Latest / The ACL Athlete Podcast / 219 | I'm Having Surgery: Pulling Back the Curtain - Part 2

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219 | I'm Having Surgery: Pulling Back the Curtain - Part 2 · The ACL Athlete Podcast

• 0:18
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:22
  SPEAKER_00: This is the podcast where we talk about everything related to the ACL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:31
  SPEAKER_00: I'm your host, Dr.
• 0:32
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:36
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:43
  SPEAKER_00: The goal of this podcast is to equip you, the athlete, with the education to make the best informed decision about your care and your ACL journey.
• 0:54
  SPEAKER_00: Thanks for joining.
• 0:55
  SPEAKER_00: Now let's dive into today's episode.
• 1:00
  SPEAKER_00: What is up, team, and welcome back to another episode on the ACL Athlete Podcast.
• 1:06
  SPEAKER_00: So today we are continuing this series regarding me having surgery.
• 1:13
  SPEAKER_00: The title is I'm having surgery, pulling back the curtain.
• 1:17
  SPEAKER_00: Today is part two of this series.
• 1:20
  SPEAKER_00: And yeah, we're just gonna get into it.
• 1:23
  SPEAKER_00: So with part one, it talked about the journey leading up to knowing I needed this new procedure hip resurfacing.
• 1:33
  SPEAKER_00: And so go back and listen to that episode if you haven't yet, because it'll really help tee up this particular episode so you can understand some context and some background.
• 1:44
  SPEAKER_00: So do that before you listen to this part two episode, which hopefully helps to send a very clear message of my experience and as well as just some transparency, to be honest, throughout this process.
• 2:00
  SPEAKER_00: And it's unique because I am a healthcare professional.
• 2:04
  SPEAKER_00: I have had quite a number of injuries.
• 2:06
  SPEAKER_00: I've had two ACL surgeries.
• 2:08
  SPEAKER_00: Um, I've gone through this process and understand it enough, right?
• 2:13
  SPEAKER_00: But with healthcare and with medicine, it's just complicated.
• 2:16
  SPEAKER_00: And the more and more time goes on, the more complicated it gets.
• 2:20
  SPEAKER_00: I feel like it was just much simpler back in the day, whenever a deductible was like actually$100 or$200, and insurance actually covered what it needed to cover.
• 2:32
  SPEAKER_00: But especially with the progression of technology and with just different healthcare systems and whatnot, it makes it a little muddy.
• 2:42
  SPEAKER_00: And so, what I want to do today is just kind of pull back the curtain as I shared and just be super transparent about what I have gone through and especially giving you guys the full step-by-step of getting to this point.
• 2:57
  SPEAKER_00: And so uh to recap just a little bit, this has been a 12-year process in the making, essentially.
• 3:05
  SPEAKER_00: So I was feeling super limited, especially by my left hip for years and years, and it was getting worse the past two years, especially.
• 3:13
  SPEAKER_00: I met with a surgeon here in Atlanta last year, so it was the summer of 2024, to discuss my hip.
• 3:20
  SPEAKER_00: He told me I was no longer a candidate for a hip arthroscopy, which is a scope procedure.
• 3:26
  SPEAKER_00: So they do a hip arthroscopy, and they go in and they repair the tears and reshape the bone, which is kind of the issue that I have.
• 3:33
  SPEAKER_00: It's femoral acetabular impingement, which was something that has progressed into osteoarthritis as well, a moderate version of it.
• 3:42
  SPEAKER_00: So it's just something that's honestly very rare for someone my age, being 33.
• 3:48
  SPEAKER_00: And so I thought I was gonna go into this consult with the imaging, and I was gonna be able to do this hip arthroscopy procedure, but turns out that wasn't the option.
• 4:00
  SPEAKER_00: And that was actually eliminated, or at least this surgeon said, Hey, like this is not gonna be a good option, especially for your left hip.
• 4:08
  SPEAKER_00: So what he proposed was a hip resurfacing for my left hip, which is a metal cap on my femur.
• 4:17
  SPEAKER_00: Think about your ball and socket in your hip, the metal cap on there, and then a metal socket for my pelvis.
• 4:25
  SPEAKER_00: So essentially that creates that ball and socket, which a with a metal component.
• 4:28
  SPEAKER_00: A little different than a hip replacement.
• 4:32
  SPEAKER_00: Main thing is where they cut off the femoral head and neck, and they actually drill a hole into your femur, your long thigh bone, and they insert a big metal component that is anchored into that joint.
• 4:46
  SPEAKER_00: Instead, what they do is they just shave off a little bit of my femoral head, and then they drill a small hole in there, and then they plug in a metal cap, kind of like a metal cap for a tooth, if you can kind of think of it that way.
• 4:59
  SPEAKER_00: And so that would replace essentially my hip socket and my hip joint.
• 5:04
  SPEAKER_00: And so this surgeon doesn't do that procedure.
• 5:07
  SPEAKER_00: He was like, Let me refer you to somebody who knows about this for the procedure.
• 5:13
  SPEAKER_00: So then I was in the whole processing the next steps mindset.
• 5:17
  SPEAKER_00: And so this leads into this next episode, really, to kind of give you the background of that.
• 5:25
  SPEAKER_00: And so at this point, I was really in shock.
• 5:29
  SPEAKER_00: I actually first ignored doing anything about it.
• 5:33
  SPEAKER_00: Um I was just processing, especially because I'm so young and realizing this type of procedure doesn't usually happen to someone like me.
• 5:40
  SPEAKER_00: I am in a very, very small percentage of people where this has happened to.
• 5:44
  SPEAKER_00: I mean, how many 33-year-olds males that you know are someone who's getting some sort of hip, you know, kind of replacement done, essentially.
• 5:53
  SPEAKER_00: And so this is something that even people in my community, physical therapists, friends, they're not familiar with this because it's just such a rare situation.
• 6:03
  SPEAKER_00: But it's just something I've been dealing with, and so that was something that I was just kind of processing through after getting that information during the summer of last year.
• 6:13
  SPEAKER_00: And then I started to realize how much my hip function had actually declined in the past one to two years, and especially now having a kid.
• 6:22
  SPEAKER_00: And it's just interesting because I always tell people, especially in the past, you know, one to two years, I personally feel like I'm probably operating at like maybe 20% of my capacity as a human to be able to be physically active.
• 6:37
  SPEAKER_00: Like I can go and play some sports here and there, but I kind of pay for it, and I'm almost a little bit careful with the way that I move.
• 6:44
  SPEAKER_00: It's not even anything to do with the ACLs, it's more so just my hip.
• 6:48
  SPEAKER_00: And the other thing is just weight lifting, which I love to do.
• 6:52
  SPEAKER_00: I love to lift weights.
• 6:53
  SPEAKER_00: It's my background, I love to push myself.
• 6:56
  SPEAKER_00: And the thing is, is that I've just been so limited in being able to lift weights, so I have to stick to literally machines most recently and reduce ranges of motion, you know, manipulating angles and my feet.
• 7:10
  SPEAKER_00: Like I know all the stuff to do with this stuff, and so I just work within those limits.
• 7:14
  SPEAKER_00: I can't even sit on an upright stationary bike without my hip doing some wonky stuff.
• 7:19
  SPEAKER_00: So I have to like flare my feet out and my knees out, and it just doesn't even, I'm not able to even like cycle normally to sit on a normal bike.
• 7:27
  SPEAKER_00: So I just started realizing how much I was limited in what I do and how much it influences my sedentariness, if you will.
• 7:36
  SPEAKER_00: Like I'm I like to be active, I like to move, but I don't want to get into this hip pain cycle, so I almost avoid doing things and being on my feet as much and being active because I know I'll pay for it.
• 7:47
  SPEAKER_00: So then I started to really think about this, and I'm like, this has kind of gone not in the right direction for a long time without me really noticing it.
• 7:56
  SPEAKER_00: Now, having a business, also having a one-year-old, you know, that layers into that uh with being busy and not prioritizing yourself all the time.
