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.
Wednesday, December 17, 2008
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.
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.
Yikes!
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!"
Yikes!
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.
“Terri:
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.
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.
“Terri:
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.
Saturday, November 29, 2008
I’m over 40 … and my timing stinks
A new study was published which concludes that the outcome of PAO for patients over 40 is “not as good as” the outcome of total hip replacements. While it doesn’t say the outcome with PAO is “bad,” for an insurance company this is denial fodder worth its weight in gold.
Thanks guys, please kick me while I’m down.
As of November 1st, my insurance company, along with most others, has unilaterally decided not to pay for PAOs. This probably means that they WILL pay for some, if you make a really great case on appeal, but that by and large they consider this rare operation, which has helped women for 30 years, to be “investigational.” Not enough large studies have been done. Hmmm, how many is “enough”? There are quite a few small studies that I’ve read, but how can anyone do a large study when this surgery is so rare? This isn’t like diabetes or heart disease – run of the mill maladies which every Tom, Dick and Harry seems to have nowadays. And oh, by the way, Tom, Dick and Harry probably don’t have hip dysplasia because the vast majority of people with this condition are WOMEN. We all know what whiners women are … with their subjective complaints and all. Those women, they want special, expensive surgery for all their silly little problems … we big insurers need to let them know that we know what’s best for them!
Believe me, if I could have a total hip replacement or resurfacing instead of a PAO I’d be overjoyed. Recovery time for THR is short, and one is only in the hospital for a couple of days. I’d be walking and full weight bearing the day after surgery, and probably skating again within months. Not that THR is a cakewalk, but compared to PAO it’s “hip surgery lite.”
The problem is that my dysplasia is on the severe side, and it’s coupled with severe anteversion. THRs are not designed for people built like me. They, and their cousin the hip resurfacing, are designed for people whose hips are fairly normal in mechanical construction, with perhaps small abnormalities, but which are diseased or worn out. While there is a “dysplasia cap” available for hip resurfacing, again, it is not designed for severe cases. Two experts have now told me that my best course of action is PAO, based on the severity of my mechanical imbalance and the fact that my hip joint is basically healthy. Why would I remove and replace a healthy joint! Why would anyone do that? It seems obvious to me that correcting the structural imbalance, preserving the joint, and avoiding multiple revision surgeries is my best course of action. I’m seeking a third opinion. How many expert opinions do I need to override Aetna’s blanket policy?
I will add that I am not your typical 45 year old. I like to think that I am in better physical shape than most. I am not overweight. I am very muscular. I have exercised all my life. What about the over 40 patients in the new study? How many of them were like me? Is the only thing we have in common that we are "middle aged"? Yes, I am over 40, but my life isn’t over yet. I’m not ready to take up knitting or lawn bowling. MY PERFECTLY HEALTHY HIP JOINT SPACES DO NOT NEED TO BE REPLACED … that is not my problem, oh stupid insurance company flunkie reading my file. What I need is better femoral coverage. Isn’t the solution obvious?
Thanks guys, please kick me while I’m down.
As of November 1st, my insurance company, along with most others, has unilaterally decided not to pay for PAOs. This probably means that they WILL pay for some, if you make a really great case on appeal, but that by and large they consider this rare operation, which has helped women for 30 years, to be “investigational.” Not enough large studies have been done. Hmmm, how many is “enough”? There are quite a few small studies that I’ve read, but how can anyone do a large study when this surgery is so rare? This isn’t like diabetes or heart disease – run of the mill maladies which every Tom, Dick and Harry seems to have nowadays. And oh, by the way, Tom, Dick and Harry probably don’t have hip dysplasia because the vast majority of people with this condition are WOMEN. We all know what whiners women are … with their subjective complaints and all. Those women, they want special, expensive surgery for all their silly little problems … we big insurers need to let them know that we know what’s best for them!
Believe me, if I could have a total hip replacement or resurfacing instead of a PAO I’d be overjoyed. Recovery time for THR is short, and one is only in the hospital for a couple of days. I’d be walking and full weight bearing the day after surgery, and probably skating again within months. Not that THR is a cakewalk, but compared to PAO it’s “hip surgery lite.”
The problem is that my dysplasia is on the severe side, and it’s coupled with severe anteversion. THRs are not designed for people built like me. They, and their cousin the hip resurfacing, are designed for people whose hips are fairly normal in mechanical construction, with perhaps small abnormalities, but which are diseased or worn out. While there is a “dysplasia cap” available for hip resurfacing, again, it is not designed for severe cases. Two experts have now told me that my best course of action is PAO, based on the severity of my mechanical imbalance and the fact that my hip joint is basically healthy. Why would I remove and replace a healthy joint! Why would anyone do that? It seems obvious to me that correcting the structural imbalance, preserving the joint, and avoiding multiple revision surgeries is my best course of action. I’m seeking a third opinion. How many expert opinions do I need to override Aetna’s blanket policy?
I will add that I am not your typical 45 year old. I like to think that I am in better physical shape than most. I am not overweight. I am very muscular. I have exercised all my life. What about the over 40 patients in the new study? How many of them were like me? Is the only thing we have in common that we are "middle aged"? Yes, I am over 40, but my life isn’t over yet. I’m not ready to take up knitting or lawn bowling. MY PERFECTLY HEALTHY HIP JOINT SPACES DO NOT NEED TO BE REPLACED … that is not my problem, oh stupid insurance company flunkie reading my file. What I need is better femoral coverage. Isn’t the solution obvious?
