With less than 2 days until D-Day, I’ve got Europe’s “Final Countdown” running through my head. Of course, Final Countdown brings mixed memories. The song reminds me of Arrested Development’s Gob performing magic tricks and making a high school mix tape – Final Countdown was the first song on Side A of the CasEtri. It’s a tough call which is more fitting of a knee surgery countdown.
I met with my OS this morning to go over the last-minute paperwork. Most of it was routine – hearing the standard admonition not to eat or drink after midnight; receiving a prescription for powerful narcotics; and signing a waiver acknowledging all the bad possible outcomes (always a personal favorite for lawyer-patients). I did, however, learn something new. My surgeon’s starting his own practice in 2009. He spent the first 20 or so years on his own before joining the current practice a number of years ago. He brought his own staff with him then, and all of them are leaving with him now. His new practice opens January 1st.
My first thought – Oh, shit. Will he still be on my insurance plan? This doesn’t impact the Dec. 31st surgery, but might impact the dozens of follow-up appointments. EOBs full of evil out-of-network charges instantly flashed before my eyes. But Turgeon says the insurance won’t change. He picked all of his insurance carriers and medical supply contacts prior to joining his current practice, and he’ll keep them when he opens his own office. At this point, BCBS still lists him as a “preferred provider” for 2009, but it also still shows his old address. As my father wisely counsels, it’s beyond my control so there’s no need to worry right now.
After leaving the doctor’s office, it was time to pick up some last-minute items. We went to Dougherty’s Pharmacy, which, fittingly, resembles a 1950’s Mom & Pop Dime Store. In fact, I think most of the shoppers in the store today could’ve been customers in the 50’s, too. Except for the cashier, Christina and I were the only folks younger than 350 years old. All of the store signs were written in 48-point font.
A tad bit embarrassed, I asked the cashier where the shower seats and, ahem, toiler seat risers were located. At first, I wanted to lie and tell him the items were for an elderly relative. No dice. I quickly gave myself away when I started “test-driving” the different toilet seat risers. I’m not kidding. I took a couple of mock poops before making my final selection.
The store offered 2 options: (1) the toilet seat shaped like a walker with a slender bowl-rim suspended in the middle, and (2) the oversized toilet cover that rises like a skyscraper 5 inches above the bowl. After hurriedly squatting back-and-forth between my toilet seat options like an antsy 4-year old, I settled on the oversized riser. Made by Nova, the heavily molded toilet seat provides luxurious comfort, as well as side handles that allow me to push off back to my feet. I consider it the Cadillac of raised toilet seats. I have a feeling I won’t want to give it up even after my knee heals. I know George Costanza wouldn’t. For my shower seat, I chose a basic white bench with a single red handle, completing our bathroom renovation. Unfortunately, Dougherty’s refused to throw in a free Driving Miss Daisy DVD.
Anyway, here's the bottom line:
Toilet seat riser -- $85.
Shower seat -- $55.
Geriatric purchase experience? Priceless.
Showing posts with label pre-op. Show all posts
Showing posts with label pre-op. Show all posts
Monday, December 29, 2008
Sunday, December 7, 2008
Still waiting. . .
No surgery date yet. I joked that the cloning company, Genzyme, must be having a good year. It seems like every company is stuffing sales into year-end to make its numbers, yet my surgery likely will get pushed into 2009. I’ll welcome in the New Year, and then quickly accomplish everybody’s #1 resolution: getting a cloned knee.
On Friday, I met with my OS and Jimmie, a specialist from Genzyme. Jimmie was great. Part salesman, part trainer, he’s knowledgeable about the ACI surgery, having trained many orthopedic surgeons in this innovative procedure over the past decade. More importantly, Jimmie’s a terrific communicator. Before the OS arrived – by the way, why do doctors always keep you waiting for 40 minutes? – Jimmie and I spoke at length about the surgery and rehab. For each knee component, he used an analogy to enhance my understanding of the role each part of the knee played. He’s like a medical translator. This isn’t to diss Turgeon the Surgeon. Turgeon is personable, takes his time, and patiently answers all of my questions. He’s also regarded as one of the top ACI surgeons in the area, which, obviously, is kinda important. Sometimes, however, Turgeon forgets that I don’t speak medicalese, and Jimmie bridged that gap handily.
As a representative of Genzyme, one of Jimmie’s jobs was to review my medicals and confirm I’m a candidate for ACI. Jimmie quite bluntly told me, “Not everybody qualifies for ACI. Genzyme doesn’t want the wrong candidate who will screw up the company’s success rate.” Jimmie was like the anti-Chief Burrell, the Police Commissioner from The Wire who wanted to “juke the stats” to make Baltimore’s crime rate appear lower. I qualified as a “good candidate” for ACI. I’m not sure if that’s meant to be a compliment.
