The following images were entered into a photography club contest…

View more of my photos here…

Would you like to learn from someone else’s knee surgery experience? This is a summary of what I learned through my ACL surgery:

• Yoga is an excellent way to build strength and balance prior to surgery- something that I reaped the benefits of post-surgery, because there’s a lot of hobbling around in crutches and balancing on one leg while reaching down and picking up things
• Wait a while before the surgery. It took 6 months for my swelling in my knee to go completely down where I regained most of my motion back and was able to do strength exercises. The surgery is said to be more successful after all the swelling subsides. Just be careful in the mean time to not reinjure yourself, and it will be worth the wait.
• Ice machines are good if you have people around to help maintain it. They run out of ice quite often, every 1-2 hours. So, unless you have people helping you with it, you won’t get much rest constantly getting up to fill the machine with new ice and drain out the old. Crushed ice is worst, regular size ice is mediocre. The longest lasting is homemade ice in 16oz cups- denser- and still fits in container- it may last 3-4 hours each batch. There’s also an electrical shock hazard on the Game Ready ice machine I had. Water from the drainage may leak onto the AC outlet underneath. What were the product designers thinking?
• Try to avoid hopping on one leg with the other one dangling within a week after surgery. I suspect this and other extra movements led to me having some extra pain and internal bleeding- which they had to manually drain with a needle 1.5 weeks post-surgery.
• A wheelchair is not a bad idea, as an alternative to get around in your home.
• For rehab, it’s better to listen to your body (pain level) and let that dictate the speed of recovery rather than follow a physical therapist’s recovery timeframe to a T. It’s ok to take the exercises slow- there’s no rush.
• It’s nice to have a cart on wheels. One that’s not tippy. You can put dinner plates on it, and roll items from the refrigerator to the table, or for moving your heavy ice machine around, etc. Otherwise, it’s a challenge moving objects around the house with crutches.
• Don’t try to touch toes to put on/off socks- I may have pulled my hamstring doing that.
• Don’t pay your bills too soon! Wait until absolutely everything is resolved between your providers and insurance company first. You don’t want to start paying bills you don’t owe. There’s a degree of negotiation between the provider and insurance company and it’s best to postpone paying until everything is settled and knowing that you’re not getting jipped- it puts you in a better position to negotiate in case your insurance didn’t cover something they were supposed to.

Post ACL Surgery Timeframes:

• Same day: went home and used crutches to get around
• 1.5 weeks – stopped using the ice machine full time, much of the swelling gone
• 2.5 weeks – started driving (very carefully) and went completely off pain pills.
• 3 weeks – less dependent on the knee brace- went without it- and start walking.
• 3.5 weeks – able to climb/descent stairs
• 4 weeks – started walking without crutches, able to use stationary bike and do light squats

Insurance companies will harass you and will try to find any loophole possible to not cover your benefits. As tedious as it is, it’s best to speak to the billing department of each of your service providers in advance and get price quotes and take good notes with who you spoke to, dates, billing codes, time spent on each procedure, etc. Then speak to the insurance company and ask them based on this scenario what your coverage will be. They are trained to be extremely vague about everything, so it takes some work. Take detailed notes on everything.

How much does ACL surgery cost?

I got a couple quotes (before insurance coverage) and here’s the range…

Surgeon fee – $1,350 – $2,200
Facility fee – $810 – $9,300 (huge range!)
Anesthesia – $748 – $845
Implant fee – $500

Other fees:
Full knee brace – $490
Ice machine rental (2 weeks) – $300 (not covered by insurance)
Prescription pain medicine – $100
Crutches – $30

Insurance issues

My insurance is supposed to cover 80%, but with the deductible, 20%, and some things not covered, when it’s all done it’s supposed to be $2,000 – $3,000 to me. That’s a little too vague of a price range for my comfort, but that’s part of the billing game.

It’s 5 weeks out and my insurance company is playing the game, saying initially that my benefits are denied, while requesting an ‘incident report’ form to be filled out. Basically, they’re trying every possible scenario to get out of paying, fishing for someone else to be potentially liable for the incident. I think they’ll have to pay though, according to the conditions of the plan.

Provider issues

The providers are also a little tricky in the way they bill. For example, they quoted me only the surgeon’s fee each time I asked about billing with no mention of any other weird fees. But now that it’s over, they decided to bill separately for one of the assistant’s time too. I would have wanted him out of the room if it were up to me- it would have saved $490.

