It's a Bri Wise world: April 2008

Friday, April 25, 2008

M-R-Ai-yi-yiiii

I got my MRI a couple Friday nights ago. You read that right. It was not a typo. The MRI was at night. It was at 9:30 to be exact. I outsmarted myself once again. I asked that the MRI be done in La Jolla, so it would be close to my office. The reason, I explained, was so I could use my appointment as my lunch break. I could just zip over and zip back to work. Glad they were listening...

The first problem was in scheduling the darn thing. I was hoping to get it done before going on my mini-vacation. I got the approval three or four days before we were supposed to leave. However, having the approval and getting an appointment are two different things. I was entered into the computer system. When I called, they verified that I was approved. But I couldn't schedule. Why not? My paper work had not been sent over yet. That's right. The authorization was there in the system from the managed care office and the insurance. But they didn't have the signed piece of paper in their hands that proved their system was not, in fact, wrong from two different sources. So, I had to wait for them to call me to tell me to call them and make an appointment. They weren't calling me to schedule. They were calling me to tell me to call them to schedule. Fine. Great. Love a bureaucracy.

The second problem was the aforementioned hour. My office is about 30 miles from my house. It's a 40 minute drive with no traffic and an hour plus with. There was no way I was going home after work and then coming back at 9:30. The solution? Go in late and work until the MRI. Fine. Great. I can find ways to waste a morning.

After that, there weren't really problems so much as annoyances. The hospital where the MRI center is located is built into a hill side. The main lobby is on the third floor, which is ground level from the front. The MRI is in the basement and on the far end from the parking lot they sent me to. I'm not exaggerating by saying that it was a ten minute walk and elevator ride from my car to the check-in desk. And bear in mind that my leg was still hurting at this point. And what was worse? The MRI center was a stand alone, one story unit. That's right! The basement is ground level in the back. And what can you have at ground level? Parking! Grrrrr.

The MRI itself was long and uncomfortable. Fortunately, I was able to go in feet first, so my head was not in the chamber of claustrophobia. But, it took an hour for them to get all the angles of my leg that they wanted. I had to lie as still as I could for an hour. In the same position. I think my leg was more sore after the MRI than when I went in. By the time I got home, it was almost midnight.

The next step was to see the ortho to interpret the MRI. But I couldn't do that until the MRI center called me and told me that it had been read and annotated by the radiologist. That was going to take another week. I decided to make the appointment anyway and just tell them when the MRI was supposed to be ready. I managed to get the appointment for the next Friday, but even that wasn't easy. Care to guess how many people I had to talk to in order to get the appointment? Six. It went something like this.

"Hello? Scripps Ortho, Carmel Mountain" Yes. I'm trying to get an appointment with Dr. Ortho in the La Jolla office. "Oh. Let me transfer you." Thanks! "Hello. Scripps La Jolla. How may I direct your call?" I'm trying to make an appointment with Dr. Ortho. "Thank you. I'll transfer you." Thanks. "Hello? Chemotherapy and Oncology department." What?!? "Chemotherapy and Oncology." I was trying to make an appointment with Dr. Ortho. "Oh. I'll transfer you." Great. "Hello. Scripps Orthopedics." Really? "Yes. How can I help you?" I need to schedule an ortho consult to read my MRI. "Ok. Is this for your torso, head, or arms?" Ummmmm...none of those. It's a calf injury. "Oh. You want lower extremities. Hang on, I'll transfer you." (I'm not kidding. There is a department called lower extremities.) "Hello. Lower extremities. How can I help you?" *exasperated sigh* I don't know. I just want to schedule an appointment to have my MRI read. It's a torn calf muscle. "Ok, great. I just need to ask a few questions." Well of course you do. "When did the injury occur?" February 19th. "And when was the MRI?" Last Friday. "And how did the inujury occur. " I tore the muscle while playing basketball. "Oh! You wants sports medicine. I'll transfer you." Ahhhhhhhhhhh!

Fortunately, sports medicine was able to help me. And schedule me for Friday. Woot. I talked to Dr. Ortho and she was very nice. She was knowledgeable, patient, and informative. After hearing my story, the first thing she said was, "You don't need an MRI. You need physical therapy." Now you tell me. "Unless it is a complete tear, you don't need one." Well. I already got it because they said to do that before I saw you. "Well, we may as well take a look, then. But you should have just come to see me." Note to self: next time I get a sports injury, demand a referral to a sports medicine doctor immediately.

We reviewed the MRI and it was pretty cool, even if I had no clue what I was really seeing. But she walked me through it and showed me where there were still intra-muscular pockets of blood. She was not surprised that there was still swelling and told me I'd messed myself up good. She expected the blood to take at least three more months to be reabsorbed fully. In the meantime, I should get to PT and work it back to where it is supposed to be. To that end, she sent in her assistant to help with the details.

