In lieu of an abstract, here is a brief excerpt of the content:

  • Limited patient choice within the Military Health System
  • Brian T. Ipock

In the military you are told what to do, however, when you fight for your choice as it applies to your own health, be prepared for a long fight. I was rather severely injured in an automobile accident driving to work one morning. What would follow were a grueling two years of therapy and a decision that I had to make with limited knowledge and experience to draw from. Like most young service members this was my first exposure to a medical system from the patient side. We all tried to remain positive even though we were immersed in a quagmire of pain and hurt, and like all things in the military we had each other to keep us going.

Near the end of second year of my recovery from a crushed pelvis, something began to go awry. There was the all too familiar pain that would consume my days, and the inability to walk slowly crept back up on me. Lucky for me I was going through my therapy at The Center for the Intrepid (CFI), the army's foremost advanced center for Amputee and Traumatic Injury Rehabilitation. Every medical professional there worked non–stop to see that each and every service member regained their independence. It was an honor in itself to go through rehabilitation with many of our nations brave men and women that suffered severe injuries, but never let anything stop them in achieving their new goals. I was working with an excellent physical therapist, a retired full–bird colonel that ran the medical specialty corps as his last assignment. We had a respectful and professional relationship, where he valued my opinions about my course of care. He noticed that my progress had severely regressed and sent me in for an x–ray. The prognosis was not good, it appeared as far as we could see that the head of my femur was dying, from a large irregular black pattern on what should be a smooth ball surface. This was not a good thing and sent my mind and all of my concerns into overdrive as to how I should address this problem, not to mention the searing pain that would literally stop me in my tracks while I was walking, as I paused for upwards of 10 minutes until my femur reset and I could begin walking again.

This was my new mission—I needed to find out what was wrong with my leg, what were my options, and when the military could do this surgery. Little did I know that this would be such a complicated and convoluted process trying to get a surgery that I obviously needed. I began searching [End Page 92] online for any and all information about Avascular Necrosis that I could find. It did not look promising. I would need a hip replacement of sorts, and this medical intervention was only complicated by my age of 26 at the time. I began searching the most traditional of procedures, a standard polyethylene total hip replacement, and then I also found out about an all metal total hip replacement. I scheduled an appointment with the Orthopedists at the Military hospital as soon as they would see me.

My girlfriend at the time was a physical therapist, and she worked under one of the premier hip surgeons in San Antonio. I am very grateful that she had him review my case at the same time I was looking at my available options at the military hospital. Using the San Antonio doctor's recommendation, I began to scour the internet for any information I could find about metal on metal hip replacement surgery. I started watching YouTube videos specifically from the Duke Medical Center. They compiled a wealth of information for the patient, and I found the explanations very helpful in guiding my thought process. One thing they stressed, based on longevity and durability for daily activities, was metal on metal hip replacements. I began reaching out to any other contacts I had in healthcare, a friend that was an orthopedic resident at Vanderbilt Academic Medical Center, and another army friend I...


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pp. 92-95
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