Pop some popcorn . . .

As promised, here are videos of my upcoming surgery.  The first one IS for the faint of heart--it's just an animation.  Go ahead, you can handle it.  Click the title below to view.

Austin-Akin Bunionectomy

And for those with a stomach of steel . . .
These next three videos show a complete Austin-Akin bunionectomy, in three stages.  Very cool.

Part 1


Part 2


Part 3


Let me know what you think.

And the winner is . . .

I realize the world has been waiting with great anticipation to find out who will be the lucky person who gets to operate on my foot.  The suspense is over.  The winner is . . . my new orthopedic surgeon!

I decided to keep the appointment I had made to interview a prominent ortho guy in Houston.  I considered cancelling it after my last meeting with Dr. L, because my confidence in him increased.  But what can I say, I'm a researcher and a label reader at heart. I knew I wouldn't be completely comfortable until I had done all my checking and all my asking.  And in the last few weeks I've had a few people say to me, "You know, podiatrists are not MDs.  They're not 'real doctors.'" While I realize this could be typical medical field snootiness (after all, I prefer my DO to any MD for my regular checkups and visits), I also did some more reading and realized that the training for an orthopedic surgeon is more rigorous.  Long story short: everything about this orthopedist and his practice and the hospital where he operates was top-notch, very impressive.  I liked the way he answered my questions and his philosophy about whether to do a joint replacement or fix the bones that are there.  And when he left the room, his nurse gushed about his skill and expertise.  She said, "He did the president's mother's feet, you know." When I looked quizzically at her, thinking, "Obama's mother had her bunions fixed in Houston???"  She said, "Oh, I mean President Bush, you know."  Oh.  That makes tons more sense.  I didn't take the time to clarify whether he meant Bar, or Bar's mother-in-law.  Anyway, I feel confident going with this doc (to be referred to as Dr. B in this blog), and I went ahead and set a surgery date and time and went upstairs to take care of my pre-op work.  Now I'm dreading telling Dr. L's office, because I still need to go back there in a few weeks and pick up my new orthotics.  But I feel very settled, having the research part done and the decision made, and I feel fortunate to have such a top doc accessible to me for this important surgery.  I'm actually looking forward to getting this done.  The thought of absence of foot pain (after I recover) is a bit mind-blowing, because my feet have hurt for the last two decades.   5 weeks from today . . . gotta figure out how to add a count-down timer to my blog . . . hmmmmmm.
Next post: a video of the surgery I'm scheduled to have.  Not for the faint of heart, but fascinating to me!

