Dr Google Was Sort of Right

08.23.12

I forgot to follow up with the funky knee. Last week I skipped the orthopedic surgeon and headed to my rheumatologist. This ended up being a really great decision for a number of reasons. My rheumatologist is incredibly conservative and never overbooked. Every appointment is timely and we’ve never been rushed.

Dr. Rheum gave my knee a check and suspected that I might have a torn meniscus (just like Dr. Google suspected). What he made very clear was that small tears to the meniscus can be treated with physical therapy and that although the laser surgery is effective with a quick recovery you do lose volume with the meniscus and someone with Rheumatoid Arthritis (me) should be very careful about that. It should be a last resort. Before sending me off for an MRI he said to me, “Think of an orthopedic surgeon as a man with a hammer. Sometimes men with hammers think everything is a nail.”

So off I went to get my MRI. I immediately fell asleep in the machine (I know, weird) and just a day later the doctor called.

Good news! The meniscus isn’t torn. Bad news, there’s a half inch cyst resting on top of the fibula. Good news! They respond well to physical therapy and ultrasound. Even better news! There’s no sign of arthritis in the knee. This is the best news of all.

I took my script for physical therapy and called the place where Jane recently had such great treatment and the receptionist put me on hold. She then picked up the phone to put me on hold again. When she asked me to hold a third time I asked if I should call back later, “Oh yes.” She gushed, “Tomorrow would be great.”

So… can anyone recommend a great physical therapist who thinks that the minutia like answering your phone actually matters?

I Need Your Insurance Card Before I Can Make You An Appointment

08.15.12

I’m living in a perfect world insurance wise and I’m wise enough to appreciate it. Currently I’m covered at 80% for all out of network expenses and I have a FSA that picks up the rest as tax free money. My husband works for a large corporation, my primary physician is in network, my specialists are out of network and most of them don’t accept insurance anyhow.

I am a lucky woman.

I’m also betting that I’ve torn my meniscus. According to Dr. Google my symptoms indicate it’s been torn. My right knee buckles at times, is tough to straighten, hurts a lot and makes crazy crackling sounds. I’m not even sure why I’m going to visit an orthopedist, I’m like a step away from doing my own surgery if I could just find a good demo on YouTube.

Speaking of doing your own surgery we saw the Bourne Legacy last night and I loved it.

In any event, I got a recommendation for an orthopedist who has done half the tennis knees in town and I thought I’d give a call. After I got through the phone tree (yes, a phone tree for a knee doctor) I spoke to a scheduler who would ask my name and then for my insurance card. She didn’t ask what I needed to see the doctor for. Again, I’ve been living in this utopian eden where my physicians are gifted and their staff are caring so I found this all shocking.

“Don’t you want to know why I want to see the doctor?” I asked.

“We need an insurance card before we get to that.” She replied. I’m pretty sure she says this a few times a day.

“I’m driving I don’t have an insurance card handy but I have UHC and I have cash and I’d like to see the doctor.”

She begrudgingly set an appointment for me in two weeks. She said I’d have to call back within 24 hours with the insurance card if I wanted to keep the appointment.

TWO WEEKS.

In the car on the speakerphone with my son next to me I might have said something to the effect of, “I’m really fucking tired of being in pain and I understand that most of your patients are too but I’m not enjoying my life and my fucking knee hurts all day and I know there’s a motherfucking appointment that’s not two weeks away. Plus I pay all my bills.”

So anyhow, I’ve got an appointment at 10.20 today and I’m pretty sure he’ll amputate just to teach me a lesson.

I Told My Doctor I’d Get an Abortion

02.24.12

I have RA. That’s Rheumatoid Arthritis. Had I become symptomatic twenty years ago I’d be disabled by now and unable to type. Because of science and research (and insurance) I’m in really good shape. I take a handful of pills each day and an injection each month. Once in a while you’ll hear me moan about the medicine, but for the most part I love the medicine, hate the disease, love the medicine.

At my last visit with the rheumatologist we decided to add another pill to the mix. Like I said, I’m in a good shape but I’m only 41 and If I look at the other women in my family that means I’ve got another 55 or so years where I need these joints to function. Slowing the disease down is good, but we’re going aggressive, we’re looking to arrest the disease.

