Injured at work last year, still having problems, need advice (long)

[SICU Queen]

Hi everyone,

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. :redbeathe

[llg, PhD, RN]

I'm really sorry to read of your struggles. If there is anything to be learned from the mess you are in is that people in similar situations need an advocate for THEM early on in the process. Your employer is out to protect itself and save money: YOUR welfare is not their primary interest.

That said, I think you need to find an expert on the labor laws/worker's comp. etc. who will have YOUR interests at heart. Maybe that is a lawyer ... maybe there are other professionals who can help you there. Only someone with that kind of expertise will be able to sort through all the details of your case. If I were in your shoes, I would have sought such an expert a long time ago. I think you need to do that now.

As for your daughter's apartment -- she just may have to grow up and support herself a little sooner than you or she expected. She's an adult now, and she should understand that you may not have the money to fulfill your promise completely. Help her as best you can, but trust her to be strong when she needs to be. Pay her the compliment of respecting her abilities and treating her like the adult that she is. You may not be able to make the trip to get her set up, but she should understand that.

I wish you the best of luck with all of this. Having been through some minor Worker's Comp. claims myself, I know they can be very complicated -- and the deck seems stacked against you. I hope you find someone with the expertise you need.

[SICU Queen]

As for your daughter's apartment -- she just may have to grow up and support herself a little sooner than you or she expected. She's an adult now, and she should understand that you may not have the money to fulfill your promise completely. Help her as best you can, but trust her to be strong when she needs to be. Pay her the compliment of respecting her abilities and treating her like the adult that she is. You may not be able to make the trip to get her set up, but she should understand that.

Oh, it's not her. She's already told me that she will figure it out, that she doesn't want us to worry about it. She's truly a "big" girl in all respects. I just feel like crapola because her father and I talked about what we most wanted to do for her for graduation and this was it (in addition to the little things we got her) - it would allow her to buy furniture and whatnot. I know it won't be the end of the world if we can't do it, but it sure does disappoint me super bad. I'm so proud of her and wanted to reflect that in our gift to her.

Thanks for you words of advice in regard to finding an advocate. I am thinking that an attorney would be best suited to that - but I'm so nervous about taking that step.

[Silverdragon102, BSN]

It is hard taking that first step but you do need to look after yourself, as mentioned employers will look after themselves. I really hope you get something sorted soon and sorry you are going through this

[ilmbg]

SICU QUEEN- It has been a few weeks since you posted- I am sorry you are going through the process that hospitals go through when one of their dedicated workers has been hurt.

I too have been seriously hurt at work- and have been on SSDI now for several years.

You NEED to get a lawyer! A Work Comp lawyer is a must! I don't know if it is dependent upon which state you live in but where I am the lawyer took what the state allows-$5,000 for the whole thing- well worth all the work he did both for Work Comp and Social Security. You will need him in the future, as Work Comp will try to get you off their system later on- very important to have him represent you. Whenever you have to have a lawyer represent you, Work Comp pays the cost- not you. At least that is how it is in my state.

If I can help, pm me.

[Hoozdo, ADN]

Hi SICUQueen,

I also have gone through the WC wringer - and ended up losing my job over it. I have a long story that is too traumatic for me to even type (and I went through this 15 months ago). I am now working again, thank God.

You do need an attorney that specializes in WC issues. WC laws are different in each state. In my state, Arizona, I was not even allowed to have a lawyer until my case was closed! And.........even worse the max pay for WC was 300 a week. It's very difficult to go from regular pay to a pauper's wage with no notice. I couldn't even get short term disability or long term disability because it is a work place injury.

What does FCE stand for? It sounds what they call an IME (Independent Medical Examination) in Arizona. I am not sure you want to do this. The doctors they use are all stacked against you. WC is paying their checks, not you. This might sound like I am crazy and making things up, but unfortunately it is true.

I can really empathize with your pain. I was in constant 10/10 pain. I am not a drug seeker, nor do I appear to be one. The problem is that everyone THINKS you are if you dare ask for pain meds. It is unreal - like a nightmare you can never wake up from.

Please let us know how you are doing now. I am concerned for you.

:redpinkhe

[morte, LPN, LVN]

Hi SICUQueen,

I also have gone through the WC wringer - and ended up losing my job over it. I have a long story that is too traumatic for me to even type (and I went through this 15 months ago). I am now working again, thank God.

You do need an attorney that specializes in WC issues. WC laws are different in each state. In my state, Arizona, I was not even allowed to have a lawyer until my case was closed! And.........even worse the max pay for WC was 300 a week. It's very difficult to go from regular pay to a pauper's wage with no notice. I couldn't even get short term disability or long term disability because it is a work place injury.

What does FCE stand for? It sounds what they call an IME (Independent Medical Examination) in Arizona. I am not sure you want to do this. The doctors they use are all stacked against you. WC is paying their checks, not you. This might sound like I am crazy and making things up, but unfortunately it is true.

I can really empathize with your pain. I was in constant 10/10 pain. I am not a drug seeker, nor do I appear to be one. The problem is that everyone THINKS you are if you dare ask for pain meds. It is unreal - like a nightmare you can never wake up from.

