TKR Right TKR 6/5

[snowleopard]

 

[wings]

Did the eye procedure go well? I've been following your progress.

 

[snowleopard]

Hello, @wings. That thumbs-up above was about all I could manage for a check-in last night, but I guess it was too ambiguous. I can't believe that something I've dealt with since I was a child was resolved in 45 minutes on an operating table. I guess it wasn't, because the skill of that surgeon and the nurses and anesthesiologist, and everyone who built the machinery and hospital and developed the skills to keep the whole operation running have been developing since they were children, too. We've all been on this trajectory that met yesterday, and wah-lah, baby!

Met with the surgeon this morning, and he was very pleased with how I was doing, said I should expect the eyes to continue to improve for a few more months, that it will take a little time to get them to work together. I can't remember if I described what's going on, but basically, the eyes didn't track together. I was able to get them to focus by forcing the muscles to work together, but when I was tired, or stressed, or just didn't try, they went different directions and I would get a double vision. To look at a computer screen all day, read, look at notes, and get the same image in both eyes was an constant act of will.

The doc got in there and loosened up one of the muscles that was causing that. He cut and sutured it, so I have tiny little thread ends of sutures rubbing against the bottom eyelid (about as much fun as it sounds), and an eye that's been set free to move at will, and doesn't quite know what to do with itself yet. My first intimation of what was to come was yesterday evening, sitting out on that same deck, and looking across the lake. The view was snapped into what seemed to me to be crystal-clear focus, which I found riveting. I don't know if that's because the prism is out of my glasses, or if that's because there was always a little frisson of focus-refocus-refocus going on between my eyes before as each jumped back and forth. The new glasses were a stroke of inspiration--my own or just a gift from the universe, who knows?--as I tried putting on the old pair once--OUCH!--and took them immediately off. So glad I had these with me. I am typing on a laptop about 18" from my eyes, and am able to focus with their help.

I tried playing the music I was working on before, and made it through an entire piece without having to stop and rest my eyes, or go back to correct mistakes of mis-seeing. A little while ago I was looking around the room and noticed that there was an ease to doing that--it's very hard to describe, as it's subtle and not a common experience. Or maybe it's common to others, but new to me. Anyway, I think it's a glimpse of things to come.

When I arrived home today, I found a package with some more music I'd ordered, and can't wait to dive into it.
I had a call from the doc who ordered my blood-work and pap smear, and she said that all the tests looked great. Another nice piece of news.

 

[KarriB]

Amazing to hear that something you've unknowingly struggled with for so long will come easily after a while of reacquainting yourself with your eyes. Good for you, going on this journey to better equip yourself physically. Hope your knee is cooperating also.

 

[Raffs]

Delighted to hear that all went well. I've just read your post elsewhere that says you managed to do the stairs sequentially - that's great news. Hope you get plenty of rest time this weekend.

 

[Jamie]

Stopped on the way home, got a bag of ice, staggered everything inside and it's sitting at the top of the stairs waiting to go to the kitchen. Except the ice, half of which went into my cryo-cuff and the other half is sitting in the bathroom sink. Hopefully not melting too fast.

I have a little tip for you on the cryo-cuff. Since using bagged ice can be quite a pain, freeze water bottles or margarine tubs with water and use those instead. It's free, less to deal with and the bigger ice chunks last much longer.

In just catching up with your thread, I am in awe of your accomplishments!!! You are a tough and independent woman for sure.

Don't know where you live in Alaska, but I have fond memories of that state. I was there in the 1950's when it changed from a territory to the 49th state. Quite an experience. We were in Anchorage and I was just about the biggest tomboy every....roaming the woods for adventures. Such great times.

 

[susie09]

"Being disabled does not make me a cripple, guys.

Sorry, but I'm having a little problem with this - how exactly do you define the difference between "disabled" and "crippled"? I'm curious/confused since my sister happens to be a quadriplegic who is also an attorney/Presidential Scholar/Phi Beta Kappa. As a kid she was frequently referred to as "crippled". These days she's "disabled" - political correctness, you know. Is there some other distinction I'm not aware of? Just wondering....

