2009 archive

Doctor Versus Physical Therapist

When my knee MRI back in May showed bursitis and patellafemoral pain syndrome (PFPS), my doctor sent me off to physical therapy. The physical therapist was thorough and wonderful, as she assessed my condition and the contributing factors. She was able to fully understand why my knee hurts — all the components that worked together to cause my injury; my pelvis, my feet, my butt, my leg strength, the way I sit, etc. Based on what she learned, she took me through a series of exercises twice a week to get myself better and pain free.

She had me try out spin; she had me try out running. Then it was time for my follow up visit with my doctor.

Last week, I went to the doctor and he examined my knee. He said he still felt the bursitis and the PFPS and recommended continuing physical therapy. He also recommended that I see a podiatrist and get fitted for an orthotic insert for my shoes. He said this will help with my alignment problems, as my alignment is a major contributor to my knee pain.

I was very worried. Orthotics cost hundreds of dollars! Hundreds of dollars that I don’t have, given the amount of doctor visits, tests, prescriptions, other treatments that I am partially responsible for. And in addition to the $500 a month that I pay to even HAVE medical insurance.

I went to my PT that evening and told her about the conversation with my doctor. As soon as I said the word “orthotic” she immediately began shaking her head.“Bad idea?” I asked. The PT explained that I don’t NEED it. I would if my alignment problems were coming from my feet — but in my case, my alignment is off because of my pelvis. It was clear to her during every assessment and exercise she had me to. She had absolutely no doubt that foot orthotics would not help at all, would be an extreme waste of money, and would likely make my knee problems WORSE. And you remember the letter my PT wrote to my doctor — she obviously understands my condition.

Of course, I was happy. That is what I wanted to hear! But then I started getting annoyed… and then angry at my doctor. Why would he send me off — without checking to see if I NEEDED it — to another doctor for something I don’t need that costs a few hundred dollars!? (I need an interrobang symbol in here) Why not first find out if it would be worth it? It has been suggested to me that since I am not a surgical candidate, I am now a waste of his time and he doesn’t want to be bothered with me, so he was sending me off to someone else. But I think it is less cut and dry than that. I think he was doing what he thought was the next step according to his script. I don’t think he took the time to ask or wonder about the cause of my alignment issues. Not his problem. Furthermore, I went there complaining of shoulder pain much worse than my knee, and he didn’t even examine my shoulder — just wrote another prescription for more physical therapy. I am sure PT will have a much clearer understanding of my shoulder problem, regardless of the MRI, based on her actually… um… examining it.

Uhhhh.

Fight

Round 1: Doctor Versus Physical Therapist
Winner – Physical Therapist

Have I mentioned how frustrated I am that doctor’s don’t CARE?

I am getting an MRI for my shoulder tomorrow and should have answers later this week. I was trying to find out how many PT visits I have left for 2009 and came across some roadblocks (ie, stupid insurance company):

1. Depending on how many visits I have left for 2009, I was not sure if I should go for knee, shoulder or both
2. I couldn’t get a clear answer on how many I have left

I was extremely frustrated by the fact that I didn’t know how many sessions I have left. I have called my insurance numerous times. My PT place has called my insurance numerous times. We were both given completely different answers.

Here is the story. I get 20 physical therapy visits a year with my insurance. I went to PT at the beginning of the year for my shoulder, 6 times. I went to PT for my knee 12 times. That would leave me with 2 visits left — not enough to do shoulder again, just enough to wrap up knee. Sounds simple, right?

When I called my insurance to confirm, they told me that a bunch of my PT visits were charged as Occupational Therapy (OT). I get a separate 20 OT visits in addition to my 20 PT visits. Because of that, I have more PT visits left than I realized.

I called my PT place to tell them this. They called my insurance. Three times — and were told that it is all combined, I definitely only have 20 visits total a year. I called my insurance three times as well. The first two times I was given incorrect and OT-ridden information. The final time I finally got my answers.

Whoever pulled that OT information was wrong. Each PT is billed by name. Their name is associated with what they do. The charges can’t be split between two services if the therapist is certified to do only one of those services. I called the billing department of both PT offices and was told an OT bill was impossible.

After extensively going over every single date with a very nice woman on the phone on my third phone call, I  finally received my answer — I have 2 visits left. I had asked her to go over every PT visit I had this year. She did so and never once mentioned anything about OT. I trust her. Why everyone that works at the insurance company has different answers to the same questions is beyond me. I don’t understand anything about health care in this country; every time I think something can’t confound me more, it does. Like the time I had to pay $320 for a prescription. When I already pay $500/mo for health insurance. Anyway…

As we went through each date, it was finally clear that I went to PT 18 times this year (although we hung up thinking 17 — when I go through my notes it seems to be 18. I will stick with that). Therefore, I have two visits left. My plan for the next two visits (not yet discussed with my PT) is as follows:

This week – No visit (wait until shoulder MRI  results arrive)
Next week – Contingent upon shoulder MRI results, either — one hour evaluation of shoulder or regular knee PT
Following week – Contingent upon shoulder MRI results, either shoulder PT session to learn exercises for home or regular knee PT

I think that is a good plan! Let’s all hope I don’t get into some kind of accident and need serious PT this year because, well, I’m out of visits! And the year is not even halfway over.

