Please Keep Trying!

It’s been about three weeks since I updated, mostly due to bad pain from my lousy hip issues. It’s hard to type when you can’t sit or concentrate. I’m so out of alignment because of my wiggly marionette-style ligaments, any physical therapy I do without a brace causes nothing but grief. Lots and lots of stabby, burning grief. But through it all, I stayed focused on my goals: get stronger and get rid of the skin. After much pain, headaches and general bullshizer, I’ve finally made an appointment with a plastic surgeon about getting rid of all the excess skin, and that happens today at 3:00.

Although I have a slim shot at getting the insurance to cover the operation, I still have three doctors willing to advocate that it’s medically necessary, which in fact, it is. My knee doctor, who basically gave up on my knee therapy when he heard about my impingement, nonetheless agreed to advocate for me that I needed the operation to lessen the impact on my arthritis.

My physical therapist, a doc in her own right, also tells me she’ll advocate since it really, really gets in the way of PT- literally. Whenever she tries to tape me for therapy, it’s always a struggle to get around the “loose tissue” as she calls it. Hey, it’s flabby skin, but I like her PC verbage better. The flub also causes trouble when I need to do ab work. It just hangs there and can’t be moved.

I was informed by my therapist the doctor who diagnosed the funness of the hips will also undoubtedly advocated for me.

That’s three medical professionals who say they’ll step up to the plate and bat for me. It may be a long shot, but it isn’t impossible. I understand, however, the process may take up to a year to finish. It involves submitting the claim, getting certified, having the docs all write letters, submitting the letters and trying to prove the medical necessity of the operation. I’ll also be submitting testimonials from other professionals I’ve come in contact with about this and testimonials from my friends and family. That could definitely take a year.

But everyone journey starts with a step, yadda yadda, so forth and so on, so technically speaking, my journey towards a less flappy me starts today. This is something I’ll try and keep updated on the site as I know many people who lose weight also want to see how this little trip fares. It may get rough though, and I foresee many tears, curses and rallying cries in my future.

When I put the sidebar up, I included a category titled “Surgeries“. Surgeries implies more than one surgery, and when I started losing weight and then injured my knee, I figured I’d be needing plenty in the foreseeable future.

Well, Leftie doesn’t need surgery, so that leaves one I know I need for sure, body contouring, and one which is still up in the air, hernia.

After I started losing more than 140 pounds, I started having pangs in my groin/ lower abdominal area. They were really bad when I laughed, went to the bathroom, lifted heavy objects, or otherwise strained myself. The really bad pains however, occurred during intimacy. That had me stumped. I didn’t have health insurance when the pain started a year and a half ago, but I still went and paid cash for my yearly well women’s exam. I told my gyno about it and she said I may have a hernia.

A hernia. I’m a woman, what are the chances I’d get a hernia? She informed me since I lost so much weight, the sagging skin, or whatever, caused the hernia, and when I continued to lose weight, the hernia collapsed inwards. Imagine the horror of hearing something like that and knowing you can’t afford to get it fixed. I waited another pain-filled year and at my next well woman’s, one which I had insurance to pay for, I told her about my problem.

The doctor had me get an ultrasound, which came up clean, with no indicators of anything gynecologically related. Next came an exam of the outside area of the pain. Nadda. Then came something fairly obvious: I have no abdominal muscles. Duh. You don’t get stretched out like a rubber balloon for ten years and expect to have any muscle tone left.

So off I go to a surgeon who’s a pelvic wall specialist. That’s tomorrow. I’m kinda scared. Two things could happen:

1. She has no idea what’s wrong and it’s another month’s wait till I see another specialist who’ll refer me to someone else, again.
2. I have a hernia and will need surgery.

Either of those scare the hell out of me. Not knowing is the scariest, though. Knowledge is power and right now I feel pretty damn feeble.

I read that bariatric patients are prone to internal hernias due to their surgeries. Is it because of the actual surgery or the rapid weight loss? I didn’t lose my weight very fast and I never went under the knife to do it. It’s collateral damage from being obese, one of many. I have spider veins on the backs of my knees, skin sagging everywhere, a hernia and god knows what else.