 

[snowleopard]

Sorry, but I'm having a little problem with this - how exactly do you define the difference between "disabled" and "crippled"? I'm curious/confused since my sister happens to be a quadriplegic who is also an attorney/Presidential Scholar/Phi Beta Kappa. As a kid she was frequently referred to as "crippled". These days she's "disabled" - political correctness, you know. Is there some other distinction I'm not aware of? Just wondering....

Fair question. As I grapple with it, bear in mind that as I came up with that admittedly vague mutter, I was driving out of a busy parking lot at the end of a long, tiring day, and talking to myself while struggling to put into words something that wasn't exactly clear to me.
But here's what I meant by that: because there are things I cannot do, I am disabled. We are all limited in what we can do (disabled) unassisted. Yesterday, I flew 400 miles; I had the help of an assistive device. Today, I cannot fly. That day in the grocery store, I chose to use the available assistive so that what energy I had left was available for the remaining chores of the day.
I felt that even though I was using the cart, I was just another shopper, shopping in a way that was appropriate for me. The treatment I got, primarily by the one customer, made me feel that I was seen as even more incapable than I was, and thus needed to accept help from others, for which the others earned some mystic Brownie points.
The bag boy asked me if I needed help out, and I declined, and he simply went on to ask another customer the same question. That felt appropriate and respectful. The other time I was shopping and had moved my groceries to a standard cart, and was on my crutch moving them into my car which was parked in a handicapped area, someone offered help. It was a man who walked up to me, made eye contact and said, "Excuse me. I notice that you are doing this one-handed. Would you like help?" And I smiled at him, thanked him, and said I was fine, and that was very kind of him to offer. Again, respectful and appropriate. I would have accepted that if I had needed it. I was given the choice in both cases.
This other woman took away my choice. She took away my choice to wait in line like everyone else. She took away my choice to unload my own groceries. And when she did those things, I felt more disabled than I was. I was disabled by her perception of me as one who could not take care of herself, as one who was out in public trying, but actually dependent upon the mercy of others.
I'm guessing that when your sister went to school, and when she goes to work, she made and makes use of assistive devices she feels to be appropriate. I'm also guessing that she manages her energy as a valuable and limited resource. That may mean she accepts help appropriately offered. Perhaps she gets annoyed when people talk to her as if she is also deaf and a little dull, or when people who don't know her call her "dear" because she's using an assistive device. I don't know her; you do. I'm speculating based on my own very limited experience. I wanted so be seen as a human being first, able to judge what help I needed. Maybe I looked a lot more pathetic than I realized. But I wasn't a hero or a sympathy case. I just needed some food.

There was another shopper there, a lot more subtle, but who also seemed to be getting some needs met in relationship with me. She looked like she'd just come from a workout, was wearing very tight yoga gear, great posture. But she carried this, "Look at me! I'm in great shape, and you are not," aura. My first encounter with her was a glance at the scooter (not the person using it), and uncoiling gracefully in front of me to get something. Not a big deal the first time, although after it happened four times in four different parts of the store, I understood a message was being conveyed. I watched her with others, and saw the same message given: "I am very fit and healthy, more so than you. You may look, but I am better than you and I will always be fit and healthy. You are inferior to me because you do not take care of yourself as do I." I pretty much failed to give Lululemon her stated due, and thought, "Okay, we get it, but when I was your age, I could have thrown you over my shoulders and done my shopping." I shook it off because she is young and has no idea that life has plans of its own. But I was already a little hypersensitive before I hit the checkout lines.
There's an article in the Ragged Edge (formerly the Disability Rag) about Tiger Woods saying that he had "hit like a spaz." The international press quoted him accurately, resulting in criticism and an apology overseas. The AP news wire tidied it up to "hit like a wreck", and there was no knowledge of the outcry or the apology disseminated in this country, or in what the Ragged Edge calls the "crip community". Why is "spaz" offensive to people who write about themselves as "crips"? Now there's putting a fine line on language use. I think it's a bit of that ethnonymic insider/outsider, we-can-say-this/you-can't thing.

