I'm scheduled for arthroscopy on April 6th to clean up the femoral chondyle and to assess the ACL for a possible ACL revision. The doctor's involved are pretty sure that the ACL will be "revised". Revised means re-done.
The saga continues with dealing with the worker's compensation insurance company. The latest news is that they don't feel that they can pay me for the 3 weeks lull in checks because I didn't get an MRI that I wasn't informed about. I've since called a mediator and am hoping that this will help. I wonder if they've approved the brace and didn't tell me or the left knee arthroscopy and didn't tell me. I hope anyone reading this is not also dealing with worker's comp; it's exhausting and very frustrating.
Saturday, March 27, 2010
Wednesday, March 10, 2010
Follow Up with my Ortho
I had my follow up with Dr Anderson today. He asked me what happened. I didn't know. I told him I never felt a pop a twist or anything that even gave me an inkling of an idea that I'd hurt it. I told him about 3 instances early on in my recovery that could have been the cause, but even then I never ever felt any kind of injury! The first incident was when icing the first time with my dead leg from the nerve block. The second time was when I nearly fell off the treadmill in PT during the first week off crutches and the 3rd was when that woman knocked me over at pt while doing the crane walk. I suppose I recall those most because they freaked me out the most. I've kind of tripped a bit and stuff, mostly at PT doing goofy exercises, but still I never ever felt like I'd hurt it!
Dr. Anderson seemed a little disappointed. He asked me if I was running on it. I told him I couldn't run; I can barely make it down the stairs or stand on one leg and put my pants on. It's seems to be getting worse. He asked me about exercises; I told him that I've been swimming, but that aggrevates it.
He answered several of my questions regarding the MRI, I didn't ask about he the metallic artifact. I guess I forgot.
These are my notes from our conversation, more was discussed this is just some highlights.
What is causing the pain: Cartilage may have healed, but pieces may be breaking off. Cartilage not normal.
The knee is looser and under the sheer stress the micro fracture doesn’t do as well.
ACL tear: Torn at the superior attachment; apparently that's the other end of where I thought it was. Scar tissue may be the only thing holding the acl in place.
Pros/Cons: This combination is not easy to get over and frequently goes on to be arthritis. It is no good leaving it unstable.
Treatment: Clean up the cartilage and assess the ACL and be prepared to replace it.
Options: Looking at the MRI, doesn’t think there is another option.
Dr. Anderson seemed a little disappointed. He asked me if I was running on it. I told him I couldn't run; I can barely make it down the stairs or stand on one leg and put my pants on. It's seems to be getting worse. He asked me about exercises; I told him that I've been swimming, but that aggrevates it.
He answered several of my questions regarding the MRI, I didn't ask about he the metallic artifact. I guess I forgot.
These are my notes from our conversation, more was discussed this is just some highlights.
What is causing the pain: Cartilage may have healed, but pieces may be breaking off. Cartilage not normal.
The knee is looser and under the sheer stress the micro fracture doesn’t do as well.
ACL tear: Torn at the superior attachment; apparently that's the other end of where I thought it was. Scar tissue may be the only thing holding the acl in place.
Pros/Cons: This combination is not easy to get over and frequently goes on to be arthritis. It is no good leaving it unstable.
Treatment: Clean up the cartilage and assess the ACL and be prepared to replace it.
Options: Looking at the MRI, doesn’t think there is another option.
Sunday, March 7, 2010
MRI results
I always like to get my MRI results before seeing my ortho so I can look up terms that are used in the radiologist's impressions. I knew something was wrong, but I really thought it would be the micro fracture. Nope...
YIKES! Hmm. It doesn't particularly feel all that instable and what little bit of instability feeling I've had I've been chalking it up to lack of quad muscle. (Yes, it has atrophied quite a bit since I haven't done PT since December.) Let's see what else do we have in the Impressions part of the report. I'll add the meaning of stuff in ( ) as I go along.
1. The patient has evidence of an apparent re-tear involving the anterior cruciate ligament at its superior attachment (the spot where the screw was put in to hold everything in place), with grossly abnormal morphology residually present. (This one is a little disturbing, but I believe it means that the attachment point has morphed into something really abnormal looking... that doesn't sound good no matter what it might really mean).
2. There is a focus of osteonecrosis (dead bone) with some associated marrow edema (swelling of the bone marrow - very painful) involving the posterior (back side) nonweightbearing surface of the medial (inner) femoral condyle. (The knobby part of the bone at the bottom of the femur.)
3. Degenerative (deteriorates over time) narrowing of the medial joint space (space normally occupied by the meniscus) secondary apparently to prior meniscal surgery. (That makes sense). Truncation ( shortening) was seen, most likely iatrogenically induced (as a result of treatment). No definitive recurrent tear is seen (speaking of the meniscus); however, delineation (the outline) is suboptimal because of metallic artifact present. (Sounds like there's a piece of metal that's not supposed to be in there and so the MRI image shows a bright white spot because it can't "see" through it? I asked Dr Anderson if I had any metal in my knee from the reconstruction and he said no; perhaps this is just some tiny shaving? Still not keen on it whatever it is.)
So that's pretty much it. I see Doctor Anderson tomorrow.
There is an apparent re-tear of the anterior cruciate ligament repair; its superior attachment is disrupted.
YIKES! Hmm. It doesn't particularly feel all that instable and what little bit of instability feeling I've had I've been chalking it up to lack of quad muscle. (Yes, it has atrophied quite a bit since I haven't done PT since December.) Let's see what else do we have in the Impressions part of the report. I'll add the meaning of stuff in ( ) as I go along.