He asked me which insurance I had and, presumably, used this information to produce a list of PT centers. I didn't recognize any of the names or locations and he couldn't tell me, beyond the address, where any of them were. So, I chose one that had "sports therapy" in its name and that had a street address that sounded like it was near the bagel shop I sometimes visit. Then I was given the familiar refrain. "We need to submit this to our managed care office. They will get it approved by the insurance and forward the approval on to the PT office. The PT will call you to schedule an appointment."

One week. No call. I'm not waiting. I call them back. They tell me it has been approved and give me the name of the PT office. I call them. It's a different name than what I asked for. And it is a 20 minute drive from my office. In the opposite direction from my normal commute. WTF? Call the doctor's office to ask where the switch happened. "Oh. The one you chose wasn't covered by your insurance. So, we chose this one. We thought it might be near your office." Did you LOOK at a map? And why did you offer me the first one in the first place. *sigh* Can we change it to something closer? A friend told me there was a PT center located in the clinic building. What about that? "Oh. You mean Shiley? We can do that." It turns out Shiley is right NEXT TO the doctor's office. Literally. They couldn't propose that when I asked for something close by last time?!? Well. At least they can do that. "We just have to submit the paperwork to change the location."

That was almost 2 WEEKS ago. The paper was filed, but nobody reviewed it. I don't know why changing PT locations is so complicated. But it is. I am calling them back after lunch today to find out what is going on. Stay tuned for more developments.

Thursday, April 24, 2008

Mistake or Subliminal?

Take a look at the proposed new logo for the UK Office of Government Commerce.

Notice anything odd about it? I'll let people comment on it before I say why it made me laugh.

Hat tip to Rich for this link. I can't find a link to your blog, so I'll link to your company instead. :)

Friday, April 18, 2008

De-Toothified

I survived my three-dentists-in-three-days event in Escondido. Doesn't that sound like a masochist's vacation package? Sadly, it was no vacation. The first dentist told me something was wrong. The second dentist gave me the specifics of what was wrong. The third dentist solved the problem. He had to pull the tooth, which proved more difficult than anticipated.

In spite of the struggle in getting the evil tooth out, the office was very warm and inviting. I was helped by at least five different people and each one told me who they were and what their role was. I was also told what to expect next and assured that the next person was excellent and would take good care of me. It kept me from stressing out too badly, except when the actual pulling was occurring.

The tooth pulling was not stressful because it was painful. It was stressful because the tooth wouldn't come out. The oral surgeon was a tall, fit, muscular man. And he was struggling to get it to come out. It ended up coming out in about five pieces. It was quite obstinate.

After the extraction, I had to bite down on a piece of gauze for an hour. Then I had to change the gauze every 45 minutes until the bleeding stopped. That took about 4 hours. I didn't really eat all that much that night, as I am sure you can imagine. What surprised me was that I wasn't allowed to rinse vigorously or use a straw. Either of these could dislodge the clot.

My recovery followed the after care instructions almost exactly. I lost a day and a half to the Vicodin and have been coping a little better each day. The pain is mild now, but still present. And the socket is still noticeable to me. My voice sounds weird to me, but nobody else seems to notice.

I now have to wait three months for this to heal. After that, they will put a screw into my jaw and put a cap on that. Then that will heal for three months. Then my regular dentist will put a screw on the cap and a fake tooth on the post. The good news is that my dental insurance looks like it is going to partially cover the implant. Woot!

Tuesday, April 15, 2008

When Is It Time To See The Dentist

That's right. My life has become a bad joke:

Q: When is it time to see the dentist?
A: At 2:30. (Tooth-hurty)

That's really what time my appointment is, too.

Warning: The rest of this post talks about pain and teeth.

I have a dentist appointment today. It's my third in three business days. The first one was with my regular dentist. He determined that there was likely and absess or infection and sent me to the endodontist to determine the specifics. The endodontist has determined that a root canal I had done 22 years ago was not done well. He made a crack in the tooth that ran deep into its root. Well, at some point recently, an infection managed to creep under the crown. It may have happened when I had the crown replaced 6 months ago. Who can say for certain. At any rate, the infection is causing swelling inside the dead tooth. The pain that woke me up last Thursday night is from the swelling trying to push through both the inner and outer walls of my jaw. Yuck.

The endo told me that the tooth really had to come out. I'm risking bone loss in healthy teeth and in my jaw if I leave it in. I could save the tooth if I wanted to have the crown removed, the posts taken out, the infection treated, the root canal redone, and the crown replaced. My mouth aches just thinking about it. Well, that, and from the infection.

So, today, I am going to my third different dentist. I'll be seeing an oral surgeon today. He'll yank the tooth under local anesthetic and tell me exactly how much it is going to cost me to get an implant. The other option is a bridge, but that is less appealing even though it is less expensive. To put a bridge in, they would have to cut down the two healthy adjacent teeth so that the bridge has someplace to attach.

In the immortal words of Clubber Lang: "Prediction? Pain."