Yeah, I lost the weight and am still getting fit, but what price did I pay? Monetarily, physically, and emotionally, the cost is exorbitant.

Last week was a nightmare for me; dealing with doctors, MRIs and physical therapists. I have a deep distrust and dislike of most doctors, due to years of horrible encounters. I remember a few years ago going to a doctor to complain the medicine he’d given me was making me sleepy. You know what he said? Drink some Mountain Dew and you’ll wake up. I kid you not. Geez.

I had a similar experience last week when I was wrongly told my left knee had arthritis and some kind of meniscus tear, needing surgery to fix. When I heard the doc pronounce my doom, I admit I took it badly. Two physical therapy sessions (also unpleasant) into Doc One’s pre-op prescription, I scheduled a second opinion. I couldn’t shake the nagging suspicion this guy didn’t know what he was talking about. The doctor I scheduled a second opinion with was personally recommended by a friend. Anyone was bound to be better than the guy who was ready to put me out to pasture.

Doctor Two knew his stuff. He informed me I did indeed have a tiny horizontal tear in the lateral meniscus, but surgery would make it worse. He was quick to add the pain I experience is not due to the tear but to something called patella femoral syndrome. PFM happened in my case when the knee got wacked outta alignment during taijutsu. I unwittingly made it worse by favoring Leftie, thus decreasing the muscles used to hold the patella in pain-free alignment. Not only was the pain not due to a tear, it wasn’t linked to the arthritis I had because I don’t have arthritis. An x-ray showed my cartilage to be healthy and happy. Doc Two even said, “I wouldn’t operate on those knees.”

So no arthritis and no pain from some gi-normous mystery tear. It makes sense. I always thought something was fishy with the way Leftie felt. Yes, it hurts like a sumabitch, but it doesn’t hurt in the same places Leftie One (my first meniscus tear) hurt. I initially thought it was a horrible meniscus tear due to the popping and the pain, when in reality it’s a tiny tear and the pain is due to something else. I can perform activities a meniscus tear would prohibit but it hurts to kneel, bend or to sit too long. All which point to the patella femoral syndrome. With time and the right help, I’ll be stronger than I was before the injury, how’s that for good news?

Relieved is not a strong enough word for what I felt leaving Doc Two’s office. I’m not going to be crippled, I will get back on the mat, and I will have my spring bike rides! But only after intense physical therapy. A., the friend who recommended Doc Two, warned me this guy’s hardcore with his therapy. Awesome, my kind of guy!

I know I keep harping on Leftie. You’re probably wondering why I keep doing so on a weight loss blog. Well, if Leftie doesn’t get fixed, it’ll put a huge cramp in my workout routine and will keep me from the activities which make me happy and sane. An unfit and unhappy Rachel is a fat Rachel. Hence why Leftie is such a star on Please Keep Trying.

I had gone to an orthopedist last week and finally had an MRI done on my knee. When I went back to the doc on Monday, he read my MRI and told me I did indeed have a small meniscus tear. He also explained that with physical therapy I could lead a normal life, i.e. walking and going up stairs, but not much beyond that. Uh, in whose world is that normal? Cause it sure as hell isn’t mine.

The doc says it’s not a bad tear, that I have a few good years still ahead of me even with it injured, but I might not be able to return to the things I did before without a successful surgery. Say again?

Does this guy know I’m only 31? A few good years? I think I have a few good decades.No one is going to take away my rides through Forest Park. Nobody has the right to say my hikes are no longer an option. And no one, no one but no one, says I can’t do taijutsu anymore.

I asked him if the tear couldn’t heal on its own. No, meniscus tears never heal on their own. I beg to differ, some do. Why is it feeling better then? But no, he says, they never heal. I didn’t even see the MRI. Where was the tear, what kind of tear was it? Some meniscus tears, if near a blood supply, aka blood vessels and veins, will slowly, slowly mind you, heal on their own. Could mine be that variety of tear? No, they n-e-v-e-r heal on their own.

