Not Knowing
Just trying to update for a moment:
Last Tuesday, after I had finished my "Twee" post, I was doing some work and my wife called, to let me know she had experienced some "trouble". As she was getting into her car, her leg, at the knee, made a made an horrendously loud snapping sound and extreme pain shot through her leg.
She was at the emergency room (having driven herself there before calling me). They proceeded to X-RAY her hip (not her knee?!?!?!) and sent her on her way saying it was "sciatica".
It has been one nightmare after another since then. She SHOULD have had a scan (MRI) of her knee to evaluate if there was a ligament tear or rupture. Then we would actually KNOW where we stand. But, no, it has been utter insanity since:
- my wife has been resting at home with her leg elevated
- by Wednesday, I had convinced my wife she needed to contact her primary care physician to try to get an MRI of her knee.
- her primary care physician is not particularly responsive and ultimately did not even talk with my wife, but by late in the day THURSDAY had her nurse schedule an X-RAY of her knee. This is utterly foolish, as an X-Ray will NOT show any soft tissue damage (like a ligamental tear or rupture).
If my wife has "sciatica" and no knee problem, it could resolve itself in roughly 1-2 weeks.
If my wife has a ligamental tear, it could require surgery, but with a recovery time of perhaps 3 weeks.
BUT, if my wife has a ligamental tear, and she further damages her Meniscus by walking on the injury, this type of surgery and recovery can take 6 months to a year to heal properly.
And, with my wifes diabetes, and other issues, including not really being strong enough to use crutches safely.... the NEED AND GOAL is to avoid a Meniscal Tear.
- But no one listens to her or us. We got the damn X-Ray on Friday at 8:00am. It was never evaluated by the clinic nor her doctor by the end of the day on Friday. So, we were wholly immobile all weekend.
- Monday, my wife spent a lot of the day on the phone trying to get some response from her doctor.
- Tuesday, the doctor next instructed her nurse to order an "ultrasound" of the knee which will NOT tell a damn thing either. And, there are no appointments available to GET a damn ultrasound until MARCH 5th! And.... it is USELESS for what my wife needs.
But, we do not want her to try to walk normally if she has a ligamental tear that could in a matter of a mistep or two.... lead to an injury that could require perhaps a year of recovery and a lot of down time.
I am angry at health care. I am scared and worried for my wife. I am struggling to also try to do my normal work and not fall into an abyss of getting behind, which would only ramp up stresses further than they currently are.
This is why I have been away.
PipeTobacco
2 Comments:
the NEED AND GOAL is to avoid a Meniscal Tear.
And that's just it, Professor! To your physicians, the need and goal is to satisfy the various insurance company strictures that control payment for services. Most likely, there's a rigidly defined escalation hierarchy in place, where you can't get an MRI paid for unless you've first had an x-ray and then had an ultrasound, lesser procedures that could rule out the need for the more expensive MRI.
Sadly, that's not an "alternative universe." It's what most of us experience whenever we muse use American healthcare. It's the logical consequence of a system that trusts algorithms more than it trusts physicians' expertise in knowing when to escalate diagnostic procedures.
There are some companies that will let you pay for an MRI out of your own pocket, but would your physicians then be able to act on that information? There's no guarantee of that. But at least if you had an MRI done, and your physician would eventually accept its result, perhaps this could at least give you reassurance about next steps, however much bureaucracy might delay those next steps.
Without meaning to be indelicate, could your wife perhaps, while she waits for the needed test and treatment, benefit from a catheter or adult diapers to reduce the number of times she might feel the need to risk walking to and from the bathroom? And is there any sort of knee brace she might be able to wear to take pressure off of the affected area when she does stand or walk?
Finally, trying to find something positive in all of this, might it function as a bit of a "wake up call" to encourage your wife to take more aggressive steps toward controlling her weight and/or her diabetes -- steps that might minimize the severity of such episodes in the future? I'll be hoping that the two of you see a quick and successful resolution of her undetermined knee injury before too terribly long.
I am totally appalled although not surprised. Our health care is dangerously understaffed and at the mercy of money hungry insurance companies. My only suggestion would be to take her to the ER. They might be able to do an MRI much quicker than waiting for a doctor to order one. I'm worried about your wife (and you) and send you my best.
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