APPROVED!!!!!!!!!!!

  

     My surgery has been approved!!  Finally after all the doctors visits, phone calls back and forth and six weeks of physical therapy the idiots at the insurance company finally saw what everyone else already knew.  

   

     At first I wasn't sure if it was even going to happen after my follow up visit with the surgeon.  They submitted for the surgery and a week later I got a letter in the mail from the ins company that my request was under review and required more information.  Of course I received this letter when I got home from work on a Friday which meant I had to worry and stew about it all weekend.  Monday morning I called the surgeon's office and spoke with his nurse and she stated that she had already preemptively called the ins company, gave them the info they required and that were satisfied and that we had the green light.  She told me to disregard the letter, but could you blame me if I didn't 100% believe her.   I hung up with her and called the ins company, and of course they would tell me that in fact, no the surgery was not approved and was still in review status.  She did say, however that if the nurse just talked to the review board that the board my not have updated their records yet.  This being on a Monday, I decided I would give them a call on Thursday and if the status had not changed then I would call the surgeon's office again.  The same day I was going to call the ins company I received a letter from them stating that my requested procedure was "medically necessary" and that I was approved to have the surgery.  Of course I called to verify all this, and was so relieved that all this was finally over.  I have had my pre op screening at the hospital and in a little more than a week my journey back to running will begin.  

     I want to wish everyone a Happy Thanksgiving for tomorrow!  

     Those of you heading out and braving the black Friday weekend of shopping be safe and remember no amount of discount or deal is worth treating another human being with disrespect.  And that goes double when you are dealing with all the retail employees that are out there just doing their jobs and trying to support their families as well.

 

Physical Therapy is Complete

     It seems like a lifetime ago that I was running consistently and having something to say about it.  I do apologize for my posts being few and far between lately, but there just hasn't been much to say that hasn't already been said on my current situation.  However, I did want to give a quick update since I finished my 6 weeks of physical therapy and I thought this would be a good time to catch you all up to date.  

     As far as therapy goes, it was successful in the job of increasing my flexibility and strengthening my legs, hips and core, but to answer the sixty four million dollar question, I still have pain.  To be completely honest I am having pain right now as I type this.  The intensity of the pain and aching varies depending on my day, but what I have noticed is no one thing is the trigger.  If I stand or sit for most of the day is flares up or it can flare up no matter what the combination is for the day.

     If I remember correctly the last time I was running regularly was early July, and the pain has continued during this rest period. Needless to say that if I was never to run a step or do any other "sports" related type of exercise, as the insurance company calls it,  this is affecting the quality of my everyday life.  My therapist says that there is a chance that I could continue to have pain even after I have the surgery done, but to be honest I would rather get the surgery and still have pain than never get the surgery and always wonder if it would have fixed it.  Plus, don't forget the extra bone protrusion that was rubbing on the cartilage and caused the tear to begin with.  If I don't get that taken care of I am sure to have more problems in the future.

     Anyway, I have a followup appointment with my surgeon on Friday to discuss where things go from here.  I hope to have some news to share from that visit, but I am thinking it will go like this, Lets set up a new surgery time and submit it to the insurance company and see if they will now approve it.  Well, all I can do is cross my finger and hope at this point! ;)

Surgery Update WTF

     Yeah so I would love to say I just haven't been posting everything because of my recovery, but that just isn't the case.  So when I last posted it was the start to the Labor Day weekend and I was told by the doctor's nurse that he would contact the insurance company Tuesday and she would call me with an update.  Tuesday came and by late afternoon I hadn't heard anything, so I called them.  After being put on hold for several minutes I was informed that the doctor would be calling tomorrow, the day before the surgery, because he wasn't in the office today.   I thought, "Really?!, but ok."

     The next morning I wake up and anxiously awaited the verdict.  I received the call around 10ish letting me know that the surgery has been canceled.  The nurse stated that the insurance company would not budge on their position that this surgery is exploratory and that with a procedure such as this requires medication, rest and alternative treatments before they will authorize the surgery.

     Of course it goes without saying, but I will anyway, that I was SUPER PISSED and extremely disappointed.  I proceeded to call my insurance company and vent my frustrations, which got me passed along from one person to another who could supposedly help me, I was finally transferred to a voicemail where I left all my info while thinking there is no way in hell anyone will call me back.  Little did I know that I would get a call back several hours later.  The conversation with the nurse for their medical staff, basically went back and forth just like a tennis match.  I could tell she was getting a pissed off with me because I wouldn't give in and kept on till after 20 plus minutes she finally said what the real reason they denied it.  Basically, Anthem has different procedures that no mater what have a list of things that must be tried before a surgical option will be explored.  Them denying my surgery wasn't because their doctor disagreed with my doctor its because of their policy and my surgery fit this bullshit policy.  So instead of doing what is medically necessary their policy has me jumping through hoops till they say otherwise.  