In a blog article on "Reflections on the C-Word," Chava Willig Levy wrote:

Take the word “cripple.” The most appropriate use of the word “cripple” that I ever came across spanned the front page of my local newspaper: “BLIZZARD CRIPPLES THE CITY.”

“Finally!” I remember exulting. “Someone figured out what ‘cripple’ means!” And what is that, pray tell? Brought to a standstill. Stopped in its tracks. After all, according to the Merriam-Webster Dictionary, the Old English root of cripple is creep. I don’t know about you, but my disability – although severe – has not stopped me in my tracks.

You can read the rest of it here, if you wish. I found it worth the time: broken link removed: https://chava.chavawilliglevy.com/?p=12 She closes with a story of how she more gracefully handled a similar situation. I was caught flat-footed and off-guard, tired, alone, and tolerated treatment that left me fuming and uncomfortable, although clearly well-meant.

I've been thinking about this subject a bit. I have a hang-tag in my car that qualifies me for handicap (from cap-in-hand, beggar) parking, and I see buttons I can push to open doors with my crutch tip that admonish me that they are for handicap use only. And I wonder why those places that are in front of us daily are exempt from the political correctness that has eliminated the use of those words in conversation or casual writing such as this.

Do we need something to designate people who require a little more leveling-of-the-playing-fields for situations like that? Maybe, or else we would have name-specific parking all over town, and that wouldn’t work either, nor would buttons that were labeled to be used only by Chandra Levy, your sister, and myself (but only through November). Unwieldy at best.

My grappling for words to integrate and understand that event wasn't necessarily successful. I often look back over what I’ve written and think, “Nope, that’s not it.” I continue to attempt to put experiences that are new to me, that are uncomfortable, disturbing, that leave me feeling helpless or amused or triumphant, into words, to share them here and to have them ideally sifted and given back to me, somehow understood in spite of their limitations, as they so often are.

There's a story told of a three year old who could not wrap his tongue around the -sh ending of a word, but when someone was talking to him and used the boy's pronunciation in his own speech, the child angrily retorted, "I said FIS, not FIS!" That's kind of what I was struggling to put into my own words there--that I don't have the words for my experience and feelings, but I still had my experience and feelings.
I think it’s completely valid for you to challenge what I wrote. The answer is, I don’t know what the answer is. I like Chandra Levy’s term best: “the quest for the ho-hum.” Until Ms Yogapants and the person who was climbing into heaven based on points accumulated by helping me made a point of my being otherwise, I was simply on my own quest for the ho-hum, as well as some nice red peppers.

 

[Jamie]

Wow, snowleopard.....I am blown away by your essay on this subject. You write so well and have obviously put a lot of thought to this. It's an important issue, I believe. Too often people who have challenges in life (be they temporary like those of us in recovery from surgery or permanent) that others use to define a person and place them neatly in a compartment. How much grander things could be if we all approached the humanness of a person instead and dealt only with the here and now - their "quest for some red peppers." Miss yogapants will learn herself one day. As one of my favorite sayings goes, "Eventually everyone gets something, life is what happens when you're busy making plans" and one day she will have challenges of her own to deal with. That thought always makes me smile inside as the yogapants tra-la-la through their day thinking life will always be so perfect and planned.

And, @susie09 ..... I would love to meet your sister. She sounds like one heck of a gal who definitely has her head on straight. The world needs more people like the both of you.

 

[Slainte]

Way back in 1990 at the youngish age of 32 I broke my ankle in 9 places, had unsuccessful surgery, and degenerative arthritis set in. I was told that I needed an ankle fusion, but by that time was expecting child number 3 and had to wait until 6 weeks after his birth for the surgery. Consequently I spent about a year in a wheelchair. Amazing how differently I was treated. People would avoid meeting my eyes, and I remember one time shopping with my mother I handed the cashier the payment and she gave the change to my mother. I really felt like a second class citizen. So I totally get your resentment at being treated like a "cripple". Made me be certain to treat folks in wheelchairs equally.

 

[snowleopard]

Oh gosh, I'd forgotten about that. When I broke my leg (which started me down the path to this adventure), I was in a chair when I was recovering. I went to a restaurant with my son, then about 18 (I was paying), and got situated in a booth with the chair folded and parked. The waitress took my son's order, and then asked him, "What will she have?"