• 8:07
  SPEAKER_00: And so it's just had its challenges over the years, but I know that I've kind of let myself really take a backseat with especially the physical activity side of things, and it's something that I love.
• 8:19
  SPEAKER_00: Um, and so this is something that I started to truly reflect on.
• 8:24
  SPEAKER_00: Um, I think I was just in this kind of denial period for a period of time.
• 8:28
  SPEAKER_00: And so then eventually I came around to just kind of thinking about this a little bit more and processing it, and you know, in terms of the like being able to do things that I want to be able to do and be a strong dad, right?
• 8:47
  SPEAKER_00: Like I wanted to show my son that I'm strong, I can move, I can be athletic, um, I want to be able to lift, I want to be able to move and live for a long time.
• 8:56
  SPEAKER_00: Being strong and being active is such a huge predictor of you know, being able to live longer and getting the most out of the years as you live your life.
• 9:07
  SPEAKER_00: And so that's something that's important to me, but especially just having my kid now, Asher, like there's just something about it that puts an extra fuel to the fire, if you will, because I want to make sure I am physically there for him, being able to play, run, you know, kick the soccer ball, be able to coach his teams, be able to sprint and throw the football, jump, work out, him watching me work out.
• 9:30
  SPEAKER_00: There are just so many things that I know as a dad I want to show an example of for my son and hopefully future kids that this is something that is so important to me as a core and a human being, right?
• 9:43
  SPEAKER_00: And so I started to just kind of think about my why.
• 9:46
  SPEAKER_00: Like, why did I really want to do this?
• 9:48
  SPEAKER_00: And so then that got me into the place where I was like, all right, let's do the thing.
• 9:54
  SPEAKER_00: So I started down the rabbit hole of research, and I want to talk you guys through how I specifically did it because I know a lot of people listening are exploring their own ACL process after they've injured it, or for the surgical process and the recovery overall.
• 10:12
  SPEAKER_00: So I'm gonna share with you step by step what I did.
• 10:15
  SPEAKER_00: So here's how I went that route.
• 10:18
  SPEAKER_00: So the first thing I wanted to do was make sure that this was the correct route for me.
• 12:29
  SPEAKER_00: That I didn't have other options that existed.
• 12:31
  SPEAKER_00: Was hip resurfacing really the only option?
• 12:34
  SPEAKER_00: Because, you know, in this space, there can be different opinions, right?
• 12:39
  SPEAKER_00: And so I connected with multiple other providers, people who are world-renowned professionals in this space, to see what their take was on this specifically, because I was still in denial, but I was also like, okay, let's see if there are some people who are like, okay, I can do this, right?
• 12:58
  SPEAKER_00: And so I had five different consultations with multiple providers.
• 13:02
  SPEAKER_00: Three of them were hip expert physical therapists, one of those being a world-renowned researcher for FAI and hip arthry.
• 13:11
  SPEAKER_00: And we talked through all of the details, not only my left hip, but my right hip, because that one also has some problems.
• 13:19
  SPEAKER_00: And so we talked through the different options.
• 13:22
  SPEAKER_00: And then I also connected with two different hip arthroscopy surgeons who are also world renowned, especially here in the US.
• 13:29
  SPEAKER_00: They're really good surgeons, really good reputations, um, got some good referrals, word of mouth, and did some research on them.
• 13:37
  SPEAKER_00: And so I'm sharing this because I want the absolute best information to see what my true options were.
• 13:43
  SPEAKER_00: While I trusted the initial surgeon I went to last year, I always believe in multiple opinions for any surgery, especially for complex cases.
• 13:52
  SPEAKER_00: Even for ACL, y'all, I tell y'all all the time like, don't just go to one person, go to two or three people, get some different opinions because bedside manner could be different, their approach can be different.
• 14:04
  SPEAKER_00: Just because they walk into the room confident and tell you this is what happened and this is what you need doesn't mean that they have the answer.
• 14:11
  SPEAKER_00: I promise you that.
• 14:13
  SPEAKER_00: Because in the especially orthopedic surgeon community, how many timid orthopedic surgeons have you guys met?
• 14:21
  SPEAKER_00: I've got zero.
• 14:22
  SPEAKER_00: I've got zero on my list, and I've met a lot of them.
• 14:24
  SPEAKER_00: And so, with that said, we need to make sure we do our due diligence.
• 14:28
  SPEAKER_00: And so that's where multiple opinions are so, so helpful.
• 14:33
  SPEAKER_00: So I went into this and I wanted to make sure that I just had the information that I was gaining in order to make sure I can make the best informed decision for myself.
• 14:46
  SPEAKER_00: And so the three hip PT experts and researcher all concluded that the hip didn't look great, and I'd be looking at hip resurfacing as my best option.
• 14:55
  SPEAKER_00: If I tried hip arthroscopy, I'd probably be really unhappy based on what the longitudinal data of the research looks like, as well as what people's recoveries are with osteoarthritis.
• 15:06
  SPEAKER_00: They said a hip resurfacing, given my age and activity level, would probably be the best option.
• 15:12
  SPEAKER_00: And then I met with the surgeons, um, and then they said they wouldn't operate on my hip.
• 15:17
  SPEAKER_00: They were like, if you came to me, I'd say you need a hip resurfacing.
• 15:20
  SPEAKER_00: It was due to a number of factors, but mostly the osteoarthritis played a big role in my hips and said, let's do hip resurfacing.
• 15:29
  SPEAKER_00: And so they were like, hey, I could refer you to X, Y, and Z.
• 15:33
  SPEAKER_00: And so that plus the three hip PT experts, plus my local surgeon that I went to initially, it made it pretty clear the decision that hip arthroscopy was eliminated.
• 15:47
  SPEAKER_00: And so I either, option one, don't do anything, or maybe I can get injections periodically, but that doesn't resolve really the limits of my range of motion, which is the biggest problem.
• 16:00
  SPEAKER_00: Um, and also as this gets further and further along, there's something that I'm probably gonna need to do about it.
• 16:05
  SPEAKER_00: Either that or just don't do as much activity to not flare it up.
• 16:09
  SPEAKER_00: Number two, get a hip resurfacing.
• 16:11
  SPEAKER_00: Number three, get a hip replacement.
• 16:13
  SPEAKER_00: I did not want to do anything, right?
• 16:16
  SPEAKER_00: That wasn't a solution for me because I've been doing that for quite some time, basically 12 years, and didn't want a hip replacement when there seems to be a better option with hip resurfacing.
• 16:28
  SPEAKER_00: So I felt settled in knowing I needed to explore the hip resurfacing option next.
• 16:33
  SPEAKER_00: I honestly didn't know a ton about hip resurfacing until it was brought to my attention because it is not done nearly as much as like an ACL reconstruction, knee replacement, or hip replacement, because it's this unique group of people who are between typically the ages of 30 to 60-ish.
• 16:54
  SPEAKER_00: Now, there's obviously like buffer room on the outsides of that, but it's between 30 to 60 are probably the most common capturing groups, and it's people with hip arthritis that has progressed.
• 17:08
  SPEAKER_00: Um, usually they might have had some FAI or femoral acetabular impingement that progressed into our osteoarthritis, which is who I am.
• 17:17
  SPEAKER_00: Maybe they had labral tears that had reconstructions that failed.
• 17:20
  SPEAKER_00: Maybe they had hip dysplasia.
• 17:23
  SPEAKER_00: There are a number of factors that play into it.
• 17:25
  SPEAKER_00: Some people are just more prone to an osteoarthritis tendency.
• 17:29
  SPEAKER_00: Um, and usually there's something pre-existing that exposes them to this.
• 17:34
  SPEAKER_00: And so it's a small group, though.
• 17:37
  SPEAKER_00: You know, not a lot of people are dealing with osteoarthritis, especially in the ages of 30 or 40 yet.
• 17:43
  SPEAKER_00: If it is, it's very minimal, um, not to the level of being moderate.