As for my doctor? I haven’t told him I barely have any visits left. I’m not sure what he will advise going forward to get better, but I will be going there in a couple weeks and I will take it from there. Hopefully he won’t send me off to another expensive service that I don’t need. At least this time, I have a great PT I can ask — one who knows what she is doing and cares about my health. Which is more than I can say for my doctor.

I Probably Think This Song is About Me

Note: I originally titled this post Doctor Versus Physical Therapist. I decided to write about my hair first and then on to my next topic. I didn’t want to do another post solely about my hair — how vain! But life got in the way, and I became very busy. And then the hair entry wound up being super long. So vain I will be, and the medical post will wait until next week (and I’ve got lots to say about it!).

As you know, I went to Devachan on Wednesday evening to get a much needed haircut my a curly hair expert. I was also there to learn how to style my curls so they actually look good and to get advice on the transition of curl on top, straight on bottom. When I accompanied the boy there a couple weeks ago, I felt like I was drafted into an elite club but was missing the main requirement to join. I decided I wanted to join.

The first time you walk in to Devachan, the decor is overwhelming — in a positive way. The colors are a green that is a little darker than lime colored and white. There is a really cool display with little round convex windows. In each little window is a real lock of curl! The setup and design is unlike anything I have ever seen, and it is a lot to take in, but it is gorgeous. This was my second time there, so I had already taken this all in.

This is the shade of green:

DevaCurl

I went to the coat check to trade in my coat (yes, coat in the middle of June. I don’t hear Fox News making fun of global warming anymore! Interesting) and traded it for a golden robe. I was taken right away even though I was early, and met the stylist’s assistant. He brought me over to my chair while offering me a drink. I accepted a strawberry kiwi iced tea that I had read a lot about, and now I understand why. This was hands down the most delicious iced tea ever. I want to buy gallons of it! I drank so many cups down so quickly, it was just that great.

I met my stylist, Robert, and explained my situation. And then I reached into my bag and pulled out…. my POSTER. I brought my before and after poster with me to the salon. Robert looked at it and said “WOW.” He explained the reasons my hair looked so…. uhhh… the way it looked, which I will get into. Then we discussed my current situation. “This part will be straight, there is nothing we can do. It just needs to grow out. Unless you want to cut it all off.” Obviously I don’t want that! He explained that it would take about a year and a half to two years to grow out my curls all the way, but advised me on how to speed up the process.

First things first, I needed a good cut. The ends were broken and split. And when I say ends, I mean last 3 inches. Robert told me that if we cut a lot, it would grow faster as all the damaged parts would be removed. He held up a chunk and said, “Can I cut this much?” I LOVE that he asked that — he was really listening to what I wanted and not just doing what he thought was best. That said, I gave him the OK to do anything he thinks is best. I read the reviews and I went into the situation trusting this man with my hair as much as the person I’ve been going to my entire life.

He started snipping away — with my hair dry, I might add. Devachan cuts hair dry. It is part of their curl philosophy, to cut the hair dry and to cut each curl individually. The reason is simple — your wear your hair dry, so wouldn’t you want to cut it how it will look? Additionally, each curl has a different bounce and spring. You want to make sure you don’t cut too much! Robert explained that he was giving me some angles in front and long layers in back. When the cut was over the assistant took me to my bed. That is right, my bed, complete with mosquito netting. For all the wildlife thriving within the confines of the Soho salon:

Devachan Bed

So comfy! The beds are curved in a way that conforms to your body. I relaxed while he massaged No Poo into my scalp, and then One Conditioner. He left the One in on the ends. When the cleaning was finished, he escorted me to a chair and had me bend forward, hair hanging down. He used a microfiber towel to gently scrunch all the excess moisture from the washing so it wouldn’t drip and then he squeezed some ArcAngell into his hands and scrunched that in. When this was over I sat down in the chair and Robert came back to put these little clips on top. I need to buy these! They give the top of the hair some body so the curls aren’t flat on top and sticking out on the sides. Brilliant!

I sat under a dryer and read Curly Girl. Robert came and checked on me and then moved the dryer to the ends and I read some more. And drank a few more glasses of the crack iced tea. Robert came back and began pulling the clips out. He said that was the hardest part. Then he touched my hair a little, used a claw shaped diffuser to dry the sides, told the assistant that my hair is beautiful, cut a little more, had me stand up and he cut a bit more to finish it up. And then…. I looked in the mirror.

Devachan Claw Diffuser

OMG.

I couldn’t believe this was my hair, these curls were MY curls. They looked amazing! Defined and sexy and just… perfect! Robert was right — my hair IS beautiful! I couldn’t stop smiling. I just couldn’t stop. I was practically jumping. Robert could tell how thrilled I was, and so could the coat check girl and the girl at the front desk, where I kept raving! I bought the Curly Girl book and read it all! I learned so much about why curly hair is the way it is and how to style it and what NOT to do — shampoo, wring out moisture, use terrycloth towel, blow dry — ALL big NO NOs! I strongly recommend this book to anyone with curls. And I highly recommend Devachan, at least certain stylists.

