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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7750
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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On November 1, 2010, I underwent bi-lateral total knee replacements

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On November 1, 2010, I underwent bi-lateral total knee replacements due to end-stage osteoarthritis. Even though the surgeon was made aware of my many metal allergies and promised the implants he planned to use were pure titanium, they weren't, and within 4 weeks of the surgeries, I had developed RSD/CRPS (evident by the hyper-sensitivity of the skin over both knees, color and temperature changes, and cyst-like lumps which wax and wane).

The original implants were removed 9 months later and replaced with the pure titanium implants which should have been used to begin with but I was, had been and still am suffering pain which is all out of proportion to that of a 54-year-old woman 11 months post bi-lateral TKR revision surgeries. My pain doctors tried 4 sets of nerve blocks, then gave up. I've been in physical therapy constantly since the first surgery in 2010 -- the past 2 months trying PT in a warm pool. Unfortunately I seem to be fighting a losing battle, with strength and flexibility in both knees & legs decreasing slowly but steadily. Currently, I'm lucky if I can get 70-80 degrees flexion from either knee, and I've recently begun requiring the use of my 4-wheeled walker any time I leave the house. Living in Anchorage, Alaska is my biggest problem: we have no physicians who specialize in this disorder, and my pain doctor is preparing me mentally for the rapidly approaching day when I'll need an electric wheelchair and a stairlift. She also believes I'm going to need to be treated in the lower 48 since we seem to have exhausted all avenues open to me here. Can you suggest any clinics or hospitals that specifically treat RSD/CRPS, or any treatment that falls between nerve blocks, which didn't work, and a pain pump which no physician in Alaska will implant? I'm covered by Premera BC/BS health insurance, so having to leave Alaska for treatment will be a logistical nightmare, but not a monetary one.
Submitted: 2 years ago.
Category: Medical
Expert:  Camille-Mod replied 2 years ago.

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Customer: replied 2 years ago.
Yours is the first response I've gotten of any kind on this post. I'd be most appreciative of any assistance you could provide! Embarassed
Expert:  Camille-Mod replied 2 years ago.
Thank you for your reply. Sometimes finding the right Professional can take a little longer than expected, and we thank you greatly for your understanding.
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Expert:  Dr. Rick, MD replied 2 years ago.

It sounds like you have been receiving good care from very qualified physicians without any significant lasting improvement in your condition. At this point I think the best thing you can do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this.

Can you travel anywhere in the lower 48?

Let me know and we can try to find you a hospital....
Customer: replied 2 years ago.
Yes, I'm fortunate enough to have the financial ability to go anywhere necessary for treatment; the difficulty comes in the form of 13 & 14 year old daughters and a workaholic husband who would all insist on coming with me (probably for the best), and the excruciating pain that sitting on a plane for even the first 2-1/2 hour lap from Anchorage to Seattle would cause. In other words, the closer the hospital the better!

There has been one possible bit of "progress" this past week -- if you can really call it that. My pain doctor put me on a very short course of prednisone 18 days ago after a bad flare up from trying a new exercise in PT. The prednisone eased the flare up and more; for the first time in almost two years my knees have shown some improvement. Unfortunately, the prednisone has caused a constant, unstoppable and now unbearable migraine. I can't take one more dose of the only medication or procedure that has had the slightest effect on my knees. Talk about depressing! Yell


I would be most appreciative if you could recommend a teaching hospital that wouldn't require too terribly long a flight from Seattle. One that has a special RSD/CRPS team would be ideal! I'll probably find it necessary to spend the night in Seattle regardless, but it would be nice if I didn't have to spend two days in agony from long plane flights.


Thank you for taking the time to help a stranger. I've been a spectator in my life and that of my beautiful daughters for far too long, and my poor husband has spent too much of our married life with just a little of the "better" and a whole lot of the "worse".
Expert:  Dr. Rick, MD replied 2 years ago.
I'm glad to hear that you have, finally, got some relief for you knees......sucks about the migraines. I wonder if they could treat the migraines as a separate issue and continue the steroids for the knees? Just a thought.......

I understand your wanting a treatment center close to Seattle but, unfortunately, one of the best RSD/CRPS centers in the US is located in Florida, which is just about as far away from you as possible :(

Here is their contact information:

http://rsdhealthcare.org/index.html

I'm sorry that they are so far away from you but I'm unable to locate a better treatment center closer to you...


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Let me know if you have further questions.

Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7750
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
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