• 17:48
  SPEAKER_00: And I know you guys are here for ACL, but I promise there's gonna be some parallels here.
• 17:52
  SPEAKER_00: So, given that I didn't know a lot about this procedure and a hip resurfacing, I educated myself about the procedure.
• 18:00
  SPEAKER_00: What is the purpose of the procedure?
• 18:02
  SPEAKER_00: What are the indications?
• 18:04
  SPEAKER_00: What implants and material is used, what are the outcomes, what's the step-by-step surgery, what's the recovery like?
• 18:12
  SPEAKER_00: Once I got familiar with this, I researched the best hip resurfacing docs.
• 18:17
  SPEAKER_00: And before I go any further, one of the things I've actually utilized a lot is yes, I've used my network of people that I know and reach out to, these people that I had consults with.
• 18:29
  SPEAKER_00: Um, of course, I did some Googling, but then I also used AI a lot.
• 18:35
  SPEAKER_00: I use ChatGPT, Perplexity, like I use these very, very solid, research-based, kind of deep research search functions, and I was able to get such deep dives, and of course, like cross-referencing whatever the references were to make sure there was no biases associated with what I was asking.
• 18:53
  SPEAKER_00: But man, it was so helpful.
• 18:55
  SPEAKER_00: If I'm being honest, perplexity is really, really awesome because you're able to type in the question, it has leading other questions with it.
• 19:03
  SPEAKER_00: Um, chat GPT was also great, but I feel like deep research for perplex for perplex, deep research for perplexity.
• 19:12
  SPEAKER_00: Um, it's super helpful.
• 19:14
  SPEAKER_00: So if you guys are looking for deep dives on stuff like this, it could be helpful to just give you just some cliff notes and you can ask it to you know dumb it down for you or get more detail about this, ask a follow-up question.
• 19:27
  SPEAKER_00: And guys, it's it we need to embrace the technology, and it's super helpful because even for me, like knowing this world and knowing a lot about it, it was still so informative for me because that thing is so smart, and then you can just kind of cross-reference some of that information across other information, things that you gather from other education resources and make yourself really well informed.
• 19:51
  SPEAKER_00: And that was my goal here is how can I make a very well-informed decision about my care?
• 19:57
  SPEAKER_00: And so I started with the education piece and started to figure out okay, what can I do with all this?
• 20:03
  SPEAKER_00: So that's how I started with that, and then started researching the best hip resurfacing docs to do this procedure.
• 20:11
  SPEAKER_00: And researching these hip resurfacing docs was interesting, and it's a very big difference in ACL reconstruction versus hip resurfacing, if I'm being honest here.
• 20:24
  SPEAKER_00: With ACL, there's tons of surgeons who do this, and you'll find any big metro city, there's gonna be a go-to surgeon or multiple ones who do them.
• 20:36
  SPEAKER_00: Uh here in Atlanta, I can name five, six of them who do ACLs all the time and different outcomes, different graph types, different ways of going about it.
• 20:48
  SPEAKER_00: But the thing is, there's a ton here in Atlanta who do it, and so any major city, because we've had people all over the world, all over the US, like there are surgeons that are doing these things, and I'm talking about they're doing at least five to ten ACLs a week, um, for example, which is a pretty decent number here.
• 21:09
  SPEAKER_00: And then, of course, there are surgeons who do five to ten ACLs a year.
• 21:14
  SPEAKER_00: Don't pick those.
• 21:15
  SPEAKER_00: That's not enough experience for a procedure that is going to change the actual anatomy of your body.
• 21:20
  SPEAKER_00: So I don't care if it's in your network, I don't care if it is just convenient because it's five minutes down the road.
• 21:28
  SPEAKER_00: Find the best person that you know you drive with that listens to you and that has the volume because that's going to be super important.
• 21:39
  SPEAKER_00: And if you can make sure to ask them the questions, we have an eight-question PDF that you can download at our resources section on the website.
• 21:48
  SPEAKER_00: I have a podcast I've done about asking surgeons, you know, your top questions, just to make sure you vet them.
• 21:54
  SPEAKER_00: And that way you also know how many are they doing a week.
• 21:57
  SPEAKER_00: So I went through this process with these surgeons.
• 22:02
  SPEAKER_00: But the thing that's interesting about the hip resurfacings that I mentioned, there's not just a ton of those in every city.
• 22:08
  SPEAKER_00: So even here in Atlanta, yes, there's hip resurfacing surgeons or hip surgeons, but they might do a ton of total hips and then they might do just five to ten hip resurfacings a year.
• 22:20
  SPEAKER_00: Guess what?
• 22:21
  SPEAKER_00: Not gonna happen for me.
• 22:22
  SPEAKER_00: I promise you that, especially for someone who's gonna be putting metal into my hip.
• 22:26
  SPEAKER_00: This is gonna be someone that I'm gonna really trust.
• 22:29
  SPEAKER_00: They have the numbers and they have the outcomes that I'm looking for.
• 22:34
  SPEAKER_00: So I'm looking for that equivalent of five to ten a week, at least for me, for example, with solid results.
• 22:40
  SPEAKER_00: So this is where I started digging in deeper.
• 22:43
  SPEAKER_00: Guess what, y'all?
• 22:45
  SPEAKER_00: I joined a Facebook group.
• 22:47
  SPEAKER_00: I know, I know.
• 22:48
  SPEAKER_00: I give you guys some grief on this sometimes.
• 22:51
  SPEAKER_00: Um, but look, I get it.
• 22:53
  SPEAKER_00: It's a double-edged sword, and you're trying to get information.
• 22:56
  SPEAKER_00: And I know that Facebook groups and Reddit, especially, are places that people go.
• 23:02
  SPEAKER_00: We've had people we work with who have come straight to us from those places, and I get why, right?
• 23:08
  SPEAKER_00: And I knew this even before I was exploring these procedures.
• 23:12
  SPEAKER_00: You know, I've been in these groups and I get tagged and stuff, and I get why, man.
• 23:17
  SPEAKER_00: Like people are wanting to understand what other people's experiences are, have comparisons, feel normal, and just be able to kind of consolidate information, right?
• 23:26
  SPEAKER_00: The thing that's challenging is that a lot of times it's people with not a lot of experience who are sharing their this is the best, this is the go-to, this is the best craft, this is the you know, place to go to.
• 23:42
  SPEAKER_00: And it's great, but it's an typically it's an n equals one, right?
• 23:46
  SPEAKER_00: And at the end of the day, we don't make decisions on n equals one, we make decisions on n equals 1000, 2000, 3,000, 5,000, 10,000.
• 23:55
  SPEAKER_00: And that's where research and data is so helpful.
• 23:58
  SPEAKER_00: We're not gonna make decisions off of just one person's anecdotal experience because.
• 24:04
  SPEAKER_00: They could have a great experience, and then there could be tons of other people who have terrible experiences, but you're only seeing the one person's good experience, right?
• 24:12
  SPEAKER_00: So that's where we have to be careful.
• 24:14
  SPEAKER_00: And I get though that people want other people's take on things.
• 24:21
  SPEAKER_00: And it was helpful for me to go through this process very freshly of seeing people who are talking about this hip resurfacing and their experiences.
• 24:31
  SPEAKER_00: And, you know, it's a very active group.
• 24:33
  SPEAKER_00: They're talking about how they're doing, you know, five days post op, what kind of implant they got, who is their surgeon, right?
• 24:40
  SPEAKER_00: And I read through a lot and talked to different people and their experiences with different surgeons and different implants.
• 24:47
  SPEAKER_00: And so it's just interesting that, yeah, I went the Facebook route just to get some information from an anecdote experience, right?
• 24:56
  SPEAKER_00: And so I think this is not something necessarily bad.
• 25:00
  SPEAKER_00: I think that we just have to filter this very carefully, especially because I know I'm coming from a place being a medical provider, being familiar in this space, so I can filter things a little differently of what people are saying and experiencing versus being the end all be all, right?