     After the conversation with the insurance company I called the nurse at my doctor's office to let them know what the ins company had to say, and that is when things start to get a little "funny" for me.  The nurse says that she is calling in a prescription to my pharmacy and will be mailing me a prescription for physical therapy that she will mail me.  I hang up and call it a day and instead of going back to work for the week, I decided to use the rest of the week to spend time with my wife, my family who were in town and for myself to just relax and decompress.  Friday my wife surprised me with a tattoo appointment because she wanted something to go right for me this week.  Only those that have tattoos and really enjoy the act of getting one just as much as the artwork involved know what I am talking about when I say that it was just the thing I needed to relieve some stress.  Wow did I feel so much better after we were all done. 

     So, fast forward a few days and this is where my head is at.

     I am beginning to think my doctor and his staff don't know what the fuck they are doing.  Sunday, a full four days after the nurse stated she was calling in my script, I stopped by the pharmacy and to my surprise there was no prescription waiting for me.  I thought to myself, maybe she meant she was mailing the script along with the PT prescription.  When Wednesday came and still nothing I decided to see just what the hell is going on.  I had to return the recovery medical supplies that I had received prior to my surgery that I wrote about here.  

     The medical supply company is located in the same office as the doctor and since I still haven't received my prescriptions for my meds and PT I thought I would kill two birds with one stone while I was there.  When I asked them about the medication and PT no one seemed to know what I was talking about.  The nurse I spoke with asked me to sit and wait till the doctor got out of a consultation so she could talk with him.  I was close enough to them that I was able to listen in on some of their conversation and when she asked him about the medication he said I don't care whatever we usually give.  After the doctor walked away, she called me back over to get everything taken care of.  After the nurse asked me what pharmacy I wanted the meds called into, she still ended up calling them into the wrong place.  I mean come on Dean, cut her a little slack, Right Aid and Walgreen's sounds exactly a like.  But I digress.  Oh, and the nurse on the phone from last week, the one that was taking care of all this, told me the insurance company needed me to have PT for 3 months and Wednesday the doctor only prescribed 6 weeks of physical therapy. WTF!  Doesn't anyone know what is going on?

     After today, I am on the fence about seeking a 2nd opinion and wondering if some of what the insurance company was blaming on the doctor was, in fact, true.

A Few Days Away

     With just a little over a week and a half from my surgery, I can say I am starting to get a little nervous about it.  I keep thinking to myself that I am laying on the table waiting to be put under and telling the anesthesiologist "Don't let me end up like Joan Rivers" I would say.  Of course this kind of fear is to be expected when anyone is about to under go a procedure that puts you to sleep, but now I am starting to worry about work now as well.  I will be off work for a minimum of 10 days and I have so much to I need to make sure is taken care of before and while I am off.  

     Today I had an appointment at the medical supply company to pick up three items that I will need post surgery for recovery and to kick start my rehab.  One machine can only be described as two large lower leg sleeves that work like a blood pressure cuff the doctor uses.  The machine slowly pumps air into the sleeves squeezing my legs to help fight against blood clots from forming.  

     The second is literally a cooler with a pump and a hose that hooks to a large pad.  I am to fill the cooler with ice and water so when the pad is attached to my hip the pump in the cooler will circulate the ice cold water through the pad.  This is to help relieve the swelling and pain that will result following the surgery. 

     The last machine is what I will use to start my rehab.   I can only describe it as a device with a frame work covered with a sheepskin cover that kind of acts like a sling that I will lay my leg in while it slowly bends my leg.  I am to lie flat on my back for 6 to 8 hours each day and allow this machine increase the bend angle of my leg slowly starting with a measure of 0 to 30.  I am to increase this ten points each day till I can get to a measure of 110.

     

Cut Me Mick

     

      For those of you that don't remember those words, they were spoken by Rocky to his trainer, when his eye was so swollen shut he couldn't see and the only way for him to continue in the fight was to have the trainer cut him to release the pressure and allow him to see.  Well it may not be my eye and this may not be a boxing match, but it is what I have to do if I want to continue running.

