I was sufferred a hand injury (broken bone) in Dec. 05. Went through PT for 4 wks, pain and swelling was not getting better. In May, 06, I underwent Arthroplasty (bone had deteriorated) and carpal tunnel release and the median nerve was neurolysed. The injury was to my dominate hand.
The pain ramped up 100x the next day after surgery. Had cast changes weekly due to extreme swelling and pain. When cast came off I underwent another 6 wks of PT. Pain still getting worse. Dr. just ignored my pain complaints. Ordered FCE Aug. 06. When the FCE results came back with accompanying letter, Dr. finally realized how severe my pain was. FCE result: 10% WP "based on this evaluation, incapable of sustaining the Light level of work for an 8 hr day".
Dr. ordered testing for RSD. Underwent stellate ganglion blocks x3. Minimal improvement in burning and pain. I had an adverse reaction after the 3rd block so they were discontinued. Ortho Dr. said the only thing now is Pain Mgt. Said I was at MMI. WC sent a VCE to my home for evaluation.
WC sent me to PM dr. He confirmed RSD dx. but would not rx any pain meds because I would not agree to undergo another ganglion block. Wc sent me to another PM...he concurred with dx, but would not rx meds either. Resorted to going to ER for rx. ER dr. referred me back to the Ortho for PM or a good referral to another PM.
Ortho referred me to yet another PM. He concurred with the dx and ordered a 1 month day treatment ie..Hydrotherapy, PT, counseling etc. This really made the pain level dramatically increase along with worsening depression and anxiety. After the month of treatment, Dr. said he would recommend to WC to settle this case. This was June 07.
Continued dr. visits every 3 months for pain meds until July 08. Burning and pain has spread up my arm, shoulder, sometimes going along my neck and past the ear. Hand feels like it is exploding. Dr. orders another FCE.
This FCE was not like the first one. I was hooked to a computer for the tasks.. Of course, anyone with RSD knows that use of the extremity causes pain levels to increase. On 7 occassions during the testing, the computer shut down the testing sequence because my HR (highest recorded was 203)was exceeding parameters set (of course this was happenning when my hand was exploding and electrical shocks were going up my arm.) FCE results: Total Upper Extermity 25% WP 15% However, evulating dr. (who is also the PM) listed on the FCE, Validity of examination: Self-limited. Right Upper Extermity Limitations: occassional fine manual, occassional gross manual, no overhead reaching. Depression: moderate elevation Anxiety: extreme elevation Distress: Moderate elevation Somatization: extreme elevation.
I have been experiencing electrical shocks, burning, and exploding sensations in the other hand and arm also for about 3 months. Dr. just nods his head when I tell him about it. He did try me on Cymbalta and Pristiq for depression and the burning. I could not tolerate either.
WC called my atty and said they had determined that I had reached MMI and therefore they would be stopping my WC benefits. Sept. 08.
Now, to my question...In January I was reading a thread about IW who had RSD and had been put at MMI. PrincessLA answered back and said " If you have RSD/CRPS you can never be at MMI". She did not elaborate. I have since seen someone else try to inquire of her about this statement, but I guess she is no longer on the board.
Do any of you wise responders have any clue as to what she meant by that statement? Please respond ASAP as I will be meeting with my atty this coming week.