• 25:18
  SPEAKER_00: And so I think that's just really, really important to make sure I share here with this information.
• 25:24
  SPEAKER_00: But I know that it can be helpful.
• 25:26
  SPEAKER_00: It also creates a community, which is super helpful, and I'm all for it as long as we just don't take it to extremes.
• 25:33
  SPEAKER_00: And so, with all this information as I was gathering, you know, there were consistent surgeons that were seeing with this, and as I had shared, there are only certain surgeons who do this really well.
• 25:45
  SPEAKER_00: Um, this procedure.
• 25:46
  SPEAKER_00: And I finally had a list of two specific ones I was gonna look at after hearing consistent positive outcomes from people and then researching each surgeon on my own.
• 25:56
  SPEAKER_00: And these were the two go-to in the entire US and the world doing this procedure.
• 26:03
  SPEAKER_00: Now, there's other countries who have like, you know, a surgeon here or there, but within the US, I'm gonna stay here.
• 26:09
  SPEAKER_00: And this was my focus was to find one of these two to do the surgery.
• 26:15
  SPEAKER_00: And so I started with one and consulted that surgeon because they were a long drive away versus one I had to fly to.
• 26:23
  SPEAKER_00: It was a little more complicated, um, especially from Atlanta.
• 26:28
  SPEAKER_00: So I started with the closest one, and he took the time to look through my imaging, look at my story, and hear my story, and let me share where I'm at with things and the goals that I have.
• 26:42
  SPEAKER_00: And he asked me about these things and he shared the general game plan with me.
• 26:47
  SPEAKER_00: I asked a lot of questions and he answered every single one of those questions.
• 26:51
  SPEAKER_00: He didn't dodge one, um, he didn't just try to move on or rush me.
• 26:55
  SPEAKER_00: Um, and it was honestly a very great experience from a consultation standpoint.
• 27:00
  SPEAKER_00: Um, I asked him how often he does it, the risks associated, his testing process, survivorship of the implants, recovery protocol.
• 27:09
  SPEAKER_00: I even asked him some pretty hard questions um about some details from his research, and he, you know, he took it on head first.
• 27:18
  SPEAKER_00: And he also told me things that he was like, I don't know.
• 27:20
  SPEAKER_00: And I respected that so freaking much.
• 27:23
  SPEAKER_00: But the fact that he answered my questions, took the time, I was like, you know what?
• 27:28
  SPEAKER_00: This is a really, really solid experience.
• 27:31
  SPEAKER_00: And I, of course, researched his outcomes, the implants, and anything you possibly could imagine, even prior to this meeting, but wanted to hear some of this stuff from him.
• 27:41
  SPEAKER_00: And you guys might think I'm crazy, but y'all, this isn't just fixing a part of your house, like painting the walls or you know, replacing the roof, or maybe even just some broken bone where they need to cast it up, right?
• 27:55
  SPEAKER_00: It's a specialized surgery that can make or break the quality of my life for better or for worse.
• 28:01
  SPEAKER_00: And I'm saying this in parallel to ACL rehab and the surgery itself, too, is that do your due diligence because I've worked with so many people who have just got caught up with the wrong surgeon.
• 28:15
  SPEAKER_00: They didn't uh necessarily answer questions or ask questions.
• 28:20
  SPEAKER_00: The surgeon just came in, walked in, this is what we're doing.
• 28:23
  SPEAKER_00: You know, they might have gotten one person who said, Go see this person.
• 28:27
  SPEAKER_00: They didn't get multiple opinions.
• 28:28
  SPEAKER_00: They're like, Okay, cool, this is in my insurance or this works, and then they do the procedure, you know, and then they end up regretting it because they didn't do deeper research on the surgeon or the graph type or what their return to sport process was, even if there was one testing process.
• 28:47
  SPEAKER_00: There's just so much, and it influenced the quality of their life drastically, whether it was months, years, you know.
• 28:55
  SPEAKER_00: I've seen people 10 years out who they were just like, Man, I wish I could have just chosen a different surgeon.
• 29:02
  SPEAKER_00: So this is why I'm stressing this importance to you guys because it's important to me, it's important to your life, and you only get to do this once, hopefully.
• 29:12
  SPEAKER_00: And so do it right.
• 29:14
  SPEAKER_00: And so that's why I'm doing this research, especially for such a unique procedure for this category that I'm in, but even for ACL, this is no different.
• 29:23
  SPEAKER_00: And the beauty is that there are some options that are probably more available, but with that said, it makes it more confusing, and I get that.
• 29:30
  SPEAKER_00: So then that's where making sure to vet these professionals who are on your team is so freaking important, and I am practicing what I preach, and that is so important to me, and that's why I'm sharing it with you guys.
• 29:45
  SPEAKER_00: And so I've learned a long time ago that we have to be our own advocates as I've gone through this process, otherwise, you're just gonna be funneled along like a part on a conveyor belt.
• 29:57
  SPEAKER_00: And so I was like, I'm not doing this this freaking time.
• 30:00
  SPEAKER_00: I was like, I know better, and now I'm gonna do better.
• 30:03
  SPEAKER_00: And so this is me going through that process.
• 30:05
  SPEAKER_00: And so, next, what I did after the surgeons meeting, I did a deep dive on the different implants and procedures.
• 30:12
  SPEAKER_00: I did super deep comparisons, used AI research again.
• 30:17
  SPEAKER_00: I went into different uh research studies, and there's a few ones out there, and it's something that I was like, oh, parallel to ACL.
• 30:27
  SPEAKER_00: Sound familiar?
• 30:28
  SPEAKER_00: Maybe picking ACL graph types.
• 30:31
  SPEAKER_00: And so I had to understand the pros and cons to each type.
• 30:36
  SPEAKER_00: There's um some risks associated, and so I finally landed on the one that I felt in my gut was right, you know, and after conversations and making sure I did my due diligence, um, I also talked to the surgeon a little bit more.
• 30:51
  SPEAKER_00: Um, and this was his specialty.
• 30:54
  SPEAKER_00: So I was like, okay, let's do this.
• 30:57
  SPEAKER_00: And so next was the insurance battle.
• 31:00
  SPEAKER_00: And during this whole time, I've just kind of been working through that, especially coming into the year of 2025.
• 31:06
  SPEAKER_00: I just kind of knew that this was something I was potentially going to do.
• 31:10
  SPEAKER_00: I wasn't sure.
• 31:12
  SPEAKER_00: And so this was honestly, as I shared in the previous episode, probably been the biggest influencer of my hang ups of being able to tackle this earlier.
• 31:24
  SPEAKER_00: And it's so interesting.
• 31:25
  SPEAKER_00: If I could just be transparent with you guys, that if our insurance healthcare system was better, if it didn't cost us so much, I would have had this probably taken care of whenever it was bothering me back in 2016, 2017, even maybe after 2018, 19, right?
• 31:45
  SPEAKER_00: But my insurance has been so awful, y'all, ever since I have been alive, to be honest.
• 31:52
  SPEAKER_00: Maybe when I was a little kid, it was good.
• 31:54
  SPEAKER_00: But I know that ever since I left for college, I've never had a good insurance plan, never in my life.
• 32:02
  SPEAKER_00: I've had such expensive insurance, high deductibles, high out-of-pocket maxes.
• 32:07
  SPEAKER_00: And so, guys, like it influenced, especially when you're a broke college student and a broke PT student, and then you're a new grad tackling this debt and you're kind of gung-ho about your your career.
• 32:19
  SPEAKER_00: Like the last thing you want to do is go and have a procedure done.
• 32:22
  SPEAKER_00: And so you just kind of ignore it, and it wasn't enough of a big deal for me to go and do that.
• 32:27
  SPEAKER_00: But it's crazy when I look back on this because every single year I've had moments where I'm like, maybe I should go get this checked out.
• 32:34
  SPEAKER_00: But then I'm like, uh, I gotta deal with insurance, find someone I trust.
