Dilemma

[trixtah]

So, I went to see the knee surgeon in Sydney today. He basically took one look at it and said, "When do you want me to operate? I've got slots Friday week." In my somewhat-bemused state, I agreed to next week, in the spirit of getting the thing over-and-done-with.

It was funny, though. He had some little junior doctors trailing him, and they got to look at my scans and tsk at them. So, it's the area to the outside of the meniscus which is on the right side of my knee joint. Other than the tear, the thing has degenerated over the last few years, and the cysts are the things that cause the pain. I feel the pain under the tendon that goes up the side of the knee. The largest cyst is right under that, and it also explains why the pain comes and goes - it's the cyst flaring up. He's going to take that out explicitly as well - normally they'd leave them to shrink naturally since they're not being "fed" with more fluid with the meniscus repaired, but this one is too large. Bah.

So, after waiting half an hour for one of the junior docs to track down the receptionist who was doing the booking, she went through the details with me. And this is why I'm starting to have second thoughts about the timing.

Firstly, I won't be able to put much weight on it immediately after the op, and that will take more or less time to heal, depending on what they do. If he repairs the meniscus rather than chopping the bad part out, it will be months of hobbling around, as opposed to a week or two. Still, I decided that I could probably manage myself onto taxis and trains (flying back to Canberra after knee surgery doesn't appeal), so that part's not too bad. What is badder, though, is the fact I'm living up two flights of stairs. Since I probably won't be able to bend my knee much for at least a few days after the surgery, getting inside my flat could be a little challenging.

Secondly, how much time will I need off work? More than a couple of days will be difficult. Surgery days are always a Friday; I could take an extra couple of days for a very long weekend. I suppose that's not too much pay to lose...

Except, thirdly, the cost. Nearly $6000, of which I'll get less than $500 back from Medicare. The surgeon is $2500, then there's the assistant surgeon (about $500) and the anesthetist. That's the part I'll get the $500 back on. Then there is the hospital charge, which is $2500, of which I will get nothing back. Not bad for a few hours in a bed and the use of an operating theatre, eh? (It's same-day surgery - I wouldn't be staying overnight).

I could go public, but there are big waiting lists, and I don't want any old surgeon tinkering about with my knee. Getting private insurance now would be pointless, since everyone has about a 12-month waiting period for pre-existing conditions. If I'd thought of it when I first got here, I'd be over the hump by now, but I didn't. One of the curses of not thinking of oneself as requiring major treatment. Yes, I know I'm stupid. However, they won't cover 100% of the costs anyway, so I don't know if I'd have saved much in terms of excess payments + premiums.

So, getting it out the way now is feasible - I'd need an overdraft, and it'd put back my debt-repayment schedule, but it's feasible.  Alternatively, I could see if he has slots available in the two weeks I have to take off for Xmas. I don't really care if I don't make it home to the family do. Then there's another 60 days for final payment (for the surgeon's part, the hospital is cash up front), which would take some of the pressure off. Or I could postpone it entirely until after next Feb, when I should have virtually all of my evul debt paid off. And perhaps have done something about my living arrangements - ie. be living in a place where I only have a few steps to get up.

I have to decide tomorrow. Well, I don't have to - I'd just rather let them know sooner if I want to delay things. Hm. Agh.

Comments

[stormkpr.livejournal.com]

I don't know a lot about your medical history or the medical system in your country, but I am reading a book on medical care and health. It says that any time a doctor suggests surgery, always always get a second opinion. Even if what the doctor says sounds obvious. Unless your life is in jeopardy if you don't get operated on right away, get that second opinion.

You might've already had several docs examine you but just wanted to mention that.

[saluqi.livejournal.com]

I think Trix is seeing Merv Cross (http://www.kneeclinic.com.au/merv-cross.htm), if not him, then it is at least his clinic. While no-one is perfect, he's pretty much a knee surgery god.

He has declined to operate on my partner because the knee injury wasn't "bad enough", so he's not someone I think of as being a surgery cowboy.

