So here we are again - with time escaping us....let me catch up from where I left off before....
Went back to see this new orthopedist and review the MRI. The OCD is now 1.1 x 0.9 - much larger than the original (barely 0.6 square). But, he was able to show me floating bodies within the joint and felt that the next step should be a "redo" of the microfracture and debridement - and that if that fails - we still have the option of the larger cadaver replacement surgery. :::oh fun:::
His description for this surgery (at his hand) is fairly similar to the last time. He feels he can go into the previous holes so there will be no new scarring. I will come out of surgery with some sort of a cast on the ankle which will stay there for two weeks - at which time I would see him, remove that and any stitches. I would be completely no weight bearing for 8 weeks - and then I would put a shoe on that foot and start to put weight on it until I could walk normally. They felt I could do all this on my own without any PT. I got the gal's number to call and schedule and was asked if I had crutches and also suggest to get a knee roller. (I much prefer the crutches - more of a work-out, and for an active person - eight weeks of no weight means minimal ability to "work out" so crutches would be my chance to stay a bit fit.)
So - I look at the calendar and try to plan this. First monkey wrench in the mix - I'm running for state assembly at this point in time, and while it is still summer, I'm looking at the busiest time for a campaign. To decide - do I campaign on crutches - or do I wait. I decide to wait. Next monkey wrench in the mix - the cost. Last time I was on Medicaid and the surgery and PT cost me maybe $100 in co-pays. Now that I've been working, I have insurance from my company - but now my cost is much more. $2500 deductible and then a rediculous co-pay. Not only does my employer pay almost $10,000 a year for my insurance coverage, but I chip in an almost addition $2000 for premiums - and then to have this kind of co-payment? I worked it out, and the surgery would cost me (out of pocket) between $7-$10,000!!!! While the doctor's office was willing to work out a payment plan after insurance paid - they couldn't tell me how much I might have to agree to....
So - the next thing was to look at changing insurance when the plan year was up. The offerings were slim - with huge deductibles and co-pays - as well as additional premiums. I finally settled on a plan where my out of pocket would be about $4000 (still a lot, but much better than $7-10,000) and sent in the change forms.
And that's where I sit. Our renewal date at work was 12/15 - our agent knew I was making a change and got the paperwork in time. But I have no new cards, and no verification that I actually have this new coverage.
And so I wait. With an ankle that is so painful, it brings me to tears. But I can't make plans without knowing 1) that I indeed HAVE insurance and 2) without knowing how much this will cost me.
So let the waiting game begin....
Friday, July 5, 2013
Life does tend to catch up with us - and get away from us - and so it has with this. I had every intention of continuing this blog and whoops - here I am not quite two years later and have not mentioned a thing. So - to catch up..... After that MRI that I had in 2011 - the doctor felt there were no real changes in my ankle. The OCD was still there and not much had changed. He recommended a shot of cortisone - which I agreed to. He advised I might want to have crutches available for three-five days in case the ankle was painful or unstable - which I took him up on. The day after the shot, I attended a university football game to watch my daughter with the band. That day a freak October snow-storm (more like a blizzard) started just as the band was welcoming the football team to the stadium. That snow continued through the game and into the evening. Trying to crutch through the snow was a real adventure. The stadium offers trolley service for those that need it. After half-time, I went to find the trolley to take me back to the bus (to parking) only to be told because of the weather, they shut down trolley service! Finally, they put me in a wheel-chair and tried to push me through the six inches of snow/slush and ice. As you might imagine, it didn't work. So I put on my big-girl panties and crutched my way to the bus - and once at the parking facility - to my car. Actually, crutching in that mess wasn't that bad. I could securely plant my crutches into the snow/slush/ice and they would hold solid while I "stepped" to the next safe spot. Crutches are also quite useful in clearing snow/slush/ice off of car windshields! So after the cortisone shot, the ankle was no better, but my surgeon was stumped. He felt perhaps we could try a lubricating injection or plasma-rich injection. However, my insurance felt those were all "experimental" and wouldn't approve them. So - I just coped. For the next 18 months - coping was all I did with the ankle. Sometimes it seemed "perfect" - no catching, no locking, no pain. Then there were the days/weeks when that's all it had - catching/locking/PAIN. A couple of ER visits when it went out on me very badly and swelled up - but all they could do was check to make sure I didn't break it and put me in an aircast and crutches. Finally, several weeks ago, while stretching the ankle suddenly and very loudly went POP!!! Pain and swelling accompanied it. I thought of going to the ER - but passed on that decision - knowing they would only re-x-ray and pronounce nothing broken/nothing to be done but rest it. But what I did do, was contact a new orthopedist - one highly recommended by my primary - who was in my new insurance. Got an immediate appointment with him. He looked at my old scans and told his PA in the hall - "That thing is HUGE! Huge I tell you!" and then told me - "its a very big OCD". Also at problem was where it is on my talus - on the corner. So much so, that he would not do any surgery on it himself as he felt an OATS or other surgery would be pointless since it would easily fail (by breaking off the corner again). His recommendation was a referral to a specialist who had developed a technique of using a cadaver talus to fill the OCD. But first a new MRI. While waiting for my MRI appointment, I checked online about this new surgery potential. Very big surgery. Full ankle exposure - almost double the recovery time. Enough to make me pause on this... The MRI went without issue - except my ankle felt worse after it was over. When I called the office to check with my doctor about it - he called back with the MRI results. Seeing the new MRI - he was now comfortable in recommending another shot at microfracture and debridement (what I had in 2010) rather than the cadaver surgery. I see him on Monday to actually review the films with him and to talk about/schedule surgery. Seems like we are back on this merry-go-round for another ride. Oh the joy of it!