I know this is long and I'm sorry, but I'm really at the end of my rope and could use some advice.
I injured myself last November '07 while working in the SICU (I was a Clinical Supervisor but took patients). I was caring for a very large, vent-dependent, combative patient who was FOS from neck to ankles. While cleaning him, he kept trying to roll over onto his back and I had to push against him while trying to wash, and my coworker was having a devil of a time helping me out. I didn't notice anything was wrong right away other than a slightly sore back, but a few hours later I noticed that I had some pain in my left groin. I didn't pay any attention to it but it got much, much worse over several days. I filled out an incident report, went to the hospital's designated ortho PA, and he diagnosed me with a hip flexor strain. I got 5 weeks of PT and light duty. Well, after 5 weeks I was no better. He wanted to do diagnostic steroid injections into my back (insisted my hip pain was referred), and I said I wanted an MRI of my hip. I got it, and it showed an anteriolateral labral tear and an effusion. Meanwhile, I was in terrible pain, walking with a cane, and was taken off of work completely in early February. I'd also been fighting with Worker's Comp to get PT. I finally saw an ortho surgeon in the middle of February '08, who then ordered more PT. Six weeks later at my follow-up appt (after being denied PT and not being able to get in to see him sooner) he reviewed my hip xrays that had been done in January and told me that I had femoral-acetabular impingement syndrome in both hips which predisposed me to the labral tear, and he couldn't help me. He referred me to another surgeon at another hospital. That surgeon declined my case. Finally, I found a surgeon on the internet that could do something for me, and I had hip surgery in May of '08. I had the tear repaired, bone shaved, and also a bursectomy. Immediate post-op pain was just horrible.
I followed that surgery with 11 weeks of PT. I was still in pain but it was much decreased and I'd gotten to the point that I could walk about 10 blocks without an increase in pain, and without assistive devices. Exactly 11 weeks to the day after my surgery, and the day before a follow-up appt with the operating OS, I got a call from my Emp Health Nurse who told me that I had to be released to full-duty or I would be fired. I had been trying to find another less physically strenuous position in my hospital while I was in recovery, and had interviewed for a transplant coordinator position (among others) which I thought was mostly a desk job with two half-day clinics. I told her that my surgeon would not release me to full-duty for ICU but that I thought I might be offered the coordinator position. So I went to my appt and asked him to release me to full-duty for the coordinator position, and it was offered to me. I still had 2 PT visits left that week, but was told that I had to come to work the next day or be fired.
SO, in I went. My surgeon had ordered 6 more weeks of PT but as soon as I went back to work it was denied and they said I had no deficits. The job was not what I anticipated. It required a LOT of walking. I had to round on our patients in three different ICU's as well as the floors. They also increased the clinics from two half-days to three. We had/have no assistant - the RN does it all. I spent the first month back at work in a LOT of pain, and I had muscle cramps so severely that they awakened me from sleep several times a night. I just dealt with it. In late September I had a really significant increase in pain, and went to the operating OS. He said I had a sartorius strain and ordered 6 weeks of PT. Only 3 weeks was approved. I was told by my PT that I had to start using my cane again, as my right hip had progressively gotten worse over the months from compensating for my left leg weakness. I was put back on light duty in October. In November I had steroid injections that were minimally helpful.
On December 15th I saw the operating OS who said he could do nothing else for me. He referred me back to my original OS to talk about a hip resurfacing, or a hip replacement. On Tuesday I went to see him. After a lengthy discussion, xrays, and me bursting into tears while telling him about how miserable I am and have been, he basically told me that I am too young for a THR, that he didn't think a hip resurfacing would be much better at this point in time, and that I need to pretty much resign myself to managing symptoms and "hobbling along" until such time as my hip(s) is/are bad enough to warrant a replacement.
He took me off of work until I complete 4 weeks of aquatic therapy and massage (IF its approved), and I will be reevaluated after that. He said if I'm not improved then we'll have to make modifications to my current position at work, and that I may ultimately be looking at a disability situation. The highlight of the visit? I FINALLY GOT SOME PAIN MEDICINE. Thankfully this doc listened to me when I told him how badly I was hurting. It's been pretty severe lately, to the point that I just cry and cry.