[trixtah.livejournal.com]

Yep, as saluqi mentions, he is the knee-surgery god. Also, the two GPs I've had look at it and the doctor who did the MRI on it were all agreed that surgery is the only way to go. More importantly, I've been dealing with this for three years, and it seems pretty definite that nothing else will work.

Thank you for the words of caution, though. This will be my first ever thing to do with a hospital/surgery, and it's certainly nothing I want to jump into.

[aquaeri.livejournal.com]

jamver0 had similar knee surgery over Christmas (he didn't have a cyst, though). He was told to not move for the first two days but we could barely keep him down. If you can get someone to help you so that trips up and down the stairs are minimised the first few days, you will probably be okay.

[trixtah.livejournal.com]

Yay, thank you, that sounds encouraging. That marries up with the basic impression I got.

And no, I quite frankly can't imagine jamver0 keeping still in one place in a protracted fashion. Heh.

[saluqi.livejournal.com]

Taxis and trains for the op? I think not. If you go ahead let me know the times/dates and between us the Bear and I will work something out so that you can just deal with the fact of being operated on while someone else deals with the transport issues.

The rest is complicated and is about your financial situation as much as anything else so I won't stick my oar in. If issues about shopping for essentials are factoring into your concerns about hopping up and down your stairs tho', that can be taken care of, as can help to minimise trips up and down stairs generally.

[trixtah.livejournal.com]

Heh, sucking up being less-than-capable isn't exactly one of my fortes, is it? Timely reminders are good, hee!

Thank you very much for the offer. I'm reluctant to impinge majorly on your and the Bear's time right at present, but I'll definitely think about it, and we'll have a chat.

Other than the money (which, yes, is eminently sortable one way or another), it's just those pesky stairs. Getting a few days' supplies in in advance would mitigate that, indeed. It's not as if I have any problems entertaining myself (normally).

Food for thought is good. I think I'll postpone to at least the Xmas run-up, if possible. I also might be able to work in something in conjunction with this weekend-away I'm supposed to be having with the OGF at some point (now that I'm reminded of resources in my life).

Having options pointed out is marvie. Yay! Thank you again. :-D

[epi-lj.livejournal.com]

Wow. You know, I have to admit that the story makes me even more leery of two-tiered health care, especially the class implications of, "I don't want any old surgeon tinkering about with my knee." :(

However, it seems like a situation where it's going to be a huge inconvenience no matter when you get it done and the longer it's left the more you suffer and the greater the chance of it going downhill. I'd probably think, "Better sooner than later," on it.

[trixtah.livejournal.com]

Philosophically, I totally agree with you. However, I let the NHS in England take a crack at it when I initially injured it. They performed a single normal X-ray, said "It's not broken; have a nice life!", with no other care suggestions than strapping it up, and this was when I couldn't walk on it for more than 2 minutes for 2 weeks, and the knee was swollen to twice its normal size.

In this instance, it's not a class implication about "any old surgeon" - it's a competency statement. I've heard too many horror stories about crap knee surgery, and I'm pretty skittish about the idea in general. I know this guy is da bomb; if he worked in the public sector, I'd be doing it that way. I totally agree that it's fucked that you can't get access to the best surgeons publically (or perhaps you can, but it wasn't presented as an option).

And yes, I don't want to let this go for another year (or two) - three years is enough. Since it has already gone downhill, having it get worse is not an appealing thought, as you say. :-(

[grey-evil-twin.livejournal.com]

Bummer about the op, dude. But if I had a vote, I'd vote for paying the knee god to fix it, and stocking up on toast and snacks to get you through resting up afterwards.

As someone whose elderly relatives are suffering from neglected knee injuries, GET IT FIXED.

[tygerr.livejournal.com]

Yowza. Good luck!

(cawingcrow may be getting knee surgery soon as well. We're hoping it's fixable through physical therapy, but surgery may be required.)

[trixtah.livejournal.com]

Thanks for the good wishes!

I hope cawingcrow's situation isn't as dire - a lot of that kind of stuff is tackleable with decent physio.

[tygerr.livejournal.com]

The docs say there are 2 diagnoses for her symptoms--one of which requires surgery, the other does not. She's had an MRI which should provide a positive diagnosis, but we won't know the results for a while yet.