The providers also quoted me one rate and billed another- higher $ of course. They also said the prices will be going up after the new year, which may be reflected in my bill. There’s really no guarantees of anything and the patient is in a very poor position for negotiation.

I hope this information helps someone. I wish I had this kind of info beforehand.

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View the original ACL reconstruction surgery post…
Or, see another semi-gross picture of the knee.
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Most people buy juice from a grocery store from time to time. The actual ingredients of juice, however, may vary from what is advertised on the package. Perhaps this is obvious to some, but to others, they may think they’re buying real juice when they are only buying sugar and water.

While the FDA regulates some aspects of the information presented on the packaging, juice makers still have enough wiggle room to mislead buyers through tricky marketing language.

How do you know if you’re buying real 100% juice?

You have to read the ingredient label on the back and ignore the label on the front. The FDA requires labels that list the ingredients in descending order of predominance according to weight. The heaviest ingredients are first and the lightest are last. Manufacturer’s don’t have to reveal the % of each ingredient in order to protect their trade secrets. Yet, if they claim something is juice, they have to say what % juice it contains. Let’s look at some examples of how buyers can still be mislead…

Safeway apple juice cocktail = not juice
Anything that says ‘cocktail’, ‘blend’, or ‘drink’ is usually code for a mix of cheap ingredients like corn syrup. Companies often substitute the syrup for the real juice, because it’s cheaper to produce.

Mott’s 100% apple juice = real juice
These are 100% apple juice. They’re usually from concentrate and well diluted, but that’s about as close as you can get to pure juice, without buying expensive apple cider. Note that you can’t simply rely on a name brand for real juice. The same brands may offer different product lines- some not containing juice at all.

Snapple = not juice
This Mango Madness Snapple is 95% sugar water and other unnatural ingredients. Only 5% of the drink is the mango juice advertised. The ingredient label reveals what’s really in it: Water, High Fructose Corn Syrup, Kiwi Juice from Concentrate, Citric Acid, Natural Flavors, Mango Puree, Vegetable Juice and Beta Carotene (for Color).

Sunny Delight = not juice
Some people confuse Sunny Delight for orange juice, but it’s not even close. The ingredients reveal that it’s again just sugar water and various unnatural ingredients, which aren’t that healthy. Water, High Fructose Corn Syrup and 2% or Less of each of the Following: Concentrated Juices (Orange, Tangerine, Apple, Lime, Grapefruit), Citric Acid, Ascorbic Acid (Vitamin C), Thiamin Hydrochloride (Vitamin B1), Natural Flavors, Modified Cornstarch, Canola Oil, Sodium Citrate, Cellulose Gum, Xanthan Gum, Sodium Hexametaphosphate, Sodium Benzoate to Protect Flavor, Yellow No. 5, Yellow No. 6. (This was just copied and pasted from a website)

Dole Pineapple, Orange, Banana 100% juice = mostly apple juice
While this is 100% juice, it isn’t the juice the front label suggests. It’s apple juice with some pineapple juice and even less of the other ingredients.

Safeway Pomegranate juice = mostly pineapple juice, apple juice, and water
This is 100% juice, but not the juice you think it is. When you’re spending $5.99 for it at Safeway, you’re probably serious about getting what is advertised. But a look at the ingredient label reveals this is mostly water, pineapple juice, and apple juice- contrary to the front label saying pomegranate juice and showing only pictures of pomegranates. A much lower percentage than the other juices is pomegranate and blueberry. The FDA doesn’t require them to put the exact percentage of the pomegranate and blueberry, but with 3 higher % ingredients, you could assume it’s not very much.

Pomegranate juice = real 100% pomegranate juice
This is actual 100% pomegranate juice. It says it right on the ingredient label. And it’s the same price at the fake pomegranate blend above.

Misleading tactic:
Marketers discovered people become used to looking for the word ‘100%’, as in ‘100% juice’. So guess what? They now put ‘100% vitamin C’ prominently on many labels- perhaps so you think it’s actually 100% juice, when it isn’t. This is common for grape juice, since it’s one of the most expensive juices to produce. So, they cut many corners in not giving you real 100% grape juice but pass it off as real by the ‘100% vitamin C’ tactic. Beware!

To summarize, marketers are crafty with their juice product labels and fancy graphics. The prudent shopper should just ignore the wording and look at the ingredient label for the real story on what the drink contains. If you’re going to shop for fruit juice, you might as well get the real stuff.