Thursday, September 3, 2009

The knee cap issue

This past Monday at about 4:15, my son dislocated his left knee cap while tackling another kid during drills at football practice. I got the call at about 4:25, and by the time I got to the school (less than 10 minutes) the trainer had already put the leg into a full leg decompression device and called the team doctor. The team doctor is an orthopedic, and was willing to see the boy as soon as we could drive there so the doc could pop the knee cap back into place (the knee cap was completely on the left side of his leg...). Apparently time is of the essence in these kind of injuries. The trainer was leary of popping it back in himself, he thought it would be better to have the ortho do it. Because I live so close to the school and could get there so quickly and get him to the ortho, the trainer didn't think it was necessary to call an ambulance.

When I got to the school, the boy was pale but seemed okay in the compression device. I was concerned about my insurance not paying for a specialist without a referral. Please don't think me cold hearted. If the trainer had popped the boy's knee cap back in place on the field I still would have taken my son to the ER to make sure he was okay. Just as the trainer was thinking it would be an unnecessary expense to call an ambulance just for transportation, I was really worried about out of pocket expenses if the insurance didn't cover us going straight to the ortho. I called the primary care pediatric and asked for an immediate referral rather than waiting until after, and it's a good thing I did because they wouldn't give me one. They told me to go to the ER.

We got to the ER at 5:05. They didn't put his knee cap back into place until after 8:00. At least they gave him a morphine/valium cocktail first, which he wouldn't have had at the ortho's office. Of course, he wouldn't have needed it if he hadn't had to wait almost 4 hours with the joint swelling! Anyway, the ER took x-rays (during which the knee cap popped out again, ouch!), and no bones are broken.. We didn't get home until almost 10:00 that night, and the ER didn't prescribe anything for pain except otc ibuprofen.

I'm still struggling with guilt over putting money before my son's pain. If I had known there was going to be such a long wait, I'm not sure if I would have done things differently. It's a really hard call. If we had gone to the ortho without a referral, I would owe him a lot of money. The office has signs all over their walls advising that if you don't have a referral, you need to pay for services rendered right there and then. Not to mention the follow up treatment which wouldn't have been covered, because the first visit wasn't covered. Now I only owe the hospital a co-pay, but made my son wait hours in pain... As it was, the hospital tried to collect it's $75 co-pay, and I could not give it to them. It was Monday, I had just spent every last penny getting the boy his books for school. I asked them to bill it to me, they are going to have to wait...

We had an appointment with the ortho yesterday, my son can forget playing any football this season. There is definitely a torn ligament in his knee, but they are hoping that will heal on its own. They are trying to get us an appointment as soon as possible for an MRI to rule out torn cartilidge, which the ortho assured me would be rare. If there were to be torn cartilidge, there would probably have to be surgery. If not, he has to wear a long leg brace for 3 weeks, a short knee brace for at least another 3 weeks, and physical therapy. His thigh muscle has already started to atrophy from the swelling in the knee and he's having difficulty picking the leg up because of it. Thankfully the ortho gave him a prescription for something stronger than otc ibuprofen. The kid is in pain! He said the swelling is normal, they don't recommend draining the knee any longer as it will just swell back up. The swelling will probably be there for six weeks!

Here are some pics of his knees I took yesterday at the doctor's office while the brace was off. Yeah, I know, GROSS!


Mr. Condescending said...

Fancy, I don't think it was wrong at all. I mean I know he was in a lot of pain but its better than having a careless attitude that would have cost you a ton of money and stress. You are lucky to have insurance at least, and I hope your son realizes you are balancing the best decisions for his pain and your personal situation.

You're an awesome, loving mom!

The Vegetable Assassin said...

This to me is just ludicrous - the boy was hurt, it was an emergency, it's insane that anyone requires you to waste time with a referral. I think you did what anyone would do because circumstance dictates it but it's stupid they put you in a situation where have to think about the cost at all. I think 'insurance' should mean, if you're sick or injured you can get a doctor - any doctor - to help and be covered. This network/out of network and referral business is crazy.

