Saturday, October 10, 2009

Woe Is MY Knee

So two weeks ago, during my annual jabroni golf trip to Florida, I suffered a freakish injury, as they seemingly all are.

It was pouring, we had just eaten breakfast and were about to set off for the clubhouse to wait out the rain.

I ran to my car and wiped out trying to hop over a couple puddles. Like a Moron, I was wearing flip-flops which apparently didn't have as much *wet* traction as I thought.

So my right leg hyperextended forward, and then backward, and I went down screaming like a b*tch into the precise puddles I was trying to avoid!

Of course I iced it up and hobbled my way through two more rounds of golf. Heck, another guy on our trip also had a severely messed up leg and groin; and still another was there playing despite being the final stages of a long battle with cancer!

Two weeks later, the swelling is still there and some days it's quite painful.

I've been through this before so I know the drill. You need to see your primary to get a referral to an orthopedist. He'll do an x-ray, tug at your knee, erroneously declare the ACL *intact* and prescribe *physical therapy* to strengthen your knee. MRIs are, or they used to be, expensive. So they've been told to hold them back, I guess.

The entire process sends me into a fit of rage - from the bureaucratic BS to the *strengthen my leg* prescription. My legs are extraordinarily strong; even when I'm out of shape all it takes is a glance at the size of my calves or a touch to see that my thighs are as hard as concrete. Sometimes I think these doctors are so bleepin' clueless!

Six years ago, when I tore the second half of my ACL (right before my wedding!), I saw an orthopedist in Brooklyn who insisted that my ACL was *not torn*, that it was *intact*. He did that same little *pull* of the lower leg that they all do - surely a quack test in league with the useless Adson's. I had to beg him to get an MRI - another ordeal in and of itself.

When the results came back, he pored through half of the films muttering, "not torn", "looks okay", "normal", before ultimately realizing that, as I was telling him all along, that my ACL was *100% torn*. On another note, I can't believe I permitted that joker to do my surgery. Probably the only reason I didn't change doctors was because he was a *minority*. Even though he in all likelihood got into college and then med school with inferior credentials, I didn't want to seek out another doctor because it might appear that I was bigoted. I placed my own moral integrity above the integrity of the operation. And now, that same knee might need to be redone. No good deed...

So anyway, after hanging up on one orthopedic office that was going to make me wait a couple of weeks to *see a PA*(!), I found another that could squeeze me in. Ironically, I found the same doctor who just handled my daughter's broken wrist.

I saw him yesterday, wasting half of my day in the process. Predictably he declared my ACL *intact* and sent me down to get an X-ray which also, most predictably told him nothing except that the *hardware* from my past reconstruction was *ok*.

He started his spiel about physical therapy to *strengthen*....when I interrupted him, declared my leg strong enough, gave him my history of misdiagnoses, etc.

Right away he said he'd allow me to skip right to the MRI. And he laughingly told me the story of his own son's knee injury. Despite being an orthopedist, he declared his son's knee *not torn* when it turned out to be, like mine six years ago, completely gone. [I have another great anecdote of a doctor misdiagnosing his own son....but won't go there out on account of familial courtesy!]

I just had to respect this most rare display of doctoral honesty and humility.

But why should basic self-consciousness be so uncommon? A God-complex, anyone?

My pain comes and goes so the doc said that could indicate that I've just torn cartilage - which would only necessitate arthroscopic surgery.

I sincerely hope that is the case because I dread another full-blown reconstruction. My rehab last time was a real ordeal - much more so than what others experience. All of that sedentary time was a killer for my bad back, and my psyche. I also have two kids now to manage.

I know, this is hardly a real tragedy. Nonetheless it has the potential to really hijack my precious time and energy.

Ironically, I was very nervous about hurting my knees on that 7 hour climb of Mount Madison the week before. So it figures that I'd end up injured after eating an omelot, on a golf trip.

See also - Woe Is Knee.


Mark said...

You are kiling me...
First you are a perfect example of why health care costs are so high... it's because patients insist on tests that are not indicated, that don't change management.
A test is not always the answer... I for one did have an MRI of my knee that said my ACL was intact when my orthopedist said it was torn.. and he was right when I had my knee reconstruction surgery
Tests are imperfect as are clinical impressions at times
but we have a medical environment that incorrectly stresses "patient satisfaction" and meeting patient expectations is done by getting tests that ARE NOT needed!
so here's to your $2000 MRI and higher health care costs for all
and.. what's with all the doctor bashing!?! Would you like my job with all my antagonistic patient encounters who want to play doctor?!

CaptiousNut said...

First of all, I thought the MRI was down to $800.

Secondly, there's plenty of waste to go around. Why do I need to see a primary? Why do I have to go back (to another site) to get an MRI after the ortho orders it? How much does this all cost, keeping in mind the time off I must take from my work?

Why do doctors presribe pills instead of *throw out the TV* and *yoga*? My father takes Lipitor or something; when junk food comes near him he says that he can eat it *because he's taking Lipitor*.

I am bashing a system, not those who work within it - much the same way I bash the educational system despite there being countless dedicated, hard-working teachers.

If patients *paid their own way*, then there'd be no problem with them demanding/insisting unwarranted tests, now would there?