• 32:38
  SPEAKER_00: Um, I'm deep in this process of building a business or in my work that I was like, I don't know.
• 32:46
  SPEAKER_00: You know, and insurance was the biggest obstacle because I know that if insurance wasn't, then I would have jumped on getting this tackled sooner.
• 32:56
  SPEAKER_00: And so it's just crazy for me to just kind of reflect on this that because of the design of this, and I know some of you probably feel this, but because of the design of this system is the reason why there was just such a delay.
• 33:11
  SPEAKER_00: Now, this might be a cop-out, you guys think, because it's like, oh, well, you could have gone and done that, but if I'm being transparent, like it just is what it is, like that played such a big role in why I decided not to evaluate this earlier until I got to this point.
• 33:29
  SPEAKER_00: And so the timing of this was super important coming into this hip procedure because as a small business owner and my wife working for a small nonprofit as a special needs teacher, we don't have great options.
• 33:43
  SPEAKER_00: We haven't had great options since we've been married.
• 33:46
  SPEAKER_00: We haven't had great options over the past four or five plus years, you know?
• 33:51
  SPEAKER_00: And so a lot of these options just covered the state of Georgia as well, especially as we were evaluating these things.
• 34:00
  SPEAKER_00: So going out of state, typically quote unquote out of network, is challenging because usually good insurance is re reserved for companies who are bigger.
• 34:11
  SPEAKER_00: So if you work at a big company, typically there are these deals made with insurance companies where okay, like you have 500 people, a thousand people, and then you start thinking about these tech companies that have thousands and thousands of hundreds and thousands of people that work for them.
• 34:28
  SPEAKER_00: Guess what?
• 34:29
  SPEAKER_00: They get better deals, which means the employees get better insurance, better rates.
• 34:33
  SPEAKER_00: Companies usually pay a decent portion of this stuff.
• 34:36
  SPEAKER_00: When you're a small business owner, you're just kind of left to find what you can, right?
• 34:41
  SPEAKER_00: And I know this doesn't apply across, you know, international.
• 34:45
  SPEAKER_00: And I know there's socialized medicine, I know there's private pay insurance as well.
• 34:49
  SPEAKER_00: Um, we've worked with people for all over, so I'm familiar with the landscape of a lot of different healthcare insurance systems and socialized medicine systems.
• 34:58
  SPEAKER_00: And so it's just interesting.
• 35:00
  SPEAKER_00: Um, I literally had someone message me um and share a comment, and they were like, I paid$360 for any medical cost.
• 35:10
  SPEAKER_00: After that, my government covers anything, and they had surgery in four weeks for their ACL.
• 35:15
  SPEAKER_00: I was like, wow, that'd be super nice.
• 35:17
  SPEAKER_00: But guess what?
• 35:19
  SPEAKER_00: We're in the US and it's a business.
• 35:21
  SPEAKER_00: And so this has just been super interesting to be able to navigate.
• 35:27
  SPEAKER_00: And so, with me being this business owner, my wife working a small nonprofit, um, and not really having out of state help.
• 35:36
  SPEAKER_00: And the thing that was challenging is that this surgeon was out of state.
• 35:41
  SPEAKER_00: So, as we came into the new year, I spent so much time evaluating our insurance options, our coverage, our costs, etc.
• 35:49
  SPEAKER_00: All of them sucked.
• 35:50
  SPEAKER_00: So then you're just like, all right, pick the least suckiest one, if you will.
• 35:55
  SPEAKER_00: And so one thing that I did prior to this, I actually asked a surgeon for the cash rate for the procedure out the door.
• 36:01
  SPEAKER_00: And that's something that can be common here in the States because if people have high deductible plans, then a lot of times they'll just be like, hey, what's your cash rate?
• 36:09
  SPEAKER_00: Because you'll never meet it, especially if you're a generally healthy person and you're going doing normal medical stuff.
• 36:16
  SPEAKER_00: Then sometimes you might just be like, All right, I'll just pay the cash rate and not file it to my insurance.
• 36:22
  SPEAKER_00: And so I asked the surgeon for the cash rate.
• 36:26
  SPEAKER_00: $29,000 for my left hip.
• 36:28
  SPEAKER_00: Yep.
• 36:29
  SPEAKER_00: So I was like, I might as well use the insurance if I'm gonna pay that much, right?
• 36:34
  SPEAKER_00: So here's where I'm going to share what we landed on.
• 36:38
  SPEAKER_00: And I'm gonna give you the numbers all full in detail.
• 36:41
  SPEAKER_00: So I hope you guys are ready.
• 36:43
  SPEAKER_00: Don't let your jaw drop too much.
• 36:46
  SPEAKER_00: So, as a generally healthy guy, I don't really have any issues.
• 36:49
  SPEAKER_00: I know I got this hip thing going on, but I don't really have any issues.
• 36:53
  SPEAKER_00: My wife being healthy overall, our son at the time being nine months old at the start of the year.
• 36:59
  SPEAKER_00: Here was our best option, and we considered a lot of them.
• 37:04
  SPEAKER_00: We had to split my son and put him on a different plan, and me and my wife on a plan together.
• 37:12
  SPEAKER_00: And my son's plan per month is$320 per month.
• 37:17
  SPEAKER_00: His deductible deductible is essentially the amount you have to pay yourself before your insurance starts to help you out at all.
• 37:25
  SPEAKER_00: Now, there are certain things like a general health exam or checkup, or maybe basic blood work that's covered without having to meet your deductible, or sometimes there is a co-pay, maybe you pay$20,$50,$100, or maybe there's a coinsurance involved.
• 37:43
  SPEAKER_00: Usually a coinsurance is hey, you pay 20% of this bill, the insurance pays 80% of this bill.
• 37:50
  SPEAKER_00: And so with his deductible, it's$1,500, and then his out-of-pocket max is$5,000.
• 37:58
  SPEAKER_00: So basically, if he were to have something done outside of basic stuff, we would need to meet$1,500 total.
• 38:08
  SPEAKER_00: And then after that, there's an out-of-pocket max of$5,000.
• 38:11
  SPEAKER_00: And so his plan would cover 80% of charges up to$5,000.
• 38:17
  SPEAKER_00: And then we would be responsible for 20% of that.
• 38:22
  SPEAKER_00: And so then therefore, that would be$3,500 essentially left where we would need to fill up$3,500 in order for them to start paying 100%.
• 38:33
  SPEAKER_00: So that is usually something when there's a bigger medical cost, like a surgery or multiple days in the hospital.
• 38:40
  SPEAKER_00: Sometimes uh, you know, people with ongoing disabilities and things of that nature have to usually meet this.
• 38:47
  SPEAKER_00: And so that's where usually, you know, we're hoping this at least like covers him.
• 38:52
  SPEAKER_00: And if anything goes south, at least we have a certain amount that we know we'll hit, and then we'll get 100% coverage after hitting 5,000.
• 39:01
  SPEAKER_00: And that's only with in-network providers, not at a network.
• 39:05
  SPEAKER_00: So in network means basically there's a contract with the insurance, and out of network means there's no contract, and sometimes there's no coverage with those out of network providers.
• 39:15
  SPEAKER_00: If you have a certain type of insurance, a PPO, then it can kind of cross over.
• 39:22
  SPEAKER_00: And so, anyways, all that to say, we pay$320 a month for him.
• 39:25
  SPEAKER_00: Uh, and then that's his deductible and out-of-pocket max.
• 39:28
  SPEAKER_00: For me and Abigail, drum roll, please,$1,100 per month.
• 39:35
  SPEAKER_00: Our individual deductible is six thousand dollars.
• 39:38
  SPEAKER_00: Yep, six thousand.
• 39:40
  SPEAKER_00: Our individual out-of-pocket max is eighty five hundred.
• 39:43
  SPEAKER_00: So basically, I have to pay up to six thousand dollars before anything really gets to start getting any coverage.
