Seven Weeks After ACL Replacement Knee Surgery: Waiting For Spring

It has now been exactly seven weeks after the first surgery and I have switched from using crutches to a trekking pole instead of a cane.  The goal is to walk as normally as possible.  At this point I just need that wee bit of support from the pole, and will likely continue to need it for the next several months.  In the past week I'm getting to the point where I can hobble along without great pain, though still a lot of discomfort.

Just today, for the first time, I was able to pedal full rotations on the stationary bike.  I was told to do only ten minutes, slowly, but out of sheer joy I kept a seven mile per hour pace for fifteen minutes.  That doesn't sound the least bit impressive, but to me it was glorious.

It's not like living through Winter and waiting for Spring, where it might be cold and dark longer than expected and then one day it's warm and sunny and the trees are suddenly turning green.  Recovery is slow and steady.  You can't wish it into going more quickly, nor should you try.

You have to learn to be patient--not determined, motivated, and inspired, just patient.  Do only what your physical therapist tells you to do, nothing more, no additional exercises you thought up yourself.  If the physical therapist tells you to raise your foot three inches, twenty times, don't raise it three feet fifty times just because you can.  At the same time, don't take it too easy because you wont simply heal up.  Without the physical therapy, you could heal up in a way that disables you somewhat for the rest of your life--tear a ligament that was just repaired or remain too tight for comfort.

I am also looking forward to my next surgery.  I'm preparing for it.  Things I didn't have before but wish I did I'm getting delivered--like a laptop desk for instance.  I may even buy a recliner.

Learning How To Walk And Pedal A Bike Again; Be A Good Patient By Being Patient

I had the first knee surgery on December 6.  Now it's January 10.

I can stand and hobble, and I thought I could walk short distances without crutches, but apparently not according to my physical therapist.

She insists that I use the crutches because it's no good for me to be walking with a limp.

So now I practice walking, with crutches, perfectly.  Even at home, I am required to use the crutches.

Patience is very important when you're recovering.  When the therapist says kick only so high, even if you can do far more and better, you need to only do what they tell you to.  If you're able to do something which exceeds what the therapist has you doing, don't do it--it's a mistake.  Be a good patient by being patient.

On the positive side, I was allowed to get on the stationary bike for the very first time today.  As a cyclist, this is what I was really looking forward to.  I'm not able to make a full rotation of the crank yet, just back and forth, but having my feet on pedals again for the first time since I was hit on October 2 sure feels good.

Deleted by Author

Deleted by Author

Disability: Top Of The List of Biggest Worries; How I Get Paid While Out Of Work

I've been talking to a lot of people who have been hit by cars and haven't met one--besides myself--who didn't fail to get the treatment they required and deserved.  One girl who works in the shop where I bought the money order so I could get a copy of the accident report from the police station told me she received only $2,000 and no treatment, and that hasn't been able to do the aerobics she loved to do so much before being hit in the years since.  She says she gained weight and now has no way to shed those pounds--and she is only about twenty years old.

Injured people usually miss out on treatment and benefits because they don't realize the need to take charge of the situation, to get an MRI on anything that's constantly painful and discuss it with a surgeon, or check with their Human Resources department to see if they're eligible for Disability benefits which are most likely part of their compensation package.  They're worried about losing their jobs or that they'll have to fight to get paid and in the meantime lose everything--their job, their home, everything.

I can tell you that in my case, until I asked to get an MRI I wasn't told I needed one; and once I had the MRI I was told I needed surgery--then another MRI and another surgery, and I will have yet another MRI later on and likely another surgery.  The moral is, you wont get anything that you don't ask for.

At the company where I am employed, they automatically include Short Term Disability insurance in every employee's benefits package--covered from day one.  It pays up to 26 weeks, job protected, paid benefits.  For the first 13 weeks they pay 100% of regular salary and thereafter 66.66%.  If I had been with the company more than five years, it would pay 100% the entire 26 weeks (six months).

