My 2016 ICD-10 is titled ICD-10 Expert for Hospitals. Can't remember who, I believe it was an instructor advised to get the Expert for Hospitals Optum.
This Optum also has that HUGE spiral and you are right. It is a constant slow down, always having to shift the hunk of pages, flatten them, smooth them because somehow they get creased, and I have already slightly torn a couple of pages, even though my treatment has been careful and delicate so as not to tear. I guess you can gather by this description that I don't like the spiral.
As to the spiral wandering out of its holes, I took the hint from one of the students who took her hint from one of the instructors, and with the use of some pliers bent the end of the spiral backward and tucked it into the nearest spiral and that took care of that problem.