• 39:50
  SPEAKER_00: Um, and then out-of-pocket max, eighty five hundred for in-network.
• 39:55
  SPEAKER_00: So once I hit$8,500, um, the insurance will pay 100% for everything else.
• 40:01
  SPEAKER_00: Our family deductible, so this is just for me and abs because we're on separate plans.
• 40:05
  SPEAKER_00: Um, this is$17,000.
• 40:09
  SPEAKER_00: Yep,$17,000.
• 40:11
  SPEAKER_00: And for our family out-of-pocket, oh, I'm gonna back this up.
• 40:16
  SPEAKER_00: For our family deductible, it's$12,000, and for our family out-of-pocket max is$17,000.
• 40:23
  SPEAKER_00: So that basically means um if we hit our family deductible, then our coinsurance kicks in and we have a 70-30 split.
• 40:31
  SPEAKER_00: So 30% we pay, 70% the insurance pays, up until we hit$17,000.
• 40:38
  SPEAKER_00: Then as a family, if we spend$17,000, then the insurance will pay 100%.
• 40:43
  SPEAKER_00: Real cool.
• 40:44
  SPEAKER_00: $17,000 in medical expenses.
• 40:47
  SPEAKER_00: And then the individual, these are that was all for in network.
• 40:52
  SPEAKER_00: Now, here's for out of network.
• 40:54
  SPEAKER_00: Now we were able to find a plan at least that covered some out of network, but it's kind of crazy.
• 41:01
  SPEAKER_00: It's basically like not really covering it.
• 41:03
  SPEAKER_00: So individual out of network deductible is$12,000.
• 41:07
  SPEAKER_00: So before they cover anything for out of network, you have to spend$12,000 for an insurance to even touch anything, even 30% coverage.
• 41:17
  SPEAKER_00: And then once that 30-70 split kicks in after 12k, guess what?
• 41:21
  SPEAKER_00: It's a 25k out of pocket max.
• 41:24
  SPEAKER_00: So basically, to give you guys a good reference here, and also these don't cross over.
• 41:30
  SPEAKER_00: So the 8,500 for the deductible or the out-of-pocket max doesn't cross over and just work for the 25k for the out of network.
• 41:40
  SPEAKER_00: So basically two different paths, and so you can choose which one you want to go to.
• 41:45
  SPEAKER_00: Maybe um one person is on one path, one person is on the other.
• 41:50
  SPEAKER_00: But that's essentially how it is.
• 41:51
  SPEAKER_00: So we pay$1,420 a month for insurance for my family.
• 41:57
  SPEAKER_00: I'm just gonna pause there for a second just for a moment of silence.
• 42:02
  SPEAKER_00: And we basically have to hit$1,500 for my son and$6K for either myself or Abigail for us to get any true coverage outside of the general basic coverage, like a health exam, some basic blood work.
• 42:16
  SPEAKER_00: That's about it, y'all.
• 42:18
  SPEAKER_00: Otherwise, we gotta pay$1,500 or$6K, depending on the person, for insurance to even start helping us out.
• 42:26
  SPEAKER_00: So the cost for the out of state for this surgeon is$6,000.
• 42:33
  SPEAKER_00: He does not accept the insurance we have.
• 42:36
  SPEAKER_00: He is an out-of-network provider, so that$12,000 out of network deductible I talked to you guys about, that's where this$6,000 is gonna go.
• 42:43
  SPEAKER_00: And guess what?
• 42:44
  SPEAKER_00: I'm only 50% there with this out-of-network cost.
• 42:47
  SPEAKER_00: So guess who's responsible for that amount?
• 42:51
  SPEAKER_00: Yours truly.
• 42:52
  SPEAKER_00: The cost of the surgery center and the anesthesia, and just the the way that they bill this.
• 42:58
  SPEAKER_00: To give you guys an idea, um, I had the billing insurance lady send me the details because I was like, I am not going to accept anything until I see an itemized bill, and their itemized bill bills are laughable.
• 43:13
  SPEAKER_00: Um, but anyways, with that said, they sent it to me, and here is the breakdown.
• 43:19
  SPEAKER_00: They gave me the CPT codes of two different things, they gave me the descriptions of each, and then they gave me the build charges.
• 43:26
  SPEAKER_00: So, this is what the surgery center is going to bill them, and this is not even actually including the anesthesia.
• 43:33
  SPEAKER_00: We don't even know what that looks like yet.
• 43:35
  SPEAKER_00: But this is the surgery center alone.
• 43:38
  SPEAKER_00: The first CPT code for this procedure is$34,436 is the bill charges that this surgery center is going to send the insurance.
• 43:51
  SPEAKER_00: And then the expected reimbursement there they are expecting to get back is$18,000.
• 43:59
  SPEAKER_00: So, here what happens is that it's just kind of this game of kind of Russian roulette, if you will.
• 44:05
  SPEAKER_00: Um, a lot of this stuff is based on the uh the Medicare bases a lot of rates, and so then other insurance companies will kind of dictate things based on their rates.
• 44:16
  SPEAKER_00: There's a lot of back and forth negotiating, contracts, all this stuff.
• 44:20
  SPEAKER_00: They inflate the charges because they want to get as much out of the contractor rate as possible, right?
• 44:28
  SPEAKER_00: So they're hoping if they bump up the build rate that the reimbursement will be higher, right?
• 44:33
  SPEAKER_00: So that's just more money for the companies, more money for the surgeon, the surgical facility, and this is just across the board.
• 44:42
  SPEAKER_00: This is how it works.
• 44:44
  SPEAKER_00: And then in terms of the implant itself, it was$6,140, so$6,140, and that's essentially how much they expect to get reimbursed.
• 44:54
  SPEAKER_00: And so, all in all, you know, they are billing for almost$40,000, but this doesn't include anesthesia, and it doesn't include the surgeon's expenses either.
• 45:04
  SPEAKER_00: So if I had to guess, we're probably talking like a$50,000,$60,000 procedure, all things considered that are built.
• 45:15
  SPEAKER_00: Now, uh the only fortunate thing about this, if you want to quote call it fortunate, is that the surgery center and the anesthesia is quote unquote in network.
• 45:24
  SPEAKER_00: So that's the thing that you know is gonna kind of save me here with these costs a little bit, but it's just kind of depending on how you look at it.
• 45:32
  SPEAKER_00: But as I shared here, what I'm looking at from the itemized bill, which is those two CPT codes, that's gonna be a total of roughly like 40,500.
• 45:44
  SPEAKER_00: And their expected reimbursement of that is gonna be roughly about 24,000.
• 45:50
  SPEAKER_00: So, you know, they're trying to get bill 40, 40,000, a little bit above that from what I see from the surgery center, and then they're trying to get back twenty four thousand of that, and that's what their expected reimbursement rate is, and so.
• 46:03
  SPEAKER_00: So, for me to give you guys perspective on this with the insurance, it's basically gonna cost me$8,500 because they are in network as I had shared, the surgery center itself.
• 46:15
  SPEAKER_00: This is different from that surgeon fee that was$6,000 that will go to my 12k out-of-network deductible.
• 46:22
  SPEAKER_00: So, all in all,$6K to the surgeon,$8,500 to the surgery center.
• 46:28
  SPEAKER_00: That's just because it's going to end up hitting my out-of-pocket maximum for my deductible and for the in-network charges, if you will.
• 46:39
  SPEAKER_00: So then, therefore, I'm gonna max that thing out.
• 46:41
  SPEAKER_00: And then after I hit$8,500, my insurance is gonna pay 100% of whatever is left.
• 46:46
  SPEAKER_00: So that you know,$24,000 that I shared, I'll basically pay$8,500 of that, and then the insurance is on the line for the rest of it.
• 46:55
  SPEAKER_00: And so, to all in all, from my end, what I'm looking at is$14,500 so far.
• 47:03
  SPEAKER_00: So all I'm paying right now is that total.
• 47:07
  SPEAKER_00: I say all.
