On August 2nd and 3rd, I went doctor appointment happy. I had my usual appointment with my osteopath for my biweekly and bodily tune-up. I scheduled a new visit appointment with a rheumatologist just down the road from me. I saw my orthopedic surgeon, and then I finally closed the two-day doctor meetings with my nephrologist. It was four doctors and then 4'11" ABC (American-Born Chinese) lady me with my bad attitude left hip to determine if I was finally going through with my left hip total replacement surgery.
I was most intrigued and even teetered on excitement with the rheumatology appointment. When I confided to my closest friend about this rheumatology appointment who had somehow fell naturally into the reserach role of all my medical options, she said to me: "But, you do not have Rheumatoid Arthritis."
I grinned and said: "Yeah, but get this...rheumatologists see patients with all kind of arthritis! If only I had known this years ago when I was diagnosed with the avascular necrosis and osteoarthritis!"
Ever the cheerleader and support in my life, she said to me: "Mare, that is really good that you are doing the reserach and taking control of everything!"
I glimpsed the picture of this gray-haired and thick-framed glasses rheumatologist on the Internet and imagined him telling me of some magical or miracle cure to undo the damage that the Prednisone steroid had inflicted on me or to wave a magical stethoscope that my left hip could finally be "normal" and rid of the blood supply cut-off death that had decayed my left hip joint. Even now after 20 years of dealing with the Arthritis and Avascular Necrosis of my left hip, there was still a part of me that imagined there could be some kind of cure for my hip. I was a dreamer. I was the idealist. I was holding on to invisible hope.
The waiting room was tiny with magazines haphazardly scattered on one pitiful coffee table in the corner. I had missed my lunch and was munching aimlessly on low sodium Veggie straws and celery sticks. I refused to check the clock, though I predicted that at least a half hour had went by. In one corner sat a woman who was in her mid 80's with a walker by her side and swelled and blotchy legs. In front of me sat a woman in her 60's with platinum dyed blonde hair, puckered red-colored lips, and electric blue eye shadow. And, there was me. 29-years-old. The youngest one in the waiting room.
With a thick Irish accent, the woman with the swollen legs glanced at me munching loudly on my Veggie straws and said: "You know that this is the two hour doctor, don't you?"
I stopped in mid-munch and said: "Really? Does he always make patients wait 2 hours?"
"That's why I just called him the two hour doctor," she said with a chuckle.
I was tempted to check my watch, but didn't. I knew that looking would just cause me to get into a mode of irritation and bordering anger. I stayed occupied with my food and watching the Arthritis documentary with factoids and drug commercials that was playing over and over again. Apparently, actress Kathleen Turner had rheumatoid arthritis. Apparently, Osteoarthritis was the number one and most common form of Arthritis. Apparently...I snuck at peek at my watch...I had waited there for an hour and a half. I could feel the bubble of irritiation blowing up.
Just when I thought I may get all huffy, a tiny Asian woman who had to weigh about one of my legs and with a broken Chinese-American accent said to me: "Mary Wu? I am the doctor's nurse. You are next. Come on in."
There was the rheumatologist in all his gray-haired glory, but he appeared frazzled and in disarray with bleary eyes at a small laptop in front of him.
He glanced for a millisecond at me and said: "I'm really sorry for the delay. We are being forced to be upgraded to electronic medical records and it is just taking forever to scan and type everything in."
I was wordless. The lights were dim and almost created a romantic ambience. There were piles and piles of paperwork and folders surrounding him as almost a barricade or shield from whoever sat in front of him. Lucky for him that the person who was sitting in front of him was me.
"I have to say, Miss Wu, your medical records are really well-organized and impressive," he finally said when he tore himself away from the laptop and looked in amazement at all my copies of medical history, recent bloodwork, medications, and doctors.
"Ohh...well, that happens, you know, when you've been dealing with health stuff ever since you were little."
"So, tell me what's going on."
