Guaranteed Healthcare

My horror story features more monsters than just our healthcare industry. My injury turns out to be poorly understood by the orthopedic profession as a whole, though they have made rapid strides in the last decade or so. I live in a poor and isolated area, somewhat cut off from the booming, competitive goods and services of California civilization. I have an unusual aversion to travel. And I was unlucky--it took several strokes of fate and wrong decisions to get into the jam I found myself in by February of last year (2007) after a half century of some of the best health in the country.

But left lying on my back all but two or three hours a day, afraid to move and in some of the ugliest pain I have ever felt; mentally crushed by the cataclysmic loss of not only my athletic lifestyle but even the ability to do things like stoop over to pick something off the floor, I found out who my real friends were and they sure don't include America's health care system. It began with a small-medium tear of the meniscus of the left knee incurred during a week of strenuous delivery work in another town. I knew a knee operation was far beyond my means to pay (about $20K), having no permanent job and of course no health insurance. I also knew the difficulty healing this type of injury on one's own but I had to do it. Looking back, I could have, but to do it I would have had to shut down my athletic lifestyle and walk around only on crutches for a good five weeks at least, preferrably more. But I didn't know this at the time and, like most athletic active types, I refused to shut things down: I kept my cycling and developed this peg-leg type of walking where I would keep the left leg straight and try to make up for it with the other side. This was a mistake. It put too much stress into the right hip and I surreptitiously developed a small tear in the upper front of the acetabular labrum on that side.

I remained too focused on the knee and the hip developed into a nagging though not yet debilitating problem before I stopped the peg-legging. My knee did make progress. After about five months still doing my usual activity, my knee slowly improving but my hip in limbo, fate intervened. I had a small bike crash. Twelve days later I knew something was disturbingly wrong with the hip. What it turned out to be was the little rip had become a progressive detachment, sort of like unzipping, moving around the front periphery of the socket. All of a sudden, the knee was no longer important and indeed I had to start abusing it to compensate for the increasing loss of ability on the right side. I struggled to maintain my active lifestyle by swimming more and cycling less but to no avail--the tear had passed a kind of point of no return and continued to worsen.

Despairing, I finally shut things down on January 9th 2007, the first time in 26 years. I hobbled around first on a walker and then on crutches when those could be obtained. Later I would make more mistakes and wound up bed-ridden. The loss of exercise became so severe that my right leg wasted down to such weakness I lost the ability to walk. In the last three months (today is May 12 2008) I have struggled back with excercise to regain some limited ability to walk but I'm still severely limited--can't sit on a chair, for example. No medical help except a small charity in town that provided a couple devices. I hit the internet hard, gobbling up whatever papers I could get and reading tons of sob stories, on blogs, much like my own. The blogs revealed a disturbing pattern of orthopedists failing to even diagnose this kind of problem, much less properly treat it, and several papers I managed to get confirmed this. There were also insurance issues reported, though the better off did get coverage for the top-notch surgeons they wanted.

But it didn't take long to determine that what medical expertise there was in my little town--basically two doctors, one of which specialized in hip replacement surgery, about $100K and something I desperately wanted to avoid anyway; and another guy based in a much more cosmopolitan area--wanted nothing to do with me because not only did I LACK insurance, I didn't even have the kind they wanted. I was ineligible for Medi-Cal because I had more than $2K in personal assets. There was one kind doctor, not originally from the US, who would take people who could not pay--and predictably, had a waiting list a year long. My application for disability ended in denial, though that was partially my own fault, and is currently a w.i.p.

So I wound up lying on my back watching the days go by through the window--completely on my own against one of the toughest injuries to come back from. Looking back after A YEAR, I got some things right but also did some basic things wrong that a trained professional could have prevented. No doctor and only one nurse in my little town would condescend to a house call. I expanded my intense research to include the state of health care in America--not a lot else one can do, lying on one's back 20 hours a day with a laptop on their belly.

It was shocking to compare our situation with that of countries like Canada or even Cuba! We all hear about the 47 million uninsured all the time but there is much worse than that: ugly stories of poeple dropped right in the middle of treatment, even. People with anything but the very best coverage, such as that given to members of Congress, are finding their costs going up several times faster than wages at the same time their insurers are sneakily thinning out their coverage. As far as I know we are the only country in the world that would tolerate this--but this so-called market has failed, pure and simple. "Best medical care in the world" some politicians have the gall to claim--best for WHO?! Excuse me if I don't feel very patriotic these days.

My story isn't over yet. My knee, after 18 MONTHS, feels like it's ready to go but my hip is loaded with a bunch of awkwardly constructed scar tissue and my leg is still too weak to run, hop, or even step up on the curb. I now know, looking back, that I failed to follow the proper orthopedic procedures required by conservative treatment. So I'm trying to figure those out and make up for all the lost time. The success rate for this type of injury has been reported in one paper to be around 15 percent. Wish me luck and wish our country luck, too, for the current so-called "system" has got to go.