• 47:09
  SPEAKER_00: And while you think that's a bargain compared to the you know 50-60k that's billed, it's just wild to think that that is like okay, or this is a discount, or this is good.
• 47:19
  SPEAKER_00: In reality, this is just bizarre for just a general just health procedure, y'all.
• 47:25
  SPEAKER_00: That a basic human need, right?
• 47:28
  SPEAKER_00: Um, to live life, right?
• 47:30
  SPEAKER_00: And so it's crazy.
• 47:31
  SPEAKER_00: But uh let me kind of make this a little bit more real for y'all.
• 47:33
  SPEAKER_00: That's$14,500, and then$17,000 for our monthly premiums for our family this year.
• 47:41
  SPEAKER_00: So, all in all,$31,000,500 on this procedure and basically medical coverage for my family.
• 47:48
  SPEAKER_00: Now I'm gonna give that a moment of silence.
• 47:53
  SPEAKER_00: It's crazy.
• 47:55
  SPEAKER_00: And this is assuming my family needs nothing else, they don't need to have some sort of medical procedure done, they don't need to have testing done, even just a basic, like, hey, you need to go get x-ray on this, or hey, you need to go get extra blood work on this.
• 48:08
  SPEAKER_00: You know, that's gonna cost us.
• 48:10
  SPEAKER_00: It's not basic health care, it's additional, right?
• 48:13
  SPEAKER_00: When we go to see a specialist, for example, it's a hundred bucks for a copay.
• 48:17
  SPEAKER_00: Um, for my son, it's$20 to go see even just the primary care provider.
• 48:21
  SPEAKER_00: So every time we walk into that office,$20,$20,$20.
• 48:25
  SPEAKER_00: Every time he gets sick,$20,$20.
• 48:27
  SPEAKER_00: And guess what?
• 48:28
  SPEAKER_00: Kids get sick, y'all, and you're gonna take them in more than you think because you want to make sure that they're okay and you're a new parent, you don't know what's going on.
• 48:36
  SPEAKER_00: So that stuff adds up too.
• 48:39
  SPEAKER_00: And so what's sad in all this is I may be considering my other side, which will cost me another$6,000.
• 48:48
  SPEAKER_00: Luckily, the$8,500 has been covered for the end network.
• 48:52
  SPEAKER_00: So, you know, if I have this procedure again, I won't be having to front that.
• 48:56
  SPEAKER_00: Um, but the$6k will be something I will have to pay the surgeon fee for because he doesn't take my insurance.
• 49:02
  SPEAKER_00: And this is if my insurance approves it, you know, there's always a chance for it to get rejected um or unapproved.
• 49:10
  SPEAKER_00: Um, so then therefore that'll be a problem, and I have to do it before the end of this year.
• 49:15
  SPEAKER_00: So isn't that kind of crazy with all this considered that this is how this kind of all works out?
• 49:23
  SPEAKER_00: And what's most important here is like what's wrong with this.
• 49:29
  SPEAKER_00: And I just want to kind of just pause here for a second, just because it's like, how is this possible?
• 49:36
  SPEAKER_00: The US healthcare system and the insurance, it's awful, y'all.
• 49:39
  SPEAKER_00: It's terrible.
• 49:40
  SPEAKER_00: And I'm like, I'm in a place where I'm educated, I understand this stuff better than most people.
• 49:46
  SPEAKER_00: I do deep dives on understanding this stuff.
• 49:49
  SPEAKER_00: Um, it's why we honestly don't work with insurance as a practice and working with people, is because it just is so frustrating because we want to give you value and service outside of someone else dictating the care.
• 50:03
  SPEAKER_00: You get to control it, we get to control it, so we eliminate this middle person who is a for-profit business, and that is where it has gotten us into trouble, is because it's this constant business, let's make more money, more profits.
• 50:21
  SPEAKER_00: If y'all looked up how much that these CEOs for these top insurance companies make, your jaw would drop, and the amount of profit that these companies make.
• 50:31
  SPEAKER_00: So we're talking about billions of dollars, y'all.
• 50:34
  SPEAKER_00: It's so much money, and all they do is milk a system and milk the consumers.
• 50:41
  SPEAKER_00: And the thing is, is that the government isn't helping us as much as they can with this, and it is just so challenging, and it makes me really, really sad for our healthcare system, and the amount of chaos that is provided, and just like how sad it is for a lot of people going through this, and I get it.
• 51:00
  SPEAKER_00: Look, like y'all, like one thing that's good about medicine is it's great at keeping us alive and being able to do really cool stuff that's innovative, but in terms of being proactive and helping just basic human needs, it just doesn't, it just doesn't do it.
• 51:16
  SPEAKER_00: And so I truly think that something else needs to happen, something needs to change.
• 51:20
  SPEAKER_00: I think that insurance systems need to go away, and I think that there needs to be a competitive market where you can't just be in network with people.
• 51:29
  SPEAKER_00: I think that there needs to be more players in the game which will diversify the field and then therefore make the costs more competitive.
• 51:37
  SPEAKER_00: I also think there needs to just be more transparency.
• 51:39
  SPEAKER_00: Like, if I get a bill, I need to know exactly what those costs are and why.
• 51:43
  SPEAKER_00: I know we get explanation of benefits, but like those things are so vague sometimes.
• 51:49
  SPEAKER_00: Um, so it's just kind of crazy to me, and I won't even spare you guys the amount of time my wife and I have spent over the years on the phone just talking to insurance companies, to agents, people who have just, you know, billed things wrong, did insurance stuff wrong.
• 52:06
  SPEAKER_00: They were like, oh, oops, and it could be like a$5,000 bill that changed into like a$200 bill, y'all.
• 52:12
  SPEAKER_00: And if we didn't look at that, we'd just be on the line, or they're like, hey, this is going to collections, and it's like, no, like you didn't bill this right.
• 52:20
  SPEAKER_00: And it's just crazy to me.
• 52:23
  SPEAKER_00: And so I'm sorry, I know I'm like belaboring this point here, but I know a lot of you feel me here, and it's just something that just really hurts my heart for our healthcare system and where we're at at this current point.
• 52:38
  SPEAKER_00: And this is me being able to, you know, pull out of savings and being able to do some of this stuff, fortunately.
• 52:44
  SPEAKER_00: But I think about other people who are just less fortunate.
• 52:46
  SPEAKER_00: It's like, what are they gonna do, man?
• 52:50
  SPEAKER_00: And you know what?
• 52:51
  SPEAKER_00: That's why, even though we spend the most as a country, we are not the healthiest country.
• 52:56
  SPEAKER_00: It's because we have a very bad system, and there just needs to be something that changes in order for us to make it to the top of having a healthier society, and then also being able to somehow bring these healthcare costs down.
• 53:11
  SPEAKER_00: And I think the biggest thing is transparency in healthcare, being able to also eliminate insurance somehow.
• 53:18
  SPEAKER_00: The solution to that, I'm not sure, but I think eliminating it, and in my personal opinion, I think it should be no different than car insurance.
• 53:28
  SPEAKER_00: I think for basic health insurance stuff, like we don't need to expect health insurance to cover everything, but maybe for you know, an oil change, your car insurance isn't covering that.
• 53:40
  SPEAKER_00: For you know, your tires to get changed, it's not being covered.
• 53:44
  SPEAKER_00: And I think that's the best way the system is going to operate.
• 53:47
  SPEAKER_00: It makes way more people competitive, therefore, the rates won't skyrocket.
• 53:53
  SPEAKER_00: And therefore, you know, when you get in a big car accident, guess what?
• 53:56
  SPEAKER_00: Insurance kicks in and it helps you.
• 53:59
  SPEAKER_00: Same thing here.
• 54:00
  SPEAKER_00: I think that's how our healthcare insurance at least could be better operated.
• 54:04
  SPEAKER_00: Now, I don't have the solution for everything, different socioeconomic status, all these things that are such layers to this, but I know the biggest thing about it is money and it's profit and it's just the government and insurance associated companies that are just kind of in cahoots together.