The 3 of us reviewed my MRI results and discussed the 2 lesions to be filled. The lesion on my patella is the smaller of the 2, but it’s trickier than the trochlear groove defect. Patella lesions historically have the worst ACI track record, largely because patellas absorb most of the pounding on a person’s knees. Moreover, the underlying injury often screws up knee alignment, which further increases stress on the knee. Over several years of trial-and-error (an expression that doesn’t comfort patients), surgeons discovered ACI implants in the patella were more successful when combined with a procedure to alleviate the stress on the patella. Jimmie said adding the second procedure improves the success rate by almost 20%. Usually, this means re-aligning the patella that got jostled during injury. In my case, however, my knee alignment is stable. Basically, my knee’s perfectly fine. Well, except for the 2 holes that shouldn’t be there.
Nonetheless, a similar procedure can still alleviate stress on my patella. During the ACI surgery, Turgeon will slightly raise my patella by a smidgeon (not a precise medical measurement). This doesn’t sound like a lot, but wait until you hear how doctors elevate the patella. In a procedure called a distal realignment (my particular version is called a Fulkerson), the surgeon breaks the edge of the tibia bone and re-connects the bone to the raised patella with a handful of screws. Yes, it’s supposed to be as painful as it sounds. Of everything that the knee suffers during the ACI surgery, this is supposed to hurt the most, though the pain generally subsides during the first 2 weeks. Of course, the screws will set off airport medical detectors for years to come...
Right now I’m waiting on final approval of the surgery from Blue Cross, Blue Shield, my insurance carrier. BCBS was at the forefront of coverage for ACI, and, according to Turgeon’s insurance liaison, covers ACI. Under my particular insurance plan, all surgeries are covered at 100%, minus $100 surgeon fee. Unfortunately, insurance carriers aren’t known as benevolent entities, even during the holiday times, and since ACI surgery costs $30,000 – new knee or new car? – I’m expecting some hassle over coverage. Don’t be surprised to see blog entries entitled, “BCBS is the devil.”
Once BCBS approves the surgery, Genzyme will produce 4 vials of my cartilage cells. Each vial contains 12 million cells. Turgeon doesn’t think he’ll need 48 million cells to fill my defects. I’m hopeful I’ll be able to take the leftovers home in a “To Go” vial. You know, just in case I need a few million cartilage cells some day.
On Friday, I met with my OS and Jimmie, a specialist from Genzyme. Jimmie was great. Part salesman, part trainer, he’s knowledgeable about the ACI surgery, having trained many orthopedic surgeons in this innovative procedure over the past decade. More importantly, Jimmie’s a terrific communicator. Before the OS arrived – by the way, why do doctors always keep you waiting for 40 minutes? – Jimmie and I spoke at length about the surgery and rehab. For each knee component, he used an analogy to enhance my understanding of the role each part of the knee played. He’s like a medical translator. This isn’t to diss Turgeon the Surgeon. Turgeon is personable, takes his time, and patiently answers all of my questions. He’s also regarded as one of the top ACI surgeons in the area, which, obviously, is kinda important. Sometimes, however, Turgeon forgets that I don’t speak medicalese, and Jimmie bridged that gap handily.
As a representative of Genzyme, one of Jimmie’s jobs was to review my medicals and confirm I’m a candidate for ACI. Jimmie quite bluntly told me, “Not everybody qualifies for ACI. Genzyme doesn’t want the wrong candidate who will screw up the company’s success rate.” Jimmie was like the anti-Chief Burrell, the Police Commissioner from The Wire who wanted to “juke the stats” to make Baltimore’s crime rate appear lower. I qualified as a “good candidate” for ACI. I’m not sure if that’s meant to be a compliment.
The 3 of us reviewed my MRI results and discussed the 2 lesions to be filled. The lesion on my patella is the smaller of the 2, but it’s trickier than the trochlear groove defect. Patella lesions historically have the worst ACI track record, largely because patellas absorb most of the pounding on a person’s knees. Moreover, the underlying injury often screws up knee alignment, which further increases stress on the knee. Over several years of trial-and-error (an expression that doesn’t comfort patients), surgeons discovered ACI implants in the patella were more successful when combined with a procedure to alleviate the stress on the patella. Jimmie said adding the second procedure improves the success rate by almost 20%. Usually, this means re-aligning the patella that got jostled during injury. In my case, however, my knee alignment is stable. Basically, my knee’s perfectly fine. Well, except for the 2 holes that shouldn’t be there.
