The Case of the Swollen Not-Knee

Oy, my fucking leg. Thigh. Knee. Whatever the hell I’m calling it this week.

And yes, I am fully aware those are all different parts of the human body and that words are supposed to mean things. I’ve previously referred to this as a “knee” problem, even though that was never actually true. The problem lives in the lower interior section of my left thigh, right above the knee. Specifically: a Morel-Lavallée lesion.

For the uninitiated, a Morel-Lavallée lesion is basically when tissue gets sheared away from the muscle underneath it and fills with fluid. That fluid doesn’t politely leave on its own. It just… moves in. Sets up shop. Expands. In my case, it ballooned out to include my entire left knee, creating a swollen zone that ran from the bottom of my knee up the inside of my thigh for about eight inches.

And here’s the fun part: that fluid was never going to resolve itself. Worse, it was actively preventing healing by keeping the tissue separated from where it needed to reattach. The fix is brutally simple: Drain the fluid, apply compression, and let the tissue heal.

That’s it. No mystery. No magic. No $20,000 ordeal.

Which, of course, means the medical system turned it into exactly that.

I’d already done the research. I already knew what this was. But you can’t walk into a doctor’s office and say, “Hey, I googled this and here’s the diagnosis,” unless you’re interested in being mentally filed under problem patient. So I kept my informed, well-researched opinion to myself and climbed aboard the bloated, bureaucratic medical machine instead.

What followed were multiple doctor visits, referrals, gatekeepers, delays, holidays, insurance hoops, and the familiar sound of money being burned without any actual problem-solving occurring.

Eventually, after several rounds of this bullshit, I landed in an orthopedic office where someone finally gave a damn. Someone who wanted to solve the problem instead of managing it indefinitely. Great. Progress.

I was referred out to have the lesion drained.

That appointment was today.

When I made it, they told me I would need to be sedated. I told them no. There was no reason to put me under for a fluid drain. I requested a local anesthetic so I could drive myself home. The nurse checked with the doctor. It was approved. Local only.

Remember that.

This morning I showed up early, ready—eager, even—to get my goddamn leg back. That enthusiasm lasted right up until patient registration, where I was presented with a $2,600 bill.

I have insurance, by the way. The hospital was planning to charge my insurance nearly $20,000 for this.

When I asked why, the woman at the desk had no idea. No breakdown. No explanation. No answers. She told me I’d have to call billing because they don’t deal with that.

Which is, in a nutshell, the entire problem with American healthcare: everything is siloed, no one is accountable, and no single human being is ever responsible for the whole picture.

But I needed this drained. So I signed, fully intending to tear the billing apart later.

Then came the payment dance.

“How much can you pay today?”
“I won’t be paying anything today.”
“Well, how much would you be able to pay?”
“Nothing.”
“So… some amount?”
“No.”

We eventually landed on “set up payments,” which apparently satisfied whatever script she was required to follow.

From there, I was herded deeper into the hospital maze. More waiting. More listening to people say deeply stupid things to receptionists. Another hour evaporated.

Eventually, my name was called. I stood up, hopeful again, only to be led to—surprise—another waiting area. This one at least came with a gown, vitals, and someone pretending this was about me.

That nurse asked, again, about sedation. I reiterated: no. Not necessary. Not wanted. I said I’d call someone if an emergency somehow required it. Fine. Whatever. Queue another nurse, sent in to try and talk me into sedation like it was a lifestyle choice I just hadn’t considered yet.

Still no.

Another hour passed.

Finally, the doctor came in. “So, we’re going to put a drain in your thigh today.”

I stopped hearing words after that sentence.

“No,” I said. “That’s not why I’m here. There’s no drain. Nothing is being installed in my body.”

He asked me to explain, in my own words, what I believed was happening today.

I told him, calmly, that I had a Morel-Lavallée lesion, that the plan was to drain the fluid and apply compression, and that I would maintain that compression at home while it healed.

He left to review my chart.

Thirty minutes later, he returned.

“I think we’re going to go with your plan,” he said. “That’s the right approach for this injury.”

Wow. Just… fucking wow.

Suddenly, the $20,000 made sense. Suddenly, the insistence on sedation made sense. I wasn’t scheduled for a simple drainage, I was scheduled for a much more invasive, much more profitable procedure that I never agreed to.

Five minutes later, the lesion was drained.

When he inserted the needle to numb the area, I didn’t even feel it. Truly. I could have done this myself.

They wrapped the wrong place afterward, compressing my knee instead of the actual lesion, but I didn’t have the energy left to argue. I got dressed, got out, and went home.

And then I fixed it myself.

Correct compression applied. Lesion drained. Problem addressed.

Two months late.

Check.
Check.
Check fucking check.