Easy come, easy go :(

False alarm on the insurance covering my orthotic shoe inserts (see last post). I called the doc's office today in advance of my 2:30 appointment to get casted for orthotics, just to make sure they had called and gotten verification with the new confirmation code (you know, the one where she typed in all caps: "ORTHOTICS ARE COVERED" on my record?).  Dr. L's secretary said they had called with the new code and gotten a "no" again.  So I called and spoke to a different insurance rep this time, and she saw the note, but said that previous rep had been mistaken.  Yes, the paragraph she read to me saying orthotics were covered was there, indeed, but she had neglected to read the fine print, where it says: "exclusions to orthotic coverage: foot orthotics" and "exceptions to the exclusion: patients with diabetes." I scolded her for her company's ineptitude (which was really that other rep's oversight) and asked her if she realized I almost went to the doctor today for a $500 expense that I thought was covered; she replied, "I realize that, and it's a good thing you called one more time to verify."  Yes, a good thing.  Okay. What I wanted to say was, "Rooooaaaaaarrrrrrr!"
Realizing this conversation was a dead end and persisting at this point would probably just cause me to embarrass myself, I hung up and picked up the phone to cancel my appointment, but then I checked myself and texted Jon about my frustration instead.  He talked me through the decision and said we would find a way to fund this expense, because it was necessary for the future health of my feet. I thought about all the reading I had done to make sure this was really necessary and asked myself if I thought Dr. L's was the right place to go for this, and decided that I should keep the appointment.
Soapbox moment: It is VERY frustrating and VERY wrong that our insurance companies do not recognize the importance of preventive meds and devices and procedures, instead preferring to wait until there is actual disease or disfigurement before laying out a penny. I think it could actually be good business (and more moral) to cover a variety of preventive measures that could save health and thus save money down the road.  Stepping off the soapbox now (carefully, so as not to hurt my foot!) . . .
Now on to the appointment: While I was there, Dr. L said with great animation, "Oh! I have something I want to show you! The new hospital I've been operating at has these cameras in the ceiling, so I've been snapping pictures during surgery." Then he proceeded to open another patient's chart and show me the photos of his big toe joint replacement surgery, step by step!  It was actually really fascinating! "Here's his bone, you can see the degeneration of the cartilage, see how it's all yellow and squishy here? That should be all white. K, now here's the bone with that part all cut off . . . "
From me: "Oh!"  (looking at the two pieces of the bone with a huge space between them now)
Dr. L: "Yep, and that blue plastic piece there is a spacer, that I'm using to measure the size of the artificial joint I need.  And here's the new joint, in place."
Me: "Wow!"
Dr. L: "Oh, hey, he's still here, I bet.  You want to talk to him?"
Me: "Heck, yeah!"
So he runs out and drags in this patient he had just finished seeing, and I said, "Dr. L just finished showing me the inside of your toe, so I thought we'd better introduce ourselves, you know, meet."
Was that funny or dorky?  Jen?
The first thought through my mind was, "He's so young! He's like, MY age." (You see, I have this lingering perception of myself as somewhere in my late 20's, and I can't believe my foot is this bad off already.)  We had a really interesting conversation; I asked him several questions, and he said, "I really only used the pain meds for 2 days. It was really a breeze." I saw he was walking in one of those walking boots, and I said, "So how long ago did you get this done?" (Thinking I would hear 2 or 3 weeks ago.)
He said, "Last Thursday."  Wow!  That's not even a week ago!
Every part of that visit did my soul some good.  Getting to spend some time talking with Dr. L while he slapped the plaster on my feet to make the molds was helpful, seeing the pics and talking to the current surgery patient was helpful, getting to ask some more questions--very helpful.  I feel more at rest.  I'm even considering canceling the 3rd opinion appointment I have with an orthopedic surgeon later this month.  What do you think?

Persistence Provides a Passel of Pennies

Alright, so remember how disheartened I was to find out my insurance would not cover the new pair of orthotics I need? Well I picked my sad self up off the floor and thought, "I'm just going to check this out . . . what if there's a way?" I got the idea to try again from all the reading I did on the Internet, trying to decide whether I really needed a new $500 pair. From what I read, people with high arches and the foot structure that causes bunions really need to wear good, custom made orthotic support, if they don't want their feet to worsen rapidly. Considering my goal is to keep my left foot from getting as bad as my right foot, I decided I needed to get them. I noticed that the articles I read said that sometimes insurance pays, and sometimes not, depending on the diagnosis. Both diabetes and plantar fasciitis are often covered reasons for getting orthotics. I recalled that my MRI report mentioned "mild to possibly moderate plantar fasciitis. The posterior plantar fascia is moderately thickened and edematous posteriorly."  So I called my insurance company to see if orthotics were covered for fasciitis, and I found out they are covered for any condition, as long as a doc prescribes them. When I asked why my doctor's office was told no, she said, "Oh, they use the provider line, which is staffed in India. Those reps sometimes don't pull the correct information. So I'm giving you this confirmation number and I'm typing 'ORTHOTICS ARE COVERED' in all caps on your file.  Ask your doctor's office to verify benefits again, and they'll see this note."

No comment on how wrong that is on so many levels; just GLAD I'm going to get orthotics sooner rather than later, now that I know they are covered! 

Bad foot day. . . good life day . . .

Bad foot day . . . nevertheless, I'm grateful.
I have two feet.
I have amazing people in my life.
The weather is gorgeous.
My work is energizing.
Chocolate is yummy.
And so much else . . .

