Monthly Archives: January 2009

Long battle



Long battle

By Wire News Sources on January 11, 2009

By Jane Elliott
Health reporter, BBC News


Teenager Jaimee Mallion has written to thank doctors who finally helped her cope with chronic pain that blighted her life.

Jaimee had experienced a series of falls at ice skating and gymnastics when she was 13.

It took her two years before she was diagnosed with complex regional pain syndrome – a condition that develops after an injury, and continues even after it has healed

But it was not until she met Dr Richard Howard at Great Ormond Street Hospital in London, that she got the help she needed.

Jaimee said: “Great Ormond Street was the last resort”.

But she added it was a turning point, with staff treating her with pain killers and physiotherapy as well as being taught pain management techniques.

Jaimee’s mother Andrea explained that few doctors had previously believed the teenager’s back and leg pains were real.

“She had been taken into hospital and had some investigations, but they were not very helpful.

As soon as Dr Howard saw her he said ‘I believe you’ and that was a great relief”

Andrea Mallion

“Eventually she was referred to another hospital to a pain clinic and they discovered a stress facture in the spine, hypermobility (extreme flexibility) and complex regional pain.

“She had gone from being incredibly active to not being able to walk.”

It took two years before local specialists diagnosed Jamiee’s condition.

“Along the way we were actually told that she was making it up, that she was not in pain,” said Andrea.

“It put an awful lot of pressure on Jaimee, and on the family.”

She said the experience has left her daughter scarred.

“She has developed a bit of a phobia about doctors.

“Jamiee is more than happy to go to GOSH or her GP, but when she has to see anyone other than them she is very nervous because she thinks they will not believe her.

“Over the last month she has been in casualty about five times with dislocations. Every time we go we see a different doctor, and not one of them has known what complex regional pain syndrome is.”

Jaimee Mallion

Dr Howard, a consultant in anaesthesia and pain management, said Jaimee’s experiences were not uncommon.

“It is not infrequent that children with this kind of condition feel disbelieved.

“That’s often because the clinicians who see them are not sure what is wrong and somehow manage to convey a feeling that maybe it is not something real.

“I think it is a lot to do with confusion about the diagnosis and the uncertainty and the children feel they do not believe what they are saying.

“We are experienced in dealing with this type of condition, which is quite rare and even paediatricians working in the community might never see a case of this or might only see one or two in their whole career.


This article is from the BBC News website. © British Broadcasting Corporation







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Nurse to graduate in spite of cerebral palsy


Nurse to graduate in spite of cerebral palsy

By KATINA TENGESDAL, Staff Writer ktengesdal@minotdailynews.com

POSTED: December 31, 2008

Carla Pease always wanted to be a nurse. Now, she is one – but it hasn’t been easy.

At age three, she was diagnosed with cerebral palsy. She admired the nurses who took care of her.

“I was never one of those kids that said I wanted to be a doctor or a lawyer. I always knew I wanted to be a nurse,” said Pease, of Garrison. “When I was three, I was diagnosed with cerebral palsy, and I spent a lot of time in the hospital having surgeries. The nurses were the ones who took care of me.

“I knew I wouldn’t be happy being anything other than a nurse,” she added.

On top of her many surgeries beginning at a young age, Pease recalls developing reflex sympathetic dystrophy (RSD) – a condition that attacks the nervous system after a surgery or some type of trauma – when she was 16.

Yet she still held on to the hope that she could be a nurse one day.

“When I was 16, I made a deal with God. When they told me I had RSD, I prayed so hard that I would push wheelchairs every day of my life, so long as it wasn’t mine. If I do have to push my own wheelchair some day, everything up to that point was worth it,” Pease said.

“It has been brought to my attention that physically, nursing isn’t the best career for me to go into, but I would rather have 10 seconds of something meaningful than a lifetime of doing nothing special,” she added.

Pease finished her LPN degree through the Dakota Nursing Program this past July, and she’ll finish the RN program in May. She hopes to continue on to get her masters in nursing. She credits the help of the Dakota Nursing Program and the students in it for her success.

