At least for a little while.

If you're a regular reader of my blog, you've followed this "year of the doctor" that I've been having.  You know about my tennis elbow and the painful, time-consuming, and costly physical therapy that I've geen going through.  You also know that the physical therapy didn't work.

Today I went back to see my Orthopaedic Surgeon.  He's convinced that if the ASTYM therapy didn't work and I was doing the prescribed stretches and exercises (religiously, actually), that there's damage that will only be healed by surgery.

He told me that he could give me a cortisone shot.  It would be painful and would help with inflammation, but according to the latest research and his experience, it wouldn't help with healing.  I would end up in the same position I'm in today in another 3 or 4 weeks.

He told me that he could do an MRI to take a closer look at it, but he said that he thought it would cost around $1200 for the MRI and it wouldn't give him much information, if any, that he didn't already have.

He said that he believed that the best route to healing for my elbow would be surgery.  Yes, surgery.  Ugh.

I'm scheduled to go under the knife on Wednesday.  This particular procedure has a very high success rate.  He's going to use a 2-inch incision, clean up any dead or loose tissue, clean up the epicondyle (the bumpy bone on the outside of the elbow) and re-attach the extensor tendon.  It's an outpatient surgery and isn't very invasive.  I will undergo a "light general" anesthesia during the procedure.

I'll have to wear a brace to completely immobilize my elbow for a week to ten days.  Then I'll need to wear a removable brace that I can take off to shower for another month or so.  Then I'll have therapy to regain flexibility, range of motion, and strength.

All this because I was stupid and played too hard too quickly with a new racquetball racquet.  Hopefully I've learned that this 40-year-old body doesn't take punishment as well as a 20-year-old body.

I should finally be back to normal in 3 or 4 months after the surgery.

Just like I think they finally found the cause of my kidney stones and I'm now taking steps to make those stop, I believe that this is the beginning of the end of the pain in my elbow.  Keep your fingers crossed for me.

I have a new favorite number.  It's a little more complicated than "lucky 7" or "3 is a magic number."

My new favorite number is:

999999999999999999999949999999999999999999999

I know it looks cool, just sitting there all by itself.  That many nines all put together like that makes the number look really really big.

The 4 is smack dab in the middle.  That means that this number is a numeric palindrome.  It has the same sequence of digits if you look at it left-to-right or right-to-left.  That makes this number even cooler.

But coolest of all?  This is also a prime number.  It's only evenly divisible by itself and 1.

Now THAT is a cool number.  Yes, it's definitely my very favorite 45-digit prime number.

No, don't run away screaming.  This has nothing to do with ObamaCare or whatever is going on in congress.  I was just looking at the medical procedures that have been billed to my insurance this year.

So far this year, my insurance has been billed more than $6700.  Wow.  This will almost double when the bill for my lithotripsy finally comes in.  Double wow.  So far, between us and the insurance, we've paid just over $3800.  This is the "contracted rate."  The difference between the two is around $2900.  This is how much we have "saved" by being insured, just in what was billed.  The average "contracted rate" is around 57% of the billed rate.

But is any of this really "savings?"  Medical providers know that they won't get the amount they bill to insurance companies.  I'm SURE they take this into account when they decide how much to bill for any given procedure or consultation.  Without such contracted rates, would the amount billed actually come down?  Maybe this is a chicken-and-egg problem.  Which came first, the high bills or the contracted rates?

All I know for sure is that I'm grateful for health insurance.  VERY grateful.

My wife's CT was clear.  I guess kidney stones aren't contagious.

I'm done with physical therapy.  It was a painful six weeks getting scraped twice a week.  The last couple of weeks, he really bruised the heck out of me.

That's the good news.

The bad news is that my elbow is not pain free, so next week I have an appointment with my Orthopaedic Surgeon.  He's going to send me to get imaging done on my elbow (probably MRI images) and see where there are torn tendons.  Once he sees what's going on, we'll probably end up scheduling surgery.

After surgery will be more physical therapy, of course.

However... looking at the bright side of things...  If there IS something that can be corrected using surgery, I'll FINALLY be able to heal and get back to normal again.

The really REALLY bad news is that my wife is going to have a CT scan tomorrow to look for kidney stones.  WHAT THE??  That's MY pain, not hers!  That is NOT allowed!

Oy.

I'm sick and tired of physical therapy.  SICK. OF. IT.  Yet tomorrow, I'm going to go get my arm scraped on again.

Thursday's therapy session was more brutal than Monday's.  I was about twice as bruised.  My arm is pretty green now.

It's not one bit better.  As a matter of fact, this weekend was pretty painful.

