Monday, November 22, 2010

The Year I Single-Handedly Took Down the Health Insurance Industry (or “The Year of Pain”)

Prior to this year I have rarely sought medical attention (I swear!). I have gone years without a checkup, even going without asthma medication until I was just too miserable to go on without it. In retrospect, this may be the reason why my medical claims for this year alone have reached the catastrophic level. Having let the small things go until they have built up my leaky faucet has turned into a geyser of hurt and need for medical attention.

I chose not to go to the doctor for many of the same reasons everyone else has for not going. I didn’t have health insurance. If I did have health insurance, I couldn’t afford the co-pay. If it required time out of work or school, then it would have to wait, etc.

It all started out innocuously enough. I decided to test the waters of healthcare and go in for a routine physical and to get my annual lab work done. After being told I was overweight (Um, hello? Not quite a news flash, that one) and my HDL was a little low I carried stoically on until the hip pain I have been living with for fifteen years finally got to the point I could no longer ignore it and continue to live any sort of life at all. After a referral to an orthopedist and several x-rays later it was determined I had an advanced case of osteoarthritis in both hips and needed to have them replaced. This was when I first began to understand just how I was going to be affecting my employer insurance group’s utilization. I could hear the faint groaning of actuaries as their estimates failed to take a 27 year-old needing a bilateral hip replacement into account in their calculations. This was to become typical of the kinds of medical predicaments I would find myself in. Experienced medical professionals scratch their heads in disbelief at me.

Before getting either hip replaced I had received instructions to take care of any outstanding dental work, but here’s the thing: It was mid-August when I learned that I needed to get both hips replaced. Being somewhat educated about the health insurance industry (seeing as I work in it) I knew that the most cost-effective way to get these procedures done would be to have both hips replaced before the end of the year. In addition, I live in Minnesota and I didn’t particularly like the idea of learning to walk with prosthetic hips when there was snow on the ground. I decided to get both hip replacements as soon as possible. My left hip replacement was scheduled two weeks after the diagnosis, so this left me with scant time to look into catching up on over a decade of dental care. Oh, but don’t worry. I still managed to squeeze a root canal in two days before my first surgery. This is the year of pain after all.

By the time I had my second hip replacement surgery my leg and lower back muscles had understandably atrophied. The recovery from this surgery was slower and more painful than the first, but I was slowly making progress so I wasn’t too worried about it. It was just getting to the point where I could lay off the narcotics on Friday. I had a slight cold and decided to take it easy and stay home from work. I had enough room in my schedule where it wouldn’t be devastating to take the time off, and I could use the rest.

That day I watched TV and worked on a knitting project. I was making a blanket for my roommate for Christmas. I had made quite a bit of progress with that panel. I set the knitting down on the couch and cleaned the kitchen before my roommate came home and then made a start on my bedroom. I had fallen behind on the housework during my convalescence and was looking forward to finally catching up. I walked into the living room to pick up the blanket I had been snuggled up in all day to take it into my room. I was stepping off of the leg I had the most recent surgery on and so I was bearing all my weight down on my other leg as I set it down. I felt a hard poke in my leg and looked down to realize that my knitting had gotten knocked off the couch and the 9mm (size 13) knitting needle was pushing against my leg. I reached down and realized that the needle had punctured the skin. Later I found out that it had actually entered 3-4 inches and had almost poked out the other side. And that is how I brought the health insurance industry to its knees. I’ll write more on my KRI (Knitting Related Injury) at a later time, including a photo for you folks who have a strong stomach and macabre interest in bodily injury.

What is the most embarrassing injury you have had?

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