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Wednesday, July 30, 2014

Ups and Downs

Now past week six post-op, I can agree with my doctor that hip surgery recovery will be up and down.
On Wednesday I felt great.
On Thursday my hip ached.
On Friday the pain was almost constant, just aching and throbbing a little.
On Saturday the pain vanished, and I felt not a twinge the whole day.
On Sunday I felt mostly wonderful, but some aggravation after a long walk.
On Monday I was in pain.

I'm plugging away at PT, and can now do:
- Bridges
- Squats (not all the way down)
Leg lifts
- Lunges (!!!) - believe it or not, they do not aggravate the hip, and are a great mild stretch to the hip flexor, as long as you keep the back leg totally straight and directly below the hip.
- Balance moves on half-bosu (or at home, a stack of pillows)
- Side leg lifts
- Wall sits

The better I am about PT, the better I feel, so I have been trying to get it in twice a day, although I occasionally slack off.

Last week I got a chance to talk to another runner who was having the same surgery. She had it this Friday; I spoke to her Wednesday (I just met her, but I know her boyfriend well). She had a lot of questions prior to the surgery, but I felt like I had NO helpful info for her - there is just so little consistent information out there about hip labral tear surgery! She is seeing the other hip specialist in town, Dr. Suri, and his post-op instructions differ hugely from those of my doctor (like, wearing a brace for only 10 days versus 6 weeks from my doc!).

I'm being patient with the ups and downs, because I was told to expect that. I'm just hoping that in time (but not too much time!) the ups overtake and leave behind the downs.

Monday, July 28, 2014

Bay St Louis a few weeks ago
Seven years! Happy Anniversary to this guy, who got a pop quiz on the "in sickness and in health" part of the vows this year, as he waited on me hand and foot while I was on crutches. What a stellar guy!

I'm blessed to have a partner who shares my sense of humor and balances my personality. He's patient where I'm not; organized where I'm disheveled; smart about the things I'm dumb about; and serves as my go-to guide to movies and music since I can't be bothered to pay any attention to either myself. And besides that, he's the sweetest person I've ever met and adores me - so you can't beat that in a husband.

Here's to many more years!

Monday, July 21, 2014

Confession: the brace is history

No brace!
(Excuse the wrinkles -
I actually wore the
shirt tucked into a skirt
for church)
Our social calendar was packed the weekend before last, popular kids that we are. Saturday we had to juggle helping the church out with an errand to the dump, a birthday celebration downtown at the Bastille Day festivities, and dinner with friends. It was hot - in the 90's - and after putting on shorts and a tank top, I just could not, could not, could not wrap that hot and heavy brace around my waist.
I went without it. Carefully, but coolly!

And then for dinner I kind of forgot it. And for church the next day I definitely left it home on purpose. I'm just over it!

Now, this is the only point on which I have strayed from doctor's orders, so I think I'm probably not doing irreversible damage: especially since my doctor said, "Four to six weeks". I made it to four and a half weeks with the brace, so technically I'm ok. Lower end of the estimate, but probably no big deal.

And when I look at protocols for the same surgery at other facilities or with other doctors, I can't find any that recommend the brace for longer than five weeks at the absolute max. Most say 3 weeks. So I gave myself permission to ditch the brace.

And I'm posting this info over a week later because no way was I posting that I got rid of the brace, only to feel worse and worse as time went by! Instead I've been feeling better and better, so I am OK with publicizing my disobedience to orders.

Looking at the picture I just took braceless (with my handy phone camera timer app I just downloaded), I notice that I'm in my typical left-leg-not-engaged stance. I'm trying, guys, but I have to undo months, if not years, of poor posture, stance,and gait!

Wednesday, July 16, 2014

$22 at the Goodwill

It was a good weekend at the Goodwill.
I picked up these two matching tops with tags still on, which were sold from Anthropologie. I don't know which one I'm keeping yet, because I'm letting my sister pick one so we can be long-distance twins.

Then I got four tops: a yellow tank with sheer panels in the back (wore it to dinner); two serviceable T-shirts from Ann Taylor that are just dressed up enough to pull off at work, in tan with lace and black with ribbon; and a J. Crew button-down that also still had tags.

But the steal of the day were the Etienne Agnier pumps, clearly never worn, in navy snakeskin. They're a classic shoe and comfortable, since they are actually a wide size. I have been slowly replacing my shoe collection with leather shoes only. When I was a poor college student, leather shoes were an unthinkable luxury (unless they were a Goodwill find), but now I'm looking at the worth of comfort. My feet are so oddly-shaped that I rely on leather's malleability to get the shoes to even fit a little bit. At $3, I think these heels are a good investment!