     For those of you that have been following along, today was my follow up doctor visit to review my MRI results along with my x-rays, and what I hoped would not be the case, was the case.  The MRI shows a possible labral tear of the cartilage that separates the ball from the socket of my hip joint.  I say possible because no doctor is every going to deal in absolutes until he actually is cutting me open and seeing it for himself, but the evidence seemed pretty convincing.  

     Well, how to we fix it you ask?  We cut me open of course!  Ok, I will stop being overly dramatic, since it is only a one day out patient, arthroscopic procedure where he will cut three small incisions in my hip and thigh to fix the issue.  What I will not exaggerate about is the recovery time, holy shit!  I will have to be off of work for a week to ten days, followed by trying to maneuver around on crutches for three to four weeks.  After those initial ten days I have roughly three months of physical therapy and an estimated time of six months before I can return to running regularly pain free.  Chances are it will be at least year or so before I can attempt another marathon, if ever.  

     Those that I have talked to about this have said I seem rather positive about the whole thing, well what can I say, this has really fucked up a lot of plans and goals I have set for myself, but it is what it is, right?  I mean I would be lying if I said I wasn't completely devastated, but feeling that way and throwing a tantrum like a four year old won't do me a bit of good, so moving on.  Now I have to figure out when is the earliest I can get in to have the surgery done, and based on work related commitments, that looks more like late August or early September at best.

     The other issue I have due to today's news, is what to do with my Detroit Marathon registration.  I cannot get a refund and other than just losing $75 and not showing up for the race, I could do a transfer to someone else.  I am going to do a little research on transfers and maybe just donate my registration fee to someone else who could use it.  So stay tuned for that!  

My MRI Pulp Fiction Experience

     I have to say that yesterday was a bit of an experience for me.  I haven't ever had any major medical issues that required anything of this magnitude when it comes to testing.  I had my first ever MRI yesterday, and not knowing what to expect I went in filled with more anxiety than I usually do.  My appointment was at 3:00 so I headed over to that area of town to grab a bite to eat and walk around the mall to kill some time before all the festivities began.  

     I arrived thirty minutes early to get checked in and only had to wait about fifteen minutes before they called me back.  The order of the day was going to be started with getting injected with a numbing agent, MRI contrast dye and a steroid that was ordered by my doctor, followed by a forty five minute MRI session as the nurse explained to me.  She first took me back to get changed for the procedure, which I had brought a pair of shorts to wear, but my anxiety quickly skyrocketed when she told me to strip down to just my socks and put on a medical gown.  Despite feeling truly uncomfortable in the situation, there was something very freeing about hanging in the breeze.  

     After I changed I was introduced to the MRI tech who went over my two page questioner, which I stated I was claustrophobic and had tattoos.  The tattoos could have been an issue because some inks contain metal which can feel a burning sensation and can irritate a patient during the MRI, I however had no issues with this during mine.  She showed me the "open" MRI machine she would be using and actually loaded me into the machine for a trial run to make sure I would be ok.  I was fine and didn't feel boxed in, but my face was about two inches from the machine, so it was a little unnerving. 

     Once she let me out, I was headed to another room to get the injections done.  I climbed aboard the x-ray table where the nurse positioned my leg and pull my gown up to the point I was very uncomfortable.  Now the whole time I was there the nurse and the MRI tech was so nice and accommodating, but at this point the nurse was explaining the injection procedure and by the time I was done I felt like the doctor was going to come in and go all John Travolta in Pulp Fiction on me.  As the doctor began to inject the needle I was prepping myself for a painful stabbing by clenching my hands and squinting my eyes as tight as I could.  Wouldn't you know, it wasn't shit to deal with.  I have had more pain getting my blood drawn than what I went through here.  Now for the cool part, I mentioned I was on an x-ray table, well he had a live x-ray shot of my hip on the screen so he could see where he was guiding the needle.  Once I realized the pain wasn't anything to deal with I looked at the screen to see this long needle injected into my hip joint.  He explained that I would feel pressure in the joint once he pumped all the drugs and the dye in, and sure as shit, it felt like someone was putting slight pressure on me.