Please let us know how you are doing now. I am concerned for you.

:redpinkhe

FCE= functional capacity exam

[sissiesmama, ASN, RN]

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.

Anne, RNC

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.

[riverbirch1970]

You Need a Lawyer end of discussion. I am an older nurse with over 30 years experience and a completely ruined back I was injured on the job and needed 2 fusions less than a year apart. The 1st one after the injury didn't work. I can barely walk still and have constant back pain but my neurosurgeon released me to go back to work "light duty" Just exactly where is a "light duty" nursing job?? Utilization review jobs are just about all gone and Case Management requires a CM certificate. Like you I also thought that if I did everything right and wasn't a complainer things would be OK. You need a lawyer, and if ANY doctor asks you how your doing don't be the good nurse and say "I'm doing OK" say the truth "My hip and leg is killing me and I can barely walk"

[seasonednrs123]

Hi just wondering what exactly "short and long term disability" entails?

[Babs0512]

I injured my back 11/08 doing nothing strenuous, I was washing down a stretcher. Felt a stab in my low back. Got worse over the next hour, so I filled out an incident report, told my NM, and went to the ER for an eval per our hospital policy.

The ER pried me with meds, and sent me home with a couple of days off. I followed up with my PHP, he felt I "sprained" my low back, put me on PT, lite duty etc... Didn't decide to order an MRI for 6-8 weeks. I wasn't getting much better. I have only two small herniations in my lumbar spine and two small buldges. My PT feels these herniations could have been bigger if he had done the MRI right away. Workmans comp is paying for everything, I managed to get "almost" back to full duty, when I made the mistake of trying to clean my house (yes, cleaning my house, doing dishes, changing my gradsons diaper, all kill my back) - all I did was dust bust the sofa, loveseat and chair, dusted the wood furniture, and washed the floors (mop) - dear GOD!! The next day I was in AGONY!! That was 1 week ago. For two days I was in severe pain. PT said all my lumbar disc's were "stuck" and "not moving" - I had significant spasm in the lumbar area, down into my buttocks that caused pain all the way down the back of my legs.

I go back to work tomorrow. Moved back a stage to even lighter duty - already been told my employee health that as of this month "they won't be able to accomidate my restrictions" - which is BS - as I work in PACU, ASU and PAT's- and a nurse has to be floated to PAT's every day, which is basically a desk job (which I can handle).

Any how, I have a workman's comp attorny, and my first hearing is the end of April.

Employee health, and workman's comp nurse all feel "your back isn't that bad, you should be better by now" - well, that may be true, but so help me GOD, my back hurts 24/7 - just in varying degrees - good days and bad ones. I can't garden, clean my house, walk my dog, or take a walk with my hubby because of this "should be healed" injury.

I can't take narc's for pain, EVERYTHING makes me nauseated. I use a TENS unit and celebrex. I'm about to lose my job, and my attorney doesn't do disability, I would have to get another attorney for that.

Anyone have any words of wisdom? I take Lyrica (not much help) and Tizanidine (for spasms) helps a little. I'm on effexor and Seroquil - depression was a problem already, but kept in check with meds, obviously, the back situation has made it worse - working on it with Psyc.

HELP!! Don't want to lose my house, and everything I've worked for. Can't really do anything but sedentary work, any suggestions?

Blessings to all

[izeofblu1973]

How is everyone doing now? i am going through a workers comp case right now and I cant believe what is happening. If someone had told me that this could happen, I would call them a liar! I have posted my story already. but here is the basics:

I had a herniated disk with osteophytes at C5-C6 and had a laminectomy and foraminotomy in Dec 2009.(this was not workers comp). I went back to work Feb at an ED. In March I was lifting a sedated and intubated patient that was very large back and forth to different stretchers, the CT , ICU bed, held leg to place Foley, etc and had a shooting pain go down my right arm. I went to the walk in care center as soon as my shift was over and filled out an injury form. The doc thought that it was a muscle sprain. Since then I have went to an ortho doc, my PCP, a neurologist and my original neurosurgeon NP and had physical therapy and finally the last neurologist ordered an MRI and it showed a large herniation at C5-C6. I had been having pain all along in my neck and back and now my right arm. I was pulled out of work in Sept2009 and have been out ever since dealing with Worker's Comp, unethical surgeon, I have l ost my job after 6 weeks of absence (even though they asked me to reapply after I get better) and I might end up living with this pain forever ( I am wondering if it is failed neck surgery syndrome). I will probably never be able to do direct physical patient care that requires any lifting. I am depressed and battle hoplessness. I cry every time I think about the fact that I may have to live with this pain forever. I keep saying :they cant just leave me like this" . I see another neurosurgeon on the 22nd to see what he recommends. The last one said that i needed a anterior diskectomy then when workers comp and my health insurance declined payment he said I didnt need it. i cant believe that this can be happening to anyone but especially nurses! Its disgusting, I know that its not meant to be this way, but I cant help but feel that we are seen as disposible. I feel chewed up and spit out. I hope you all have had wonderful, pain free recoveries. GOd bless.