So why am I going back tomorrow?  Because my Orthopaedic Surgeon told me that if it's not better after six weeks of therapy--if it's not pain free--that I should come back and we'd take the next steps to figure out what's wrong.  He didn't say five weeks, he said six weeks.

If I end up having surgery, I'll probably always wonder if that one more week of therapy would have made a difference.  I can tell you right now that I have about zero hope that it will, but he said six weeks, so I'll go two more times and spend another hundred dollars.

</whiiiiiiiiiine>

Sorry.  It hasn't been the best weekend as far as this stoopid elbow is concerned.

Physical therapy was more painful than usual this morning.  I told the therapist that my elbow wasn't getting any better, so he decided to use a bit more pressure with the ASTYM tools today.

OUCH.

You can only see about half of the bruises, but you get the idea.

At this point, I have 3 more therapy sessions before I go back to the Orthopaedic Surgeon.  If it's not pain free by a week from Thursday, the next step will be to get a MRI on my elbow to see what's so wrong that it couldn't be helped with ASTYM.

At this point, I'm also continuing to lose optimism that it will become pain free by a week from Thursday.

*sigh*

My thoughts on this, the opening day of another Harry Potter movie:

• The "Meh" in the title of this post is not a review.  I didn't see the movie.
• I forgot to see the previous Harry Potter movie.
• I don't think ANY movie is worth staying up and dealing with hordes of people for a midnight showing.
• There are worse tragedies than not seeing a movie in a theater.
• There are better ways for me to spend my time than waiting in line for a good seat amid people with way too much nervous energy to be sitting through a movie.
• There are better ways for me to spend my money than on a costume of a movie character.
• I have no problem with the people do do any of the aforementioned things.  It's just not me.
• I might see it when it comes out on DVD if I've happened to find the previous installment at RedBox first.
• J. K. Rowling has to be SO freaking rich it's not funny.

So there you have it.  Meh.

I went to a Nephrologist on Friday.  He told me what I already knew:

1. I get kidney stones
2. The kidney stones are calcium oxalate stones
3. The amount of oxalate my kidneys excrete is normal
4. The amount of calcium my kidneys excrete is high
5. The amount of calcium in my blood is normal
6. My parathyroid hormone level is normal

He told me that the urologist's idea of trying a restricted calcium diet had a very very small chance of actually working.  My kidneys are genetically programmed to do what they do, and mine just like to filter out calcium.

Fortunately, the Nephrologist had a better plan.  I'm on a tiny pill called Hydrochlorothyazide.  It's a blood pressure medication that has a side effect of causing the kidneys to output less calcium.  There are a couple of other side effects that are less common: dizziness (too low blood pressure), heightened sensitivity to the sun, and hyperglycemia.  It's also a mild diuretic, which is also not bad for kidney stones.

After two months on this "water pill," I'll do another 24 hour urine study (this one analyzed by a different lab and much more in depth), and if the calcium levels are low or normal, this will be the solution to my particular problem and I shouldn't get any more kidney stones.  Hooray!

After three weeks of ASTYM therapy on my elbow, I'm starting to worry that it's not going to work.  It got a little better for a little while, but despite doing stretches and exercises at least three times a day, my tennis elbow doesn't seem to be getting any better.  The healing and progress seem to have stagnated.

That depresses me a little bit.

I probably need to be more patient.  I probably need to baby my right arm a little bit more.  I probably need to chill out a little bit and not jump to conclusions.

I'm tired of taking the time and spending the money on therapy.  I still have 3 weeks to go before my Orthopaedic Surgeon wants to see me again, so I'm only halfway through this and I still have hope.  Yet the fact that it's not getting better as fast as I would like makes me worry.

If I end up going back to my Orthopaedic Surgeon, he's going to want an MRI of my elbow (expensive) so that he can figure out how badly tendons have been damaged (not good) so he can decide what type of surgery (painful, expensive, and hard to recover) to do so I can get back to normal (what's that?) again.

No.  I'm not happy about this because I'm not sure that it's working.  I'm not so sure that it's ever going to work.  That would mean that I've thrown away a bunch of time and money, which would also make me not very happy.

All of this is because I was actually really enjoying playing racquetball.  I thought I had found a way to continue playing racquetball without trashing my knees (by only playing once a week).  But apparently, my elbow decided to rebel against such an idea, causing problems that are keeping me from riding my bike too.  (I can't brake with my right hand without pain.  I can't even ride my spinner.  I tried.  The angle of my hand on the handlebars hurts.  Wonderful.)

*sigh*

I'll keep at it for 3 more weeks, but I'm not so sure that it's even worth it.