Additionally, employees have the option to purchase Long Term Disability at 50% of salary for cheap or 66.66% for about $19 a month.

I always buy the max--which I've never needed until now--because I'm a very active guy who enjoys cycling, hiking, and general outdoor head cracking activities.  But even if I wasn't so adventurous, I'd say it's a good idea to purchase this additional insurance.  I was hit in a crosswalk for instance, not during some glorious downhill, high speed adventure.  I was moving maybe 3 mpg.  This could have happened to anybody.  Even if I slipped and fell in the shower, and required Disability benefits, I would be paid.

If you don't have Disability coverage, you have to pursue payment from the driver's insurance carrier, and as I wrote in an earlier post their whole goal is not to pay or to pay as little as possible.

So far I haven't had any lost income because of the coverage I have, but after 13 weeks the amount of money I receive from my employer will be reduced by a third, which in my case is a rather large sum of money.  I would be stupid not to pursue payment from the driver's insurance for that lost income.

So in Week 5 I was required by the driver's insurance to see their doctor to determine just how disabled I am.  I went yesterday.

It was obvious that this is the bulk of this particular orthopedic surgeon's business.  People were packed in the waiting room to see the surgeon for five minutes.

I filled out a form which asked all too simple questions.  I advised everyone around me, "If these forms do not ask you for information you feel should be included, then write that information on the form.  And don't be the least bit shy about whining about how you feel, about every little ache and pain."

The insurer's doctor's entire goal is to make it seem like you're not really injured at all, that you will heal up just fine.  There will likely be another person in the room who will record everything you say--so complain, complain, complain!

In my case, I complained about both knees and my right ankle, as well as my back, my hip, my shoulder--anything that ever ached after being hit.  The doctor asked me to stand up, move side to side, raise my arms, reach for my toes, et cetera. 

Near the end he said, "So the right knee isn't so bad."  I wasn't going to let him get away with that!  I immediately said, "The MRI revealed a torn ACL and other damage that requires surgery.  I'd say any damage that requires surgery is very bad.  Just because I can dance around for five minutes after sitting on my butt for a month doesn't mean I can resume normal activities."  And sure enough, I saw the other person in the room writing down everything I just said.

Besides all that of course, I have my own surgeon, and MRIs, and physical therapists who can all attest to the fact that I require more surgery.  So the insurance company can try, but they can't win.

One final bit of good news: I was just approved for an extension of the Short Term Disability benfits I receive from work, to the end of February.  The doctor certified that I need to be out until July, but the benefits folks will only approve short intervals at a time.  In any case, I can relax and recover until at least March at 100% of my normal salary.

How To Prepare Yourself For Having Knee Surgery

You will no doubt receive instructions prior to surgery which include that you can't eat or drink after midnight the day before, but I have a few things to add.

Stock up on Wet Wipes or similar (something antimicrobial) because you won't be able to shower or bath for several days, perhaps even a week, after surgery.  Guys will think this is easy because we go camping for weeks at a time without showering, but trust me this is completely different.  Combat soldiers take wet wipes into the field for when they're stuck in a hole for weeks at a time.  (By the way, they're also a really handy thing to bring on your bike rides--especially on tours where you need to use public restrooms and port-o-potties.  Just bring a travel size pack and stick it in your jersey pocket or pack).

Get a haircut immediately before.  Women I imagine need to add to this list of pre-surgical grooming. You'll be glad you did it.

Load up the fridge and pantry before surgery.  Only my idiomatic experience, but I found that the medicine I was taking (Endocet which contains oxyconton of Rush Limbaugh fame, made from opium) after surgery made everything taste pretty dull, so I wanted strong tasting foods--extra strong coffee, spicy food, pickles, cheese.  Make sure you have Tabasco and mustard.  Next surgery, I'm getting Indian food for sure.

