When the date of the first doctor appointment came around, I was a little embarrassed about going. It’d been awhile since my knee really bothered me and I arrived to the office with little to no pain. For about the previous 3 weeks, I was able to walk around just fine.
As we all know, there can be many steps to a doctor visit. The sign in, the forms, the wait in the community area, the wait in the room once you get called in, etc….The first visitors are student doctors, with which, I really don’t have a problem. Initial tests from these two student doctors didn’t show many limitations on knee motion. Nonetheless, I was sent for x-rays — and those didn’t show much either; meaning, the bone structure was in tact.
Time for a visit from the main doc, the guy behind the guy. He ran me through similar flexibility tests. I had to be told, over and over again, “Relax your leg.” Sorry chief, but you moving my leg around like a joy-stick doesn’t give me a peaceful, easy feeling. A little more poking around the back of my knee….wait, he felt something. There was some “looseness”, just enough to send me for an MRI. The students, of course, agreed.
So what exactly is an MRI – well, for those who don’t know, MRI stands for Magnetic Resonance Imaging. An MRI machine can give a pretty decent picture of what’s going on anywhere in your body, on any plane. Your standard unit costs $3 million, and hundreds of thousands a year to maintain. They can be about the size of a mini-cooper. Basically, this moo-chine, as Dominican Lou would say, creates a magnetic field and aligns the magnetic ability of the hydrogen atoms in your body. The MRI then sends some radio waves to alter the alignment, thus, causing all those hydrogen atoms to send a radio signal back to the machine. Somehow, these radio signals and their strength, placement, etc. are composed to form the internal image of the body.
The whole process takes about 45 minutes, I actually got a nice mid-day nap out of it. They put your knee in some type of holder, slide you into the machine….looking like side-ways well with walls taking up about 70% of the surface size of the tubular structure. It makes noises that sound similar to answering a call from a fax machine. They go on and off in the same low pitch And that’s it. You are off to the streets with an envelope the size of an SUV driver’s side window filled with about 15 MR-images. Off to wait for next week’s appointment.
So, that day comes and just like last time, I see a couple student doctors first. Mind you, at this point, I’m still a little hesitant to be there. My knee feels relatively okay, and I’m fully expecting the doc to say, ‘knee is fine, you just gotta rehab it a little.’ But these two cats…..first of all, they’re bumbling with the back-light on the viewer, it’s broken. They then go with the ‘holding the MRI up to the window’ method. Terms like “torn” are being thrown around loosely, but I’m somewhat under the impression that the doctors in training are not exactly sure what they’re looking at. The possibility of a serious knee injury made me uncomfortable, especially after thinking that I was going to leave the office with a thumbs up and a pat on the back.
Finally, the main doc comes in to take a look. Yes, I can see what he sees on the MRI shots, the tendon they are calling the ACL is gray. Tendons are usually dark, when they appear gray, they may be torn. The doc also noticed some bruising around the bone. Here are the options, he said, surgery is not a must, and there are some risks to a procedure, but it would be my recommendation. The doctor seemed to stress the ‘option’ part and that the choice was mine to make. Time for questions.
I told him that my goals here are to avoid knee problems in the future, and to remain as active playing basketball as I am now. Considering this, is surgery the best option? I am told yes.
Now, I’m welcome to seek a second opinion. The thing about knees, x-rays and MRIs can only tell you so much, they really don’t know what’s going on until they scope in there. So, the doctor told me, when they get inside to investigate the situation, if the procedure from the initial assessment is not necessary, they will not do it. Now is when I received the pat on the back.
I went ahead and scheduled surgery, knowing that cancellation was a possibility. Still, I had a decision to make. In the meantime, I would go to pre-surgery rehab, as the doctor prescribed, and would try to inform myself as much as possible. Surgery was scheduled for December 19th, just over five weeks to solidify my resolution. The general consensus among those with whom I talked was that if you are having surgery, you should get a second opinion regardless.
So, I half-heartedly tried to seek a second opinion. Health plans, HMOs, PPOs….let me just join the chorus and say it’s all messed up. You see, I was able to get an appointment with this first orthopedic doctor without having to go through the great system of “official” referrals. Plus, the guy was recommended by a bunch of lawyers. He had to be good, right? Went back to my health insurance plan website, yup, it’s Aetna. The search feature is terrible, but somehow I was able to come up with a call-list.
One-by-one, for each doctor’s office I called, I was given the straight shut-done since I was sans referral. The expected dose of attitude from the receptionists/whatever came, no referral needed. Becoming frustrated and pissed was the sensible point A to B result. I didn’t want to go to my regular doctor, who is not in my health network (don’t ask why), just get a “permission slip” from him. And I didn’t want to find a new doctor just to get a referral. I already had an MRI done, and all the slides were in my possession; I just needed some trained monkey to look at them. Eff all that. I should’ve just outsourced the work to Bangalore.
Time passed and I had pretty much convinced myself that if the surgery date came around, and I had yet to procure a second opinion, I was going to go through with it. Like I said, my knee doctor made me feel comfortable, and he had the experience; a background of treating team sports injuries. Eventually, I spoke with my regular doctor, who thankfully took time out of his schedule to talk with me over the phone. He gave me the name of someone I could call….but by this time, it was less than a week away from surgery. However, he also offered me some advice. He said that long ago, he had a knee injury and opted not to have surgery…and after that, he could not play basketball again without hurting it. Granted, he wasn’t as frequent a player as I would like to be….but that fact went on to further seal the deal. No second opinion, I was going to get me some knee surgery.