1. The patient has evidence of an apparent re-tear involving the anterior cruciate ligament at its superior attachment (the spot where the screw was put in to hold everything in place), with grossly abnormal morphology residually present. (This one is a little disturbing, but I believe it means that the attachment point has morphed into something really abnormal looking... that doesn't sound good no matter what it might really mean).
2. There is a focus of osteonecrosis (dead bone) with some associated marrow edema (swelling of the bone marrow - very painful) involving the posterior (back side) nonweightbearing surface of the medial (inner) femoral condyle. (The knobby part of the bone at the bottom of the femur.)
3. Degenerative (deteriorates over time) narrowing of the medial joint space (space normally occupied by the meniscus) secondary apparently to prior meniscal surgery. (That makes sense). Truncation ( shortening) was seen, most likely iatrogenically induced (as a result of treatment). No definitive recurrent tear is seen (speaking of the meniscus); however, delineation (the outline) is suboptimal because of metallic artifact present. (Sounds like there's a piece of metal that's not supposed to be in there and so the MRI image shows a bright white spot because it can't "see" through it? I asked Dr Anderson if I had any metal in my knee from the reconstruction and he said no; perhaps this is just some tiny shaving? Still not keen on it whatever it is.)
So that's pretty much it. I see Doctor Anderson tomorrow.
Wednesday, March 3, 2010
A new MRI
FINALLY after months and months of waiting, I had an MRI today 3/3/10 on my right knee post ACL reconstruction. I don't have much more to say about that until I get the results, I didn't like the facility as much as the one I normally go to. They didn't have free coffee and donuts... LOL. Ok, on top of that it's a mobile MRI unit which means it's in a big truck trailer. It was kind of cool, but kind of uncomfortable.
I pulled up the images on my computer at home and I have to wonder about the quality. The pictures weren't as clear as what I get from the other place. Then again I'm no radiologist and I was told that the MRI machine was very powerful.
I'll get the results before seeing Anderson so I can ask educated questions.
I pulled up the images on my computer at home and I have to wonder about the quality. The pictures weren't as clear as what I get from the other place. Then again I'm no radiologist and I was told that the MRI machine was very powerful.
I'll get the results before seeing Anderson so I can ask educated questions.
Monday, March 1, 2010
Where's my check?
I get a "paycheck" from the insurance company since this is a work related injury. The checks arrive on Tuesday. Well this past Tuesday the check didn't come. This isn't the first time this has happened they get delayed because of holidays usually and even though there was no holiday we did have a lot of snow so maybe that's why it got held up.
I called my claim rep on Thursday 2/25/10. I didn't even ask her about the check but asked her what the situation was with all the back and forth commenting. She then told me that they had approved the MRI back in January. January? WTF? I told her I didn't know the MRI was approved. She told me that she sent the approval to my doctor's office and so she "guessed" that was my notification. Guessed? Hmm. This doesn't sound right. I didn't get hysterical or anything so I was good, but I did forget to ask about the check in my state of shock.
Seriously, I've been waiting for a call from her regarding some result from all this bantering of comments back and forth between doctors while I gimp around and waste away. Yeah, you should see the quad on the ACL reconstruction leg. It's looking pretty skinny.
Ok, so I'll call Anderson's and get the ball rolling.
Friday comes and goes and no check then Saturday no check. It must be lost in the mail. So I call claim rep on Monday 3/1 (she was out of the office on Friday, but I left a message.) She tells me that since I hadn't gotten the MRI or scheduled an appointment with Dr Anderson that my checks are being held! Held? Um, yeah, you didn't tell me that you ever approved the MRI! About now my slight paranoia with dealing with these people sets in and I begin wondering what her angle could possibly be for not informing me of the approved MRI? She even told me that she called my doctor's office last week and they told her I hadn't had the MRI. So why didn't she ever call me? Maybe she wants enough time to go by and then I would be in default for not complying and not getting the tests or making doctor appointments that were approved. Seriously though, if YOU were paying someone to sit around and do nothing wouldn't you let them know right away of something as important as this?
I hadn't made the MRI appointment because doctor Anderson's office hadn't called me back yet from Friday.
WOW, I wonder if this woman will have a job by the time all this is over.
I called my claim rep on Thursday 2/25/10. I didn't even ask her about the check but asked her what the situation was with all the back and forth commenting. She then told me that they had approved the MRI back in January. January? WTF? I told her I didn't know the MRI was approved. She told me that she sent the approval to my doctor's office and so she "guessed" that was my notification. Guessed? Hmm. This doesn't sound right. I didn't get hysterical or anything so I was good, but I did forget to ask about the check in my state of shock.
Seriously, I've been waiting for a call from her regarding some result from all this bantering of comments back and forth between doctors while I gimp around and waste away. Yeah, you should see the quad on the ACL reconstruction leg. It's looking pretty skinny.
Ok, so I'll call Anderson's and get the ball rolling.
Friday comes and goes and no check then Saturday no check. It must be lost in the mail. So I call claim rep on Monday 3/1 (she was out of the office on Friday, but I left a message.) She tells me that since I hadn't gotten the MRI or scheduled an appointment with Dr Anderson that my checks are being held! Held? Um, yeah, you didn't tell me that you ever approved the MRI! About now my slight paranoia with dealing with these people sets in and I begin wondering what her angle could possibly be for not informing me of the approved MRI? She even told me that she called my doctor's office last week and they told her I hadn't had the MRI. So why didn't she ever call me? Maybe she wants enough time to go by and then I would be in default for not complying and not getting the tests or making doctor appointments that were approved. Seriously though, if YOU were paying someone to sit around and do nothing wouldn't you let them know right away of something as important as this?
I hadn't made the MRI appointment because doctor Anderson's office hadn't called me back yet from Friday.
WOW, I wonder if this woman will have a job by the time all this is over.
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