Ahead of Schedule

The traffic on I-95 near the airport was at a crawl. We hadn’t moved a mile in 10 minutes. It was late afternoon and the Philadelphia rush hour exodus was in full swing. I was inching along toward 476 West (aka . . the Blue Route). i-95It would be a couple hours before I got home. I was tired and hungry and had the biggest grin on my face!

No, I’m not some sort of masochistic traffic junkie. I had just completed my second post-surgery followup with the good doctors of the Vincera Institute. The prognosis: I was ahead of schedule and could start swimming and increasing biking. Wohoo!!! No running yet but no restriction on stairs or walking either, as long as I didn’t get sore from it. In another month  I can begin adding in some jogging on the treadmill. After weeks of nothing but rehab exercises this was supercalifragilisticexpialidociously good news.

Supercalifragilisticexpialidocious
Yes supercalifragilisticexpialidocious can also be used as an adverb.

On the financial front, about a week ago I received a subrogation form from my health insurance. If you haven’t received one of these, essentially it is a form that tells insurance more about your injury so they can go after anyone else that they feel may be financially liable. Whether that be your neighbor because you stepped in a gopher hole on their property, the gym because you overloaded the bench press bar and dropped it on your teeth, or your mother because you choked on a cranberry while yelling at the NFL referees during Thanksgiving dinner. In insurance terms, there is no such thing as an accident or bad luck. Someone is at fault and they use fancy terms like “subrogation” to make it all seem fair. But I’ll play the game. subrogation

This is my third or fourth go round with this form. I had to fill it out when I suffered tendonitis and plantar fasciitis a few years ago. I had to fill it out again last year when I rolled my ankle repeatedly and suffered a high ankle sprain. The funny thing about the form, is they aren’t written for athletes. I guess based on their experience, most Americans sit in a room staring at their phone or TV and if something like an injury occurs it must have been a single, traumatic event such as slipping on melted ice cream in the frozen section of the grocery store whilst loading up on pita pockets for the big game. The idea that someone would sustain an injury slowly, steadily, over time from an on-going active lifestyle doesn’t really fit on the form anywhere.

 

I filled the form out as I always do, not incriminating anyone but myself. Where did the injury occur? “At home. In my driveway”. At that point the remainder of the form becomes irrelevant. When I did this for my tendonitis I briefly considered attaching 6 years worth of Garmin files from my runs but decided postage would be cost prohibitive.   As I completed the form and prepared to mail it, I had to chuckle since I know they’ve already rejected it. I’m not sure why the exercise in futility but that is our fantastic healthcare system here in the States.

Screen Shot 2017-12-20 at 5.39.31 AM
A small sample: Imagine 6 years worth. 

I am still planning to appeal and have begun to gather documentation around this fun event. The billing staff at Vincera are very helpful with this. I now have in my possession a full packet of information surrounding athletic pubalgia in general and my case in particular. The documents are lengthy but I dug in to give them a read. It turned out more interesting than I anticipated. I’ll share some of the golden moments here.

First one of the more useful documents is an article titled Experience with “Sports Hernia” Spanning Two Decades. This was authored by Dr. Meyers, and Marcia from Vincera along with several other doctors. It describes in detail the background of how the Vincera practice and procedures developed. It is well written and very informative. My favorite part is when describing one of the measurements for success and referring to “Return-to-play” they make the following statement: “We define return-to-play as an athlete’s actual returning to full competitive play. This definition does not include the athlete’s or close associate’s assessment as to whether this level of play was satisfactory”. I can’t help but laugh every time I read this. I can see it now. “I’m still slow but I can run again”. Is there a runner or triathlete out there who thinks they are fast enough?

I moved on to the visit notes. This quote from my initial consultation with Dr. Meyers brought a smile: “Peter Githens is a very nice 51-year-old IT project manager from Reading, PA”. It still brings a smile. I smile not just because Dr. Meyers had a good impression of me but because I’ve never seen a doctor note like this before. In fact usually they are some hodgepodge of a voice transcription later typed by a clerk.

The next bit I found interesting was in reading the surgical notes. It actually wasn’t a bit at all but rather extensive and detailed. I assumed, for some reason, the surgery was a quick cut & sew kind of thing. It seemed that way in the picture.

IMG_3314
This diagrams the core muscle injury repair performed by Dr. Meyers. It looks simple here.

Not. At. All. In fact I suddenly had retroactive groin pain while reading. It was well over a page of notes! But reading these notes really solidified the decision for me. Damage, edema, and calcification around the injury were significant.

groin_pain
I cringed a bit while reading the surgical notes.

This was not something that would get fixed any other way. It was also clear that Dr. Meyers treated me the same as he would a high-priced NFL quarterback.

I have another appointment in February. I’m hopeful that I’ll get the all-clear for all activities at that point. In the mean time, I’ll continue to work with Vanessa at physical therapy and continue my exercises on my own. I may need to also add in some professional massage to help avoid scar tissue forming around the adductors and core muscle repair. It’s a tricky balance!

Finally, if you ever find yourself in need of any of the services offered by Vincera Institute remember one thing. They are a very busy office and the doctors and staff there take their time with patients. It isn’t your typical “Rest and take some ibuprofen” type of visit. When you leave Vincera, you will have answers and a treatment plan or recommendation. This takes a long time. There may be multiple MRIs and other tests involved and the doctors spend a lot of time with each patient. That means your 1:00pm appointment is probably going to stretch much longer. Don’t rush to the office planning to be back at work later that afternoon or needing to catch a flight home. It probably won’t happen but you will leave with an answer.

Now, I have to publish this and go to the pool!

happy_dance.png

 

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