On the surgery front--I'm grateful to have a loving, caring mate who is committed to seeing me through the  recovery period.  In fact, Jon and I are actually really looking forward to our QUIET Thanksgiving break.   Surgery is scheduled for 7 weeks from today!

I'm trying not to complain, but . . .

Today's post is difficult to write, because I'm conflicted and frustrated. The issues are:

• Orthotics: So I have an appointment to get casted for a new (better) pair of orthotics tomorrow.  Now I'm not sure I should keep it. I am very certain that getting a new (better) pair is the right decision for my future foot health, and I was really excited to get this going. But today I found out that this pair will not be covered by my insurance either.  I paid out-of-pocket for the expensive pair two years ago, but I was led to believe (by another podiatrist, not Dr. L) that they could easily get them covered by writing a letter of medical necessity.  Not so. Now I'm faced with paying $500 for a new pair, and I'm asking the questions: "How do I know these are better? What if there's an even BETTER pair with a doctor across town? Is it worth it to have them custom made, or should I just wear the $20 WalkFit inserts I got at Bed Bath & Beyond?" The frustrating part is, I don't know who can help me answer these questions. I trusted the guy who sold me the other pair.  Now trusting a new podiatrist for a different pair, at $500, just seems risky.  
• Surgeon: I followed the advice I've heard a few times and made an appointment with an orthopedic surgeon today. I narrowed my search by calling the practice in downtown Houston that seems to be held in great esteem in our community, and then by asking who specializes in feet.  Then I read all four of their bios and picked the one who has the most experience and accolades.  Can't get in to see him for two more weeks.  I think I do need to go, just to get his opinion and to satisfy this nagging feeling that I've not yet done enough research to settle on Dr. L. Even so, I think this might make the decision between the two difficult. And it probably delays my getting orthotics, because I want to see what he recommends about those, too.  And I can't think of who can help me answer the question: "Who is the best person to operate on my foot?" I can do lots of research, but I'm sure there's insider scoop that would be so valuable.  
• Surgery yes? Or surgery no?: This one's tough, too, although it probably shouldn't be. A few weeks ago, when my foot was so painful during the day and waking me up at night, it was easy to say, "I need to have this done." But since I started wearing the better shoe inserts and only wearing my two most sensible pairs of shoes, the pain has decreased significantly.  What does this mean? That surgery is premature at this point? It's to the point where I hope my foot will hurt, so that the decision is a no-brainer.  Ridiculous!  But that's how overwhelmed I am with all this decision-making.  Ugh.

As you can see, most of my frustration and conflict come from having TOO MUCH choice (and not enough guidance). That's why I titled this, "I'm trying not to complain."  I realize what an amazing blessing it is to have such an array of healthcare at my fingertips and to have the resources, ultimately, to pay for it.  Still, I wish preventive care were more valued by our insurance companies, and I wish I knew where to get the inside scoop on the most skilled surgeon in town, the best orthotics, and a crystal ball to divine the future of my foot if I don't have surgery.

Melancholy me

It's true, I'm sad and discouraged today because in the cool air and glorious sunshine, over 32,000 Houstonians are gathering, stretching their calves and quads, and racing for the cure.  Those of you who read my FB posts about Couch to 5K know that I was soooo excited about this race as the first goal of my running program. Then, bunion pain hit, and I had to stop running. At this point, I don't even dare walk the 5K, as I'm sure my right big toe would object heartily. I've been moping about it, but also reading two different books that are helping me put such things in perspective and look for the ultimate purpose behind some of my travails, so here's my new orientation toward my failed attempt to become a runner and toward the Komen Race for the Cure:


Starting this running program brought the degeneration in my big toe joint to light in a big way, as the screaming pain got my attention. Now, I'm being proactive: getting new orthotics and planning surgery to correct the joint structure and save what cartilage I have left. The ultimate goal is pain-free feet--a luxury I've not had since my 20's!  If I'm going to walk on them for 45 more years (and why not!), then it's time to make sure they can go that distance.  

SO: next October there will be another Komen race. It's my new goal. Will I walk it? Will I run it? Will I WIN it?  (lol, that one made me laugh)  Who wants to come to Houston and run that race with me on my new feet in a year?