Month: February 2017

Well,  my knee has NOT stopped hurting since September 21st and after my January 5th appointment with Dr. Frush, my knee began popping out of its socket.  It has popped out from January 6th to February 15th eight times.  That doesn’t sound like a lot, but each of those eight times has been excruciating! It makes a popping noise when it comes out and another popping noise as it has to be put back into place. This fact has  concerned me greatly!

My friend Renée took me to Dr. Frush’s office and came back into the exam room with me.   The nurse case manager had arrived to Dr. Frush’s office and explained to me that my physical therapy had been approved but only twice a week for six weeks.   I REALLY liked going to therapy three times a week.

I had called Dr. Frush’s office the week before and told  one of his assistants about my knee popping out.  So he knew about it before he came into the room.  He sat next to me and we talked for a while before he examined my knee. He had his “thinking face” on.   He asked me specifics of my knee popping out and clarified the fact that I have not been to physical therapy since December 1st.

 Then the examination  began.  He pressed on my knee and it still hurt everywhere he pressed. I asked him about my “Mount Kilimanjaro” and he told me that it is called the “Hoffa’s pad” and that I do not need to worry about it. I researched “Hoffa’s pad”online to spell it right, first of all, but also to get some more information about it.

Apparently, it is actually called the Hoffa’s fat pad.”  The peak happens when there has been knee trauma or surgery which I have had both. It happens with the shortening of the patellar tendon  from the trauma or surgery. He told me it was  just the “Hoffa’s pad.” So it was good form that he didn’t tell me that  my knee was “fat.”

 Then he held my knee with his left hand and pulled it to the left with his right hand. That hurt a whole lot more! Then he switched hands and pushed my leg to the right.  Instead of just saying, “yes” when it hurt, I grabbed the arms of my wheelchair and gasped.   My reaction kind of concerned me almost as much as his look of concern.

 He told me that he  wanted to hold off on surgery because I had not done all of the possible and necessary non-surgical remedies.   Two extensions of my physical therapy have been denied.  He told me that he was going to prescribe one more round and see how my knee is doing the next time I see him.

 Then, the nurse case manager went in to talk to him as I went to the front desk to see about my discharge papers. As I was arranging my return visit,  she came up and met me at the front desk.   She told me that I should go to therapy three times a week for four weeks and she will work on getting the two more weeks approved. She told me that Dr. Frush told her that if my knee is not doing better at my next appointment, he is going to  go in with a scope. She then told me that paying for two weeks of therapy is a lot cheaper than a scope!

My school was still on Christmas break when I went back to see Dr, Frush.  The nurse case manager who usually accompanies me was not able to attend so there was another woman who came in her place.  I went back to the  examining room with my mother and we met with Dr. Frush’s resident first.  I unsnapped my pants and he poked around on  my knee and it still hurt everywhere he poked.  I told him about the discontinuation of my physical therapy.  He looked a bit surprised and then left to get Dr. Frush.

Dr. Frush came in and also poked around on my knee and it hurt everywhere he poked as well.  He  also looked surprised when I told him that my physical therapy was discontinued.  He asked what their reasoning was and I told him that they said it was “Not medically necessary.”  He immediately turned to his resident and told him to write in my notes to set up a “Peer-to-peer.”  I didn’t know what that meant but I know that he looked like he meant business!  He told me that physical therapy IS medically necessary because my knee looked WORSE than it did the first time I saw him.

He wrote another extension for physical therapy and told me that I can not rehab normally.  Yay MS! Right?!  Dr. Frush  left and the nurse case manager was called in.  When she came into the examining room, we waited a little while until Dr. Frush  reappeared.  He explained to this woman that I have a “nonsurgical injury”  and he wants to set up a “peer to peer” with the examining physician from the company.

It was here when I figured out what a “peer to peer” meant.   My doctor wanted to talk to the Doctor who examined me from the company to get my injury straight.  My doctor, Dr. Frush, understands that the physical therapy Is necessary. So two doctors are going to get together and talk about my knee.   I was excited that I would start physical therapy again!

I am writing this blog post on February 8, 2017 and I have not been back to physical therapy yet.  My knee has not stopped hurting! I go to sleep with it hurting and I wake up with it hurting. It hurts all day and sometimes wakes me up throughout the night. I desperately want all of this to be over!   I see Dr. Frush again on February 16, 2017 so we will see what he says then…

I went back to work that Monday, December 5th. It was a rough day. For many different reasons! I was able to ice my knee and that was a fiasco in and of itself.  I could feel my leg throbbing more because I was doing a lot more than just sitting at home.  I looked forward to going to physical therapy and getting my knee worked on, I swore it was swelling by the minute!

I can’t tell you where exactlyI was when I got Luba’s call (but I know that I was in public) but I remember the feeling after receiving it.  I felt the sting in my eyes and nose as I tried to hold back tears after I hung up the phone.  I had that hollow in my throat as if I’d just been punched in the stomach.   The responsible party was no longer paying for my physical therapy.  They hadn’t paid for my last seven visits.

I told her that I had Dr. Frush’s prescription for extended physical therapy but Luba told me not to come to ATI until this gets straightened out.  She wasn’t sure if it was my fight or theirs to get this paid for.  She was going to get answers and get back to me.  I was shocked and completely at a loss!  I asked her what their reasoning was because I was STILL in a lot of pain!  She told me that they said that physical therapy was, “not medically necessary.”  I hung up shortly after hearing this and focused on holding back my tears instead.

I worked with Kristen on the last Thursday before my return to work.  I hadn’t told her about my appointment with Dr. Frush so I was excited to get her take on it.  When I got there, I explained everything.  What he said, my MRI results (the Pac-Man chunk), and the lack of improvement after the cortisone shot.  She listened as she rubbed my knee out.

I told her that I was a bit concerned that I was returning to work with my knee still hurting.  Dr. Frush said that I didn’t need surgery so I guessed I just had to deal with the pain.  I had broken my ankle in March of 2005 and it tool 6 months to heal.  Having MS has made my lower extremities slow to heal so I guess I just have to deal with it and take it as ANOTHER perk of having MS. Yay! (That “Yay!” is COMPLETELY sarcastic!!!)  I’ve decided that I REALLY LOVE physical therapy!  Kristen said after looking at my knee that she thought that the swelling in my knee has FINALLY gone down!  IT’S ABOUT TIME!!!

She hooked me up to stim. and iced me and I decided that I REALLY love that!  Kristen told me that  she would tape me, she decided to “double-cross” me (two layers of tape in the cross formation to reinforce things for my return to work) so she doubled up the tape across my kneecap before snapping my pants back up.  I got back into my chair and was grateful that I was “Double-Crossed” because it felt good!  I guess I am on the road to recovery.  Thank God!  It’s about time!  Finally!