Wednesday, December 31, 2008

New Year

Perry and Blue say, "happy new year!"

As we bid farewell to 2008 and welcome 2009, I am in the kitchen baking a marzipan cake for the new year (a family tradition).

In my two blogs I've focused on skating and hip issues, with the occasional toilet discussion thrown in for good measure. I haven't talked in detail about my family, politics, the economy, or a number of other important issues. It's not that I don't care about those things, it's just that the purpose of these blogs is fairly narrow. But on new year's eve I feel justified in branching out a bit.

Family: Our parents are in good health and we see them often. My sister and brother-in-law live close by. Perry's boys, my stepsons, are doing well. Aaron is a senior in high school and busily applying to college. Isaac is a freshman in high school and busy with many activities. My stepdaughters are also doing well; Melanie is married and living on the east coast while Ashley is in Ft. Collins in the pre-veterinary program at CSU. I'm proud of all the kids and I know they will all be successful in their many endeavors.

Perry has been supportive of my skating, hip issues, and life in general. As he will readily admit, I can be "high maintenance," but he puts up with my shit and I try hard not to give him too much of it. We still enjoy each other's company after 5 years, and I couldn't ask for a better husband.

Friends: I am grateful for having so many of you in my life. Those of you I count on the most -- Kianoosh, Larry, Linda M, Mary, Marilu and Tim --- I couldn't ask for better friends. Through Facebook I've reconnected with people from high school and beyond which has been fun and enlightening. I'm not generally good at "keeping in touch" so I really am thankful for Facebook, even though it can be a time waster.

Home: We've put our renovation on hold for now. Until I know the status of the insurance payments for my upcoming surgeries, I really can't justify spending money on a new kitchen and guest bath. It's frustrating, since we really wanted to get this house done this year. The kitchen and bathroom are functional but ugly, so there are worse fates, but I can say that if the insurance comes through, we'll be renovating next year, to be followed by a big party. If the insurance doesn't come through I think we will still have the party anyway.

Pets: 2008 brought our family sorrow and happiness. We lost our faithful and beloved 18-year-old feline companion, Toulouse, exactly one year ago today. Miss Blue, an abandoned cat who we noticed hanging around our yard, moved in to the house on thanksgiving and has quickly become a member of the family.

Blogs: Thank you all for reading, and for commenting. Blog readers include friends, family, fellow ice dancers and fellow hip chicks. In 2009 I'll continue to report on the good, the bad, and the ugly as I see it. I hope readers continue to find this blog informative and entertaining.

Be safe, be healthy, be happy ... hug your loved ones ...and don't drink and drive!


Monday, December 29, 2008

More gear

You'd think I was having surgery tomorrow by the way I am stocking up. This is what happens when you combine strong project management skills, a controlling personality, and after-Christmas sales. It's just too much for me to resist.

So over the weekend I bought a few things, including a teakwood shower stool for the inevitable seated showers, some non-slip socks, a new duvet cover (I will be spending a lot of time in bed, come on), and some posh new jammies (for all that time lounging in bed).

The shower stool is from Smith & Hawken and it's a nice looking addition to our newly-renovated master bathroom, if I do say so myself. I looked at all the plastic and metal versions and just couldn't stomach the thought of spending approximately the same amount of money for something that is so butt ugly. I've heard that I should get a shower chair with a back, and mine doesn't have one, but I can lean against the shower wall. OK, probably not the most practical and I may regret it, but I promise to get a proper plastic raised toilet seat when the time comes. I don't think Smith & Hawken makes one anyway.

I guess I should try the shower stool out, but how will I simulate the experience of being post-PAO? I can't get my hands on narcotics without breaking the law, but I suppose I can get rip roaring drunk on New Year's eve, immobilize my leg somehow, and see how it goes. I could probably sell tickets as well - standing room only! I can fit about 6 people around my glass-walled shower stall. Tickets will be expensive because I am trying to finance two surgeries; stay tuned for details.

Meanwhile, another hip chick has posted this fab link on her site:

While I have yet to purchase anything I am very tempted. This site is also a good resource on how to correctly size a cane and how to walk with one for those who are new to this hip thing. Yes, it's sad that we young dysplastics all eventually become such experts in geriatric devices like shower chairs, raised toilet seats, walkers and canes.

In fact, I have noticed that most adult-aged diagnoses occur either in the 29/30 age range (how many blogs have I read where people were just about to turn 30 either on their diagnosis day or right before or after surgery?) or, for us late bloomers, at 45. I haven't read any blogs that talk about a diagnosis at age 37 or age 41. It always seems to be 29/30 or 45. Interesting.