If you don't have a particular chair--like a sofa or recliner--which you can literally be on, with your leg raised, all day, every day, for a week or two, and you can afford it, then this is the time to buy it.  Whenever you're not doing physical therapy, you're going to be in that seat, watching TV, drugged up, falling asleep, eating, et cetera.  You might even sleep there as it may be more confortable than your bed, or you might not even be able to get to your bed in the beginning.

Bring something to entertain yourself while you wait for surgery, such as a book, an iPod with a movie download in it, or a laptop and a DVD.  It could be several boring hours before you're actually heading into surgery.  Don't count on having good wifi or cellular data service; try to have the media in hand.

Wear or bring a big pair of pants--such as sweatpants or warmup pants.  Most likely the dressing and brace will be too big for you to get anything else on.  Even if you brought shorts, you would have to get them on over the dressing and brace first.  I had a dressing, a brace, and refrigerated thingamajigg that keeps my knee cold.  My Carhartts wouldn't fit over it all, so I was glad I brought some semi-stretchy pajama pants as well because otherwise I would have been going home bottomless or in some kind of skirt.

Pig Out the day before: Let me clarify, as I did with a friend who is an anethesiologist: When they say you can't eat or drink anything after midnight the day before, they mean the night before.  They do not mean you have to go an entire day without eating or drinking anything.  So for most people this should be as easy as skipping breakfast.  You will not piss and crap like a dead person on the operating table.  I went to an all-you-can-eat Sunday brunch buffet the day before just after speaking to my doctor friend, and I think I redefined all-you-can-eat.  I also ate normal meals the day before, and snacked on crackers and peanut butter just before midnight.

I was allowed to make phone calls on my cell phone, but out of respect to the other patients I would recommend you don't.

Don't worry about anything.  Trust your surgeon and the nurses.  They know what they're doing--and you don't.  Relax.  Whatever your problems in life are, there's nothing you can do about them right then.  On the other hand, if whining about your problems gives you some kind of relief, go right ahead--just don't transfer your worries to the other patients.

Have someone pick you up afterwards.  I actually think they wouldn't release me if I didn't have my brother come to take me home.  But do your friends and family a favor by not having them come with you before the surgery and waiting for you the whole time.  You're going to be unconscious pretty much the entire time, and when you're not they wont be allowed in the room with you anyway.  Having them waiting is just some sentimental silliness.  It's surgery, not your funeral.

After surgery, that same person who picked you up will need to go get your medicine from the drug store--which you're going to need desperately within the next few hours.  In my case, it had to be a drug store which accepted No Fault insurance, and it was some distance away.  You might want to have a nice thank you gift at the ready for this person.  In my case, I gave my brother a bottle of Hitachino Nest White Ale, which is the best beer in the world in my opinion.

If you don't have someone who is going to be home with you 24/7 after the surgery, think about various services you might need--like having your laundry picked up washed and returned to you, having your groceries delivered, or ideally have all your meals prepared and delivered to you.  Figure you're not going to be able to do anything yourself for at least the first week, and appreciate it when you can.

Overall, it's like preparing for a sporting event--like a bike tour.  You prepare everything you're going to need ahead of time, on the morning of the big event you just arrive and relax until the start, and then you pace yourself through it.  You don't head in unprepared, or psych yourself up for an hour before the event begins only to crash and burn later.  Being a patient is an endurance event.

Deleted by Author

Deleted by Author

It Pays To Be An Insurance Expert: Bicycle Replacement and 'Subrogation'

Six years ago I started a career in Insurance working on large accounts--oil refineries, national governments and their departments of defense.  Though I am an expert on Property and Liability Insurance, I really didn't know anything or had any experience with what we call Personal Lines: car, home, health, life, worker's comp., et cetera.

Until I went to the orthopedist over a week later, after hobbling around work on crutches, the driver's insurance didn't know who I was, but immediately contacted me after that.

As I wrote earlier, I didn't think I was seriously injured.  I just wanted them to pay for my medical care, replace my bicycle, and maybe give me a few thousand dollars for 'pain and suffering.'

