases (99 and 00), so you could say I know what it's all about. The first foot also had a posterior tibial (tendon) tenosynovectomy (one cast for three weeks when I think the stitches were removed, and then another cast for two weeks), so no weighbearing for 5 weeks. Still have some structural (I believe) non-nervy trouble from this foot. (Laurie R also had substantial tendon-type work done, so her nonweightbearing experience may not realte to yours.) The second foot was just pure TTS, stitches were off in 10-14, no problem at all instantly weightbearing thereafter. My second surgeon was one of the big names, and his opinion is to get moving around faster to avoid the bane of TTS surgery, namely scar tissue. But how much that matters is a bit unclear. I did have some strange nervy irritation centered in one spot upon awakening from surgery, and this got terribly worse three months post-op (but I was able to walk and work at my desk job, although had trouble wearing shoes for any duration); now, over two and a half years later, I am nearly pain- and symptom-free in that foot (you listening, Laurie R? No rushing into second surgery allowed. :-)).

Re: Outline of treatment plan

Kari B on 11/29/02 at 15:54 (101427)

Elliot,
I truly appreciate your input!! Thank you! As for WC attorney's I've heard alot about them, not all too great if I may add. Like you, I have heard and seen the greedy, money grubbing ones that tend to lean toward staying off work, 'Let's go for the big money', mainly because that is their profession and although they are attorneys and probably fairly comfortable financially, they also work on a no settlement, no pay contingency and are forced to take on an overload of clients just to stay in business, which I'm sure can lead to some crooked lawyers trying to bank on someone elses injury (or often on someones false injury). I am hopeful that my attorney is not one of those that would steer me in the wrong direction here. I have spoke to her by phone only 4 times in 5 months and never has she tried to tell me to stay off work longer, or in any way tried to persuade me to 'take it easy, relax and get better'. To tell you honestly, she has never said one word about recovery time. I was asked to let her know when I go in for surgery and that was the last thing we spoke about. WC laws have gotten stricter, which hopefully will deter the fraudulent claims. Unfortunately those fraudulent claims are the ones who give everyone who accepts WC a bad name. I am concerned that I will forever have a stigma on my work history for this and all future employers may shy away from hiring me just because I chose to accept the insurance to cover my work related injury. I didn't have to accept it, my husband is military and we have 100% medical coverage...but, I had to let my immediate supervisor know that I had broken my foot because she was on her way to visit my office and I was sitting there with a cast on my foot and elevating it. I was then asked by her how I injured my foot so I explained to her how it happened and she immediately asked me if I had filled out an accident report... and feeling really dumb then, I explained to her I didn't know what that was or where I would find one. Two days later she was back (making the 5 hour drive from the cooperate office to here) hand delivering the WC forms. I was stunned, I had no clue what it was or whether to fill it out or not so I waited and asked my husband about it and he said that I should fill it out just in case so that they can't come back later and say I didn't follow protocol or something. I believe that I was so unaware of what WC is about because I have not worked for too many years outside my home since my oldest child was born 11 years ago. I have held 4 long term jobs (this being the 4th since I was 16 years old). I was lucky enough as a teen to get hired for a local company and stayed with it for the duration of my high school years and 1 year after graduation. I then married and when my first was born I became a stay at home mom until she was 6. I did childcare at home for a few years, and then went back out to the working world only 4 years ago. Being a military wife, it's not the easiest to find an employer to hire someone they know is going to be leaving in 2 or 3 years. My main concern right now though is that I don't want to be seen as someone trying to get a free ride or take advantage of the company I work for because I do enjoy my job and miss working terribly. I was fortunate enough to be offered this promotion and very challenging position only 2 months after the death of my mom and was very grateful for the distraction. I had been working for the company for 1 1/2 years before being offered this promotion and am so disappointed that I had to turn my duties and my office over to someone else while I heal. My goodness, this sounds so whiny LOL.. I just want you to understand though Elliot, that I am not trying to stay off work and truly looking forward to returning but I also want to be sure I am doing the right thing health wise. I was not pleased with being taken off work in the beginning and I'm still not happy with it. I was actually told by the VP of the company that I couldn't work while I had on a cast and had to elevate and ice my foot... that she did not want me to appear like that in the office while dealing with our clients. I was unable to move around too much because I had never been on crutches in my life and actually fell on my rear a couple times in the beginning. My husband, luckily for me, is not afraid to be seen carrying my purse in public as he did so many times while I was on the crutches. Anyway, my whole point to this email was just to let it be known that I don't want to be seen as an employee out to stick my employer with some kind of outlandish settlement or in any way jeopardize my job. I am told often that I am too soft, or naive as my hubby puts it, so I have to be careful of how my attorney handles this. I am wary of being pushed by my attorney to 'take as long as I need to recover' or any other such phrases. This is my job on the line, one that I worked hard to get, and I am not willing to let it go so easily. (Also, just to set the record straight, even though I am not standing on a cement floor all day or working in a factory on my feet for 8 hours, I do have a very demanding and physical job, I do have to lift and move heavy boxes or supplies when they are delivered or when files need to be moved in and out of storage.) There are many times a day that I am walking on pavement, through grassy areas, gravelly areas... etc as I have to check the properties that I am responsible for. I assure you, this is no easy task, especially when I'm suddenly finding myself being chased out of the fence or yard by a 200lb (is this for real?) rottweiler or shepard that was quietly sleeping on the oppososite side of the yard leaving me unaware until I'm running out of the gate. :-) Anyway, I am pretty sure that the VP won't let me come back on modified duty since she is the one who wasn't thrilled with me elevating my foot while I was at my desk. Ok, this is enough on WC... I've noticed that each post I make seems to get longer and ramble on more. I hope I've made my position clear though and am not being judged and frowned upon for using WC. Hope everyone has a great day!
Kari