Sunday, July 13, 2014

I feel like a million bucks

So I'm backing off everything.
One of the discharge instructions I read from a prominent physician who performs hip labral tear repair mentioned that patients will often feel very good around 4 or 5 weeks post-op, and then they overdo it.  I don't want to be one of those patients! The last thing I want is a set-back of any kind. So when I woke up feeling like surgery was a thing of the distant past, I slowed down instead of speeding up.

- I was given a whole list of new PT I can do now that it's been over 4 weeks, but instead of introducing it all all at once, I just added one new activity a day.
- I completely skipped a walk in the park, knowing I might have to park far away for a birthday party/Bastille day celebration later in the day.
- I actually reduced the number of reps in PT
- I wore heels to a dinner party but made sure I either stood correctly (with weight evenly distributed to both legs) or sat.
At the city's Bastille Day celebration on the River

I was glad I made those choices, because I accidentally hurt my hip yesterday! Don't laugh, but I was cleaning the bathroom and was trying to put a new mophead on the mop. As I fiddled with the screws, I sat down on the toilet seat while I was working on it...except I forgot I had just cleaned the toilet bowl, and the lid and seat were up. I expected the seat to be higher than it was, so I CRASHED down that extra two inches, catching myself squarely on the injured hip. It did NOT feel good! Luckily, the pain was short-lived, and I was fine after about five minutes, but I would have been frustrated if I wasn't. If I had done too much, and it hurt all day, I'd keep wondering if I hurt it accidentally or by overdoing it.

I didn't just feel good physically yesterday. I felt good mentally and emotionally, too, because I got some quality time with good running friends! My running group, Varsity Sports, has more or less kept tabs on me via Facebook, but a couple in the group, Jon and Janell, invited us to dinner this weekend. We joined them at their lovely home, along with several other group members, and it really was wonderful to see everyone again. Jorge was there - he and I were probably the closest in speed on speedwork Mondays, so he's sort of a training partner; also several of the members who've been with the group for years, and Andy, who I ran with for the Greek Fest 5k. It was so nice to see everyone, especially Jon and Janell, whom I really look up to. Jon is a cancer survivor and I would like to tell his story here once I get his permission.

It did suck a little to hear everyone's racing and running stories, but that mild pain was worth the pleasure of good company, good food, and good wine.

Saturday, July 12, 2014

P.S. to yesterday

I should add to yesterday's post that $55,000 is only what the hospital charged for the surgery and my outpatient hospital stay. 
I got separate bills for:
1. My pre-op hospital visits
2. My anesthesia
3. My doctor's charge for actually doing the procedure (he charged over $5000)
4. X-ray and imaging during surgery
5. PT while in the hospital, which consisted of a therapist not fitting my crutches to me

All in all, the surgery bills were close to $70,000.

Friday, July 11, 2014

Money is meaningless

You know what's all wrong with our whole medical system? Money is meaningless. Really. It means nothing.

For example, I might dispense a prescription for quetiapine, a generic drug that costs me $11 for 30 tablets. I bill the insurance $302. That's because the other options I could bill - like the brand-name drug, which retails for nearly $600 - would cost the insurance company much more. So they are willing to pay me a little extra for this generic. But they don't pay me what I ask for. They pay me a $4 dispensing fee, and $271.80 for the drug, which is 90% of the average wholesale price of the drug. Because they set their own pricing, and if I don't like it, I can just jump off a cliff. I like the $264 profit, though, so I stay on top of the cliff.

Or, I dispense a bottle of insulin that costs me $88 to a patient. I bill the insurance company a reasonable $96. They reimburse me $82.50, because the drug is the wrong brand. They prefer a different brand of insulin that costs $79.50, so they only reimburse me based on that drug, even though I don't have the authority to substitute it for the other brand. I lose money, but I can't do anything about it, because my contract with the insurance company says I can't turn patients away based on reimbursement. I'm considering jumping off the cliff.

Or, you go to the emergency room with a fever. They give you a tylenol, and you go home. You read your (whopping) bill later, and see that you were charged $9 for a tylenol. That's because you weren't paying for the tylenol. You were paying for the boxed lunch the hospital provided a Medicare patient who came in to the emergency room because she was too busy on Friday to go to her scheduled dialysis appointment, and now she's trending toward acute kidney failure. That, and she likes the box lunches that the hospital provides but Medicare doesn't reimburse.

Or, I have an outpatient surgery. The hospital bills my insurance $55, 000.

My insurance company disallows $45,000 of it and, between United Healthcare and I, pay the hospital $10,000.
Was the surgery worth $55,000? Heck no. That's stupid. They didn't give me a platinum implant, geez. Is it reasonable to reimburse just 9% of the bill? No, that's stupid, too! Of course the hospital can't bill the actual cost of the surgery, and the insurance can't just pay them back.

Ludicrous? Yep. Money has absolutely no meaning in the world of medicine.