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Shot of Steroids

12 Saturday Nov 2011

Posted by Ed Mahoney in Medical Files, Running

≈ 1 Comment

Tags

Boulder Surgery Center, cortisone, fluoroscopy, MRI, orthopedic, symphysis

Dr. WW called back again to let me know he’d reviewed my MRI with Dr. Stilp – an Orthopedic Surgeon across the street at the Boulder Surgery Center.  She concurs with the radiology diagnosis of arthritis in my symphysis pubis and wants me to call her to schedule myself to receive a fluoroscopic-guided shot of cortisone.  Dr. WW actually let me agree first that I was interested in receiving the shot.  He might have been following some ethics protocol.  He seemed happy with my decision though.  And he related to me that I’m only the second case of symphysis pubis arthritis he’s treated.  The other guy was a few years ago.  That guy was in his 30s which makes me feel better about this not simply being about my age.  Dr. WW ended the call by giving me the phone number to Dr. Stilp’s nurse Heather, to setup the procedure.

Nurse Heather penciled me in for this coming Wednesday afternoon.  I’ll take a half day vacation as this will suck up too much time to simply squeeze it in between conference calls.  Heather briefed me on what to expect.  The shot itself will take just a few minutes, but I’ll need an hour for prep and another hour post-op.  Apparently this isn’t a simple flu shot.  The doctor will use fluoroscopy to guide the needle into the area of my hip bone.  Heather surveyed my medical history over the phone so I won’t have to spend time filling out forms once I arrive.  I declined the anesthesia so I’ll be able to drive myself home afterward.  I’ve never had anesthesia before but have seen others receive it and can say that it doesn’t appeal to me.  Heather answered most of my questions.  I’ll have to wait to talk with Dr. Stilp to answer other questions such as ongoing expectations.  I neglected to ask just exactly where the point of entry will be for the needle.  My buddy Dave suggested I should expect it to be where I least want it, and that stirrups might be involved.  Ouch.

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The Call Back

08 Tuesday Nov 2011

Posted by Ed Mahoney in Medical Files, Running

≈ 2 Comments

Tags

arthritis, MRI, orthopedic, sports hernia, symphysis

After the trailer MRI by a Radiologist likely located half way around the world, I wasn’t expecting much in terms of a call back.  A voice message from the Orthopedic’s nurse perhaps.  Shoot, assuming there was no big news to relate, I’d be good with a text.  I personally could not read into the picture I took of the MRI scan, but I did have my own guess.  I side with my primary care physician.  She thinks I have a tear in the tendons connecting the abdomen to the symphysis pubis.  It feels that way to me and I could see that taking a long time to heal without proper rehab.  I don’t know enough about sports hernias to say anything intelligent, but a hernia does not sound like the sort of thing I would be running marathons with or hauling up 14,000 foot peaks on the Colorado Trail.  My optimism might be biased by wanting to avoid the potential surgery required for a sports hernia.  So that was my frame of mind as I waited for the call back.

Dr. William Williams called me on my mobile tonight at 7:19 MST.  He used a lot of big words and never definitively committed to anything.  It might as well had been Alan Greenspan who called me.  I’ll be much more direct in my translation.  My symphysis pubis is arthritic.  This is apparently rare in this type of joint.  Dr WW then lectured for several minutes tangentially on the different types of joints and how the symphysis isn’t really a joint anymore than spinal vertebrae.  But it sort of is a joint.  He’d either made his point or realized I was no longer responding and returned to topic.  He exhorted that a hernia is still possible but less likely now given my symptoms.  The advised treatment for the arthritis is a steroid shot and he thinks he might know someone who could administer such a thing if I were interested.  I am.  He’ll talk to Heather. I envisioned my eye doctor’s clinic where the eye glass and frame shop seem to exist as separate entities yet within the same building.  This guy distances himself from the dealers. The upside is that a positive response to the steroids would further suggest I don’t have a hernia.  Or perhaps the upside is that I’ll now have a fairly valid subterfuge for a medicinal marijuana card.

