March 27, 2010

Make It Go Away

Yesterday I arrived at my surgeon's office and the receptionist asked me for my insurance card.

"Oh, when you scheduled your appointment, did they tell you that we don't take your insurance anymore?" she asked.

"No," I told her, "If they had told me that, I wouldn't have scheduled my appointment."

I looked at my card, saw the 50/50 out of network numbers and figured I was just going to go through with the appointment. I once fought my insurance company over not paying for an ultrasound because I went "out of network" after I had specifically called and asked them where I could go and they told me that place. I could fight this one too.

I'm nothing if not a fighter.

A familiar face took two x-rays of my knee. It was like deja vous. This is number three.

I sat in the room waiting for my surgeon, staring at the computer screen with the picture of my knee on it, trying to figure things out myself. I don't know what I thought I was going to figure out. It's pretty obvious when there is a screw protruding from your tibia so much so that you can feel it through your skin.

My surgeon came in and held out his hands, a gesture that said, "What are you doing here?" and I pulled up my pant leg. (See that yellowish spot to the direct right of the dark purple part? That's the screw.)


He spent some time poking around at it, moving my skin around, something that makes most people want to put their head between their knees and say "stop it before I pass out."

He said what I knew he was already going to say. I need more surgery. This time, he says he will remove more of the screw. I asked him why he can't just take the whole thing out and he said he can't. Part of it has turned into bone in the middle of my tibia. The part sticking out has not.

The weird indentation I have in my leg is due to "fat atrophy," probably a side effect from the cortisone shot he gave me a while ago, back when I kept complaining I was in pain and he thought it might have just been from an abundance of scar tissue, not from the screw sheath sticking out which only became obvious after the months of swelling had gone down. Because of this fat atrophy, my body is literally skin and bones at that part of my leg. I have no cushion and that my friends, is no fun.

He talked about excising some tissue and pulling the skin over when he closes me back up so that this problem will hopefully go away. I asked him why he couldn't just take some fat from my butt, thighs or stomach and he said it doesn't work that way. Truth be told, it should work that way. That would be sweet. 

As we wrapped up our conversation, I told him that his office no longer takes my insurance. He said he would call me next week, after they talked to my insurance company, to let me know how much it would cost me. I can already tell you the likely answer: too much.

I asked him about a "buy two, get one free" special, but unfortunately, surgeons are not shoe stores.

I called Mr. BBM and put him on the insurance questions I had. Which surgeons do take my insurance? Does the hospital and surgi-center take my insurance? They both do, so the out-of-pocket costs for me come with my surgeon's fees. Last surgery, I believe it cost me about $100 per minute, which is probably a drop in the bucket for a surgeon. Unfortunately, that's not the case for me. 

Not to mention, I have already spent thousands of dollars on co-pays, surgical costs, appointments and physical therapy. This has been almost three years of expenses for me. As soon as I get one paid off, I've had to go back for more surgery.

I came home and Mr. BBM encouraged me to call a different surgeon. A couple months ago, I ran into my old high school athletic trainer. He is still at the school and is a wonderful guy. I worked for him as an athletic trainer my senior year and loved it. He asked me how I was and I embarked on my ACL saga. I asked him which surgeon he recommends if a student athlete tears their ACL. He gave me a name and that's who I called yesterday afternoon.

My trainer had told me it might take me weeks or even months to get in with him, so he told me to mention his name. I did and I have an appointment on Wednesday.

I am torn though. I have a real comfort level with my current surgeon. While some of my friends and family think I should see someone else, I don't know what to think. My surgeon has a personality, one that I get along with quite well. I feel like he's always been straight-forward with me and that he has my best interests in mind. However, I'm also on my third surgery now for what should have been finished, once and done, back in December of 2007. I don't know what to think. Am I part of the 3% that has a problem with the bioscrew? Am I part of the small minority that will have an unfortunate reaction to a cortisone shot?

I don't know.

The way I see it, Wednesday's appointment will be a fact finding mission. I will gather as much information as I can this week so that I can make an educated decision about who I want to do the surgery and when. When my current surgeon calls me with the fees he would charge, I have a feeling the decision will be more obvious.

However, I don't look forward to another OR visit. I especially don't look forward to going in there with a stranger.

There is one thing I'm absolutely sure about though. I want this to be the last time; and I want this ordeal to be over.

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