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Madison Kitchen was jumping over hurdles in her fifth-grade gym class when she tripped, fell and sprained her left ankle. Though painful at the time, Madison’s mother, Nicole, recalls that it was an "unremarkable injury." They had no idea that it would be the beginning of two-year journey to resolve her unexplained pain.
After that initial ankle sprain, Madison’s pain in her ankle never fully went away. Her doctors couldn’t see any fractures or breaks in her X-rays, so they prescribed her physical therapy and medication to curb the discomfort. However, her leg and ankle remained sensitive and she continued to see doctors looking for an answer.
That second sprain did set Madison back, but it was yet another sprain shortly thereafter that caused her problem to flare to a new level. This time Madison and her mother knew something was seriously wrong. Her ankle became so sensitive that even the brush of her pants or bed sheets caused her pain.
Madison’s doctors were stumped. Lacking more answers, they referred her to a hospital for children in the mid-west, where the Kitchen family was living at the time. Doctors there identified her condition as Complex Regional Pain Syndrome (CRPS), a nerve condition that causes chronic pain, typically in the arms and legs. Doctors explained that this neurological condition was causing her brain to believe that her previously injured ankle never had healed.
At that point, Madison began undergoing more intense physical therapy and taking numerous medications that helped her become more high-functioning, but things still weren’t 100 percent right. Her pain was affecting her daily life, causing her to become socially withdrawn – abnormal behavior for the typically bubbly performing arts student.
Not long after receiving the CRPS diagnosis, the Kitchen family moved to Colorado, Nicole remembers calling Children's Colorado Pain Clinic from a hotel room on their cross-country journey to Denver, hoping for a fresh start and some new answers. They were at Children’s Colorado within five days of arriving in their new home.
Madison began seeing Robin Slover, MD, in the Pain Clinic to treat her CRPS diagnosis. She was receiving nerve blocks (the injection of local anesthetic onto or near nerves) in her leg in an attempt to block her pain, but these outpatient procedures would only help for a matter of hours.
As a last resort, Madison’s health care team suggested a one-week inpatient treatment where she would undergo intense physical therapy in a concentrated environment. The inpatient stay was hard on Madison and didn’t result in the projected outcome, leaving the Kitchens wondering, "What’s after the last resort?
Not giving up when all else failed
Children's Colorado was not going to give up on helping Madison. The Pain Clinic referred the Kitchens to the Orthopedics Institute where they met a team who believed that the frequency and severity of Madison’s pain seemed more localized than what is normally associated with CRPS. They had seen patients before who, like Madison, were female adolescents with radiating, localized pain near a sensory nerve in the lower leg.
Our team was able to give Madison a more refined diagnosis after a series of pin-pointing nerve blocks indicated that a the superficial peroneal nerve (a sensory nerve) in Madison’s lower leg was entrapped, causing pain to radiate down to her ankle. We believed surgically releasing the nerve would stop her pain.
One-hour surgery ends two years of pain
After the surgery, Madison's surgeon confirmed that there was indeed a nerve trapped in some scar tissue that was likely causing Madison’s pain.
Only a few days later, Madison was certain that she no longer felt pain in her ankle or leg – but this was a reality that took awhile to sink in.
"I must have asked her 500 times that week after the surgery, ‘Are you sure it doesn’t hurt?’ After searching for an answer for so long you just become guarded," said Nicole.
"After two years of anguish, it just all disappeared after an hour-long surgery," she still says with disbelief.
Madison loves the scar on her leg – to her it represents an end to the pain and validation for those who did not believe in her condition.
With her pain gone she says, "Now I can do everything I want to do and even some things I don’t want to do." In a strange way, Madison is happy not to have an excuse to get out of doing chores or skip gym class.
Although there is still one thing she wishes the doctors could help cure – her self-proclaimed klutziness.