Nonetheless, a similar procedure can still alleviate stress on my patella. During the ACI surgery, Turgeon will slightly raise my patella by a smidgeon (not a precise medical measurement). This doesn’t sound like a lot, but wait until you hear how doctors elevate the patella. In a procedure called a distal realignment (my particular version is called a Fulkerson), the surgeon breaks the edge of the tibia bone and re-connects the bone to the raised patella with a handful of screws. Yes, it’s supposed to be as painful as it sounds. Of everything that the knee suffers during the ACI surgery, this is supposed to hurt the most, though the pain generally subsides during the first 2 weeks. Of course, the screws will set off airport medical detectors for years to come...
Right now I’m waiting on final approval of the surgery from Blue Cross, Blue Shield, my insurance carrier. BCBS was at the forefront of coverage for ACI, and, according to Turgeon’s insurance liaison, covers ACI. Under my particular insurance plan, all surgeries are covered at 100%, minus $100 surgeon fee. Unfortunately, insurance carriers aren’t known as benevolent entities, even during the holiday times, and since ACI surgery costs $30,000 – new knee or new car? – I’m expecting some hassle over coverage. Don’t be surprised to see blog entries entitled, “BCBS is the devil.”
Once BCBS approves the surgery, Genzyme will produce 4 vials of my cartilage cells. Each vial contains 12 million cells. Turgeon doesn’t think he’ll need 48 million cells to fill my defects. I’m hopeful I’ll be able to take the leftovers home in a “To Go” vial. You know, just in case I need a few million cartilage cells some day.
Sunday, November 30, 2008
Pre-Op Preparations
Surgery #2 -- aka, the really painful one -- hasn't been scheduled yet. I've been assigned a rep from the cloning factory (sounds like a role in an Arnold Schwarzeneggar movie), and I have another follow-up appointment with my OS on Friday. By then, I’ll hopefully know when the cartilage cells will be ready and we’ll pick a surgery date. Once that happens, I’ll probably start some kind of D-Day Countdown on the blog. Maybe I’ll figure out how to post one of those T-Minus clocks NASA uses for the shuttle launch.
Meanwhile, I’m quickly grasping how drastically this surgery will change my life, especially in the short-term. It’s been just over 2 weeks since the “minor” arthroscopic surgery to harvest the cartilage cells, and my knee is close to 70%. I’m still limping, but I can walk without pain.
Many things, however, remain difficult, including several really simple, daily functions you take for granted. Let's just say it's not easy going potty with a leg you can't bend. I learned this the hard way when I got some sort of stomach bug after Thanksgiving. I spent most of Friday night in the bathroom. Not good times. I was just “thankful” I didn’t puke it up. My knee couldn’t handle praying to the porcelain god. Anyway, I might need one of those medical alert bracelets in case I get stuck on the toilet.
To minimize bathroom difficulties, it's recommended that ACI patients buy a toilet seat riser and shower seat. Neither is covered by insurance. I never thought I’d have to spend the cash left-over in my flex-spending account on these items. I’ll probably be the only shopper under 90 in Wal-mart asking about toiler seat risers. Of course, my recently deceased grandfather had both of these items, and I don’t think any of his heirs claimed them. I wonder what UPS would've said if I tried to ship home a toilet seat riser. Hmm...
Meanwhile, I’m quickly grasping how drastically this surgery will change my life, especially in the short-term. It’s been just over 2 weeks since the “minor” arthroscopic surgery to harvest the cartilage cells, and my knee is close to 70%. I’m still limping, but I can walk without pain.
Many things, however, remain difficult, including several really simple, daily functions you take for granted. Let's just say it's not easy going potty with a leg you can't bend. I learned this the hard way when I got some sort of stomach bug after Thanksgiving. I spent most of Friday night in the bathroom. Not good times. I was just “thankful” I didn’t puke it up. My knee couldn’t handle praying to the porcelain god. Anyway, I might need one of those medical alert bracelets in case I get stuck on the toilet.
To minimize bathroom difficulties, it's recommended that ACI patients buy a toilet seat riser and shower seat. Neither is covered by insurance. I never thought I’d have to spend the cash left-over in my flex-spending account on these items. I’ll probably be the only shopper under 90 in Wal-mart asking about toiler seat risers. Of course, my recently deceased grandfather had both of these items, and I don’t think any of his heirs claimed them. I wonder what UPS would've said if I tried to ship home a toilet seat riser. Hmm...
Subscribe to:
Posts (Atom)
