Surgery Countdown: Seven Days

The surgery is seven days away.

We spent Monday filling out forms, producing insurance (or as I like to call it, “UNsurance”) information and getting stuck with needles.

The lowlight of the day was when I had to see the cardiologist for a routine EKG. This is like a 40 second test. We were in the offices of Drs. Mandal (a father-daughter cardiology team) for 90 minutes, with only one other patient in the whole place. WTF? It was like a Three Stooges movie, with two admins and the doctor and her “Medical Assistant” running around and literally bumping into each other. And can I just add that they had the absolute worst magazine selection ever? There were three copies of the same issue of a golf magazine and some Prevention wannabe. The highlight of this lowlight was when the MA was taking my history and asked if I ever drank. I said yes. She said how much, I said a lot. She said how often, I said a lot. She asked if I went to AA. Well! I don’t, but hello? It’s ANONYMOUS!? Finally we were released so I could go donate my own blood to be used in the surgery.

The blood donation was definitely the highlight of the day. Darlene was the phlebotomist and once we started to joke around a little with her, she really loosened up, though she still wouldn’t let me take my camera out to take a photo of my blood, all neat and warm in its little pouch …

I found out that another surgeon will be making the incision in my stomach and pushing my organs to the side, exposing the spine anteriorly. They referred to this doctor as a “general surgeon.” Yeah, I know, doesn’t sound good does it? Sounds sort of like the interns are in the back flipping a coin to see who cuts my belly open (I’ve GOT to stop watching Grey’s Anatomy). That’s actually not the case, thank goodness, the General Surgeon that will be making that incision is Dr. David Wernsing and he’s been working with Dr. B for years. I’ll meet with him briefly the day before the surgery. Theresa told me that some patients don’t even ask to meet with him, laying eyes on him for the first time just prior to letting him cut them open. Ack!

She also told me that because of the anterior approach to the spine, I won’t be able to have anything by mouth for 3 days. This is what I’m dreading the most. I do like to eat and am worried about what my stomach will feel like. I get all gurgly after not eating for about 6 hours, I can’t picture three days! But I will definitely be on morphine and out of it from the surgery for at least two of those days so I’m hoping it won’t be too bad.

The operation itself lasts about 3 hours. Once Dr. Wernsing opens me up, Dr. B. will go in and insert the ProDisc(s) in L5-S1 and (if he can fit it) L4-5. Then they’ll close that incision, turn me over and cut again (this one Dr. B. can handle as there are no organs in the way to confuse him, ha) and fuse L3-4, then saw through the bone grafts in my thoracic region and take out the metal rods that have been in there for 20 years.

It’ll be at least two to three days till I can get up out of bed on my own, though they will help me to stand up and take a few steps, if I’m able, the day after surgery. I’ll have a catheter and a pee bag so I won’t have to worry about using a bed pan. Yay! Life is good when you have a pee bag.

Oh, and she also told me that since they’ll need access to the incisions on my front and back, wearing my own pajamas is out. Tune in tomorrow for pix of my own chic handmade hospital gowns!

Big Changes/Small Worlds

There’s going to be some big changes in my world soon.

I’ve been struggling with intermittent pain for the past five years or so, but by the time I have my surgery on December 6th, it will have been eleven months since the rapid deterioration of three of my lumbar discs set in.

Eleven months of being pretty much stuck in the apartment most of the time.
Eleven months where I went out on social gatherings maybe eight times.
Eleven months where I rode the subway twice.
Eleven months where I watched from my perch on the bed as the bare tree across the street grew buds, then leaves, then lost them, and now is bare again.

Eleven months in which my world has gotten steadily smaller. Except for the occasional bus or cab ride, my world consists of the building that I live in (which is expansive, a whole city block), and the sidewalk that runs around its perimeter where I walk Tony in the morning.

I know the world outside my little environment hasn’t changed just because I rarely venture out into it anymore, but in the few times that I have gone via cab to get together with friends, to go to a doctor’s appointment or to get my hair cut it sure seems different to me. Bigger. Wilder. Weirder.

As much as I am looking forward to the surgery and seeing how things turn out (nothing is guaranteed you know, plenty of people go through things like this and get no relief, but I try not to think of that), I’m more afraid of what’s going to happen after the surgery. I was telling a friend in an email last week that I’m not sure if I remember how to be a functioning adult out there in the big, wild, weird world.

When you have to take a bus to go two blocks to pick up some fruit because you can’t possibly walk that far even with a cane to support you, taking a cab down to Horatio Street to get a hair cut or to the Upper West Side for a teeth cleaning is like going on safari.

While my world is so much smaller, my personal discomfort zone has grown. I’m much more aware of the space around me now, fearing, even more than a typical personal-space-obsessed New Yorker, the jostling of a hurried crowd of people; an accidental brush of an elbow could send a spasm running like an electric shock from my spine up to my shoulder or down my leg. Someone’s casual misstep could knock my cane out from under me, throw me off balance, the pain seizing at my twisted muscles.

