An Impromptu 32-Week Visit and Firsthand Exposure to the Health Care Reform Debate

Last month I had an MRI of my gimpy knee. As I blogged about earlier, the MRI technician/specialist/whatever-his-title-is, thought he was checking for a torn ACL, not an ACI repair. Hey, mistakes happen, right? Well, he still wrote up a report. When I met with my surgeon last month, however, the report was not available. Instead, my surgeon told me he asked the MRI guy to re-do the report, which, I thought, meant focusing strictly on the ACI repair. Bad assumption, it turns out; more on that in a moment. Meanwhile, we reviewed the actual MRI pictures together, and Dr. T shared the good news that everything looked great. I still wanted the report, though. Dr. T said he would send me the revised report when it was available. He knows that, as a lawyer, I like written reports.

A few days after my appointment, I had yet to receive the “revised” MRI report. It turns out the guy never re-did his report. Instead, he simply noted on a separate cover sheet his mistaken assumption about my ACL. That’s it. Considering how much MRIs cost, that MRI probably wasn’t a good use of health care dollars. Consistent with today’s debate over health care reform, they’re not “my dollars” so, frankly, I’m not too concerned. Sad, but true.

Anyway, I still wanted a copy of the report. Even though it focused on my ACL, it nonetheless examined other parts of my knee, so that information would be helpful and I was anxious to review it. I finally received it about one week after my appointment.

Incredibly, the report failed to mention the ACI-repaired lesions on my patella and trochlear groove. At first, I thought this was yet another example of the technician’s incompetence. I don’t think it’s a stretch to say that the guy who mistakenly checked for a torn ACL would also miss a cloned graft, right?

Apparently not. When I finally reviewed the report with my surgeon, Dr. T told me he actually spoke with the MRI guy, who told him he was surprised to learn I had undergone a cartilage implant. When he examined the MRI, he simply didn’t notice any difference in the consistency between the “old” cartilage and the “cloned” cartilage. Now, I’m hesitant to do the Tiger Woods double fist pump because of the guy’s earlier screw-up. But it’s hard not to be pretty stoked.

(Speaking of Tiger, why didn’t the CBS golf announcers state the obvious at the PGA Championship: Tiger choked on those last few holes. Period. Even Michael Jordan missed potentially game-winning shots. It happens. Yeah, it sucks when your off day just happens to be during the final round of a major in a year in which you hadn’t won one. But there’s no shame in that. Hey, even the best f*ck up. Ok, back to my knee)

The MRI report, however, did identify some areas of concern, which I discussed with Turgeon. Incredibly, it said I had a torn meniscus on the medial side of my posterior horn.

What the f*ck?!?!

For the past 7 months, I haven’t been preparing for my UFC debut or even playing pickup hoops. Nope. I’ve spent my time on the couch or hobbling around an office with a bunch of government drones. My craziest activity has been riding a stationary bike – not exactly the kind of situation that leads to torn meniscuses, you know.

Before I share my conversation with Dr. T about the MRI report, let me explain a few things about a meniscus tear before friends and family freak out. First, this “tear” has nothing to do with the areas of my knee repaired by ACI. Totally unrelated (well, except for the fact that multiple knee surgeries surely have made my knee more prone to injury). Next, in the world of knee surgeries, a meniscus tear is pretty minor. Usually, a simple scope cures it. I’ve actually felt a slight twinge of pain in this particular spot for a few months. Nothing serious, though. The discomfort rarely lasts more than a brief moment, and doesn’t impact my daily functioning. I mean, I don’t want to downplay a meniscus tear. But I’m not overly concerned, other than how I could’ve possibly torn it during my recovery. I’m still shocked.

Despite what the report says, Dr. T isn’t convinced my meniscus is torn. During our initial review of the MRI pictures, I recall he noted some splotches on the MRI of some minor concern. I’m not sure he was pointing to the meniscus. But during our follow-up, he showed me the affected area. There was some “grayness” there, which apparently might be indicative of a possible tear. However, it wasn’t large or deep enough, in Dr. T’s mind, to say definitively, “Yes, it’s torn.” He said the only way to tell would be if he scoped my knee.

Of course, my response was a subtle, “No f*cking way.”

I only want him – or anybody – cutting me open if surgery is absolutely necessary. And it’s not necessary to “scope me” just to see if it’s torn.

So, as of now, I’ll just continue rehabbing as usual. Actually, Dr. T wants me to step things up to improve my quad strength. He reiterated that everything looks fantastic with my knee; he’s ecstatic how things turned out. Now it’s time to put Lou Ferrigno to shame with my workouts.

We also took another X-ray of the osteotomy, something we do at every visit. My screws and the bone wedge continue to irritate me. The screws bulge from my shin like the belly on a 9-month pregnant lady. You can read the Black-and-Decker label through my skin.

Things have gotten better, but I still feel like the osteotomy is holding me back, even more than the actual surgery. After reviewing the X-ray, Dr. T isn’t surprised. While the bone has filled in just, he says it’s continuing to harden, and thus the bone remains sensitive. Normally, the hardware can be removed at the 12-month mark, but in my case he suggests waiting several additional months to give the tibia extra time to heal.

Next up is another MRI in October, at the 10-month mark. Dr. T mentioned this time they’ll do a bunch of other stuff to specifically focus on the cartilage. My first thought? Uh, why didn’t they do this type of review the last time? Is there a particular reason to do another MRI only 3 months later? Again, because I’m not paying (I don’t have a co-pay for MRIs), I’m not complaining. The extra information can only benefit me. But this just seems symbolic of the current debate over health care waste. Maybe the additional test is just covering for the previous screw-up. I’m not sure. But part of me – that speck of a conscience buried far deep inside and which rarely surfaces – feels a bit uncomfortable being a party to possible wasteful spending.

And then I remember how often insurance companies screw over patients, and those concerns begin to fade away.