“Everybody in the Dakota Nursing Program was really wonderful. They didn’t wait to see me struggle with something. Tthey always offered me help if I needed it. They never treated me any differently with my cerebral palsy. They never gave me the easy patient to take care of or anything,” Pease said.

“I never felt like I was a second-class nursing student because of my cerebral palsy,” she added.

When Pease needed to have a joint repair surgery done on her foot during spring break, those in the nursing program were supportive, as was the community. Pease received braces nearly free of charge through a program called Jerene’s Wish, a program in Garrison supplying free orthotics to children who need them. Jerene’s Wish made an exception in Pease’s case, though she was over 18, and offered her braces for a fraction of the normal cost.

“The day I had taken my state boards for my LPN degree, I had received braces from Jerene’s Wish. They put the braces on me nearly free of cost. I was getting them for nearly a tenth of what they would be. It was amazing for a struggling college student,” Pease said.

The Dakota Nursing Program has supported her all along. She began her schooling with the program through Williston State College, and has attended classes at the Fort Berthold Community College site and at the Minot State site.

Fort Berthold Community College is sponsoring her in her latest venture – a preceptorship at a Tampa, Fla., Shriner’s Hospital, where she will be exploring one of her areas of interest in the nursing field. Pease will be at that hospital from Jan. 5-9.

Pease is no stranger to the Shriner’s Hospital. She had many surgeries and therapies at a Shriner’s Hospital in Minneapolis, from the time she was three until she turned 21. She’s excited to return to one to work.

“I have the opportunity to work in what is called the motion analysis lab. There are very few of them in the U.S., probably 20 or less. It’s a state-of-the-art facility at Shriner’s that studies how children move with joint and muscle problems. I will be taking care of surgical patients that have cerebral palsy,” Pease said.

Pease likes to focus on preventive care, and she encouraged parents to be proactive.

“With kids that are young, if you’re noticing they have trouble walking, or they’re walking on their tip toes, don’t ignore it. Parents think that if they ignore it, it will go away, and that’s not the case. Any child that has trouble walking or with balance, they need to take them to a specialist,” Pease said.

Another area of interest for her is geriatrics, where she hopes to stress the importance of preventive care as well.

“I really want to focus on preventive health care in the elderly. They don’t really seek medical attention until there is multiple health problems. We (health care providers) suggest having a physical at an earlier age instead of waiting until your cholesterol is out of control or you’ve already had the heart attack,” Pease said.

“Health maintenance is really important. I was in physical therapy a lot when I was younger, to prevent complications from developing. That’s something I learned from Shriner’s and the Dakota Nursing Program – it’s important to stop problems before they start,” she added.

Pease is looking forward to her career, and she hopes to extend the same care to others that she has received.

“I’ve been in the hospital, depending on people to do every little thing for me. I want to be there for my patients like that,” Pease said.

“Ultimately, in every patient situation, I want to be the nurse that makes the bad things seem not so bad, and the good things seem a little bit better,” she added.






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Pain-racked jockey will sacrifice leg


Pain-racked jockey will sacrifice leg


Peter Hawkins
December 28, 2008

KYLIE KEEBLE has been in pain 24 hours a day since she was crushed by a 450-kilogram horse.

On December 30, 2006, while preparing for race one at Kembla Grange, near Wollongong, the young jockey was thrown and pinned under her mount, Walking Street.

“It reared up and flipped over and fell on to the ground on top of me. As soon as they pulled me out I couldn’t feel my legs,” she said.

At Wollongong Hospital she was diagnosed with a bruised right leg, told she needed physiotherapy and given crutches.

But 3 months later, as the pain worsened, she had an MRI scan. It revealed a minor fracture, which had almost healed.

“It was getting to the stage where I couldn’t put my foot to the ground and I was fainting and sick, and I couldn’t eat. It was getting worse and worse,” she said.