(I'm sure I am going to get a bunch of comments from those diagnosed at 26-and-a-half, and 48, and 39 ... I know you're out there as this was not a scientific study, just my recollection after reading a lot of blogs and posts on the Yahoo list. I'm just saying.)

Thursday, December 18, 2008

Explain to me again how this is saving water?

I have lost about 5 pounds in the past couple of weeks. I attribute this to loss of muscle, mostly because I can't exercise as much as usual. I haven't had such a dramatic weight change since losing 190 pounds of unsightly fat back in 2003, when I divorced my first husband. But I digress.

In an attempt to be as healthy as possible pre-surgery, I've been eating sensibly and drinking a lot of water as well. All of that water has to go somewhere, and so I've spent some quality time in the restroom lately. And that leads me to today's topic.

The concept of a toilet which flushes automatically intrigues me. You know what I'm talking about, right? You don't have to flush these beauties because they take care of the dirty work for you. I am not exactly sure what the point is though. It may have something to do with hygiene, perhaps, since not having to touch that disgusting handle is a major step in the right direction. But clearly there must be a cost to installing them, and thus there must be a cost savings involved, or else entities like airports wouldn't bother.

We all know that, in public, people often "forget" to flush, causing major backlogs and grossouts in the stalls. Perhaps the cleaning crew charges overtime for this, and the cost savings come into play there.

Nah, I don't buy that.

Maybe these toilets save water in a way that I'm just not understanding. Although even if they worked as designed, it seems they'd use more water than the old fashioned commodes because they flush every time, whereas we know that people don't flush every time when they have to do it themselves.

Problem is, these toilets don't work as designed. Nope. In fact, my theory is that the airport gets a kickback from the water department for every one of these uber toilets it installs, since they use FAR MORE water than a normal toilet. Variations of the following scenario have happened to me more than once, most recently during my trip to Lake Placid.

I hobble through the airport with my carry on and large puffy down coat, and find myself in need of a pit stop. After walking past about 20 gates I see the ladies room ahead of me and duck inside. I stuff myself into the tiny stall and come face to face with one of the newfangled toilets.

Since I am wearing a long coat, I take it off and hang it on the hook in front of me, but as I do that the movement of the coat evidently sets off the motion detector and ... fluuuuuush ... goes the toilet. A few drops of water end up on the seat. I hang up my cane and put my bag on the little shelf, and oops, the sensor is tripped again. FLUUUUUUUSSSSSHHHH!!!

More water gets on the seat of course, so I turn around and wipe it off with some toilet paper. Of course you all know what happens next, because this too sets off the motion detector and yet again, the toilet flushes.

I pull out one of those sanitary toilet covers and place it on the seat, carefully so as not to ... oh hell, of course you have already guessed that this sets off the motion detector and the toilet flushes, pulling half of the sanitary toilet cover into the bowl.

I am annoyed now and realize it's time to just do my business and get the f*** out of there. I step as far away from the bowl as possible so as not to set anything off, and carefully, slowly, holding my breath, unzip and de-pants myself in preparation for sitting down. I slowly back up toward the toilet, and I'm just about to sit when ...

FLUUUUUUUSSSSSSHHHHHH goes the toilet, throwing up more drops of water. I slam myself down and "go" as quickly as possible, praying that I won't be flushed on in mid-pee. Thankfully I make it, stand up, zip up, and gather my belongings while waiting for the inevitable final flush. Silence.

I move around, waving my bag toward the sensor, and shuffle my feet a bit. No flush. I do a little dance in the stall, shimmying as close to the sensor as possible in order to set off the flush response. Silence.

I stare at the toilet, realizing that I am now required to push the little red button hovering over the bowl. This means that the hygiene benefit of the automatic toilet is lost on me, along with whatever water saving functionality this monster is supposed to provide. Sigh. I lean forward and push the button. Nothing. Evidently I've exceeded the maximum number of flushes or something and the damn thing is now taking a "break."

Sheepishly I exit the stall, hoping the next occupant doesn't think I'm some sort of pig who doesn't bother to flush. No such luck, the woman waiting next in line sees the situation and gives me a dirty look as we pass one another. There's no point explaining of course. She'll find out the disturbing truth soon enough.


(Post Script: Turns out you can buy one for your own home!