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Trailer Medicine

02 Wednesday Nov 2011

Posted by Ed Mahoney in Medical Files, Running

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Tags

Bangalore, Cigna, MRI, orthopedic, symphysis, under armour

Today was the big event – my first MRI.  I woke up to a half foot of fresh snow.  Much less on the sidewalks and roads.  Not that it mattered, my appointment wasn’t until late afternoon.  The roads were dry and clear by then.  I left a bit early anyway since I’d never been to the Lafayette branch of the Boulder Community Hospital.  Good thing as I mistakenly drove to the Exlempa Good Samaritan Medical Center first.  I figured it out after Registration couldn’t find a record of my appointment.  Still made my appointment on time as the two medical centers are located fairly close to one another.

Registration was quick although Cigna never called in my negotiated rate.  I know I will eventually owe 20%, but don’t know what the 100% is yet.  Fortunately I did not have to pay in advance.  I understand MRIs to cost over $3000.  The Cigna negotiated rate should be about half that, give or take 10%.  I was still ahead of schedule and sat down to read my WSJ that I brought along.  I brought my own newspaper for two reasons.  First, it was delivered late today due to the weather so I wasn’t able to read it in the morning.  Second, I’ve been disappointed lately with the lobby magazine selection in medical offices.  And I say this from experience having been to three others in less than a week.  My Primary Care physician is a woman which might explain the literary tripe in her office.  Then the Orthopedist had a bunch of Yacht Club magazines.  Who the hell even boats in Colorado let alone owns a yacht?  And to his credit, the Podiatrist at least had Time Magazine, but still, my erudite tastes are particular.  I read the Internet.

I just completed a survey of the page one index when the MRI tech stepped in to escort me to the lab.  The MRI room.  The magnetic resonance imaging facility.  We exited the back through sliding doors and walked into the parking lot as she droned on about why her MRI machine was temporarily located in a trailer.  It was one of those modular buildings that often are used as class rooms in fast growing school districts.  She warned me to be cautious navigating the ice as I climbed the pressure-treated wood stairs.

She locked my metallic valuables in a file cabinet and explained the procedure to me.  I was surprised to learn the routine would take 30 to 45 minutes.  My previous experience consisted of 10 minute x-rays.  Good thing I’d dressed comfortably.  Expecting belts and buckles to be an issue with the big magnet, I sported Under Armour fleece lounge wear.  I was both warm and comfy and declined her offer for a blanket.

Recumbent in a supine position, I pierced the alluring grotto feet first.  Soon the machine emitted a noise not unlike a tennis shoe bouncing around inside a clothes dryer, but more synchronous.  A minute or two later I was done.  Apparently I fell asleep to the rhythmic drumming as my iPhone confirmed I’d been in there at least 20 minutes.  So I’m unable to report much more on the details of being MRI’d, but can tell you it’s very cozy.  The pic above is the image of my symphysis pubis after redacting some of the personally identifiable information from the upper right.  Supposedly some Radiologist whom I never met – likely working out of a cubicle in Bangalore – will provide the results to my Orthopedist in about 3 days.  Stay tuned.

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The MRI

29 Saturday Oct 2011

Posted by Ed Mahoney in Medical Files, Running

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Tags

Cigna, MRI, orthopedic, podiatrist, sports hernia, symphysis

I don’t imagine MRIs to be very scary, unless of course you are claustrophobic which I’m not.  From what I know, they don’t even use X-Rays like a Cat Scan but instead generate radio waves from a big magnet.  It certainly doesn’t appear to be painful although it could brick my iPhone.  But I’m stupefied how I reached this ripe old age without ever having been referred to a specialist and I now am having four medical visits in less than seven days.  My doctor referred me to a Podiatrist for my plantar fasciitus and to an Orthopedic Specialist for my abdomen.

I immediately started doing the math on potential out-of-pocket costs and discovered both specialists would be in network.  So OK, fine.  I visited Boulder Orthopedics yesterday.  The visit took over an hour which I didn’t expect.  I got an X-Ray which suggests a possible sports hernia – whatever that is, it sounds made up – and the need for an MRI.  Dr. Williams couldn’t be certain of my injury but my Symphysis looks to have some issues.  I’ll spare you the profanity here but know that I’m cussing under my breath as I write this.  I called Cigna as soon as I got home and learned I will be responsible for 20% of the MRI cost.

Seeing how one visit to a specialist has begun to spiral out-of-control, I’m no longer looking forward to visiting the Podiatrist Monday.  I’m picturing thousand dollar custom-built insoles made from rare earth metals.  And I’ll probably have to travel to China to be fitted.  This isn’t going well.

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