I then asked him, can you guarantee that after physical therapy I can get back on the mat and do what I did before, without crippling myself further? He didn’t say a word for some time, then he said no. I could make it worse if it wasn’t fixed. The doctor then said he’d pencil me in for March for arthroscopic surgery.

Errr, something doesn’t feel right. I know doctor’s can’t make lofty promises, and they should usually err on the side of caution with news, but c’mon, why can’t he tell me why this bastard won’t heal on its own? Not just that, but why did he cave in to my surgery request? I really want to see the MRI. I hate getting MRI’s done but I did get it done, I paid for it, I wanna see it and I want it explained to me in language that’s not too clinical nor condescending.

So now I’m looking for a second opinion. Someone who will tell me what the MRI says and whether or not I can get this thing healed up by itself over time. I don’t want surgery, but if that’s what it takes to be active again; cut away. But don’t put me out to pasture before my time and don’t take for granted that I’m not in charge of my own health. That’s right, I’m in charge. I can walk away from any doctor I don’t feel fully comfortable with. I’ve got too many unanswered questions for the orthopedist I’m dealing with now. After coming so far and losing so much weight, this is my life and my time, and it’s time to find a new orthopedist.

I had my first appointment with the orthopedic doctor today. I was so excited! At least until he took some x-rays, and his assistant had me do some exercises to see where the pain was (I could have told her). Then he started twisting my knee around. Does this hurt? No. This? Nope. How about now? Yep! It was only when he bent my knee all the way to my chest that it hurt. Then he dug his thumb behind my patella and asked, does this hurt? No. How about here? Yes!! Then he dug in some more and asked if it hurt. Are you sure? Right here? OMFG, YES!

From this lil’ session he was able to ascertain I may have two things going on simultaneously:

• torn meniscus (duh)
• mild arthritis

I was told in 2000 after my first arthroscopic surgery, I had the beginnings of arthritis in my left knee. I was heavy back then, and destined to become even heavier. I figured after I had lost so much weight, the arthritis wouldn’t be an issue. Guess I may be proved wrong in that assumption.

I’m getting an MRI done tomorrow and will see the doctor again next week to get it read and to figure out what exactly’s going on and what we can do about it. I’m not going to be like the rest of my family and get a total knee replacement by my fortieth birthday because of raging degenerative arthritis. I’ll lose the rest of the lard and the excessive skin and maybe that’ll help the situation. But the bottom line right now is, we still don’t know for sure what the heck’s going on and won’t know until next Tuesday. Hey, I waited almost seven months to get this thing checked out, I think I can wait one more week!

I’ve been researching plastic surgeons in the area, and researching if my new insurance going into effect in February will cover any part of the body contouring surgery I’ll need.

Sadly, most insurance companies will not cover excess skin removal due to weight loss. I figure the companies got fed up with forking out the dough to Bariatric surgery patients who lost hundreds of pounds in a short period of time. People who lose weight too quickly have much more skin to deal with than say, someone who safely and healthily loses it a few pounds at a time.

Body contouring surgery is an umbrella phrase encompassing different surgeries which target different areas of the body. Brachioplasty, for example, is a surgery to remove the excess skin under the arms. Abdominoplasty focuses on the tummy area.

These surgeries aren’t cheap and they’re not without risks. An abdominoplasty (aka, lower body lift), which is the surgery I need the most, costs on average, $7578. That’s not including the fees for the facility, the anesthesiologist, the operating room costs, the hospital stay, or lab fees. Kinda depressing, especially since I need three other surgeries.

I averaged out how much it would cost me for everything I needed done and came up with a price tag of $50,000. Ouch. Hmmm, down payment on a house or skin removal….

It’s a safe guess I’ll only be getting two surgeries per year, due to cost and healing time. It takes about two months to heal up from many of the surgeries, well enough to return to strenuous activity. I can’t see going back under the knife two months after a prior surgery anyway. Surgery is traumatic, and takes its toll, no matter how healthy a person is. Which would mean I’d be finished with all the weight loss details by the end of 2010, maybe. Who knows?

This is mostly conjecture at the moment. There may be some sliver of a chance my insurance may cover some of the costs. Something would be better than nothing.