Ed. Note: This post is from @AndeeD on Twitter. Had she received preventive care as a child, she might not have needed knee replacement as an adult. However, she was evidently a candidate for NSAID drug trials which impaired her health further, because the insurance company overrode her doctor’s recommendation while approving medications that further impaired her health. Read the whole story…and ask yourself why we haven’t fixed this?)

Not long after I had my son in 2001, my right knee, which had always had problems, became so painful that I began limping. A year later, I saw an orthopedic surgeon, who, after x-rays said I had virtually no cartilage in that knee and should have arthroscopic surgery. Fortunately, I had been at my job for a year and had sufficient health insurance to cover the day surgery (though I paid later for the anesthesia that wasn’t covered in network.) Scoping my knee gave me about a year of less pain, though never pain free, then the deterioration of my joint accelerated and by age 41, I was in such pain that I was forced to use the electric carts when in large stores and make decisions about when I wanted to bother walking somewhere.

By this time, I was living in Arkansas (my original job had transferred me) and was working for a new company. Again I had enough health insurance to see an orthopedic surgeon (though he was considered a specialist so I had to pay much higher co-pays for office visits and lab work) but between the lack of specialists in my area and the ones that would take my insurance, I had exactly one choice for an orthopedic surgeon who treated knee problems. He admitted that the osteoarthritis in my knee was advanced (called it my 95-year-old knee) and I probably would need a replacement, but because I was 42, he wanted me to wait. His reticence to do surgery could have just been the sort of cautious doctor he was, but I also suspect it’s because he didn’t want the insurance company hassle of getting approval.

I called my insurance company to ask if I could have total knee replacement and they responded, only once my surgeon recommended it. My doctor continued to balk, though he gave me a corticosteroid injection, pushed me to have Synvisc injections ( I did, they gave me no relief) and finally said I should have my knee scoped again. He did the day surgery this time, declared the damage horrible and said I needed a knee replacement. But in the follow-up visit two weeks later, again said I should wait because I was so young and “knee replacements only last about 15 years, which means you’d have to have another some time.” Yet, my quality of life was reduced to as little walking as possible. The pain was so horrible, it exhausted me. I took way too many NSAIDs until I ended up with chest pain in an emergency room. No heart attack, but the NSAIDs had so damaged my esophagus that I thought I was having a heart attack.

Now I had the excruciating knee pain and could never again take anti-inflammatories or exacerbate my acid reflux problem, eating away at my stomach lining. Finally, while home visiting my mother in Texas, I ran in to the orthopedic surgeon who saw me as a teenager with bad knees. He listened to me, asked me to forward my scans to him and said he thought I should have a total knee replacement.

I followed up with him and after seeing the scans, he said I should have TKR as soon as possible. As soon as possible was going to be nine months after the other OS had said I needed the TKR after my scoping because, between my doctor’s surgery schedule, my work schedule and my ability to take off work for two weeks to travel to another state and recover enough to return home, I scheduled the surgery for January of 2007. I had probably needed this TKR since some time in 2004.

My insurance did cover the surgery, the rehab went well and now my knee is wonderful. To be fair, this orthopedic surgeon was a friend of my parents and though he would never say, I think the reason it seemed my insurance covered so much is that he waived some of his fees. My left knee is now starting to trouble me in the way the right did. I’m not sure how many years (less than five, I would imagine) before it will need replacing also. If I’m lucky, I will still have this job then, but I work for a small company that is always on the verge of being sold, reorganized or going out of business. I doubt I can afford COBRA if that happens. So, I can only hope that my future need for major surgery coincides with more good luck.