Re: Re:NO FREE RIDES

Laurie R on 11/30/02 at 10:25 (101493)

Hi Kari , Wow what a post..... LOL , Thank you for explaining ... Frist off , it is not up to your attorney how long you stay off work . That is up to your doctor . As you know I am also on WC in your same state ...

Way back when , before I got all the other things going on with my foot , I tried to go back to work . My doctor and I had a great plan . I called my job and they said no way , if you are not 100% you can not come back . Then they fired me over the phone ..

I, just like you wanted my job , but I also knew they could not hold if forever . They had to replace me . I worked for my company for 5 years .

What my Pod has done to protect himself was , he has sent me out to a few different doctors for their opinions on my case .. This through comp , it did not look like he was just keeping me off of work . Each doctor agreed with my Pod what was going on with my foot and all the diagnosis .

I have some advise for you , ALWAYS , keep every paper you get that pertains to your case .... Every report , every test .... I have about 8 folders full ..

After a point and time they will send you to a QME doctor . This doctor works for WC . I have been two times, each time the WC doctor agreed with my doctors .... Which they don't always do ... But like the last time , the comp doctor told me , I could lie ,but in the end the truth comes out .

I really don't know how any doctor could lie in my case, I have plenty of tests and reports to prove I really have what I have wrong ...

Don't worry Kari , their are really no free rides. And I don't know anyone that has gotten rich off of WC .... What I get every two weeks won't even pay my rent. Thank God I am married or I would be living in the streets ..

Yes it is good you filed a comp case if you got hurt while doing your job . Your boss was right to bring you the paper work. It is the law , she had to do it.. She and your company would of got in big trouble if she did not ......

Plus in your case you broke your foot first , right ? Then you got TTS after right ?

What I just did was , I got a copy of all my doctor's notes... It was pretty cool to read through over three years of visits .... I have always trusted my Pod 100% , when things get bad he always sends me out for another opinion ...

Like I said , if I can help you in any way , please just ask . I don't know a lot , but I have been through a lot in the pass three years with Comp ... I have a great attorney on my case.

I did not understand why your doctor would not take you if you had an attorney .. I sure would ask him why ????It is very common for a person on comp to have an attorney ...

My best to you always , Laurie

PS your surgery is just in a few days right ? I wish you only the best in your recovery ..