So, I told him. Everything. His eyes were in a tug-of-war battle with his laptop and me, but I believed that I was winning when he suddenly interrupted and said: "Wait, you have avascular necrosis? Are you bone on bone? Because, if you are, then I can't do anything for you. The only option is a hip replacement surgery."
"I don't know if I am. I just know that this year alone has been a roller coaster ride with my body with lots of muscle spasms and pain."
"Well, if you aren't bone on bone then the only thing I can think of for you are 'Synvisc Injections,' which injects synovial fluid or lubrication into your bones and alleviates the pain. However, the injections are not FDA approved for the hip and would need to be prior-authorized with your insurance and then require an Interventional Radiology Department to do a ultrasound guided with local anesthesia. When you see your orthopedic surgeon tomorrow, have him do an x-ray of the left hip and if it is not bone-on-bone then we can go forward with this option, as it really is the only option left."
I cringed in response.
Injections. Local anesthesia. Prior insurance authorization. No, none of this sounded good at all.
Before I could express my dislike and discomfort for this option, he sent me into an examination room and said he would be in shortly. That is when I realized that I was already running late to my osteopath appointment. My appointment with the rheumatologist was at 1PM and it was already past 3:30PM. I had no choice. I had to leave and go to my osteopath appointment. I apologized to the rheumatologist's nurse and sped to my osteopath appointment who took me right away.
The first thing I told her about was the appointment with the rheumatologist. My osteopath shook her head, which made her honey brown locks of hair fly. "You absolutely cannot get those injections. They will not help you because your hip joint is beyond repair. They are not even FDA approved for the hip. No, I don't agree with him at all."
I nodded in agreement.
Somewhere between her fingers manipulating and trying to align my aching back, the lightbulb turned on and brighter than ever in my head that I had literally done everything in my power within these last few years to put off this hip replacement surgery as long as possible and have taken care of myself to the best of my ability. My weapon to fight against osteoarthritis and my deteriorating hip was to stay active with swimming up to four days a week and and walking as much as my legs could muster before pain kicked in. I utilized my external analgesics of Bengay and IcyHot that made me smell like the menthal and mothballs of senior citizens. I had a lift and orthotics to support my feet and minimal walking abilities. I rested periodically. I had struggled to find that balance of moving, but not moving as Arhritis is a constant reminder about quality of life and living. I was vocal against the fight against Arthritis as the leading cause of disability. I was my own best advocate for myself and my ardent attempt to help others.
That is when I made my decision. That is when I knew my Game Plan. And, that is whe the tension and stress that had built up in me in these pass few months began to fade in that examination room with my osteopath kneading my body that was as dull and hard as dry and floured dough.
"I know what I'm going to do. I'm going to put off the hip replacement surgery until Spring 2013. September is too soon with too much going on with friends visiting and organ donation and transplant speaking engagements. My family is too preoccupied now. The weather is going to get colder and the timing is going to be busier than ever with the holidays of Christmas and New Year's. I want the weather to be nicer so getting to appointments and doing whatever I need to do will be better in the nicer weather. Summer is too far away. I can't go another year. Spring is the middle ground. In the meantime, I'll continue with these oseteopathic treatments, swimming, staying active, my creams, and I'm going to look into building outside of the shoe to alleviate the pain and try to get a doctor's note. One of my good friends has already looked into the information, and I know you already have the standing X-ray that I took a couple weeks ago so the measurements in the leg discrepancy can be determined. Once I have those measurements then I could go to a shoe repair place to try to build outside of the shoe. Most of all, I am going to lose at least 10 pounds."
I paused for a breath. Very strangely, I had never felt so calm, serene, and suddenly so scarily sure and certain of myself and my decision that this was the path I was going to take. This was the decision I made and the Game Plan was just about laid out and set.
My osteopath had been encouraging me ever since last year to get this surgery in September. I held my breath, awaiting for her predictable shake of the head and disagreed disappointment, but she finally said: "That sounds good to me. I'll get the measurements to you along with the shoe repair place as soon as possible. I know that you are doing the best for you and your hip."
