Another surgery — while knee-deep in the insurance swamp

A columnist has to have his other knee operated on. What he dreads more than the surgery is the stream of medical mail from a paper-shuffling, profit-driven, CEO-bonus-building system.

Andrew Fabella, are you out there?

Please report to post-op at Keck Hospital of USC early Monday morning.

I'm coming back to have the other knee done.

That's right, folks, I'm kicking off the new year by getting a partial right knee replacement because my medial cartilage is cottage cheese and I'm bone on bone, just like I was on the left knee. I need to be in top shape this year because I've got mayoral candidates to chase and a 9-year-old daughter who's already too much for me to handle on the tennis courts.

Last August, the surgery was a breeze, but I had a little surprise in post-op. A heart arrhythmia was a bigger problem than anyone knew, and my ticker went on strike for half a minute or so. Fabella, a nurse, saw me flat-line and started chest compressions, which brought me out of sudden cardiac arrest.

Some readers have questioned my sanity in going back for more, but I feel pretty good about it. As several doctors have pointed out, my knee problem may have saved my life, revealing a condition for which I now have a pacemaker.

Besides, I've heard from lots of readers who rave about the surgeon we share: Dr. Daniel Oakes. Same with my cardiologist, Dr. Leslie Saxon, who told me she'll drop by post-op to make sure I don't try any new tricks.

What I dread, more than surgery, is having to strap my leg into the continuous passive motion machine for six hours a day when I get home from the hospital. While you're flat on your back staring at the ceiling, the monotonous motion machine bends your leg, it straightens your leg. Bend. Straighten. Bend. Straighten.

Six hours of this.

The police should strap suspects into these things. They'll confess to anything.

The other thing I dread is the stream of medical mail that is guaranteed to land in my mailbox every few days, every last bit of it entirely indecipherable.

BlueCross BlueShield of Illinois keeps sending me things that say, "This is not a bill."

Then don't send it to me.

It's not as if anything in the correspondence makes sense. And then there's always the line that says, "Amount you may owe provider."

If they're not sure, how can I be?

I was notified by the insurance company last time that home physical therapy was not a covered expense. I'm guessing they'd rather have your knee lock up until your leg has to be amputated, ruling out any future billing for osteoarthritis.

I was looking for a number to call, so I could contest the decision, when I discovered on the last page of a six-page waste of paper that I "may be eligible" to receive my "adverse determination" in several languages. According to this document, I could be denied coverage in Spanish, Tagalog, Chinese or Navajo.

Sure, send one of each.

A Keck medical assistant told me to ignore the denial and get the physical therapy while the insurance company bean counters and medical administrators fought it out.

Can't they all just get along?