• 54:23
  SPEAKER_00: They're just like, cool, like if they're getting the money from the taxes, then like let's keep rolling with this, right?
• 54:29
  SPEAKER_00: So it's just a lot of layers to this, and I know I'm on this long tangent at this point, but it's just something that is just really troubling.
• 54:36
  SPEAKER_00: And I wanted to share some transparency on the numbers for this procedure for myself, as well as what my family is dealing with, and this is probably the average American family to some degree, and so this is just kind of crazy.
• 54:52
  SPEAKER_00: And my brother, who uh works for a corporate company, he pays little pennies compared to what we pay.
• 55:00
  SPEAKER_00: Um, and it's because he works for a big company, right?
• 55:03
  SPEAKER_00: And so then, therefore, you know, he has great health insurance, um, he has uh very little to pay from a premium standpoint, and so that's great for the bigger companies, but then what about us little people who are trying to do something different?
• 55:18
  SPEAKER_00: I'm just you know, it's kind of crazy for there to not be other options that are just as equivalent, you know.
• 55:25
  SPEAKER_00: And so there we are with my insurance rant and complaint, but I just wanted to share that with you guys.
• 55:32
  SPEAKER_00: And the last thing I'll share that with this is that the billing lady who asked me to pay for this amount initially, it was like about a month ago, she billed me actually$1,400 saying the insurance will cover the rest.
• 55:46
  SPEAKER_00: And so I was like, okay, I was like, all right, we're not bad here.
• 55:50
  SPEAKER_00: I'm guessing that maybe like the surgery center doesn't bill a ton, and so I was like, maybe this procedure doesn't cost that much.
• 55:56
  SPEAKER_00: So I was like,$1,400, cool.
• 55:57
  SPEAKER_00: And then three weeks later, she like calls me multiple times and she emails me, or she doesn't email me, she just calls me and she's like, Hey, um, I'm I'm here to pick up the amount.
• 56:08
  SPEAKER_00: We were able to reduce it from$8,500 to$7,300.
• 56:11
  SPEAKER_00: And I was like, wait, I got an email from you saying it was$1,400.
• 56:15
  SPEAKER_00: And she was like, No.
• 56:17
  SPEAKER_00: And so then she went back and looked and she got the wrong number.
• 56:21
  SPEAKER_00: So my cost went from$1,400 to$7,300 because I had met some of my deductible already.
• 56:29
  SPEAKER_00: So instead of$8,500, I've already paid some of that, so I had$7,300 left.
• 56:33
  SPEAKER_00: That's not even including the$6,000 for the surgeon.
• 56:37
  SPEAKER_00: And so the craziest thing with this is that I just got sent a link as well, and it was just like, hey, pay this.
• 56:44
  SPEAKER_00: And so um, I've gotten tons of bills over the years, especially with this thing coming up, and it's just payment links, no amount, no amount of detail to why it's for this particular thing, no itemized bill.
• 57:00
  SPEAKER_00: I would almost equate it to, you know, you take your car to the mechanic and you have a lot of stuff done to it, and then they just give you this just general, you know, here's you know,$2,000.
• 57:15
  SPEAKER_00: But they don't really give you an amount or they don't give you the detail of what was done in it.
• 57:21
  SPEAKER_00: They're just giving you like, hey, it's$2,000.
• 57:24
  SPEAKER_00: So then you have to go through and dig through and be like, all right, well, tell me how much this was, how much this was, like, why was this labor this much?
• 57:31
  SPEAKER_00: You know, and but the thing is, like, usually they provide all those itemized bills and costs.
• 57:36
  SPEAKER_00: And so with this, like, you have to dig deep to get that stuff.
• 57:40
  SPEAKER_00: You can't just get it flat out.
• 57:41
  SPEAKER_00: It's just payment links, pay this amount, otherwise, it's going to collections.
• 57:45
  SPEAKER_00: So I looked up the coding to all the stuff, make sure it lined up.
• 57:49
  SPEAKER_00: Sadly, because I'm meeting my out-of-pocket maximum, anyways.
• 57:52
  SPEAKER_00: I decided not to really dispute any of this.
• 57:55
  SPEAKER_00: Um, even though there were differences in the amount of upcharge they did, it didn't matter because I was gonna have to pay$8,500 one way or another.
• 58:03
  SPEAKER_00: But if I was someone who only had to pay$4,000 because it's a lesser procedure, and I had an$8,500 out of pocket max, I would have fought this because they're just upcharging the crap out of things.
• 58:15
  SPEAKER_00: And so this is just something I was like, it's not even worth the fight.
• 58:20
  SPEAKER_00: Um, and then to wrap this thing up because it's already been way too long, I hired a coach.
• 58:27
  SPEAKER_00: So I tell you guys that it's important to have a guide, it's important to have someone that is an expert, it's important to have a plan, it's important to have a roadmap, and it's important to have testing.
• 58:38
  SPEAKER_00: Well, guess what?
• 58:39
  SPEAKER_00: I hired somebody.
• 58:40
  SPEAKER_00: While I could have tackled this myself, I'm knowledgeable enough to be able to handle and do this.
• 58:47
  SPEAKER_00: I didn't want to.
• 58:48
  SPEAKER_00: And I wanted to make sure that I had someone who knew this procedure, who has walked people through it, who can talk me off a ledge sometimes if I'm in my brain, who can just kind of do the programming for me, give me the roadmap, give me the guidance, be there for me when I want to ask questions.
• 59:06
  SPEAKER_00: And guess what?
• 59:07
  SPEAKER_00: It's been awesome, and that is something that I want to practice while I preach, which is why I did this.
• 59:13
  SPEAKER_00: So I hired my own remote coach.
• 59:15
  SPEAKER_00: And so if you're listening here, guys, like I'm not above this, just even because I know this space, like there's so much value out of getting someone else to do this for you because they can look at it objectively, they can help you along in this process, especially if they're experts in this space and know what they're doing.
• 59:36
  SPEAKER_00: So for your ACL rehab, find an expert to help guide you because, guys, it's been a huge game changer to have him along my side and to just not worry about things as much and him checking in and being able to talk.
• 59:49
  SPEAKER_00: Like it's been awesome, and my progress has been awesome.
• 59:53
  SPEAKER_00: And so then, therefore, I just wanted to share this with you guys as I wrap up this podcast series.
• 59:59
  SPEAKER_00: Wanted to pull back the curtain a little bit and be as transparent as I could be, step by step, my journey, and I'm doing this for myself, I'm doing it for my family, I'm doing it for my son, for hopefully future kids.
• 1:00:13
  SPEAKER_00: Like, I'm doing it for them, I'm doing it for myself, and it's important to me, and it's important that I share this with you guys.
• 1:00:20
  SPEAKER_00: So I love you guys.
• 1:00:21
  SPEAKER_00: I know that's a lot to say to people I've never met, but I really do.
• 1:00:25
  SPEAKER_00: I love this community, I love the support, I love the messages that I've gotten, and I promise we will get back on continued ACL education and info.
• 1:00:35
  SPEAKER_00: I've got a lot of stuff lined up that's gonna be super fun.
• 1:00:38
  SPEAKER_00: But I hope that this was helpful, y'all.
• 1:00:40
  SPEAKER_00: For those of you who stuck with me, hopefully you did it on 2x because I rambled a lot.
• 1:00:45
  SPEAKER_00: But just wanted to share this.
• 1:00:47
  SPEAKER_00: I think it's so important.
• 1:00:49
  SPEAKER_00: And as myself walking through this, having my two ACLs, having this hip resurfacing, I think it's important.
• 1:00:55
  SPEAKER_00: So I just wanted to bring that to you guys, and I hope that you got something out of it.
• 1:01:00
  SPEAKER_00: That's gonna do it for today, y'all.
• 1:01:02
  SPEAKER_00: Until next time, this is your host, Robbie Patel, signing off.