Re: Re:NO FREE RIDES

Kari B on 11/30/02 at 13:08 (101508)

Hi Laurie,
Thank you so much for the encouragement. I think I really needed that! Yes, my surgery is Tuesday morning. I'm getting quite nervous. Talk to you soon.
Kari

Re: Outline of treatment plan

Ed Davis, DPM on 12/02/02 at 14:53 (101598)

Kari:

Interesting angle from your doc. I have considered refusing to take over existing worker's comp. patients unless they HAVE an attorney.

Some may feel that attorneys tend to 'stir the pot' and prolong cases. That may occur at times but I find that I end up taking some of the attroney's responsibilities, arguing on behalf of my patient, when no attorney is involved. Many worker's comp. carriers really give injured workers a hard time and the help of an attorney is needed to successfully navigate through the obstacles. That is particularly true with complex cases.

I have strong feelings against many professional liability attorneys but definitely will not lump all attorneys into the same group and have nothing but praise for attorneys who are helping my patients obtain necessary treatments. I would hope that enough doctors can make this important distinction.
Ed

Re: Outline of treatment plan

Kari B on 12/02/02 at 15:17 (101601)

Dr. Ed,
Thank you so much for that outlook. I was hoping to get a professional opinion on that. I still wonder though why he tends to refuse patients with attorneys involved already. Well, anyway, my surgery is 7 am Tuesday morning and I'm still going through with it. If the Dr wasn't sure about (and able to show me on the tests we ran) that there is definitely tissue putting pressure on the nerve I might have chosen to consult other opinions on it first but I feel comfortable having the procedure done. Thank you again for your opinion!!
Kari

Re: GOOD LUCK TOMORROW KARI

Laurie R on 12/02/02 at 16:56 (101607)

Dear Kari , I want you to know I wish you all the luck in the world on your surgery tomorrow . Can you have a family member updates us on how it went and how you are doing ?? I would so appreciate it ....... Good luck and I wish you a speedy recovery .......Laurie R

Re: GOOD LUCK TOMORROW KARI

Kari B on 12/02/02 at 17:40 (101609)

Laurie,
Hi, thank you!! I will see if I can get a good friend of mine to update everyone when I get home from the hospital. Hubby is computer illiterate and doesn't understand how to do this. Again, thanks for the support!!
Kari

Re: Outline of treatment plan

elliott on 11/29/02 at 08:14 (101391)

Kari, it does not sound unreasonable to me at all. I'd even view it in some respects as on the generous side. In a regular case of TTS release, if there are no complications with the surgery, there isn't much need for PT, and two and a half weeks would be enough to return to normal walking to and fro and to function at least for a desk job. Not sure what kind of work you're doing; obviously, if you stand on your feet all day you'd need longer, and your previous fracture is another factor possibly slowing things down. To me the schedule itself is what's tough, as it assumes you'll be able to stick to it no matter what; TTS surgical results can be unpredictable, especially from a nerve pain perspective. Of course, it could take a year or more for the nerve pain to completely settle down.

I find 3 weeks for removal of sutures to be on the long side; 10-14 days is more normal.

[]

Re: Outline of treatment plan

Laurie R on 11/29/02 at 10:43 (101404)

Hi Kari , Frist off , every doctor is different in the way they do things. I had a tt release in May of this year . My stitches came out at 10 days post opp . I agree with Elliott ,3 weeks is a long time . MY Pod told me 10 to 14 days .....I had to into his office three days post opp . He wanted to make sure I was doing alright .

Are you asking if your doctors plan sounds right ? Or do you think he may be doing this plan just for WC ? Your doctor should be working for you , not Comp.

I know your surgery is scheduled for Dec 3nd . Are you comfortable with your doctor ? Also are you comfortable with his plan ?

All I can tell you is about my case . I was off my foot for 6 weeks no weight barring at all .....Then slowing I used crutches and could put about 50% of my weight on my foot for a few more weeks ..... I will say , my recovery was long . But I did everything my doctors asked of me . I was not going to rush anything for anyone.....