Given what I do for a living, I confidently called up the claims adjuster and did a recorded interview.  I was brilliant at this, but I wouldn't recommend anyone do it--in fact, I wouldn't do it again.  The claims adjuster asked me very specific questions meant to throw me off.  She asked how many lanes the crosswalk spanned, how many I crossed before I was hit, what color the car that hit me was, what I was wearing--even asking leading questions like "Were you wearing long pants?" so she could claim I lost control of the bike on my own and simply fell in front of the car.  I didn't give her an inch to stand on.  Still, it was a stupid thing to do.

You have to understand, an insurance company is not your friend--even if you're the insured, even if they seem not too bright, or if they come across as genuinely concerned about your welfare.  Their entire goal is to never have to pay a claim, and if they're going to pay anything at all it's going to be to their paying customer who has been sending them premium for years.  Don't agree with anything, don't sign anything, don't accept any quick offers of compensation.  In other words, I did a very stupid thing by speaking with that claims adjuster, which could have turned out very badly for me.  And this was just the Liability adjuster.  They had one claims representative for each: Liability, Property, Medical, and Auto Physical Damage.  The ones that really pissed me off though were the Property and Auto PD adjusters, and here's why.

The Property claims specialist was insisting that the Auto PD adjuster visit my home and look at the bike to see what the level of damage was.  Again, I do insurance for a living, so I said 'absolutely not.'  My argument was that an over one ton vehicle struck an 18 pound bicycle, which has no protective body around it (except the rider of course).  It's a given that the bike is unsafe to ride and should be replaced.  They weren't going to x-ray it for fractures or check to make sure the frame was still straight--literally just a visual inspection by someone who is not any kind of bicycle expert.  I did invite the adjuster to ride the bike down a mountainside at 50 miles per hour if he felt confident that his visual inspection deemed the bike safe to ride, that it wouldn't simply fall apart beneath him when he hit a bump at high speed, while I followed right behind him in an SUV, but he didn't take me up on it.

So I called State Farm, which is my insurance carrier for Renter's Insurance to ask if the loss of the bicycle was covered, and sure enough it was.  I told State Farm the make, model, year; when I bought it; what the equivilant current model would be that could serve as a replacement and its Manufacturer Suggested Retail Price.  I did not inflate the numbers.  I even provided the specifications of the bicycle that was destroyed and the one I deemed its replacement.

Most importantly, I didn't tell either the driver's insurance company (which asked) or State Farm (which didn't ask) how much I paid for the bike.  How much I paid doesn't matter.  I got a good deal, but let's say for example that it was a gift--would that mean that my loss was $0 ?  Of course not.  I was not going to pay to get hit by a car and have my property destroyed.

State Farm adjusted for depreciation and altogether calculated the loss of my two year old bicycle at just short of $2,000--which is a bit more than I paid for the bike and upgrades I mentioned to them, but only just a bit.  Less the $500 deductible, I received a check for about $1,500.

The way insurance works is my $2,000 loss was then State Farm's $1,500 loss, and they wanted their money back.  Also, I was given the amount of my loss less $500, so I wanted my money back too.  This is where Subrogation comes in.

What Subrogation means is my insurance company has just bought me a new bike and therefore the right to collect from the driver's insurance for that loss is now theirs instead of mine--I can't collect twice for the same loss--not like in the movies where someone's $100,000 house blows up and they get a million because they overinsured (that's just a myth).  The duty of the Insured is to provide any requested evidence for them to recover their loss.

So I went out to the crosswalk where I was hit one week later, at the same time of day, to take pictures and video.  Sure enough, not only did I clearly show the scene, but I easily found several drivers who stopped in or after the crosswalk in the exact same spot I was hit.  Some of the pictures are actually hillarious, but for privacy reasons I will not share them here.

I sent the pictures as well as a satellite image of the location and a detailed description of what happened to State Farm, and in a very short time I received a check for my $500 deductible as well.  Had I not done the work, we wouldn't have seen that money for months, if ever.