As another month passed she was referred to Royal North Shore Hospital pain-management unit, where she was diagnosed with complex regional pain syndrome, or CPRS.

Today Keeble remains in acute pain. “I don’t get a break from it. Sometimes it eases; sometimes it’s more. My life revolves around how much pain I’m in day to day,” she said.

Such is her despair, she is prepared to take extreme measures: “I am fine with getting my leg amputated but I just want to see [what happens next] before I make the final decision.”

She was earning $1500 a week before the fall but hasn’t worked since, living on $200 a week (after tax) in worker’s compensation from Racing NSW and one-off payments from the NSW Jockeys Association. She is waiting for Racing NSW to review her case for compensation.

Keeble said she had lost count of the number of trips she had made from Wollongong to Sydney for pain treatment, having learned to drive with just her left foot.

She has had a spinal cord simulator implanted in her stomach.

Professor Michael Cousins, from Royal North Shore Hospital, said treatment of CPRS was very difficult.

“The condition is not in question at all, in our view. It is quite complex because it involves changes in nerves which provide sensation to a limb, nerves responsible for controlling blood vessels and sweating, and nerves that control muscle function,” he said.

“She had a large horse fall on her and an injury. Injury is one of the causes of CPRS.”

Keeble, who uses crutches to walk, said she had lost movement in her ankle and toes, and was losing it in her knee.

“I feel like I’m 21 within a 50-year-old’s body sometimes. I just ache all over at the moment and it’s just getting worse. I am really starting to wonder what else they can try.”

Racing NSW chief executive Peter V’Landys told The Sun-Herald: “Racing NSW will do their utmost to get her back to some sort of normality but it really is out of our control medically, what can happen.” At Ms Keeble’s request, Racing NSW had approved expensive, experimental surgery.

“The cost [of the surgery] didn’t come into the calculation and her payments are in accordance with WorkCover regulations,” he said.





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Jacksonville Woman Develops RSD after Dog Bite


Jacksonville Woman Develops RSD after Dog Bite

A Jacksonville woman developed reflex sympathetic dystrophy (RSD) after being attacked by a dog on her own property. The dog bit deeply in her arm, but the wound itself was not severe enough to require stitches. After being initially seen by doctors she was sent home.

Within days she developed a serious infection of the wound site. The infection was followed by the onset of severe burning pain, color changes, a cooler temperature in the arm, and abnormal hair growth on the arm. Unfortunately, all of these are classic symptoms of RSD.

RSD, previously known as Complex Regional Pain Syndrome, is a serious, usually permanent neurological condition that is usually caused by an injury to an extremity.

This situation highlights the very serious nature of dog attacks. Every year, we hear of people seriously injured or killed by pet dogs in Jacksonville. Children are the most frequent victims of dog attacks, accounting for 70% of dog attack injuries. In the United States, there are almost 600,000 dog bite wounds that require medical care each year.

If you are in need of a Jacksonville Dog Attack Lawyer, please contact us for a free consultation.





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Woman Awarded $2.78 Million in Malpractice Suit against Planned Parenthood Associated Doctor


Woman Awarded $2.78 Million in Malpractice Suit against Planned Parenthood Associated Doctor


By Thaddeus M. Baklinski

PHILADELPHIA, August 15, 2008 (LifeSiteNews.com) – A woman who went to a Planned Parenthood clinic in Philadelphia in February 2003 to have contraceptive implant rods removed from her arm, has successfully sued the doctor who bungled the removal procedure.

Dana Asbury, a 39-year-old mother of three, was awarded more than $2.78 million in damages in a medical malpractice suit in which she maintained she has suffered excruciating and chronic pain, first, after Dr. Joel Lebed, who was associated with Planned Parenthood of Philadelphia, attempted to remove contraceptive implant rods, and then later when she underwent “unnecessary” neck surgery, said a report by Delcotimes.

“Obviously we’re pleased that the jury felt she had a meritorious case,” said Asbury’s attorney Garland D. Cherry Jr.