PLEASE my advise to you is , take your time with your recovery ... Don't let anyone rush you . After all it is your foot and your pain .....

I am one of the lucky ones , my Pod always listens to me and has never ever rushed me or has he given up on me ...

I wish you the best of luck with your surgery . If I can help to answer any questions you may have , just ask ...

Laurie R

Re: Outline of treatment plan

Kari B on 11/29/02 at 10:56 (101405)

Elliot,
Thank you for taking the time to read my post and reply. I've noticed that others on this board tend to seek your opinion and trust it so I am grateful for your answer. I've got to ask though because I can't remember with all the posts I've read whether or not you have had a tts realease? If so, what were your experiences with it as in recovery time, time before walking again etc.? I am still left feeling as though my dr's idea of recovery time is quite short, although, he did leave room for change with stating that 'return to modified duty will depend on the assessments during the post-op visits'. And this is assuming that my employer will allow me to return to duty with restrictions. I am a property manager and do so many different things in my job I couldn't begin to name them all. Some days I have alot of desk work, others I have alot of walking and stair climbing to do. I am the 'one and only' at my job site (although I am employed by a large cooperation that has offices all over CA) with the exception of an assistant who is on duty every other weekend for 3 days. I also suspect that after being off work for 6 months my employer will not look kindly on having to take time off 3 x's a week for Physical therapy. One thing that has left me feeling bothered by all of this also is that when I first made an appointment with this Dr. I explained to the receptionist that it was a workmans comp case and was immediately asked if I had an attorney because this Dr would not accept patients that have lawyers involved before seeking treatment from him. Well, at that time, I had not, it wasn't even a flicker in my mind that I would need to hire an attorney to protect my rights. And, I'm sure you have guessed already that I have had to hire an attorney since then just to deal with my pay amount. So, what I'm wondering is this; Does anyone think that there is a possibility that he is trying to cut things short now that I have hired a lawyer? I'm not one of those money grubbing people you see about on the news all the time faking injuries, suing people for no reason etc. As a matter of fact, this is the first time in my life I have ever been injured on a job, had no idea what workmans comp was or did, and have never hired an attorney prior to this in my life. I'm not trying to get rich, I just want to receive the benefits I'm entitled to from the employer who thinks it's ok to under report wages. My attorney is not a malpractice attorney or personal injury... she is strictly a workmans comp lawyer and has only contacted my Dr one time and that was to request copies of his reports and findings so she could make sure that what the WC insurance company has is the same as the Dr and herself. It did seem somewhat stinky being told he wouldnt treat me if I had an attorney but I didn't think about it again after seeing him the first time until just recently. This is really bothering me because up until I recalled that statement I had implicit trust with my doc but now I'm having doubts. Why would a Dr refuse to treat if someone is represented by an attoreny for a matter that doesn't even include malpractice in the case... nothing other than being the treating Dr. Hhhmm... I think I will ask this on the ask the Dr. board. Hope to get some insight from you all. Again, thank you Elliot.
Kari

Re: Outline of treatment plan

Kari B on 11/29/02 at 11:19 (101407)

Laurie,
Hi, thanks for sharing your experience. That seems to be what I read most on here is that taking time to heal has been more successful than rushing any kind of recovery. I just responded to Elliot and included in there that I have trusted my doc implicitly until I remembered a statement his receptionist made when I called for my 1st appt stating that he doesn't take patients that have retained an attorney, even though the case is WC and shouldnt bother him if he is treating the patient correctly. My thought is that the only thing that should bother him about patients with attorneys is if he has doubts in his diagnosis and treatment of his patients. Am I just feeling this way due to anxiety over the surgery or does anyone here think that there is some merit to how I'm feeling? The funny thing about my doubts with my Dr are the nagging feelings I have that he may have written that treatment plan based on what WC wants to hear and the fact that he wasn't even appointed as my Dr by WC... my employers WC medical care is provided by Kaiser and there is no Kaiser within 150 miles of where I live so the VP of the company told me to pick a doc and go to him. I had been initially treated at my local ER and the Dr I'm seeing was recommended by the ER doc to follow-up with. So, how would I find out if the Dr is working for WC or if he's working for me? I can't seek another opinion without approval from WC (and with their track record on my case, it could be months before I could get that approved... my surgery is scheduled for Tues.) I haven't mentioned this to my attorney, by the way, as I just remembered the receptionists statement on Wednesday... and the doubts started trickling in LOL. I have called my attorney's office and left a message for a return call but I am not even sure if she is working today since most people take 4 days off for Thanksgiving. And to top it off... she is located about 4 hours north of me and I can't just drive there to see if the office is open today. Wow, this sure got alot longer than I intended but I hope someone can help me. I am hoping that this isn't just a case of pre-surgery anxiety creeping up on me. Thank you for giving me some advice and direction Laurie! Hope you are having a good day!
Kari