Wednesday, December 17, 2008

Lost in PDX

Here are the highlights of my trip to Lake Placid:

~The rubber tip of my cane fell off on the first leg of my flight, and by the time I figured it out it was too late to go back and get it as I was "running" (those of you pre-PAO know that "running" is the euphemism for "hobbling a bit faster than usual") through the Atlanta airport, trying to make my next flight. Atlanta - now that's one big airport, especially if one is hobbling.
~Traveler's "Tip": Always carry a spare tip. Wooden cane without rubber tip on marble floor does not make for a stable walking aid! In fact, it's rather useless and just served to get caught in my coat and backpack.
~When I arrive in Lake Placid I have to explain to everyone who hasn't seen me yet what the cane's all about. Helpful yet annoying acquaintence tells me my upcoming hip surgery will be a piece of cake. "A friend of mine had both of hers done at once and was back in action a couple of weeks later." A few repetitions of, "I'm not having them replaced" did not get through ... I finally resorted to the tried and true, "they are breaking my pelvis in 3 places" ... Blank look ensued. I smiled and went to get some hot chocolate.
~I am told by everyone that the hotel is a "short walk" from the rink. This "short walk" is downhill on snow and ice and I have a cane that is broken. The able-bodied judges, some twice my age, walk to the rink while I wait for the shuttle. Alone. Pathetic. Feeling sorry for myself.
~Shuttle passes the others, who look mighty cold out there. I smile smugly from the warm heated shuttle seat. Perhaps there is a silver lining after all.
~My husband calls from home to tell me that my handicapped parking papers have arrived in the mail. Yee haw, I will be able to go to the mall before the holidays!
~On Sunday I am scheduled to leave on the 5:15 AM shuttle for the two hour ride from Lake Placid to Albany to catch my 12:45 flight out. Um, OK, I guess sleep is overrated after all. The later shuttles all appear to be full so I half-heartedly set my alarm for 4:15 AM.
~I'm on the shuttle on time. It's one of those big tour buses. Thankfully there is a bathroom. However, the heater appears to be broken. I attempt sleep in a half frozen state and eventually give up and listen to the guy behind me snore. The scenery in the Adirondacks is beautiful, but this early in the morning it's too dark to see much.
~I am in first class on my flight and finally able to sleep after a couple of Baileys!
~I arrive in Portland to the rare winter storm which has shut down the city. After traveling all day, all the way across the continent, I am halted within 20 miles of my home and have to spend the night in an airport hotel room. The lesson learned - always pack an extra pair of underwear just in case you are stranded for an additional night. Thankfully I learned this lesson on a previous trip and I was well prepared.
~Screaming children run up and down the hotel hallways into the wee hours. The people in the room above me appear to weigh a lot and walk around the room dragging tree trunks or dead bodies, and/or jump on and off the bed, until midnight. Is this my destiny? Do these loud hotel people follow me around every time I travel somewhere? I swear I am not making this up.
~The next day dawns bright and early. My office is closed due to weather, which means I can spend most of the day getting from the airport to my house. I take the hotel shuttle to the airport, take the parking shuttle to my car, drive my car downtown and park it at work, wait for the bus for an hour and a half (temperature = 18 degrees, but note that it's really zero degrees with wind chill). I know my car won't make it up the ice covered hill to my house without chains, and the last time I left a car at the bottom of the hill and walked up, someone smashed into it. Thus I am leaving the car in the lot downtown. I would rather bus it and walk than deal with that hassle again.
~Buses are on "snow routes," which means they come sometimes, maybe, on occasion. I ride bus 51 which shares a stop with bus 15. Within 10 minutes, four (FOUR) #15 buses come and go. None carries more than a few people. Where is the 51? Can't someone simply reverse the damn digits and give me a 51 bus? I'm freakin' freezing out here! And hey, I have to pee, but I am not going to do that because if I do I know the bus will come while I'm in there.
~The 51 finally comes (I've been standing outside waiting for over an hour and oh by the way, I walked 10 blocks to the bus stop) (and 10 blocks may not sound like much to those of you with normal hips but for me it is about 9 too many), and today the bus is on "alternate route" status which means it goes everywhere it would on a normal day, except near my house, and so I realize it is going to drop me half a mile from my house vs. a few blocks away. I get on the damn bus anyway because what else am I going to do?
~I realize that I am not supposed to walk, much less on ice in subzero temperatures, for half a mile. Oops. Oh yeah, I'm disabled. Forgot about that. And did I mention I never had time to get the cane fixed? It's going to be pretty useless.
~Bus drops me off, I walk the half mile (very slowly) ... the standing in the cold waiting for the bus made my hips hurt, but the walking on ice is making them REALLY hurt. I am almost home, but then ...
~I live on a narrow winding steep two-way road which is only about one car width wide. We call it the Goat Trail. I realize I may have to slide on my butt down the iced over goat trail to get home. Luckily I am able to remain vertical, but it takes a very long time to negotiate the icy slope.
~I arrive home to a roaring fire and needless to say, run for the bathroom. It takes about 2 hours to thaw out.
~Next trip: Cleveland in January, oh joy. Another icy cold adventure awaits, but at least I know I'm up to the challenge.
~There's no place like home!