If you're thinking why didn't I get my insurer to pay me for the liability portion as well and have them subrogate against the driver's insurance for that, the fact is they simply can't do that.  In Property insurance, it's easy to adjust a claim because there are definite dollar amounts attached to property and repairs, but liability awards to injured parties are indefinite; they could be simply the amount of lost wages, or double the amount of the medical costs for pain and suffering; or they could be enough for you to retire comfortably, buy a house and a car, pay off your student loans, and take a trip to Europe. 

If you want more than the monetary equivilant of a light apology, and particularly if you are really injured, you need a lawyer.  Don't worry about paying for it, as most (perhaps all) lawyers will take your case on a contingency fee basis.  In New York the lawyer gets one third of any money awarded you by law, no more / no less.  And if you think that's a lot, consider the fact that without a lawyer you may only receive a few thousand dollars--if anything--whereas with a lawyer you will likely get at least whatever the Liability limit is on the driver's insurance.  In New York state, the statutory liability limit is $25,000 but many drivers purchase excess limits of $100,000 or $300,000 because it protects them against your lawyer going after their personal assets to make up the difference between their coverage and what a judge has awarded you in court--which, again, could be any amount whatsoever.

This Is Gonna Hurt: My One And Only Collision and the 'Blame It On The Sun' Defense

On October 2, 2010 I headed out on one of my regular rides, which usually last two hours and 30 miles.  I started out from where I live in Astoria, NY and was planning to ride to a favorite bike shop in Great Neck, NY then ride home as I've done literally hundreds of times.

Just a mile or two after starting out, at 4:15pm, in the crosswalk over the service road leading from the Grand Central Parkway up to Astoria Boulevard at 78th Street, after waiting for the light, I crossed two lanes out of three before a car hit me from the left side.

My first reaction was to get up and get out of the street, but when I stood up I felt a strong pain and looked down to see that my left knee was badly bruised, and also saw that my bicycle wheels had twisted and snapped.  So I went from reprimanding the driver to immediately sitting down on the street in front of the car which had just backed off me--behind the line that she should have stopped at apparently in an effort to make it look like it wasn't her fault.  I was determined that this driver wasn't going anywhere until the police arrived.

I called 911.  A witness came over and talked me through the shock--can't thank him enough.  The police came along with an FDNY ambulance.  I told the officer that I had the light and was hit in the crosswalk.  I verified this three or four times.  When the light turned to the walk signal I said, "Just like this.  I was crossing, with the light in my favor as it is now, and the car hit me right here in the crosswalk where I'm sitting."

I was so shaken up that I actually had to call my wife and ask her to verify our home address where we have lived for the past four years, completely forgetting that I ALWAYS carry my Driver's License and health insurance cards on every ride for this specific reason.  All I had to do was hand him my ID, but I was in a kind of stupid shock.

Once I was in the ambulance, I was asked if I have a lock for my bike and nearly didn't go to the hospital for fear of losing the bike.  I told the police officer that I even if I had a lock, my road bike (a Trek Discovery bike) would be gone in five minutes if we left it there.  The police officer--from the 114th Precinct in Queens--volunteered to bring my bike to my home where my wife was waiting, to just leave it behind the house.  In reality, he actually went to the front door and told my wife, who was worried sick, "He's OK."

The police took down the driver's insurance information and statement and assured me that I didn't have to worry about it--and indeed I didn't. 

The driver's story was that she could not see the traffic light because of the glare from the Sun.  I joked, "But she could feel the accelerator."  Obviously nobody bought the 'Blame It On The Sun' defense.

I was taken to the Emergency Room at Elmhurst Hospital, where they x-rayed my knee, said it appeared 'normal' and released me with a pair of crutches.  In my mind, I thought I would recover in a few months and was only concerned about having my bicycle replaced.

I had no idea that this event was about to cause me to possibly lose my job for lack of ability to perform, have multiple surgeries--rebuilding both knees and my ankle--and go through all sorts of red tape to make sure I was compensated at all.