Re: Outline of treatment plan

elliott on 11/29/02 at 12:28 (101419)

Kari, not too familiar with WC, but a back PT I went to recently told me that it is all too common that a WC attorney unfortunately does not always work in the best interests of his client; in particular, he often tries to dissuade the client from returning to work in order to get a bigger $ettlement, this even when the client desperately needs money and is capable of returning to work much sooner in at least some capacity. Also, I'll ask you, if the surgery does not go well, might there then possibly be trouble to the doctor coming from the WC attorney? Even if surgery is a success, is there a hassle of paperwork and the necessity for the doc to voice messy opinions (e.g. it definitely came as a result of work, you must stay out for such-and-such duration, etc.)?

Well, fortunately your job capacity does not include lifting boxes or assembly line work. Again, I claim with a basic TTS release (no tendon or bone work) and no complications, stitches should be out in 10-14 days and normal getting-around walking in two weeks. Ther are others on this board who had longer nonweightbearing periods even for a standard TTS release, so one can't say it's wrong.

I had bilateral TTS releases (99 and 00), so you could say I know what it's all about. The first foot also had a posterior tibial (tendon) tenosynovectomy (one cast for three weeks when I think the stitches were removed, and then another cast for two weeks), so no weighbearing for 5 weeks. Still have some structural (I believe) non-nervy trouble from this foot. (Laurie R also had substantial tendon-type work done, so her nonweightbearing experience may not realte to yours.) The second foot was just pure TTS, stitches were off in 10-14, no problem at all instantly weightbearing thereafter. My second surgeon was one of the big names, and his opinion is to get moving around faster to avoid the bane of TTS surgery, namely scar tissue. But how much that matters is a bit unclear. I did have some strange nervy irritation centered in one spot upon awakening from surgery, and this got terribly worse three months post-op (but I was able to walk and work at my desk job, although had trouble wearing shoes for any duration); now, over two and a half years later, I am nearly pain- and symptom-free in that foot (you listening, Laurie R? No rushing into second surgery allowed. :-)).

Re: Outline of treatment plan

Kari B on 11/29/02 at 15:54 (101427)