 

[snowleopard]

Went in for the mammogram today. Completely no big deal. Didn't even hurt that much, a bit of a pinch, and passing quickly. Bone-density scan results Wed; butt cam on Thursday; dental cleaning on Friday. Then all that remains is the hearing test, and my knee sugeon's 3-month check-up at the end of the month. Thus endeth the month of no-insurance-copays, and thus endeth this seemingly unending round of procedures and tests, and glad to have it behind me I will be indeed.

This must be a bit confusing for our Brit/Candadian/Ozzie/Kiwi members, but each insurance-year (not the same as a calendar year, except when it is) for most private insurance starts with a lump sum that comes out of the insured's pocket. Once that deductible is met, the insurance company starts paying a percentage of what is billed, except, of course when they don't, either because they pay a smaller percentage, or don't cover certain procedures, or the moon is in the second house and Jupiter aligns with Mars. And sometimes they turn something down just to see if you're paying attention, and will request that they re-bill so that they know that you know that they're obliged, not that this is binding in any way. The co--pay continues until you meet a certain minimum (your annual salary, usually), and then they pay at 100%, in theory, pursuant to all applicable exceptions.

So when you get to the point when out-of-pocket expenses have been met, it's like winning a medical lottery or something. One zooms in and takes care of all the things that have been neglected up to that point. And thus the mad whirl. The knee surgery resulted in lights flashing and bells dinging and confetti flying, and now it's use-it-or-lose-it-in-three-more-weeks time. Also tried to time all these tests so that if there's a problem that shows up in these tests, they have enough coverage to take care of it before the clock stops and the new ins. year starts on Sep 1. So any support and nagging and pushing and yenta-ing is greatly appreciated to get through this. Hate it-hate it. But not as much as I remembered hating it. First mammogram in ten years. Even I get that this is ridiculous.

 

[puppywalker]

That sounds so complicated!

 

[snowleopard]

@puppywalker, I was canoeing on a remote Canadian river long ago, and getting a severe sunburn. Nothing for protection in the little store in the village we stopped at, and they recommended the medical clinic. I was very impressed by the facilities in this truly-middle-of-nowhere village, and was given a tube of zinc oxide. I don't know who was more confused, the care-provider or I, when I asked how much I should pay.

It is past complicated. I hate that feeling of needing to squeeze all the care I can out of this coverage while I have it; makes me feel like a user. And then with my next though I wonder, "Should I see a dermatologist for a mole-patrol while I can?"

Some insurance plans self-pay; the covered group essentially saves up what they would pay for coverage and then they pay for medical expenses. Works well until someone needs a liver transplant, I suppose. But that also makes one a little hesitant to drink deeply from the fountain. Or not, I suppose.

 

[PolarBear60]

Short answer. Yes. You should.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

 

[PolarBear60]

Hilarious explanation of the U.S. Insurance system. I thought my knee surgery would put me over my $3000 catastrophic cap for sure. I didn't know whether to be elated or disappointed when I got the bill for $33. (I chose to be elated!) I think they didn't bill right, because I thought I was responsible for 20% of the cost of the device. If they don't know how to bill, I'm not saying anything.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005

 

[KarriB]

All my working life I was told I had the best insurance around, then when I need it the hospital/insurance groups in Pittsburgh decide they don't want to play together anymore so I can now only go to certain hospitals and certain docs. Exasperating!

 

[Celle]

Insurance is so variable!
New Zealand, like the UK, has a free public health service - funded out of taxes. It's there for everyone and the emergency care is superb.
However, as in many places, there are long waiting lists for routine surgery.

Many Kiwis (me included) also take out private medical insurance. This gives us more choice of specialists and also means we can get routine surgery more quickly. There are a variety of providers and plans, ranging from covering the entire cost of medical, surgical, optical and dental care, to specialist and surgical care only. The amount of cover you get depends on how much premium you are willing to pay, and the cost increases as you get older. You can choose from a variety of plans.