Just like that. Three simple sentences of her actually agreeing with my very own choice that had mentally tortured and twisted my brain cells and my friends and family who patiently listened to my ongoing worries and concerns. The decision-making process, or any process for that matter was always more difficult than the final end point or conclusion. I exhaled. Relief filled me, and the weight of the decision I had fought to make was lifted.
Two doctor appointments down. Two more to go.
I always looked forward to seeing my orthopedic surgeon because, quite frankly, he was cute. He had these blonde curls, glasses (I am always a sucker for a guy that wears glasses!), tall at around 6'4, and had this sturdy and toned upper body and crooked half smile that made me swoon just a bit. Surgeons are notorious for anti-social and lacking interpersonal skills, and this surgeon was definitely in the awkward category but many notches above the average surgeon with his smile and bluntness that was on the funny-gawky side.
When I shared my latest with the rheumatologist and especially my bright lightbulb moment that I was going to seek at building outside of my left shoe as my last resort before surgery and that a dear friend of mine had done research on orthotists that specialize in lifting shoes to equal out leg discrepancies, he said simply: "Well, it sounds like you know much more about it than I do."
I chuckled and bit my usual sharp tongue from saying: "Well, duh."
He said, "I'm with you on your game plan. I just don't agree with the rheumatologist because your hip is beyond repair. The injections will probably do more harm than help you in anyway."
Then, the next lightbulb moment came that my orthopedic surgeon clearly did not specialize or know a thing about leg discrepancies. His only job was "the carpentry job" of cutting open my left thigh in an anterior position, digging through my muscles to then locate my crumbled hip and saw it out to replace with ceramic on ceramic material that we could only hope would not squeak, stay durable, alleviate pain, and cause me to move and groove like any normal 29-year-old yearned for. It was as clear as day that my osetopath was the gal that I had to stick with like glue with the shoe-building option.
My last doctor's appointment was with my nephrologist. Out of all of my mainstream physicians, he was my favorite. Out of all of my doctors, I somehow felt like he was the one that held everyone together, because everything always went back to the root or origin of my problems-- my chronic kidney failure and all the lifetime immunosuppressant medications that had taken its toll on the various parts and functions of my body. He reminded me of my Father with the way he sat next to me to truly listen to me yammer on and on. He meticulously checked my medications and the bloodwork I had to have done. He updated me that the next pieces of the game plan was:
1) Lose Weight-- he gave me a business card of a nutritionist to see
2) Find a Primary Care Physician as she was going to be another go-to person who needed to give me medical clearance-- he gave me another contact phone number
3) Check about my blood pressure. My blood pressure was on the low side and the wheels in his head were turning that maybe I should be off my blood pressure medication because perhaps it was the culprit for my fatigue and doing more harm than help.
4) Indeed, follow-up with my osteopath on building outside of the shoe and obtaining a doctor's note for my workplace that I was going to live in a certain pair of shoes for the next six months to relieve the arthritic pain that hammered at my hip and to get my lower extremities in as much shape as possible prior to surgery.
5) Keep up with swimming, light walking, and the balancing act of staying active, but not overdoing anything.
I completed my last appointment with my nephrologist and truly all my other doctor appointments (with the exception of the rheumatologist) with confidence, relief, but, most of all, hope.
I did not want to admit it but I had lost a great sense of hope in the battle to make my decision. It was not until I gained all the details to make my Game Plan of my Decision that I realized just how anguished and hopeless I had truly been. But, this is life. Life moves in waves and the up, down, upside down motions of a roller coaster ride that makes us scream with fear and then laugh and cheer with gusto.
The Game Plan is in motion. I await my measurements and the shoe repair clinic details. I forge forward with shedding pounds and alleviating the heavy weight burden that I have gained these past few months. The appointment with the primary care physician is scheduled. I do not have any regrets, and only look forwards, upwards, onwards, and beyond in the best, positive, and only way possible in this roller coaster of life.
Keep smilin' until we meet again,
Mary
