Back on the hip wagon

It's been a while since I posted anything about my hip. Hopefully a long enough hiatus to ensure that you're not all groaning in misery at the mere mention of it - but then, maybe not! ;o)

Anyway, if you've been following my titbits on Facebook, you'll know that I finally decided to make a doctor/PCP and medical group switch, and today was my first appointment with my new PCP.

Since my insurance is an HMO, my medical group is a big deal, in fact more of a big deal than my PCP, ultimately, becuase it dictates which specialists I can see. Long story short, I was originally with Hill Physicians when I first moved up to the Sacramento area several years ago and was very satisfied with all the referrals I received BUT hated my backwater doctor at the time. I switched to a younger doctor, with computer medical records (woot), who I loved (love) but she was a part of Mercy Medical Group - sort of like a mini Kaiser around here. Unfortunately, the "mini" meant mini service and mini options but with all of the same restrictions as KP. I had to fight to get my hip surgery done arthroscopically because Mercy didn't have a surgeon who had done it before (finally having to get a surgeon affiliated with Hill to scrub-in, so I wouldn't have to have open surgery). I then had to go out-of-network and out-of-pocket for physical therapy after my surgery because the Mercy therapists kicked me out the minute I was walking. Finally, to get the Osteopathic Manipulation my doc felt I needed to progress, I had to drive 45-60 minutes each way, to a town called Lincoln, on a 2-lane highway.

Although I loved my doc and honestly believe it is unlikely that I will ever find someone with a bedside manner that so completely suits me, the reality is that, aside from all but the basic cold, flu type illnesses (which I rarely have), she refers me out and so I spent more time with disparate "specialists" than I did with her. And, as I said, the specialists in Mercy are not all that special, in my humble (yet increasingly experienced) opinion.

It pains me to have to start this whole process again for the third time but I've plateaud with my hip in a place that is not acceptable for me at this time in my life. I honestly don't know if moving around like this is the solution but what I do know is that I've got to keep trying. I won't rest until I turn over every rock, trying to find the magical combination of treatment and care that will help me get to a better place.

Unfortunately, I've eliminated "recovery" or "pain free" from my vocabulary these days, as I'm not sure these are reasonable goals. Honestly, I'd just like to be able to get in and out of my car without worrying about twisting or turning the wrong way, pulling something, or clicking or popping something. Not to have to think about every little movement and make adjustments all the time would be victory for me. I want to be able to chase Daisy around the garden and perhaps even ski down a bunny hill with her for the first time - no black diamonds or anything, just a gentle little slope and some amateurish ploughing. Beyond that, I don't know what I'm going to achieve but I know I'm going to work hard to make it the best result I possibly can.

With all this in mind, I went to my doctor's appointment this morning.

The new guy is literally a quarter of a mile up the street. I practically passed his surgery every day without even paying it a second notice! I found him through my health insurance's online doctor site, by looking for another D.O. (Doctor of Osteopathy.) I have a lot of respect for doctors who do the extra time (2-6 years more than a regular doctor) and become a D.O. and, so far, I like their approach to treatment, so it was important to me not to lose that, if possible, in the switch.

Doing a little research on him, I was intrigued. In these days of computerized medical records, where doctors half-listen to you while they busy themselves with typing on a keyboard or fighting with an "F" button of some sort, he is an old-fashioned type doctor with an old-fashioned family practice. He "specializes" in total health care, from infancy and childhood, through adulthood, everything from pediatric to women's health, dermatology, nutrition, chiropracty, osteopathic manipulation, in-office minor surgical procedures and physical therapy - all in his surgery. (I KNOW!) I met with him briefly before I made the switch and he bristled at the very mention of referrals. "We like to take care of as much as we can here," he said. "For us, it's about continuity of care." Although I know this could either be a blessing or a curse, it was different enough to make me curious. The PCP >>> referral route hasn't served me too well as yet, so a truely different approach is probably my best chance yet at a different result.

Not that old-fashioned equals "old" or out of date, at least where it matters. No, he doesn't have computerized medical records and has had his local practice for 20 years but he's a fit, energetic, attractive, 50-ish man, the chief physician for the local Hill Physicians region and is involved in academic testing on the California Osteopathic State Board. These things tell me that he stays up-to-date yet is experienced enough to know what's what, especially within his own medical group - and knowing how to negotiate the system is an under-valued quality in a doctor, I am finding.

In person he turns out to be the typical "A-type" personality. A short, brusque, multi-tasker, who knows what he's doing and likes to get to the point. He is constantly on the move with purposeful energy, walking around his surgery simultaneously signing-off on charts, texting on his mobile phone, making and answering calls between patients, and conversing in harried-tones to his staff. He takes notes by verbally recording his voice on his smart phone, presumably because he doesn't want to take the time between patients to sit down and write (or type) something. He moves from one task to the next fluidly and his staff orbit around him in the kind of practiced way that makes you realize that he demands a lot of them but is admired by them; they've also obviously been with him as a team for some time.

His bedside manner isn't touchy-feely and sitting in front of him to explain the reason for your visit is an exercise in summation and verbal bullet-pointing - state your needs up front and remove the unecessary words; get to the point! He's a jolt to the system if you've been used to someone chatty and sympathetic, as I have. And if you're looking for someone to talk about how you're "feeling" non-medically... this guy is not for you.

But, I think I'm going to like him. He's definitely an adjustment for me but one I can easily make with my "get on with it" personality. Although I like to think of myself as a fairly friendly individual, I have come to value expertise and capability over friendliness. I've had friendly and look where it's got me. I go to the doctor to get "fixed" not to socialize, so I can look past this if I get results.

Within five minutes, we'd moved beyond my long-winded hip history (which he rushed me through) and determined that there wasn't much point in looking at what had already been done: Surgery - check; Orthopedists - check; Physical Therapists - check; Osteopathic Manipulation - check; Results - notsomuch. What did I expect to gain from seeing him? he asked me. I couldn't provide a concrete answer because I don't know what it's realistc to expect. It's an open-ended objective, really. We settled on someone different doing something different for, hopefully, a different result.

He immediately whisked me away to his manipulation treatment room where he cracked (and I mean popopopopopopop) my back, my ribs, my hips and pelvis in 3 swift and yet painless movements that took less than 30 seconds to perform. He then told me that I hadn't had really good physical therapy until I had been to a local lady, just half a mile away. He said she was the (and I quote) "best in the west" and if something was "fixable" to any extent possible, she would be the one to fix it. He told me she wasn't within my medical network but that he knew her well enough over the years that he his patients had a special cash rate with her of just $45 per visit (only $20 more that I would have to pay with insurance anyway.) He scribbled illegibly on a pad to refer me to her as we walked out and back to the front desk, mentioned a follow-up appointment in two weeks and said goodbye as his receptionist took his cue and had three appointment times/dates ready for me to pick from.

Not ten minutes after I had first shook his hand, I walked out of there, having been assessed and dismissed in short order. It was like being at the Dennys of doctors: good, solid food you can rely on, dished-out quickly by a busy and well-practiced kitchen. (I like Dennys, by the way. If you don't have a favorable opinion of Dennys, just replace with your favorite fast-and-yummy diner-food joint.)

Of course, as we say in the UK, the proof is in the pudding. Meaning, the results will speak for themeselves. But right now, I'm just happy to be on a different course.

I called the Physical Therapist, by the way, and have an appointment for 8:15am tomorrow morning. So, more after that...