I went to give my manager the bad news. She asked me (in a rather skeptical tone, so I thought, but maybe I'm paranoid), "Are you just going to go home and basically be on bedrest?" I answered her in the best way that I knew how: I told her that for the past year, "I haven't lived my life fully. I can't clean my house, I can't garden - my mother drives down once or twice a week and does all of that for me. I can't walk with my husband in the French Quarter. I can't go to the Art Market and the festivals that we enjoy. When I DO go somewhere (usually to the coffeehouse), it's only because I'm married to an angel and he drives me up to the front door and drops me off, and then we leave shortly thereafter when I can't take the pain anymore. On a recent trip to Oklahoma to see a dear friend, I had to be wheeled in a wheelchair from gate to gate in the airports, and given special priority boarding due to my mobility issues and loss of balance, and I basically spent the entire visit on her couch and taking a ton of Advil. When I'm at home, I am either in the recliner or laying in my bed. When I DO sit on my porch, or attempt to cook, I pay dearly for the activity with a major increase in pain. I have become severely depressed to the point that I am now on an anti-depressant. I've taken so much Advil and Naprosyn that I am now on Protonix because my GI tract is so torn up. I have extremely painful callouses on my left heel from walking incorrectly. So yes, basically I'm going to be at home on bedrest, and if I DO manage to go somewhere, I will pay the price for it." After she picked her jaw up off of her desk and we said our goodbyes, I went to my office, cleaned up my desk, put a vacation notice on my email, forwarded my phone, and came on home.
Now I've got to figure out how on earth we're going to live with more than half of my income being gone again. I am also anxious about an upcoming trip to Tulsa to look for an apartment for my oldest daughter who just graduated from college and is going there to do training for her new job. She's counting on me and her daddy fulfilling our graduation gift of setting her up with rent and deposit, and that's going to strap us severely because in two weeks I'm not going to have a paycheck. (Worker's Comp pays me 60-something % of my pay, but with a cap of $522 a week - LOTS less than I make.) I'm worried too about how I'm going to get around the airports. Wheelchair again, I suppose... but I'm also in a lot worse shape hip-wise than I was when I went to OK earlier in the year. Once I'm there I will be okay as I can rest a lot; it's the getting there that I'm fretting about. I'm stressed too that I will again be threatened with termination - or what may even be worse, that I'll have to go back to work in the same amount of pain and just have to deal with it some more. I don't know that I can do that - but what choice do I have? I've got to earn a living. I've also got to come to terms with the fact that I may be stuck with a cane for the rest of my life.
I'm very distressed about it all - seriously distressed.
A nurse friend who's done Case Mgmt told me that I need an FCE. Has anyone ever had one of those? She also said that I should get a lawyer, but that doing so would "change things" between me and my employer, and honestly, what would a lawyer do for me?
If anyone has been through this, I'd sure appreciate some words of advice. Thanks so much.
Jan 30, '09
SICU - I am just reading your post and I am so very sorry you are having so much pain and also that you have been having trouble trying to get care of your injury without being so freaking miserable. I have been a nurse for 18 yrs and live in Louisiana. Wasn't sure by your description if you and your family lived in the same state or if you were just close by, Miss or something, by your description about the French Quarter. I know in La, it just seems like they try every trick in the book to just not make it any easier to get any relief.
You would think that since we are in the profession of helping others that we could find assistance for ourselves, especially when we are hurt while at work.
I hope you may be feeling a little better, it sounds like you are just miserable, and about worn down with all the roadblocks that have been put in your way. Feel free to pm me anytime if I can help in any way. Please know my dh (who is also an RN) and I will keep you in our prayers.
I guess I am of the naive type that honestly believes that as long as you go by policy and fill out the proper forms, that you would be taken care of. Wrong. And, I can't comprehend a doc taking so long to actually give you, a nurse who had been injured at work) adequate relief.
Last edit by sissiesmama on Jan 30, '09