Discussions By Condition: Cardiovascular disease

Sudden onset of Plaque in lower leg after Surgery-Unremitting leg pain-amputation

Posted In: Cardiovascular disease 1 Replies
  • Posted By: Anonymous
  • August 9, 2006
  • 11:08 AM

Hello, My wife had been diagnosed with PAD in her legs and had a Stent placed in her right Iliac Vein early this year. as well as one near her heart.

She has been normally active since with no problems. She went in in June to have her knee worked on for a childhood injury that bothers her all the time. She had some pain in that leg afterwards (the left-The one opposite the side with the stent).

That surgeon ordered a venous ultrasound and they discovered some calcification of the vein in the left leg just above the knee and sent her to her cardiologist for further testing. She was only in mild pain at the time in the left leg only.

She has some mild degeneration of the back at the l3-l5 disks and likes to have in rubbed at night, but was not a major issue either.

However on the 19th of July she had an exploratory procedure when the cardiologist used a catheter to go in and look in the left leg to see what he could and the right to check on the stent that he had placed at the start of the year.

In post op he claimed the stent had failed and he said it probably could not be restented and was getting a second opinion from a vascular surgeon. He said her blockage on the right was 90% and the new block on the right was also 90% and that she had a new blockage just above where the two veins meet as they go up to the heart.

This would be her 3rd such procedure and besides being in the hospital for observation that evening she never had any problems.

This time however she came out of the operating room and even while they were holding the vein closed so it would heal shut she was trying to turn and move while complaining of back pain and that her left leg was killing her. They gave her triple the pain meds she had needed before and she was not moved to the hospital room for 4 more hours, 2-3 hours longer than before and 2 hours after everybody else who had had similar procedures had been moved out.

By this time she was both in alot of pain and groggy from the meds. She continued to have escalating pain into the night. The doctor had left by then had not left instructions for pain meds beyond lortab 10 every 4 hours and these would not touch the pain which was now in her back and BOTH legs all the way to her toes.

The nurses called the doctor numerous times to get more and more pain meds until he told them not to call again, and he still had not authorized repeating meds. except for percoset. She had been given more powerful injection pain meds so far. She finally fell into a painful sleep and still had elevated but lower pains the next day when he released her. She hates narcotics and was not asking for meds unless it got unbearable. I said that to get the obvious assumption out of the way.

Anyway she also had high blood pressure and low heart rate trough-out the post surgical recovery room stay (200/115 down to 180/96) she was released with a prescription for lortab 10 with her pressure still high (160/93). She thought she could get more comfortable at home rather than the hospital.

That was Thursday. On Sunday night and again on Tuesday night I took her to the ER for pain so bad that since Friday she had not been able to get any sleep. By Tuesday she was passing out while trying stand, from lack of sleep, and hallucinating. She had to use crutches to get around until Tue when she could not get out of the truck at the ER and had to be helped into a wheelchair.

I don't know if you have had a loved one in what is called intractable pain, but it is a horrible experience. She would sit and cry or beat on the table and say Oh My God over and over again. The only time she would get any relief was while n the ER, within a couple hours the pains would be climbing back to what was unbearable again.

The 1st ER just gave her one pain shot and a prescription of Oxycodone, the 2nd gave her Oxyxontin and about 4 shots of what they said was 9-10 times more powerful than Morphine! She managed to get some real sleep from that, but again only for a couple of hours. Our daughter stayed with her that night as I went to work (7pm-7am). When I got home they were still up and my wife was completely out of it and whimpering, hallucinating and would try to do things or move and when asked could not tell us what she was trying to do.

I have left a lot of the stuff out, but that should give you an idea of her state a week after the surgical procedure.

Now about what the doctor did or did not do.

We had called him on the day after she was released from the hospital. And he said to see a pain specialist. We could not find one that could see her earlier than 3 weeks away. We called and asked him to call one to use his status as a fellow doctor to get a more timely one. His staff called and gave us an appointment that was 2 weeks away. I asked later and he had not called himself but left it up to his staff, and they were not advised of her state.

