Saturday, July 19, 2008

Falling Through the Cracks

Is that a pun? That sort of thing doesn't happen for me very often, because I am not very clever (and I can't tell jokes, either). At any rate, I feel like I am in limbo land as far as moving to the next stage in my recovery. It has now been 6 weeks since the accident, and I am almost positive that the crack in my pelvis is healed:
  • I can sneeze and cough without excruciating pain.
  • I can roll over on my stomach, and it doesn't hurt.
  • I can stand with my weight on both feet, and it doesn't hurt.
  • I can maneuver using the walker with about 90% of my weight on the other foot, and it doesn't hurt
What I can't seem to do is get a follow-up x-ray and an appointment with doctor who will look at it and tell me "yes, the fracture is healed." None of the physicians in this area - neither orthopedic specialists nor local family practice doctors - maintain x-ray equipment any more. So, one just can't go to the doctor and get an x-ray. And one can't show up at the imaging company (which is owned and operated by a radiologist, who is a doctor, right?) and ask for an x-ray. It has to be ordered by a doctor. I know, I called to find out. And I'm wondering why the radiologist can't see me as a patient, and then order himself to take the x-ray?. But never mind.

Because this fracture was the type that can't be treated by casting or surgery, none of the orthopedic doctors wanted to mess with it when it happened, and they don't seem anxious to see me now either. The receptionist for the first orthopedic doctor I called was totally unhelpful. After I explained the situation and asked for an appointment and a follow-up radiograph to see if it was healed, she said, "The doctor is going on vacation and you need to see your family doctor about this." The receptionist for second orthopedic doctor I called wasn't sure how to deal with me because I had not had "fracture care," - which is a fixed number of visits during a 90-day period and costs about $1000. She started rattling off the payment policy for uninsured patients* and that I had to deposit $150 at the first visit, and if the visit wasn't more than that, I would get a refund; but it could cost up to $250 (keep in mind that doctor would not be doing the x-ray, that's an additional $80+ at the imaging clinic), but if I paid it off at once, there was a 20% discount, and my head was swimming and I said "thank you very much, I have to discuss this with my husband" and I hung up the phone.

In fairness, I did arrange an appointment with an orthopedic doctor, who I thought was in a town about 25 miles away. The receptionist mentioned that they had an opening that afternoon, but I indicated that wouldn't work so she scheduled an appointment for 2 weeks away. I was very excited and relieved and I mentioned to Richard that there was an appointment "right now" and he said "Sure, let's do it." So I called her back and told her we'd come that afternoon. She asked if I knew where the office was, and although I was looking at the address in the phone book, I realized I didn't know exactly where this was. So she proceeded to give me directions to an address about 90 miles away. The office had moved since the phone book was issued. I had to cancel that appointment. Gas is too high to drive that far something that should be able to be handled locally.

And so I am back to square 1 (which I guess is a hopscotch term?). I have a friend who is a nurse practitioner at a local medical clinic, and I sent her an e-mail 3 days ago to see if she or one of the other doctors at the clinic can order the x-ray, evaluate it, and then tell me if I can start walking again. I am still waiting for a callback from her. Patience. Patience.

*Rather than formal health insurance, we belong to a Christian organization that is founded on the Biblical principle of bearing one another's burdens. The monthly payment we make is distributed to other members of the organization who have unpaid medical bills. It doesn't count as health insurance.

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