I grew up in a country with socialized health care and although it's no way perfect, it's better than the system in the US. Everyone is covered for any doctor and we don't need insurance so you have to go to hospital you never have to deal with a bill. If this happened there you'd take the kid to the doctor you needed right away and wouldn't pay a thing except any prescription costs (a flat rate of about fifteen bucks equivalent).

I think it's crazy a kid or anyone else can be hurt and the first thing anyone wants to know is your insurance. It's like "HELLO, I'M BLEEDING HERE!!!" It's scary to think that you could get sick yet not afford to be cured. It's horrible.

I hope your son's doing better! I cringed just imagining the putting it back in place thing. OUCH. And I hope you don't beat yourself up over this as you had no control over it.

Boy this was a rant, eh?

Mr. Condescending said...

Veggie is RIGHT!

Raine said...

I would have done the exact same thing. It is terrible the way the insurance companies do things. And if you didnt have insurance...

I hope he feels better now with the new meds :D

Some Guy said...

Sorry about your son. It's a shame that you're forced to make decisions like this.

Aunt Becky said...

Veggie is my new hero. Hang in there, Fancy. Poor kidlet.

mo.stoneskin said...

I agree with Mr C, and although we always look back with "what ifs" I always settle myself if I know I made the decision in earnest using the information/knowledge at hand.

Does the boy know you've plastered photos of his leg all over the internet?! ;)

Hazwani said...

Oh yeah, I kinda agree to stoneskin. oes your son know? Coz I think he'll get over the pain over money thingy after a while, but he might not get over this one so soon. Hmmm.

Anyway, you've got to do what you've got to do, and something I learnt from my dad is, the last thing you want to burden your child with, is debt.

he always buys things he can afford to pay straight away, os something he knows he has money to pay for. like our family car, or our current home.

anyway, i hope your son heals nicely. he's young and active, normally that gives anyone a good prognosis regarding this kind of injuries.

take care :)

Fancy Schmancy said...

You guys are awesome!

My son isn't upset with me over the decision at all, he's upset with the pediatric for not giving the referral.

Veggie, this is why I voted for Obama, I actually like the idea of socialized health care. Your "rant" was amazing!

The boy knew as soon as I took the pictures that they were going on the interwebs - both my blog and facebook. It doesn't bother him now since he unfriended me on facebook. This way I can't embarrass him in front of his friends any longer! lol

Andrea said...

Awwww, poor thing! Not only does he have to get over the pain but he has to deal with the disappointment of not playing this year! That part might hurt worse in the long run. I'll send my best healing vibes! :)

PS I always thought the knees (and elbows) were ugly body parts and those pics just prove it. :D

LegalMist said...

Oh, Fancy, I'm so sorry you both had to go through that. I'm glad he'll be ok. I'm nearly in tears for him that he won't get to play ball this year.

I agree w/V. Assassin, too. Crazy system we have here, that won't let you go directly to the right doctor and just have it be covered.

People are so scared of government health care "rationing." But what do they think their insurance companies are doing right now every day? If refusing a needed referral isn't "rationing" health care, what is it?

You did the best thing, and handled it just as we all would have under the circumstances.

Char said...

Oh Fancy, I am so sorry. I think you made the right decision, not so much the pede. Hope he heals quickly.

jadedj said...

Totally with you on this. You made the right decision. The screwed up health care system we have let get out of control, is a national disgrace. It doesn't have to be this way, and it is this way because of the profit motive. Health care should not be treated as a commodity.

JoJo said...

Um...OUCH!!!!!! Poor kid. I'm so sorry about your financial woes, causing you to make such a hard choice, but unfortunately that's the reality for most Americans. It's sad that we have to make choices like that.

Best wishes for a speedy and uneventful recovery!!

~E said...

You are an awesome mom and don't let guilt or whatever tell you otherwise. I hope your son gets better and believe me when I tell you it could have been way worse!