Post Surgery Update #1

     It has now been just over a week since surgery and to be honest I feel pretty damn good.  The first full day was a little rough, mainly because I felt like I had to pee every 5 minutes and when I did get up to go, I wasn't getting very much.  The nurse said it is common and would eventually go away, but when you need all kinds of help to get out of bed, it is pretty fucking annoying.  Thankfully though this has slowly subsided and not really an issue any more.  I am also happy to report that my pain has been pretty manageable to the point I haven't needed to take any of the really strong pain meds.  I have only been taking one which is more of an anti inflammatory than anything.

 

     The majority of my days have been spent laying on my back, which is NOT the most fun I have ever had.  During the day, Mandy gets me up every 2-3 hours to use the bathroom and do a little walking around with the crutches.  6- 8 hours of my day is used bending and flexing my leg in the continuous passive motion or CPM machine that slowly elevates and bends my knee and hip to a certain degree over and over.  My starting point the day after surgery was 0 to 30 and my goal in about 10 days is 0 to 120 degree of bend.  Currently I am laying here with my leg going to 100 and I have zero pain.

     When I am on a break from the CPM machine I get out in the living room to walk around, eat and play some Madden 2016 football.  After the third day I was able to sit for short burst and would stand to eat or do any other activities.  Now I am able to sit and play a game of football without any pain or the need to get up.  Most of my pain feels more like if you have ever strained a muscle and it hurts to use it to say lift something.  My large thigh muscle is very sore when I try to lift my leg in the straight or bent position, but each day feels better and better.

   

     At night when I am laying in bed trying to sleep and not using the CPM machine, I am having my feet squeezed by a machine that is used to help prevent blood clots from forming in my legs.  If anything it is really annoying, because instead of a slow even pressure, it emits a pulse of air that inflates the foot cuffs immediately.  So I will be laying there and all of a sudden puff and they inflate.

Not me, just a image I found online

  
     So far I have been able to maintain my sanity with typing, reading or watching tv, but the urge to go a little stir crazy is starting to settle in.  Today my Mom, who has been helping me during the day while Mandy is at work, told me how nice it was outside and I couldn't take it anymore.  While I was on a break I said fuck it and headed out the back door just so I could feel the sun on my face again.  I stayed out for 10 minutes or so before heading back inside to lay once again in bed.  You know it is easy to stay in bed when you are in pain or feel shitty, but as soon as you feel somewhat better, all you want to do is get the hell out of here.  Maybe I can bribe Mandy into taking me somewhere this weekend, even if its just for a short car ride.

     Anyway my follow up appointment with the surgeon is on Wednesday, I am hoping, no praying that I will be able to start physical therapy and maybe get back to work so I can feel somewhat normal.  Plus I got tickets for the new Star Wars movie on Friday, and I am NOT gonna miss it!

So What Did They Fix

     So what was the problem, a labral tear caused by a Femoroacetabular impingement.  A Femoroacetabular impingment (FAI) is defined as a condition where the bones of the hip are abnormally shaped. Because they do not fit together perfectly, the hip bones rub against each other and cause damage to the joint.  The ball at the top of the femur that fits into the hip socket had an additional growth or a an extra bump of bone sticking out.  The labrum is a rim of soft tissue or fibrocartilage that surrounds the acetabulum (hip socket). The labrum adds to the stability of the hip by deepening the socket and protects the joint surface. The labrum can tear as the result of an injury or FAI.

The surgery was performed arthroscopic with three incisions in the hip and thigh.  

Here is a look a a few picture the doctor took while performing the surgery the other day.

This is showing the labral tear.  The surgeon placed part of one of his tools right through it.

Here is another view of the tear on the left side of the photo. 

This is what the labral looks like after the repair.  He removed some of the junk around the tear and a flap of cartilage that was covering the tear.  The tear was tied up with a plastic type thread.

This photo is hard to see what the problem is here, but the bump of bone on the top of the femur that was the cause of all this.

This is what the bone looks like after the bump was shaved down and smoothed out

Day Of Surgery

     The day I have been waiting for since all this began in early July, finally arrived.  My surgery was scheduled for an 11am start, so I was instructed to arrive at 9am for all the fun of the pre surgical festivities.  The hospital that I was going to has a good reputation, unfortunately it is a little over an hour drive from my house so We had to get up extra early to get ready.  I couldn't eat or drink anything after midnight and when I got up in the morning I had to take a show with some special soap that is used to kill just about everything.  My Wife, Mom and I headed out the door and made the long trip across town to the hospital.

     Part of my rehab therapy is a cold pack machine that pumps ice cold water from a cooler to a pad that is wrapped around my body.  Its job is to help with pain and swelling, and I was instructed to bring it with me.  Funny thing is because it looks like a beer cooler everyone at the hospital had  to make a smart ass remark about me coming prepared for a party and what not.  At least it showed me they were in a good mood and liked to joke around a little.  For me I thought it looked like I was carrying around an organ I was going to have transplanted or something.

     I was in the waiting room a whopping 5 minutes before I was taken back to the pre surgical area to be prepped and to be asked the same two or three questions a million and one times, at least they are thorough.  I got my IV put in, they shaved and cleaned the area again, and then had me read and sign a consent form.  After all that they sleep doctor came in and asked me a few questions.  He asked me if I had ever had a problem with anesthesia, I told no and I didn't want to start today!  He also offered me a nerve blocker that would help with the pain post surgery and I accepted.