Here is the conversation we had.

MD: You’re still menstruating, correct?

ME: Yes.

MD: If we add this medicine I need to know that you’ve got birth control that is 100%. The birth defects would leave a baby incompatible with life.

ME: Oh I’m covered. I’ve got an IUD, this is a closed up shop [waving over my middle]

MD: And those are 100%? [he’s still writing notes in his pad and to be fair most of his patients stopped menstruating long ago] I’ll just need to contact your OB.

ME: You don’t need to contact him.

MD: [a little startled and looking at me quizzically] I just need to confirm…

ME: [interrupting] You really don’t need to confirm. I have an IUD the chances of me getting pregnant are miniscule and if I did get pregnant on that drug I’d have an abortion.

My doctor looked confused, like this wasn’t the discussion we were supposed to have but it was the discussion we needed to have. I’m 41, my “baby” is ten and I’m done having kids. If I wasn’t a pharmaceutical dumping grounds and I got pregnant I’m sure I’d be happy, or I’d find a way to be happy… maybe. But there’s a time in everyone’s life to have babies. I went on ad nauseum explaining to him why this wasn’t my time to have babies and I assured him that I wanted to be better. I want to be well and that no babies would be part of the equation. I have two great kids to raise, I wouldn’t stay pregnant just so they could watch a baby die.

I’m 41 and I didn’t want my Rheumatologist hopping on the phone with my Gynecologist to get a promise that I wouldn’t get pregnant. I’m a mother of two and a wife of one. I’m middle aged, middle income and I used to be politically moderate.

And then everyone wanted to get involved with my uterus.

A Little More Strabismus

04.4.11

This morning we were at UCLA before our 8am appointment. I know from past experience that two families will have 8am appointments, but one family will sign in first, and they will be first.

Alexander had an eye exam, no dilation, but an exam nonetheless. I thought that today they would schedule a surgery, unfortunately even after two sets of surgery, nine years of wearing glasses and diligent patching Alexander’s eyes aren’t in perfect alignment.

I thought his right eye turned out a little, but it’s actually his left eye coming up. My son cocks his head to the side when he’s concentrating. I thought it was adorable, but now that I see that it’s compensation for eyes that aren’t quite straight I find it crushing.

The doctor changed the prescription on his contact lens and we’ll see if that corrects the issue in the next three months. At the end of the quarter we’ll have another exam and evaluate the progress, the prognosis and make a decision about surgery. It’s a small surgery, only two, maybe three muscles, possibly only one eye.

Unless it’s your eye, then it’s a big surgery. Oh, or if it’s your child. That’s a big surgery too.

Alexander is old enough, and perceptive enough that he’s in on the discussions. He understands that we’re fighting to get him depth of vision, and he really loves sports, he wants to be able to see everything. It’s nice that he’s so mature, and that he can talk about what he needs and wants. We are somewhere beyond privileged that we live in Los Angeles and have the best physicians practicing here. We are just plain lucky that insurance handles everything.

But I still don’t feel lucky, happy or privileged today. Today I feel like vomiting. Tomorrow will be different.

Doctor Shopping

07.6.10

I have two very swollen knuckles. They’re very tender, and my range of motion is limited. I made an appointment with a rheumatologist as it’s been two years of discomfort and pain.

Yes, two years. I guess I thought it would stop hurting?

Today I had an appointment with a specialist at 2pm. At 2.40pm when I was still in the waiting room I asked the receptionist if I could reschedule for another day. He was very apologetic and swore up and down that the doctor never ran late. We went back to a cubicle where a lady was tapping away on the computer, and she was going to schedule my appointment, she said she was too busy, and the receptionist and I were to find an empty computer where he could do the scheduling for us.

He found one and entered today’s appointment as a “patient cancellation” and then asked me which day would be convenient.

I stood there, trying to imagine which day I’d like to return and pay another $10 to park, and wait, and wait some more.

“I think we’re not a match.” I said. And left as politely as I knew how.

There are a half dozen highly regarded rheumatologists within walking distance of my home. It’s good to have choices.