Elliot,
I truly appreciate your input!! Thank you! As for WC attorney's I've heard alot about them, not all too great if I may add. Like you, I have heard and seen the greedy, money grubbing ones that tend to lean toward staying off work, 'Let's go for the big money', mainly because that is their profession and although they are attorneys and probably fairly comfortable financially, they also work on a no settlement, no pay contingency and are forced to take on an overload of clients just to stay in business, which I'm sure can lead to some crooked lawyers trying to bank on someone elses injury (or often on someones false injury). I am hopeful that my attorney is not one of those that would steer me in the wrong direction here. I have spoke to her by phone only 4 times in 5 months and never has she tried to tell me to stay off work longer, or in any way tried to persuade me to 'take it easy, relax and get better'. To tell you honestly, she has never said one word about recovery time. I was asked to let her know when I go in for surgery and that was the last thing we spoke about. WC laws have gotten stricter, which hopefully will deter the fraudulent claims. Unfortunately those fraudulent claims are the ones who give everyone who accepts WC a bad name. I am concerned that I will forever have a stigma on my work history for this and all future employers may shy away from hiring me just because I chose to accept the insurance to cover my work related injury. I didn't have to accept it, my husband is military and we have 100% medical coverage...but, I had to let my immediate supervisor know that I had broken my foot because she was on her way to visit my office and I was sitting there with a cast on my foot and elevating it. I was then asked by her how I injured my foot so I explained to her how it happened and she immediately asked me if I had filled out an accident report... and feeling really dumb then, I explained to her I didn't know what that was or where I would find one. Two days later she was back (making the 5 hour drive from the cooperate office to here) hand delivering the WC forms. I was stunned, I had no clue what it was or whether to fill it out or not so I waited and asked my husband about it and he said that I should fill it out just in case so that they can't come back later and say I didn't follow protocol or something. I believe that I was so unaware of what WC is about because I have not worked for too many years outside my home since my oldest child was born 11 years ago. I have held 4 long term jobs (this being the 4th since I was 16 years old). I was lucky enough as a teen to get hired for a local company and stayed with it for the duration of my high school years and 1 year after graduation. I then married and when my first was born I became a stay at home mom until she was 6. I did childcare at home for a few years, and then went back out to the working world only 4 years ago. Being a military wife, it's not the easiest to find an employer to hire someone they know is going to be leaving in 2 or 3 years. My main concern right now though is that I don't want to be seen as someone trying to get a free ride or take advantage of the company I work for because I do enjoy my job and miss working terribly. I was fortunate enough to be offered this promotion and very challenging position only 2 months after the death of my mom and was very grateful for the distraction. I had been working for the company for 1 1/2 years before being offered this promotion and am so disappointed that I had to turn my duties and my office over to someone else while I heal. My goodness, this sounds so whiny LOL.. I just want you to understand though Elliot, that I am not trying to stay off work and truly looking forward to returning but I also want to be sure I am doing the right thing health wise. I was not pleased with being taken off work in the beginning and I'm still not happy with it. I was actually told by the VP of the company that I couldn't work while I had on a cast and had to elevate and ice my foot... that she did not want me to appear like that in the office while dealing with our clients. I was unable to move around too much because I had never been on crutches in my life and actually fell on my rear a couple times in the beginning. My husband, luckily for me, is not afraid to be seen carrying my purse in public as he did so many times while I was on the crutches. Anyway, my whole point to this email was just to let it be known that I don't want to be seen as an employee out to stick my employer with some kind of outlandish settlement or in any way jeopardize my job. I am told often that I am too soft, or naive as my hubby puts it, so I have to be careful of how my attorney handles this. I am wary of being pushed by my attorney to 'take as long as I need to recover' or any other such phrases. This is my job on the line, one that I worked hard to get, and I am not willing to let it go so easily. (Also, just to set the record straight, even though I am not standing on a cement floor all day or working in a factory on my feet for 8 hours, I do have a very demanding and physical job, I do have to lift and move heavy boxes or supplies when they are delivered or when files need to be moved in and out of storage.) There are many times a day that I am walking on pavement, through grassy areas, gravelly areas... etc as I have to check the properties that I am responsible for. I assure you, this is no easy task, especially when I'm suddenly finding myself being chased out of the fence or yard by a 200lb (is this for real?) rottweiler or shepard that was quietly sleeping on the oppososite side of the yard leaving me unaware until I'm running out of the gate. :-) Anyway, I am pretty sure that the VP won't let me come back on modified duty since she is the one who wasn't thrilled with me elevating my foot while I was at my desk. Ok, this is enough on WC... I've noticed that each post I make seems to get longer and ramble on more. I hope I've made my position clear though and am not being judged and frowned upon for using WC. Hope everyone has a great day!
Kari

Re: Re:NO FREE RIDES

Laurie R on 11/30/02 at 10:25 (101493)

Hi Kari , Wow what a post..... LOL , Thank you for explaining ... Frist off , it is not up to your attorney how long you stay off work . That is up to your doctor . As you know I am also on WC in your same state ...

Way back when , before I got all the other things going on with my foot , I tried to go back to work . My doctor and I had a great plan . I called my job and they said no way , if you are not 100% you can not come back . Then they fired me over the phone ..

