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Help A Vet Get Knee Replacement!

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MY Campaign is about me trying to raise funds from friends and family, and even caring strangers, for knee replacement surgery for both my knees , so I can go out and live a full, enjoyable and rewarding life, with the years I have left.

I'm a 60 years old US Air Force Veteran and I live just above the poverty level on Social Security Disability.


I have been trying to work with my local VA Hospital here in Sheridan WY for 7 years now in an effort to get my knees replacement surgery done here in Sheridan Wyoming.  There response- you can have it done here with the VA's contracted orthopedic surgeons, but I have to pay for it through my Medicare, and it's 20% co-pay.  Or, go to the Cheyenne VA Hospital and have their orthopedic department do the surgery. It would be numerous 700 mile round-trips, and after the surgeries, I wouldn't be able to drive home, but that logic matters not to the VA Hospital in Sheridan. Finally, I have a 24 year old Aerostar minivan that I do not trust for these numerous journeys, as the last time I went to Cheyenne was 6 years ago to see the orthopedic surgeon after my initial MRI back on February 12, 2009.

It all started years ago, when my primary-care doctor here in Sheridan, after looking at some x-rays he ordered of my knees because I hurt one somehow, said to me that I have 5, maybe 10 years left on my knees before they would need a knee replacement surgery. That was 23 years ago. The escalation of the destruction and deterioration of my knees happened when I tore the ACL in my left knee Tuesday evening prior to Thanksgiving in 2008. It's been downhill ever since, with the VA's obstinance increasing exponentially as the last 6 years have come to pass.

The idea 'Veteran's 1st' is just a fantasy some ad man dreamed up, because it sure isn't my reality.


Because I am disabled, and getting Social Security Disability, I do have Medicare, but I need to come up with 20% of the total cost of the knee replacement surgery, which for both knees is in the $90,000 to $140,000 range, so my cost are between $18,000 to $28,000, if there are no complications.
Besides the knee issues, I have many other health issues, including neurological issues, which encompass an inoperable brain tumor, severe spinal cord compression in both the C-Spine and L/S-Spine, which the Denver VA Neurosurgery Dept. has handled excellently over the last 12 years.

Just a few facts about my knees:

Here is the most recent X-Ray and MRI information from May 19, 2015:
VA Radiology Reports - Source: VA
Last Updated: 19 May 2015 @ 1617

Procedure/Test Name: KNEE 2 VIEW LEFT
Date/Time Exam Performed: 13 May 2015 @ 1100
Ordering Location: SHERIDAN VAMC
Requesting Provider: MCDONALD,JAMES W.
Reason for Study: knee pain
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Clinical History:
Reason for request: Per request Sheridan Ortho
Radiologist: WANEBO,KEVIN

Report:
AP and PA as well as lateral views left knee.
Findings: Complete loss of medial femoral compartment joint space with bone-on-bone appearance and moderate to significant regional degenerative osteophytes. Associated 10 degrees varus. Moderate
degenerative osteophyte formation lateral and patellofemoral compartments. No overt joint effusion. Diffuse osteopenia may be present.

Impression: Significant osteoarthritis. Please see details above.

Procedure/Test Name: KNEE LEFT W/O (MRI)
Date/Time Exam Performed: 13 May 2015 @ 1059
Ordering Location: SHERIDAN VAMC
Requesting Provider: MCDONALD,JAMES W.
Reason for Study: knee pain
Performing Location: SHERIDAN VAMC 1898 FORT ROAD, SHERIDAN 82801
Clinical History: Reason for requesting MRI: Per request Sheridan Ortho
CREATININE 2/24/15 12:57 1.9 H
***************************
Collection DT Spec CREAT CR-eGFR
02/24/2015 12:57 SERUM 1.9 H 38.8 L
Does the patient have ESRD, an eGFR < 60ml/min in the last
30 days, acute kidney injury or transplant and/or significant liver disease or transplant? No
Radiologist: SABATINOS,MARTIN MD
Report: Multiplanar MR imaging of the knee without Gadolinium.
Patellofemoral joint osteophytes and severe patellofemoral chondral degeneration. Minimal joint effusion. Nonspecific increased linear and reticular hyperintense PD fat-sat signal in subcutaneous tissues about the knee suggesting edema/inflammation. Minimal fluid in the popliteal fossa medially between gastrocnemius and semimembranosus tendons.
Extensive femorotibial joint osteophytes with severe medial compartment joint space narrowing and subchondral bone marrow edema pattern, also spurring of the intercondylar notch and tibial eminence region. No gross disruption of collateral ligaments.
Localized intermediate PD fat-sat signal in the midportion of the PCL, equivocal edema due to sprain however no disruption of the PCL. Suspect full-thickness versus high grade partial-thickness tear of the anterior cruciate ligament. Femorotibial joint chondral degeneration. Lateral meniscus intrasubstance degeneration. Abnormally small medial meniscus posterior horn with stellate increased signal and nonvisualized body segment of the medial meniscus.
Impression:
1. Severe tricompartmental osteoarthritis. Postsurgical change versus medial meniscus severe degeneration and/or tear.
2. Full-thickness versus high-grade partial-thickness ACL tear.
Please see details in the body of the report.