Though I’ve attempted to describe, meticulously, all the developments in the two ongoing processes: my own deterioration and the bureaucratic plodding toward the surgery, it seems that my world of words has shrunk as well. There are a myriad of words and ways to describe pain and disability, but I feel like I’ve exhausted them all, and frankly am none too anxious to coin any fresh ones. So preoccupied have I been with my physical situation and the surrounding health care drama that my own novel, as concrete a fantasy world for me as is possible, offers no escape. My mind swings, with the regularity of a pendulum, from any feeble diversion back to my reality.

My photography has atrophied too. Being restricted physically means that I have been restricted in what catches my eye. Potential subject matter is suddenly in short supply; in recent weeks it’s now mostly dwindled down to what can be taken inside the apartment or at the swimming pool: me, my dog, or the TV.

On Monday we’ll be in Philly for the pre-admission testing and to donate blood and I’ll be happy to get out in the world for a change of scenery. It’s déjà vu-ish that I’m going back to Philadelphia for this surgery twenty years after the other surgery on my spine. Back to the same floor of the same hospital with the same doctor, so maybe it isn’t all so big, wild and weird; maybe it’s a small world, after all.

My surgery has been scheduled for December 6th. yay!

Aetna approved a fusion and one disc and we will pay out of pocket (GRRR!) for the second disc (assuming Dr. B. can pry the vertebrae apart far enough to get the second one in). I go down to Philly on the 27th for pre-admission testing, and to donate a pint of blood. We’re hoping that Tyler will be able to observe the surgery and maybe (if he doesn’t pass out!) take some photos during the procedure.

I'm working on a blog entry now, and will have many more details after the 27th.

Read this while we're waiting ...

A link to an article about Dr. Thierry Marnay, the French surgeon who invented the ProDisc.

Still waiting for the confirmation phone call from someone named Melody that does the surgical scheduling. Keep it all crossed for December 6th!

Approval!

Tyler just got a call from Maureen (who has been instructed not to call me, thankfully); a one level replacement and fusion were approved.

Yay!

This means that if Dr. B. is able to fit the second ProDisc in, we'll pay for it our of our pocket. Boo! But anyway, now we go back to the waiting game till we hear what the surgery date will be. I'm not holding out much hope that it will be before the holidays, but maybe ... I'm so numb from the waiting that it hasn't really hit me yet, and I think it won't until I'm actually in the hospital getting wheeled into the OR.

Health Careless II

Got a call from someone named Melissa, Melinda, Melanie, whatever, some minion of Maureen (yes, this tactless clerk has minions). She was calling to tell me that the claim that was submitted to Aetna for the three level replacement was ... wait for it ... denied. She started to tell me that if I wanted, I could appeal. That was when I stopped her.

"Listen, I think you are missing some information," I tell her. I explain that we already knew about the insurance company denying the claim, as we'd been notified last week when we got our online statement from Aetna, but we didn't sweat it because Dr. B. had just told us that he was resubmitting two new configurations to them that had a good chance of being approved (since we'd be paying out of pocket for some of it). I was more than a little concerned because

a) When we saw Dr. B. on the 25th, he said they were going to get to work on it "right away." A week later is "right away?"

and

b) Maureen and her posse are the ones that are supposed to be up on all the insurance company stuff! That's what they do, that's their job. How come they didn't even know that there had been a change to what was being submitted? It didn't sound to me like they were working in the same office I'd been in the previous Friday. It also didn't sound like any of the new configurations we'd talked about with Dr. B. had even made it to the insurance company yet.

MM (Maureen's Minion) shuffled some papers around and said she didn't have my papers in front of her (then why was she calling me? To recite the same gloomy crap she says to every one else?)but that she would "look around" and get back to me.

I hung up and called Theresa, Dr. B's NP. Normally I wouldn't call her, since she hates talking to patients, but figured I would get her voice mail and so wouldn't have to have any actual interaction with her and of course I was right. I told her that I'd been to see Dr. Balderston last Friday (like she hadn't seen me hobbling down the hall with my cane and looked right through me, yeah) and that we'd discussed resubmitting two new configurations of the surgery to the insurance company, and why did Maureen and her minions not know of it since they were the ones that were supposed to get working on it "right away" last week?

I also told her that she was to tell that whole office, Maureen and all of her minions, to lose my phone number, that the last thing I needed was these women calling with all this negative news on top of everything else. Just call me when you've got it together, ok? Why do I have to be reminded every step of the way that I'm being shafted by the insurance company? I gave her Tyler's number to call back as I'd just as soon not have her get back to me, adding that she didn't seem to anxious to talk to patients either.

About a half an hour later, Tyler gets a call from a very apologetic Maureen, saying that she had just gotten the paperwork (explaining the various steps in between my appointment and her and her minions) and that it would be submitted tomorrow. Since we are coming up on the December 6th date that Dr. B. had penciled in for my surgery, the absolute last date we could get approval and still make that date is this Friday, the 10th.

So now I'm in another set of knots waiting for Friday, wondering if they'll hear back from the insurance company in time so the surgery won't have to be delayed again, and if it does have to be rescheduled, let's hope, for all our sakes, that someone besides Maureen or her minions calls to let me know.