Currently, we have a policy that covers 80% of the cost of medical and surgical specialists, and hospital and operation costs. We pay the other 20% and also pay for medicines and GP consultations. We, too, have an annual claim year - ours is 1 June to 31 May.

 

[Raffs]

What an interesting topic! I had no idea that health insurance in the U.S. was so complicated.

I have private medical insurance provided by the company my husband works for. The company pays approx £1000 per year to cover us both as part of a corporate policy. He gets taxed on the £1000. We pay £150 per person per insurance year as an excess ie we pay the first £150 of any claim. We are limited in how much we have to spend on consultations, physiotherapy, outpatient treatment and some diagnostic tests - £1000 per year. Inpatient procedures and surgery are fully covered.

My PKR cost approx £14,000. All we have had to pay out of our own pocket is the first £150. Appointments with the OS come out of the £1000 limit mentioned above as did the removal of the staples as an outpatient procedure. We also paid for some of my take home meds - £18. We have chosen to self pay for my PT as this is not very expensive.

I think I got a very good deal. I have no idea how long I would have had to wait to see my OS using the free National Health Service. And no idea if I would have been approved for the surgery on the NHS because of my age. I'm sure the NHS would have tried the "too young " excuse even if the actual OS had agreed to the surgery.

I am very very fortunate.

NB: think the current exchange rate is approx $1.50 to the £ or slightly lower.

 

[snowleopard]

@PolarBear60, take the bill and tiptoe away, for goodness sake! And thank you for the go-for-it advice. It makes me feel very care-taken to just go down the menu and say, "I'll have this and this and that and one of these, please, and whipped cream on top."

@KarriB, ironic and annoying! As long as the best were among your choices, that would be okay.

@Celle and @Raffs, I appreciate your chiming in with an explanation of how things work in your systems. The part that leaves me completely confused is how or whether the private insurance system and the NHS coordinate benefits.

Wow again! I think my hospital bill alone came to around $62,000USD. Then there is a bill for the surgeon ($15-ish?), the surgeon's assistant ($5K), the anesthesiologist, the physical therapists, the out-patient visits with the PA who is monitoring this in my hometown.

My health insurance is free for me through my place of employment, and costs a little under 2K a year for my husband, and an additional 2K a year for our children. Both of my children went off the insurance this year, and since my divorce is supposed to finalize (after an eight year separation) next month, my husband will go off of the insurance as well. (I keep reminding him to get routine medical tests taken care of, as our whole family's deductible and out-of-pocket is covered for the next three weeks. Nope. But then, he didn't listen to me before, so no surprise there.)

I think the eye surgery will come to around $12-15KUSD for everything, but insurance at this point should have covered it all. I can even submit bills for the flight and the room while I was there.

Throw in yesterday's mammogram and Thursday's colonoscopy, and probably a high-end pair of hearing aids once I get my hearing test done in a few weeks, and I will have probably have received double my annual salary in benefits this year.

I remain utterly grateful to live in a time and place where this level of care is available. In a hundred years, this will no doubt seem primitive, but for here-and-now, we are among the fortunate minority. l had a friend who had to wait eight years for a new knee, because she'd worked at jobs that didn't pay insurance, and when her knee went south she couldn't work anymore. Someone gave her a scooter, and for the last four years, she used that to get around. When she turned 65 and qualified for medicare, suddenly the world was at her feet offering her services: surgery, home health care, physical therapy. And if she'd gotten this surgery when she first needed it, she'd have been a productive member of the work force, not to mention a lot happier, for another decade. Her recovery was a lot slower because she had deteriorated so much over time. I'm good with having some kind of safety net for people like my friend, but I don't pretend to think there's simple solutions.

I first broke my leg about the time the big typhoon hit. I had a ride to the hospital, a professional staff to provide care and pain relief, and appropriate treatment plus support at home while I healed. I reflected several times on the sure and certain knowledge that there were people with similar or worse injuries whose only care consisted of a forked stick, maybe some aspirin if they were lucky. I also heard about medical supplies being provided via drones, and even speculation of high-risk babies who are born in off-road communities being delivered to critical care facilities via these modern-day storks. Poetic as the image is on a certain level, I find that idea terrifying.