Tuesday, November 25, 2008
Giving Thanks
I haven’t written here in a while. I’ve been concentrating on living life, and trying not to think about surgeries and such. Things are mostly status quo, except walking is getting more difficult. I walked 6 city blocks to meet Perry at the optometrist last night – I thought driving would be stupid – and I’m regretting it today. It didn’t hurt much at the time, but I need to realize that the next day is always the killer.
My knee, elbow and tricep are also sore because of a fall Tim and I took on the ice yesterday. It was just a stupid fall during a free dance run-through, on our circular footwork of all things. I just went into a drape and fell for no reason, and took him down with me. I don’t think this fall was hip related, although I do notice that generally I’m not as steady on my blades any more and rely on Tim more for support. We got up and kept skating the rest of the session since we are so tough. I’m sure Dr. Mayo would not approve of any of this since I’m supposedly limited to “low impact” activities such as swimming, the elliptical machine, and sitting on "The Bean" watching TV. Ahem. Thank goodness Dr. Mayo's way too busy to read this blog.
The purpose of this post is not to complain as I usually do, but to give thanks. There are all kinds of reasons to do this. In frightening economic times, Perry and I both have jobs. We have health insurance (although it is doubtful mine will cover my PAO, but that is a story for a complaining post, not for a thankful post). Our parents are healthy. Overall, we are healthy, hips excluded of course. The kids are doing well in school and staying out of trouble. Other than our mortgage, which is at a low, fixed rate, we have no debt. Our home has lost a bit of value but we bought it at a good price before prices started to heat up; we plan to keep it for a while and we’re not under water. Our 401(k)s have taken a hit, but we aren’t planning to retire any time soon. We do feel very lucky that we are weathering these financial difficulties well, since we know that is not the case for everyone. Many of our friends have had setbacks and we can only be supportive.
I am thankful for all that I have, for my wonderful family and friends, and for Perry, who has cheered me up even when I don’t want to be cheered up. We are truly lucky.
My knee, elbow and tricep are also sore because of a fall Tim and I took on the ice yesterday. It was just a stupid fall during a free dance run-through, on our circular footwork of all things. I just went into a drape and fell for no reason, and took him down with me. I don’t think this fall was hip related, although I do notice that generally I’m not as steady on my blades any more and rely on Tim more for support. We got up and kept skating the rest of the session since we are so tough. I’m sure Dr. Mayo would not approve of any of this since I’m supposedly limited to “low impact” activities such as swimming, the elliptical machine, and sitting on "The Bean" watching TV. Ahem. Thank goodness Dr. Mayo's way too busy to read this blog.
The purpose of this post is not to complain as I usually do, but to give thanks. There are all kinds of reasons to do this. In frightening economic times, Perry and I both have jobs. We have health insurance (although it is doubtful mine will cover my PAO, but that is a story for a complaining post, not for a thankful post). Our parents are healthy. Overall, we are healthy, hips excluded of course. The kids are doing well in school and staying out of trouble. Other than our mortgage, which is at a low, fixed rate, we have no debt. Our home has lost a bit of value but we bought it at a good price before prices started to heat up; we plan to keep it for a while and we’re not under water. Our 401(k)s have taken a hit, but we aren’t planning to retire any time soon. We do feel very lucky that we are weathering these financial difficulties well, since we know that is not the case for everyone. Many of our friends have had setbacks and we can only be supportive.
I am thankful for all that I have, for my wonderful family and friends, and for Perry, who has cheered me up even when I don’t want to be cheered up. We are truly lucky.
Wednesday, November 19, 2008
New Product Review: AquaBells
I need to remind myself that hip dysplasia is not simply an excuse to buy new gadgets, although the upside to major surgery will be getting my very own "hip kit," sock-putter-onner, raised toilet seat, crutches and metamucil.
A pre-surgery gadget arrived today from Amazon: AquaBells, an exciting concept in hip fitness.
AquaBells are ankle weights which can be filled with varying amounts of water so that they weigh up to 4 pounds. I have started with about a pound of water and have gone through my hip exercise just fine. Once I am less of a wimp, I will be able to add weight slowly by adding more water. As long as they don't leak, I should be fine.
Since I travel, these will be handy to take with me since they only weigh a few ounces when empty. The one drawback is they are a little messy to fill from the faucet, but really not much -- it's a small price to pay for portable equipment which expands as I get stronger.
Lots of fun typos on the packaging ("Exercise quadriceps, hamstrings, inner thighs, and calf's ..."). Humor like this is always appreciated, especially during strenuous workouts. Overall I recommend these.
A pre-surgery gadget arrived today from Amazon: AquaBells, an exciting concept in hip fitness.
AquaBells are ankle weights which can be filled with varying amounts of water so that they weigh up to 4 pounds. I have started with about a pound of water and have gone through my hip exercise just fine. Once I am less of a wimp, I will be able to add weight slowly by adding more water. As long as they don't leak, I should be fine.
Since I travel, these will be handy to take with me since they only weigh a few ounces when empty. The one drawback is they are a little messy to fill from the faucet, but really not much -- it's a small price to pay for portable equipment which expands as I get stronger.
Lots of fun typos on the packaging ("Exercise quadriceps, hamstrings, inner thighs, and calf's ..."). Humor like this is always appreciated, especially during strenuous workouts. Overall I recommend these.
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