     After that things started to move pretty fast.  They pumped something into my IV to calm me down and they did an ultrasound to give me the nerve blocker.  My wife and Mom were brought in to see me a few minutes till the anesthesia team came in to re-hash everything that the Doctor already went over.  I told them that I don't like vegetables and I really didn't want to be come one.  I was feeling a little loopy and we all had a laugh, but I was being serious.  Kisses goodbye and off I went.  The last thing I remember is a mask over my face and lights out.

     Recovery is very much a blur to me.  I remember bits and pieces, but mostly it is what my wife told me that I seem to recall.  I do remember the doctor coming in and saying that it went well and that my tear was was pretty severe.  The I remember my wife talking to me, but I can't recall what she had said.  I do recall the severe cotton mouth I had.  They kept giving me crackers which instantly turned to  paste in my mouth which I then had to try and wash down with water.  My stomach just could't take it anymore and right before we left I threw it all up in the trash can.  Once we got home it was nothing but sleep for me, and boy did I need it.

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.

 

Stick To Your Word, That's All I Ask

      WARNING ANGRY RANT ABOUT INSURANCE COMPANIES AHEAD.  PROCEED WITH CAUTION IF YOU ARE EASILY OFFENDED OR THINK MEDICAL INSURANCE COMPANIES ARE THE BEST THING THAT EVER HAPPENED TO US...

     So Friday, on my personal Facebook account I posted a single line and a photo that pretty much says it all to how I was feeling.  I am a simple person that has his own faults and understands simple mistakes are made in life, but as a person who has spent the better part of his working life in the retail customer service industry, I know how important your word  is to a customer.  You break that word and not only do you lose a customer, but your credibility is lost with future customers as well.  When other companies do this to me, it pisses me off!  Why a person or, a company in this case, can't or won't at least do the fucking minimum requirements of a job that would provide basic level quality customer service I'll never know.  It all comes down to the fact that if you say your going to do something than fucking do it.  Don't say you will and then weeks later take it back and wait till the last possible second to tell the customer, leaving him or her stranded with no recourse.  That is at the heart of what my Facebook post was all about.

      So here, let me give you a little insight into what I have been dealing with since late Friday afternoon.  Everything in my day was going well until Mandy opened a letter that came in the mail from the insurance company basically stating that my surgery is not being covered. That's right, 6 days before surgery they decided to tell me it wasn't covered, and better yet, when I called my doctor's office about it, the scheduling nurse said she had no idea it wasn't covered. She told me that when she submitted the codes for surgery to them they pre-approved everything and we were good to go, or so she thought.  After talking with her I called the insurance company and after several minutes of looking things up and reading all the notes on my case file she told me that everything was good to go. Wait, what?   She stated that the doctor's office submitted one code and it was denied, so they resubmitted a new code which was approved, so that is what the letter was all about.  Which is weird because the nurse I spoke with had no idea that anything was denied and was under the impression that we were good to go, but ok great, so we are good to go then right? I said.  Yes sir, she says.  She reiterate that everything was covered and after my deductible was met.

     Five minutes later is when it all changed.  The lady I spoke with from the insurance company called back to says that she miss read the notes and that my surgery wasn't actually covered. Her reasoning was that my doctor had submitted two procedure codes and the actual surgical procedure code was denied because I have not spent 6 fucking months resting from all sports related activities, sought alternative treatments options and medication to treat the tear in my cartilage.  I am by no means a doctor, but within 10 minutes of research on the internet told me what I would imagine every first year med student would know that cartilage doesn't repair itself.   What it sounded like to me is the insurance doctor that reviewed my case seems to think that those other options are viable options to solve my issue and my doctor should have prescribed these first.  So some guy or girl that probably got all D's in med school, barely made it through their residency, couldn't find a real job, probably never practiced medicine and takes home a large paycheck from the insurance company because his job is to save them money not treat the patient.  Yes I am pissed if you can't tell.  Needless to say I blew a fucking gasket and almost tore my office apart at work.

     Where does it all go from here?  Tuesday the nurse is going to call the insurance company and try to get it covered, and if she can't she will request a peer to peer review with my doctor and the insurance company doctor.  Thanks to the timing of the letter arriving on the Friday of a holiday weekend, Tuesday is the earliest they can work on this and I may not know till the end of the day Wednesday whether or not I will be going in for the procedure Thursday morning. 

     I have just had enough with all the bureaucratic bullshit.  When I had my MRI done, it was pre-approved as well for a certain dollar amount, but when I got the bill the insurance decided not to cover as much as they said they would and I ended up having to pay an additional $500 fucking dollars. If you say your gonna cover something then just stick to your word, I am just tired of it already.  The only reason I didn't completely blow a gasket on that whole deal was because I knew I was having surgery at that point and I would have had to pay it to cover my deductible, whether it was now or later.

     Anyway, sorry for the long rant, but that is what has been going on the last couple of days.  I just needed to blow off some steam and writing about it here seemed to help.  Lord knows I can't run right now to burn off this negative energy so I had to do something.  Enjoy your holiday weekend!

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!