That day I made an appointment to see HIM on the following Monday when they told me that, and after asking why so early, We got it for the Monday afternoon. In the last two procedures we saw him the following week anyway so I was concerned that they though 5 days after was too early.

Anyway all he said was that it was her back causing the problem – he did not exam, test or touch her to figure this out. And to tell the truth I thought it was the back too. She has always had pain if she laid flat on her back too long, but this was way over the top. And her pain did seem to be in the nerve distribution of that part of her back which was slightly degenerated. He gave her percoset and sent her home.

The next day her legs got these long blackish streaks on them that lined up with the blood vessels in her legs, especially the left. But they faded away by the following day before we took her to the ER, again.

(too long continued in 1st reply)

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  • (continued from original post)...Okay now we are at the morning I came home from work again (Wednesday morning) and I have had enough. It was my opinion that since this all started in the recovery room after his procedure that it was his responsibility to get her the attention she needed. He was not a pain specialist or a back doctor but all the phone conversations I had managed to get with trained people said she needed to be hospitalized – especially because of 7 days with no sleep (except for passing out for a couple minutes or so and then waking up in unbearable pain.) - and that none of the Ers could find an explanation for the pain. What she need was some sort of pain block that would completely block the nerves to her legs. If that happened she would pass out and start regular sleep and relieve the stress on her circulatory system. But she had to be watched for this to happen.So to make a horrible morning short, I basically took her to the same hospital that this doctor was doing his rounds and at the admissions desk with everybody there told them whoo her doctor was and that she needed to be hospitalized, it was not until it was clear that we were not leaving that something happended. The doctor called down from the 8th floor and told the admitting person to send us to the ER again.He did not come down to see herThe doctor in the ER said it was his responsibility to get her her care and called him.THEN she got admitted to the hospital. And was given more pain meds, but he still did not see her until the next day. I was at work trying to talk my loving employer into not terminating me for missing 4 days in 9 months (another story) and did not see him. We played that way for a week, I think her was avoiding me. Anyway he did have others, Doctors and specialist nurses see her for Pain Management, a second opinion on the cardiologist side. The 2nd opinion Dr said he would do the surgery to replace the vein that was of a concern but could not until she was more stable. Her pressure was still up and had never gone down, and she was still in uncompromising pain, no matter what they did, so while she got more unconsciousness she was not getting true sleep.She has been in the hospital now for 13 days and she still hallucinates, sleeps more but can't remember things from on hour to the next and still passes out if she trys to sit up. She can be coherent for 15-30 miutes but they are not very often. And the doctors tell her stuff she can't remember to pass on to us. I have a case manager now but can't seem to get much done.Yesterday for the first time I saw the dr. who did the procedure that started all this and he seemed to be not mad at me and tried to be pleasant. It was a tense time because I did not want to rage at him, because I need him to help her. And he seems to have accepted that he needs to treat her because he is setting up hybarbaric chamber treatments for tomorrow (today actually). I get the impression that the chief surgeon (who gave the 2nd opinion and was the one that was going to do the graph surgery) has told him that it was his charge, and he has realized that she was truly injured somehow on the table.He says he is going to do the full court press because her leg is going bad, and she has plaque in her blood that they have been worrying about clotting for days now. Today was the first day I heard about clots. That communication thing that I have been trying to find a solution to.If your wondering why I am not there 24/7 I'll just say this. No one here is blaming me for not being able to do it. I want to. But I have a daughter who had brain cancer recently and needs medical care, a wife that needs medical care and myself who through workers comp injuries will never be able to get another job anywhere and my plant is closing in 4 months. I must keep working to keep the insurance to save my wife, my daughter and I need 4 surgeries my self to fix the W/C injuries before we lose it all, so I can work somewhere else. Don't ever