P.S. - I would like to write about my ongoing adventures with that marvel of modern machinery, the automatically flushing toilet, which is available in fine airports all across America, but that will have to wait for another day. It's a topic I've wanted to write about for a long, long time, so stay tuned. It's bound to be a very special post, and just in time for the holidays.

Sunday, December 7, 2008

Thank you, Dr. Tennant

I re-read my very first couple of posts here today. Yes, I'm talking about those shocked and angry posts that I wrote post diagnosis. At the time I was pissed off about how the orthopedist, Dr. Tennant, gave me the bad news. I was particularly peeved that he had told me I had to quit skating, as if he were telling a diabetic to lay off the candy. I was angry that he assumed skating was a trivial part of my life. I was angry that he thought swimming or elliptical training could take the place of skating for me since they all were "exercise." I was angry that he didn't react with any empathy to my distress over this catastrophic new state of affairs in my life. I was angry at his monotone delivery. I was angry that he had no other answers for me.

Well, I am still skating of course (shhhh, don't tell). I am not jumping and never will again, but my primary focus has been ice dancing, not freestyle, so really it's no great loss. The fact that I took up jumping again on a whim a few weeks before my diagnosis tells me that flirting with freestyle probably exacerbated my condition. But that realization isn't what's prompting me to post today.

I have read so many accounts of people with hip dysplasia being misdiagnosed. This seems odd to me since even I can now look at x-rays and diagnose hip dysplasia. OK, I'll admit that I'm no expert, but it seems pretty obvious to me. As poor as his bedside manner was, I have to thank Dr. Tennant for correctly diagnosing me, for knowing about PAO (it amazes me how many orthopedists have never heard of PAO) and for referring me to one of the best specialists in the country for hip dysplasia and PAO. I realize now that I could have been misdiagnosed, given bad advice, subjected to surgeries which would not have done any good, or perhaps told that nothing at all could be done.

Had I been told nothing could be done, I may have waited years until my arthritis progressed to the point that nothing really could have been done. As it is, my dysplasia is severe but my arthritis is mild. I am the kind of person that PAO is most likely to help.

Dr. Tennant, I didn't like you very much in August. I guess I wanted to shoot the messenger, and I will say your delivery leaves something to be desired. I have to thank you though for pointing me in the right direction. The alternatives would have been far worse.

Friday, December 5, 2008

Hip Travels

I just realized that I'm going out of town next week by myself. On an airplane. To a place with lots of snow.


I hadn't even really thought about it since in the past I've traveled a lot on my own. But now I realize that I'm going all the way from west coast to east coast with a layover in the middle, then catching a shuttle for a two-hour ride to my destination in Lake Placid. All with luggage. Lots of luggage. We're talking big huge down coat, snow boots, hats, etc.

It didn't even occur to me when I booked this flight that I might have to walk a long way from my arrival gate to my departure gate during the layover. That has never been an issue before, but now it is. Should I get wheelchair assistance? OMG, I can't even go there yet. Maybe I can ride on one of those motorized vehicles. When I get to Albany, how will I negotiate my luggage by myself? My last trip (first with cane) included Perry to help me; this time I'm flying solo.

Lake Placid is a winter wonderland in December. I sure hope that they are providing door-to-door service from hotel to rink because I don't want to walk in all that wonderland. I can't believe I'm actually saying that! I can't believe I'm afraid of falling down in the snow and ice but I am, more from the perspective of embarrassment than possible further hip damage. After all, I skate and I'm not afraid to fall at the rink. But who wants to see a lady with a cane fall down? Who wants to be known as the lady with a cane who fell down? Worse yet, who wants to be known as THE JUDGE WITH A CANE WHO FELL DOWN? I get a headache just thinking about that. The skaters already think we are too old and decrepit as it is.

I am sure I'll do fine. I'm just realizing though how much more difficult life has become, and how much I used to take for granted.

P.S. - I know those of you who have traveled home by airplane after being discharged from the hospital post PAO surgery are laughing out loud and thinking, "Ha, you ain't seen nothin' yet honey!"

Wednesday, December 3, 2008

It's official ...

I'm depressed.

I met with a counselor from my employer’s EAP on Monday. She told me that I am “grieving,” that my response is normal, and that it is going to take a long time to come to terms with things, accept them, and transition to my new life circumstances. I have been going through all the classic phases of grief – anger, denial, bargaining, depression, bitchiness, crankiness, sarcasm, uncontrolled swearing, and whininess. OK, see, I still have my sense of humor. Kind of.