The woman’s problems began when Dr. Lebed, who was described in the legal papers as “inexperienced” to perform the medical procedure, made several unsuccessful attempts to remove the matchstick-sized rods. Asbury was described as being in severe pain throughout the procedure.

“(Dr. Lebed) gave up after a lot of pain and tears,” said attorney Cherry.

Eventually, another doctor in the PP clinic, Janet Wilson, removed all of the rods.

An article published in the American Journal of Obstetrics and Gynecology, Volume 195, Issue 1, July 2006, titled “Nerve injury caused by removal of an implantable hormonal contraceptive” warns that an experienced clinician is required for proper insertion and removal, to minimize the risk of nerve damage.

“Implanon (a brand of contraceptive implant rods) insertion and removal are relatively uncomplicated procedures in the hands of medical professionals familiar with the technique. However, injury to branches of the medial antebrachial cutaneous nerve during Implanon insertion and removal can result in impaired sensibility, severe localized pain, or the formation of painful neuroma that can be quite devastating to the patient.”

“In the event that an injury to the nerve is recognized, immediate plastic surgical measures should be undertaken to avoid displeasing sequels of nerve injuries. Therefore, the benefit of this generally well-tolerated, highly effective, and relatively cost-efficient contraception is guaranteed only in the hands of medical professionals familiar with the technique,” the article concludes.

Following her surgery Asbury became debilitated because of the ensuing pain that began in her arm and progressively spread until it affected the whole left side of her body. She was consequently diagnosed with complex regional pain syndrome (RPS), which involves a malfunction to the nervous system causing extreme sensitivity and chronic pain.

As a result of the RPS diagnosis, Asbury underwent a cervical laminectomy, a fusion of the cervical vertebrae, the bones of the neck that support the head, at the hands of Dr. Richard Kanoff, a neurosurgeon with Mercy Fitzgerald Hospital.

“The fusion itself was a successful fusion,” said attorney Cherry in the DelcoTimesreport. “The hardware was correct and everything held. The only problem was she didn’t need it and it worsened her condition.”

In awarding the money to Asbury for “past and future loss of earning capacity, future medical care, and pain and suffering” as well as to Asbury’s husband for “loss of consortium”, the jury determined Dr. Lebed was 60 percent liable for the damages and Dr. Kanoff 40 percent.

Source: DelcoTimes.com






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When sprain won’t heal, problem could be bigger

When sprain won’t heal, problem could be bigger

January 06, 2009 6:00 AM

DEAR DR. DONOHUE: I haven’t seen you write about my condition, reflex sympathetic dystrophy. I wish you would. I sprained my ankle about five months ago. I took care of it myself, but the pain didn’t go and it got worse. I finally saw a doctor, who said I had reflex sympathetic dystrophy, and he told me to take Advil for it. It helps some, but how long does this last? I have to use crutches.

— L.F.

Reflex sympathetic dystrophy has a new name: complex regional pain syndrome. The name change does nothing to alter its distressing symptoms.

After an injury — and it can be a minor injury — healing doesn’t occur and pain doesn’t leave. Typical injuries include sprains, bone breaks and even heart attacks. The injury somehow spawns the production of noxious chemicals that impede healing and promote pain.

In the first stages, which last from weeks to months, the pain is burning, throbbing or aching. The skin over your ankle is mostly red, and the surrounding tissues are swollen. Three to six months later, the skin thins and becomes shiny but the pain persists. In the last stages, both skin and underlying tissues greatly shrink and the joint becomes immobile.

Lest you think the situation is hopeless, it isn’t. Pain control is one priority. If Advil relieves your pain, fine. Other, stronger pain relievers are available, and things like nerve blocks can help.

Physical and occupational therapy are a must to prevent the joint from losing its motion and to prevent calcium loss from the nearby bones. If you aren’t getting physical and occupational therapy, start now. The sooner, the better.

Most people do recover, but it can take a year or more to reach that goal. The odds are in your favor.






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