I, just like you wanted my job , but I also knew they could not hold if forever . They had to replace me . I worked for my company for 5 years .

What my Pod has done to protect himself was , he has sent me out to a few different doctors for their opinions on my case .. This through comp , it did not look like he was just keeping me off of work . Each doctor agreed with my Pod what was going on with my foot and all the diagnosis .

I have some advise for you , ALWAYS , keep every paper you get that pertains to your case .... Every report , every test .... I have about 8 folders full ..

After a point and time they will send you to a QME doctor . This doctor works for WC . I have been two times, each time the WC doctor agreed with my doctors .... Which they don't always do ... But like the last time , the comp doctor told me , I could lie ,but in the end the truth comes out .

I really don't know how any doctor could lie in my case, I have plenty of tests and reports to prove I really have what I have wrong ...

Don't worry Kari , their are really no free rides. And I don't know anyone that has gotten rich off of WC .... What I get every two weeks won't even pay my rent. Thank God I am married or I would be living in the streets ..

Yes it is good you filed a comp case if you got hurt while doing your job . Your boss was right to bring you the paper work. It is the law , she had to do it.. She and your company would of got in big trouble if she did not ......

Plus in your case you broke your foot first , right ? Then you got TTS after right ?

What I just did was , I got a copy of all my doctor's notes... It was pretty cool to read through over three years of visits .... I have always trusted my Pod 100% , when things get bad he always sends me out for another opinion ...

Like I said , if I can help you in any way , please just ask . I don't know a lot , but I have been through a lot in the pass three years with Comp ... I have a great attorney on my case.

I did not understand why your doctor would not take you if you had an attorney .. I sure would ask him why ????It is very common for a person on comp to have an attorney ...

My best to you always , Laurie

PS your surgery is just in a few days right ? I wish you only the best in your recovery ..

Re: Re:NO FREE RIDES

Kari B on 11/30/02 at 13:08 (101508)

Hi Laurie,
Thank you so much for the encouragement. I think I really needed that! Yes, my surgery is Tuesday morning. I'm getting quite nervous. Talk to you soon.
Kari

Re: Outline of treatment plan

Ed Davis, DPM on 12/02/02 at 14:53 (101598)

Kari:

Interesting angle from your doc. I have considered refusing to take over existing worker's comp. patients unless they HAVE an attorney.

Some may feel that attorneys tend to 'stir the pot' and prolong cases. That may occur at times but I find that I end up taking some of the attroney's responsibilities, arguing on behalf of my patient, when no attorney is involved. Many worker's comp. carriers really give injured workers a hard time and the help of an attorney is needed to successfully navigate through the obstacles. That is particularly true with complex cases.

I have strong feelings against many professional liability attorneys but definitely will not lump all attorneys into the same group and have nothing but praise for attorneys who are helping my patients obtain necessary treatments. I would hope that enough doctors can make this important distinction.
Ed

Re: Outline of treatment plan

Kari B on 12/02/02 at 15:17 (101601)

Dr. Ed,
Thank you so much for that outlook. I was hoping to get a professional opinion on that. I still wonder though why he tends to refuse patients with attorneys involved already. Well, anyway, my surgery is 7 am Tuesday morning and I'm still going through with it. If the Dr wasn't sure about (and able to show me on the tests we ran) that there is definitely tissue putting pressure on the nerve I might have chosen to consult other opinions on it first but I feel comfortable having the procedure done. Thank you again for your opinion!!
Kari

Re: GOOD LUCK TOMORROW KARI

Laurie R on 12/02/02 at 16:56 (101607)

Dear Kari , I want you to know I wish you all the luck in the world on your surgery tomorrow . Can you have a family member updates us on how it went and how you are doing ?? I would so appreciate it ....... Good luck and I wish you a speedy recovery .......Laurie R

Re: GOOD LUCK TOMORROW KARI

Kari B on 12/02/02 at 17:40 (101609)

Laurie,
Hi, thank you!! I will see if I can get a good friend of mine to update everyone when I get home from the hospital. Hubby is computer illiterate and doesn't understand how to do this. Again, thanks for the support!!
Kari