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History Of Fracture. Done Physical Therapy. Have Osteoporosis, GERD, Depression, BP Problem. Painful. Suggestion?

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Posted on Wed, 10 Apr 2013
Question: I just moved to PA from another state in Oct. Then Nov 2, 2012, my legs gave out on the 2nd step and I broke the 4th (spiral metatarsal) and a "true Jones" fracture in the 5th. The emergency clinic that saw me first set up the appointment with a doctor not in my network. After 4 casts and staying in bed all day, execpt doctors and restroom brakes where I used crutches), no union whatsoever happened. My insurance paid nothing --I switched to a Network doctor since the costs are not even towards my deductible when I go out of network. I knew the doctor was giving me the shaft because i have been out of work since March 2012 and the COBRA coverage is crummy at best. My network Orthopedic Surgeon would not see me and he put me with a network podiatrist. He said the fractures were closed and said I had CRPS. Another word for hydocondriac. The podiatrist put me in an airboot and sent me to physical therapy. After the first day of exercises, I came home and was in agonizing pain. I persisted with 3 more sessions and then called and insisted on seeing the doctor. The doctor ordered X-rays. When those showed no union in either FX, he ordered a CT scan. I have since received the first doctor's report and at the time of switching (Feb 1), he said I needed either surgery or a bone stimulator. I am in terrible pain and want to know what to do. My health is complicated by osteoporosis which is "stable" since I have been getting a Reclast IV for 3 years. I have blood pressure problems, GERD, and depression. But I tell all the doctors (I am 58) that i do not heal like most people. I don't know what to do. I've had a fundaplication operation in 2002 and did not heal well. Whenever I cut myself, I don't heal right. The pain is awful but I am taking pain meds and handling it. I want to get back to normal as quickly as possible. What do you suggest?
Have you ever heard of someone getting a screw and not healing? Is it considered stupid to get the screw and also want a bone stimulator? I want an orthpedic surgeon to operate - not a podatrist. What is the best way to ensure a speedy AND successful operation?
Along with my other health conditions, I had early periodontal disease. Eight teeth pulled when I was 10 due to crowding and I wore orthodontic braces for 7 years because my teeth were unresponsive. My stomach surgery did not hear properly, I still take Dexilant and Zantac daily. I was in 3 serious car accidents (I was not at fault); 1 as a passenger and 2 as a driver. On did not heal well at those times.
I have 2 sons, 31 and 26. Both deliveries were vaginal but each time I tore 6-7" and needed many stitches. The epesiotomy had much scar tissue. After the car accident Aug 2011, where I was rear ended, I lost bladder control but the doctor did not say I had a rupture--rather the bladder muscle gave out. Is there a condition that is influencing the way I heal? Should I be looking in another direction for the best way to heal my foot?
doctor
Answered by Dr. Dr.Raju.A.T (4 hours later)
Hi,

Thanks for your query.

I appreciate your history presentation in a detailed way; this enables me to provide my opinion at the earliest.

Based on your history, I suspect you to have a nutritional defect either due to the GERD you had in past and continuing or deficiencies of vitamins. Both the above conditions render one, with poor healing capabilities. There is no such disease with specific problem like poor healing. Poor healing is most of times secondary to nutritional deficiencies.

For your metatarsal fractures, I would consider the osteoporosis you have to be the culprit for the failure in the union. The best remedy for the same is as advised by your Podiatrist, the surgery and bone stimulator. The outcome of this surgery may not be affected by your problem of poor healing except that the take some time more than normal to heal. Continuation of Reclast (Zoledronic Acid Injection), Zantac and supplement multivitamins may add to the success.

It is recommended for you o get the surgery done under the best Orthopedician in your locality for better results.

Hope, I answered your query.

Please do let me know if there are any other concerns.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Raju.A.T (16 minutes later)
I'm fairly sure that the doctor or my insurance will want me to choose between the surgery or the bone stimulator. Would I be out of line to try to get both due to my health concerns?

I have tried several times to look for a disease/condition that would link all of these ailments because my son (31) has almost every condition I have and he has lived apart from me since he was 18. The only other condition I did not bring up was that my son and I are both double jointed. He has had to have foot surgery to shorten his ligaments from a fall.

In my reading I have come across Ehlers-Danlos Syndrome, but whenever I bring it up to a doctor, I am told that my skin is not limp enough, although I do have issues with scarring and my skin looks like that of an 85 year old instead of a 58 year old. I know there are variations types of EDS.

My other son, (26) whom hs livd with me has none of the symptoms of anything. What would you think?
doctor
Answered by Dr. Dr.Raju.A.T (32 minutes later)
Hi,

I consider a surgery would be more essential than a bone stimulator alone. I recommend you to go for a combination of both considering your poor healing.

Though defective healing can be a symptom, your symptoms may not be sufficient enough to consider the diagnosis of Ehlers–Danlos syndrome (EDS). The fact that one of your sons has similar ailments as you do, do not support to consider the above diagnosis. There are many other syndromes which run in families which present poor healing as a secondary complication.

Hope, I answered your query.

Wish you good health.

Regards,

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr.Raju.A.T

General & Family Physician

Practicing since :2008

Answered : 4900 Questions

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History Of Fracture. Done Physical Therapy. Have Osteoporosis, GERD, Depression, BP Problem. Painful. Suggestion?

Hi,

Thanks for your query.

I appreciate your history presentation in a detailed way; this enables me to provide my opinion at the earliest.

Based on your history, I suspect you to have a nutritional defect either due to the GERD you had in past and continuing or deficiencies of vitamins. Both the above conditions render one, with poor healing capabilities. There is no such disease with specific problem like poor healing. Poor healing is most of times secondary to nutritional deficiencies.

For your metatarsal fractures, I would consider the osteoporosis you have to be the culprit for the failure in the union. The best remedy for the same is as advised by your Podiatrist, the surgery and bone stimulator. The outcome of this surgery may not be affected by your problem of poor healing except that the take some time more than normal to heal. Continuation of Reclast (Zoledronic Acid Injection), Zantac and supplement multivitamins may add to the success.

It is recommended for you o get the surgery done under the best Orthopedician in your locality for better results.

Hope, I answered your query.

Please do let me know if there are any other concerns.

Regards,