try to stand up for your workers comp right in Oklahoma, just use your insurance to get it fixed – I mean it. I started out with a mild elbow injury which turned into 5 more because I was stubborn (and had to work to fix my daughters brain cancer) etc, etc blah blah blah. Get fixed ASAP thats my best advice.I was not trying to blame him for what happened, it could simply be an unforeseen circumstance, but he was the only person that could or would be able to timley get her the aid she needed.I am writing this here because I want to know if there really was a malpractice and if anyone else has had the same happen to them so I can get a clue as to what is wrong with my wife.They can say that she has a bad back, But MRI and Cat scan don't show any back or nerve problems to account for this. They have ultrasounded her abdomen, arteries, veins, legs, feet. Xrays, MRI's and so on but they can't or won't say what is going on, except that she has all this plaque (which she didn't have before (OR DURING) the procedure, if you believe the dr who did it.)She has an infection in her abdomen that apparently is in a wound that was made by an ovary surgery she had 3 years ago, which is right next to and in side the pelvis where he inserted the scope and catheter and this same area is infront of where her back problems are.My daughter found this infection in the shower (at the hospital) the monday after we admitted her. The infection Dr. didn't show up until two days later and a couple days later I heard her say that there was a new infection. Her temp has hit 103 3 times now, her WCC is up, the wound is ugly and they have the wound care people in 3 times a day and they have this real powerful cream on her but no one can tell me if she is getting antibiotics. She can't.I have been up for 24 hours myself now and need to close this. If there is anybody out there that can help, advise me on what may be happening and what I can do that I haven't yet to help her. My options and any ideas as to what medically is happening.I'm sure it is not just one thing. And my head is spinning with so many possibilities that I am losing track myself.I have been told they can't replace the stent and will have to replace the vessel itself. Where would that come from? As far as I know this is the only one that larger in your body.I suspect they can't do surgery until the infection, which they say is 'superficial' is fixed. I'm pretty sure that is true.When she sits up on the edge of the bed, which she insits on doing despite the danger (she still can't understand or remember not to do that) her legs turn colors and her foot starts turning black (like it was in the ER just before being admitted). Even when her legs look good - Which is only if she lays still (which causes the most pain) – she now has a permanent reddish-blue spot above her ankle that is bothering me. That is why he is going to use a hyperbarionic chamber to oxygenate her blood (which is between 93-96% on her finger).Oh she also is supposed to have an oxygen tube on, but she keeps pulling it off or it falls off and the nurses never put it back in, it is always off when I come up there.They wheeled an xray machine in to do her left knee after she fell for the 5th time. They took Her sleep medication away because they said it was making her fall. I found that the brake on the bed would not lock in position and was rolling away from when she would sit up or try to move or get into a chair looking for a comfortable position. The Brakes not set light was blimnking but no-one checked when she fell. I figured it out myself. They replaced the bed and she hasn't fallen since, is that something I should be upset about?I have asked for a psychatrist to look at her but despite there being one or twoo on staff, she has yet to be seen.The surgeon claims my wife is refusing surgery. But she isn't, she says no because she knows she has an infection and needs to be stronger before surgery. This is absolutely true an the drs have said as much to me, but the surgeon wrote it up as if she is refusing surgery?Is the 2 day delay in getting her infection looked at important, or that they culture3d it but claim that it didn't show anything? They say the 103 temp is from the infection but they say it is superficial! I have asked if my own doctor or psychiatrist can see her, they say no because they don't have medical privileges in that hospital.The original doctor says she may lose her left leg below the knee if it doesn't get better. And it seems to be getting worse all the time, so does she.It took me a week to get her back in the hospital. A whole week she didn't sleep. I don't think she has recovered from that yet. They have reduced her pain meds alot. The pains have gone down, or she doesn't feel them anymore as much – she says she can't feel her legs sometimes. But the pain is still keeping her up again. Are they doing that right?I need some advice please. Gotta sleep.
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