Curly Girl

And he cut it in such a way that it isn’t as blatantly obvious that the bottom is straight — the long layers give it a little wave and help it blend better! Although it will remain straight until it grows, it doesn’t look ridiculous like it used to. When they say curly hair expert, they aren’t joking! And that is, after all, the reason I went to Devachan for my cut — to learn how to help my hair textures blend better.

It was hard to get pictures that really show how it looks, but I did my best. Here are some:

Day of haircut:

  hair 009   hair 013 hair 007

Day after sleeping on haircut:

   hair 022   hair 026

And there you have it. This morning I showered and made my first attempt to style my hair a la Devachan. I did have some issues with hair dripping. I guess I didn’t tshirt scrunch enough. I was also very concerned that I wouldn’t use enough gel and show up to Missy’s birthday dinner tonight with a fro. So I went overboard in the other direction. I over did it with the gel and the front is too crunch and has the “wet” look. The back came out great though! It is a trial and error process with a real learning curve, and I am sure I will soon know the exact amounts of product to use to have gorgeous curls! It might never look the way it looked when Robert did it, but I am curious to find out how my hair will look throughout this process. And if I hate it? I can always get it straightened again.

As for the Keratin treatment I said I would be getting? Not happening. I mentioned it to Robert and he advised me not to do it. For one, it is a heat treatment and heat will damage my hair. He also said that it doesn’t always “fade” the way they say after a few months — it could take much longer and it could actually grow out like the Japanese treatment, from the top down, rather than fade. And it could change the shape of my curl for good. I trust his opinion. After all, he was trained in the art of the curl!

The Curly Girl book, I have to say, makes me want to never straighten again. There is even a 12 step program detailed where I swear off straightening! The book inspires curly girls to embrace their curls, to learn to love them.

Which brings me to another point. When I have children, they are likely going to have curly hair. If I can’t love my hair, how will I  teach my kids to be confidant and love their own? Curly Girl has a bunc hof anecdotes, with a few about how little girls only 5 years old “hate” their curls and want to have their hair blown out. What is a 5 year old doing hating herself? Much like how Angela heard an 8 year old refusing to eat a granola bar with 5 grams of fat — even knowing what 5 grams of fat IS and to even LOOK for it. She opted to eat nothing instead. The last thing children need it so pick up on our insecurities and want to change the same things about themselves. Not that I am committing to curls forever, but this is a  good time to find out if being a curly girl is something I can love!

I sometimes get annoyed when people assume my hair is stick straight — even though that is precisely what I have been going for! I get particularly perturbed when I tell people how curly and big my hair is and they don’t believe me. WHY would I lie about that? That doesn’t sound fun.

Everyone always says, “Oh I’m sure it’s just a little wave” or “Your hair can’t be THAT bad. You’re exaggerating!” or “Your hair is definitely not that curly” and so on and so forth. And then I feel a strong need to defend myself. I send them the before and after picture. And then they admit defeat. Always. And then I feel triumphant. But why? Why is it so important to me for people to know what my real hair is like? Maybe because we (my hair and I) want to set it free! And that is what I am going to work on now. The way Heather has 30 day challenges, consider this my 2 year challenge. The curly hair challenge. Anyone with chemically straightened hair wanna join???

One of the biggest reason I am proud of my (hidden) curls is because I inherited them from my dad. He had extremely curly, coarse hair that at one point when he was younger was the ultimate jewfro (see photo). He died when I was five, and our hair is the one feature we truly share!

Daddy 003

 

I’d love to one day meet new people and for them to just KNOW me as having curly hair, and not knowing me as anything else. Also, somewhat wild hair can be sexy! To get to that point, let’s examine why my curls looked so bad before and what I can do to make them grow faster and healthier now.

Why did my hair look so awful when it used to be curly?
– Shampoo
– I was using it.  Harsh cleansers strip the hair of moisture and leave it dry and frizzy.
Cheap hair products – The woman I’ve gone to my entire life always explained that the ingredients in cheap conditioners are different from those in good ones. I never learned how to read the label myself though. And I like to save money. Unfortunately for me, those products sucked the moisture and vitality from my hair, leaving me with frizz and… more frizz.
Direct Heat– I was blow drying and ironing my hair ALL the time. The curly hair occassion was a rare one.
Towel Drying – Terrycloth towels dry out the hair, as does wringing the hair.
Touching It – Once curly hair is styled, hands should be kept OFF as touching it creates the frizz. And one should swiftly duck when someone else reaches out to touch. Everyone wants to touch the curl. In just the last few days, I have come across this a few times already.

 c1    c2    c3

How do I get my hair to grow long quickly?
No direct heat — no hair irons, no blow dryers (except in winter and using their claw diffuser on a low setting)
Regular tims — Robert told me to come back in 4 months. And I will.
- Hydrate for health — Lots of conditioner and hydration. Thirsty, dry hair will become brittle and broken.

And that is that. I promise to stop writing about my hair and start writing about the important things once again — food, doctors, books and the stupidity of the human race.

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