     Now, for the MRI portion things didn't go quite as smooth as the injections did.  The tech got me all loaded into the machine, cranked up some '90s rock on the headphones for me and we began the scans.  After the first two scans, lasting in total of about fifteen minutes, she came in to make changes to the machine because she said, and I quote "you are to skinny and I have to change the machine to get a better picture."  It still is funny to hear someone utter those words to a person who use to be 317 pounds, but digress.  The change to the machine took about five minutes or so before I had to climb back onto the table and start the entire procedure over again.  From this point on things were going smoothly and I thought I was done when the tech said she was coming in, but I was wrong.  She told me that the last two scans she was unable to get good images and asked me if I would try the other machine, you know the tube that feels like your in a fucking coffin.  She said it would be ten minutes at the most, I said what the hell I can handle it, I think.  Thankfully she put me in feet first so my head was still sticking out a little, but man it felt tight in there.  We got started, and after the first scan I was doing pretty good, so she quickly moved on to the last scan.  I don't know what happened, but as soon as she said we were done and she was coming in to get me, my anxiety level shot through the roof and I felt trapped.  If she would have taken five seconds longer I think I would have had a full fledged freak out.

     I should have the results in a few days and I meet with my doctor for a follow up on the results next week.  I was given a copy of the images to look at, but I don't know what the hell I am suppose to be looking for, but here are some examples of the scans.  If I am correct the really white areas are the cartilage lining the hip joint.  I'll will have to wait till next week to be enlightened on what I am seeing here. 

It's There In Black & White...Sort Of

   It certainly been an emotional roller coast trying to figure out the how, what, where and why I was having main in my groin/hip area.  I tried to rack my brain figuring this out and little did I know, the cause of all of this has been there probably since I was born.

     Wednesday I had my first visit with my orthopedic surgeon to get some answers.  Overall I would say the visit went very well and I felt completely comfortable with him.  When I arrived I was first sent to get x-rays of my hip.  When that was finished I made my way to the waiting area before his nurse came and got me for all the usual questions one gets asked at the start of a doctors visit.  When the doc came in he asked me a few questions about the background of my injury and then proceeded to perform a physical exam.  He twisted, pushed and pulled on my leg and hip spouting of a bunch of medical jargon for his assistant to write down.

     When he was finished he pulled out his iPad to show me the results of my x-rays.  What they show was some over growth of bone which amounts to, using a layman's term, a bump on the ball of the hip joint on top of the femur.  How he explained it to me is there is cartilage lining the hip joint socket, called the labrum, that the ball on top of the femur rides on.  When use my leg in a running stride type motion that bump rubs up against the cartilage and can cause irritation and / or a tear in that cartilage.  So needless to say I got some answers, but it only raised more questions for me and my doctor.

     So where do I go from here, well the next step is to find out if there is truly any damage to the cartilage itself, or any other factors that cannot be seen on an x-ray.  Next up is the super expensive MRI next week, with a follow up visit the week after to go over the results.  I would guess that after the MRI, doc will have an idea if this requires surgery or something else.  I know I have my assumptions as to the answer to that question, but no need to put the cart before the horse.

Thursday Weigh In At The Doctor's Office

     Well since Sunday I have managed to keep my head in the game this week with my food and my workouts.  I have had to make some minor adjustments but I have done everything in my plan except one yoga session.  I didn't have a big loss this week, but I am proud of myself for making the choice to get back on track.  

3/19/15 official weigh in

176 lbs

Total loss from heaviest:  141 lbs

Current BMI:  27.5 (overweight)

     Today was my long run, but before I got that taken care of I had my yearly doctor's appointment.  I new I was going to be asked to get some blood work done so fasting was on my menu last night.  I would like to say my appointment went great, but I got a little annoyed with my doctor's nurse.  She was doing the whole pre-consultation stuff, you know, blood pressure, pulse, height and finally weight.  She had me step on the scale, which read 182, as she was recording it, which she recorded as 192, she made mention of my weight from last year. She says you use to be 217 and that I was doing a good job now that I weighed in at 182. I responded and said thank you and that I use to weigh 317 a little over two years ago and the first words out of her mouth was "wow did you have gastric bypass surgery?".  Really?  Is that the world we live in now?  That is now the norm for weight loss in America.  Don't get me wrong, there is a place in this world for GB and those that do it have made that choice, but she seemed floored when I said no I did it all on my own.  WTF She acted like it was just crazy that someone could lose weight through hard work and dedication. 

     Again, if you are reading this and you have used lap band or gastric bypass for your weight loss, I understand your choice. God knows I have thought long and hard many times about heading down that path. Ultimately I decided that I was not the right person for that kind of sacrifice. It has taken me a long time to get the motivation to start what I did two years ago and I know it will take a lot to maintain this for years to come, but that is the path I have chosen.

     Lastly, I also picked up a copy of my lab work from 2012 that was the genesis for this journey.  I wanted to be able to compare today's blood work to where I was at back then.  I am hoping and assuming things will be good, but you never know these days.  I will keep you posted once I have the results.