Here are the MRI written impressions of my knees- the latest ones: Radiologist: DR. WEIN,GREGORY 
Report: MRI of the left knee. Aug 22, 2013
The study is limited due to patient motion -
Findings: Osseous structures: No acute fracture. Gross narrowing medial joint compartment with bone-on-bone appearance and complete denudation of large areas of medial femoral condyle and medial tibial plateau cartilage. Severe grade 2 and 3 chondromalacia
lateral compartment. The multiple large peripheral osteophytes.
Moderate joint effusion..
Cruciate ligaments: The anterior cruciate ligament is severely degenerated but probably not torn. The posterior cruciate ligament intact..
Menisci: There is severe maceration of the body and posterior horn of the medial meniscus which is displaced into the medial gutter. Moderate degeneration lateral meniscus without tear..
Collateral ligaments: The tibial collateral ligament is effaced by the large medial osteophytes are grossly intact. The tibial collateral ligament intact.
Patella and extensor mechanism: Diffuse grade 2 and 3
chondromalacia and patella with a superficial blistering and fissuring. similar chondromalacia of the trochlear cartilage with multiple large peripheral osteophytes. Patellar retinaculum intact. Quadriceps tendon and patellar tendons grossly intact with tendinosis of the distal patellar tendon. Edema of Hoffa's fat pad..
Surrounding soft tissues: No cyst or mass.
Posterolateral corner: Degenerative change. No acute fracture. There is popliteus tendinosis..
Impression:
Advanced degenerative change detailed above.
Maceration medial meniscus.




Reason for request: x-ray to be done in conjunction with MRI: Radiologist: DR. MOUBRY,RONDLE M.Report: Left knee: Medial compartment space narrowing is noted. A collar and then spurring is seen. Posterior patellar spurring is also noted. No fracture or dislocation. Bone mineral density is grossly normal.
Impression: Degenerative changes.
Impression:
Degenerative changes. Heterogeneous bone marrow signal. Does the patient have a chronic illness?
Degenerative changes of the knee with tear of the posterior horn of the medial meniscus.
Partial tear/tendinosis of the anterior cruciate ligament.

MRI Radiologist: DR. BEST,ALAN C
Report: Comparison of MRI and radiographs of right knee from 4/20/2012 , which was 10 months prior to above MRI, which is dated Feb 13, 2013 -
Impression: Progression of severe medial compartment degenerative changes and joint space loss.
Since the time these MRIs and X-RAYS of both knees were taken, they have only gotten worse.

Here was the 1st MRI of my Left Knee on Feb 12 2009 after I felt the pain 2 1/2 months earlier -
RADIOLOGY REPORT - DR. DONAHUE, FRANCIS I.
Report: Maceration posteriorly horn medial meniscus with almost total displacement of the medial meniscus into the medial gutter. Opposing joint surface bone marrow edema and marginal osteophytes. There is extensive grade IV chondromalacia of the medial joint compartment. Synovitis medial gutter.No tears of the lateral meniscus. Extensive low-grade chondromalacia and marginal osteophytes.
Chronic ACL tear, intact PCL Medial and lateral collateral support structures intact. Extensor mechanism is intact. Patella anatomically aligned with extensive low-grade chondromalacia of patellofemoral joint with marginal osteophytes about the patella. Patellofemoral ligaments intact. Small popliteal cyst. No joint effusion.
Impression:
Severe osteoarthritis medial joint compartment, moderate osteoarthritis patellofemoral joint.
ACL deficient knee, see above comments


I just want to say the VA Healthcare system has been great to me 95% of the time, from working with the neurosurgeons at the Denver VA Hospital to my excellent primary-care doctor, Dr. Yapuncich (I've had some really great primary-care doctors at the Sheridan VAMC since my brain tumor was discovered back in 2003.) who has advocated for my knee surgery for years. And I can't forget the great folks in the Physical Therapy Department, who are all excellent and also advocating for my knee surgery. So this bump in the road is mainly directed at the bean-counters who are not putting "Veteran's 1st".

I would greatly appreciate any help you can give me. My dream is to have a fully ambulatory life for the years I have remaining on Planet Earth, so that's why I'm asking for your generous support.

Thank You All for your time, and prayers and anything you can do to help.





Organizer

William Harasym
Organizer
Sheridan, WY

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