It was good to have a professional validate my feelings. It’s OK for me to feel crappy. If anyone tells me that “it will be all right” or “other people have it much worse than I do,” I have a right to slap them silly and walk away. I know other people have it much worse than I do. That doesn’t mean that I don’t have a right to feel pissed off about my own rather crappy situation.

Throwing fuel on the fire, I’ve been in contact with my surgeon’s office trying to understand WHY Aetna doesn’t cover PAO. They have not given me a very good reason and I need to understand so I can take action. In typical condescending doctor’s office speak, they told me to butt out and let them handle it. They also told me, in exactly these words, that I am “not the only patient feeling the financial pressures.” Duh. My response was that I am operating on the concept of "you have to look out for yourself and your own health care because nobody else will." It’s not that I don’t want to help all of the other people feeling the financial pressures out there, but right now I can only fight for myself. It's called the survival instinct.

So who out there is curious about why Aetna denies PAOs? It’s not what you think. No, it's not that they can't spell "dysplasia." It’s not that they don’t like people who walk funny. It’s not even that there haven’t been enough research studies done. No, according to what I’m hearing, it’s because there is no procedure code for this operation. Doctors bill it using the code 27299, which means “unlisted procedure.” And, seeing that it’s "unlisted," Aetna promptly denies it.

What? Are you kidding me? This has to be the most asinine thing I have ever heard. Does this mean they don’t even read the file to find out what was done? They see that something “unlisted” was done and they just say NO? Please, give me a break. Based on all of the hip women I know, quite a few of these procedures are being done. Can’t the insurers and doctors, ahem, let’s see, I need to think really hard about this because I’m not as smart as they are… can’t they just CREATE A CODE????

WAIT, I know, maybe it’s a computer programming issue. Maybe the computers need the codes to be 5 digits, and all of the digits between 00000 and 99999 have already been assigned. That must be it. We’re out of codes! There are no more! So, medical scientists, you might as well stop doing any research or coming up with new operations and procedures, because when it comes to coding them you are SOL.

Of course I don’t really think that’s the issue, but I can’t comprehend what the issue might actually be. Someone help me out here. How fucking difficult can it be to create a 5-digit number?

The doctor’s office also told me that they won’t schedule any more surgeries until they either have authorization in hand from the insurance company OR the patient signs an agreement up front promising to pay cash for the surgery (at the bargain cash price of $70,000 for each hip). I told them to keep my July date and that yes, I’d pay cash if I had to. Send me the agreement and I'll sign it.

OK, so after this news, I decided it was time for the icing on the cake of my day … looking at my retirement funds and figuring out if I have enough money to pay for this. My retirement funds have taken a huge hit. I guess that should not be news to anyone reading this since I've recently discovered that "I am not the only one feeling the financial pressures." Could the timing for this be any worse? We're in the middle of the worst recession since perhaps the great depression and I need to sell investments?

All three of my retirement vehicles are down, way down, but the good news is that if I cash out right now, the funds I have accumulated as a result of the last 25 years of living frugally so that I can fully fund my retirement will be enough to pay for two surgeries, with a little left over to buy some new underwear. My life savings can get me my PAO. And, by July of next year, who knows, the market may go up!! Or, it may go down and I'll have to forego the underwear!! I have no idea!!

Just when I thought the day could not get any worse, I talked to H.R. at my employer about the logistics for taking a hardship withdrawal from my 401(k). I explained the situation. I told them that I was not pleased with our medical plan's policies. Here, verbatim for your amusement, is their reply.

I'm so sorry---it sounds like a difficult time. {EDITOR'S NOTE: NO KIDDING}
It's true medical plans do not cover all services. The good news is that according to our benchmark surveys, most employers have increased deductibles, premiums and co-pays this year. Our plans have none of these changes this year. While the plans won't cover everything, we're working hard to help you maintain the best coverage possible.”

What, medical plans do not cover all services? No Shit. It’s not like I’m asking them to pay for botox injections, for crying out loud. This is a real surgery, for a real condition, causing real pain and disability. It is not elective. It is not experimental. It is not optional for me.

But thanks guys, thanks for the great news! I’ll sleep so much better at night knowing that my deductibles, premiums and co-pays will not be increasing this year, even though the plan won’t cover everything … in fact, the plan won’t cover ANYTHING that I need, but at least it won't cost me more. And best of all, I GET THE BEST COVERAGE POSSIBLE. Yee haw! Party time! Pardon me while I PUKE and SCREAM and CRY and SWEAR.

It’s all part of that grieving process I’m going through.