Incidentally ...

Here's the statement from the insurance company for my surgery. As you can see (click on the photo to see it larger), the hospital was allowed just over $71,000 for "incidentals." If you think that is bad, we saw the documentation on the insurance company's website showing that the hospital actually asked for $153,000 for the "incidentals." The fact that they're getting just under half of what they asked for sounds cheesy on the insurance company's part, and luckily, our insurance company did cover those incidentals, no problem, so we don't have to pay.

Still, I'm curious as to just what exactly those incidentals were. I mean incidentals are defined as things that are minor, casual or subordinate. Subordinate to what? Well, things that are not incidentals, but essentials.

So is this charge for things like those little bottles of Keri lotion or the infernal baby powder they are always pushing on you when you are a patient? Actually I think those things are better categorized under "sundries," but there wasn't a category on the statement for that. Anyway, I didn't use the lotion or baby powder, so maybe the insurance company can get the money back? Not that I'm so keen on helping out the insurance company, but then maybe our premiums would go down, or something like that.

Do the incidentals include the use of hospital gowns? Cause I brought my own, so can that be deducted too? The day I was discharged a volunteer came in and gave me a small plant; what portion of the 71K was that little schefflera?

Just the room and board alone was close to $25,000. I could have rented a room at a nice hotel in Philadelphia with that money. I sure didn't eat many meals (read: ONE that wasn't sippable, and there weren't too many of the sippable kind, come to think of it) so there should be a reduction in the "board" amount, too.

I guess I shouldn't be complaining too much, as I said earlier, our insurance company did pay for most of the bill, but I just wonder what kind of world it is where insurance companies will pay $71,000 for "incidentals" but won't approve more than one level of TDR (total disc replacement) when a doctor deems it necessary. As in essential. As in the opposite of "incidental."

Ain't Technology Grand?

I'm looking good!
Or so Dr. Balderston says. He pulled the remainder of the surgical tape off the abdominal incision and it doesn't look as bad as I thought it would. He says it's still somewhat swollen, and I can attest to the fact that it is still very sore to the touch. Those red marks on the sides are bruises from when the surgical tape was on and I had the distention problem, causing blisters to form under the tape. Ugh.
He was really impressed with my walking regimen, but didn't give me permission to do anything more than that at least until I see him again in another six weeks. I am allowed to begin doing some upper body work, mostly arms and shoulders (no lat pulldowns, chest or pec work for now), with five pound weights (he started at three pounds, but I got him up to five, ha!). I'm also allowed to start moving my body into different positions, like mild twisting, and I'm permitted to lift and carry up to fifteen pounds. But no bending yet.

I asked him about my still throbbing legs, he said it will go away as I become more used to walking upright (ha, soon I'll be using tools just like a human!). Apparently all my feverish stationary bicycle riding and swimming don't use the same muscles as good old-fashioned walking.





As you can see from the xrays, (click on the images to see them larger)he didn't take out the old rods; there was so much bone grown over them that he said it would have been a much more painful recovery for me. What they did do was cut the rods and reposition them so that my shoulders and thoracic region are now above my pelvis, and not pitching forward (compare to this). The first little red arrow in the xray on the right is where they cut the rod, the second points out the L3-4 fusion with small metal cage and screw, the third arrow points to the ProDisc at L5-S1.

Ain't technology grand?

I'm Walkin' ...

Yes indeed!

So today I decided to go the medical supply store at 8th and 25th and see about some kind of a brace to wear to help to remind me to stop twisting! Try to count up how many times a day you twist your torso, then imagine not doing it. It's nearly impossible for me, it seems. Anyway, I spoke to Theresa about this yesterday and she suggested that I try one on before I buy it, then she would fax in a script so it would be covered by the insurance.

So I get to the store and they have quite a selection; the guy who is in charge of "devices" helps to fit me with one, and when he pulls it around my waist to cinch it, his knuckles go right into the incision. Even without his knuckles in the mix, it's way too tight to be comfortable on the incision right now (this is the abdominal incision I'm complaining about right now; for some reason, the incision in my back seems to be further along in the healing process and not as sensitive to the touch). I decided not to get one, at least for now. I'm seeing Dr. Balderston next Friday anyway, so hopefully he'll tell me that it is ok to twist, or something.

I did my walking again today! After I walked over to 8th Avenue to the medical supply store I went down to the gym at 23rd and did a mile on the treadmill at a higher speed than yesterday and a .5 grade incline. Yay! I now have sore legs, sore butt, and shin splints, but man, is it a good feeling. Shin splints remind me of running, and that's ALL good. My stomach muscles are also really sore, not sure what that's about, I mean other than the surgery five weeks ago. They seem to be getting a bit more sore as I increase the walking. I'm happy for any muscle sensation I get at this point, and can't wait to be able to do more. For someone as active as I usually am, this is torture.

Progress, maybe

Since I'm not allowed to do any exercise other than walk, I've been really trying to make the most of that. I've been going on increasingly longer walks everyday (Tony is upset that I don't take him along!), beginning with just walking around the hallways in my building and now including strolls around my Chelsea neighborhood. These latter outings are usually under the guise of running some errand, like picking up some fruit, dropping books off at the library, or buying a magazine or small treat for myself (croissants from Breadstix Cafe) while I'm out.

Yesterday I walked over the West Side Highway, up to 27th Street (when it started snowing!), back over to 10th Avenue, down to 23rd Street, up to 9th Avenue and then cut through my building for the last block cause I was freezing my ankles off in my capri sweats.

Today, since my long-frozen membership at NYSC has finally been unfrozen (I'd been working out at the London Terrace gym until just before I went into the hospital, it was much, much closer to home), and since I didn't feel like freezing my ankles again, I walked the two long blocks over to NYSC at 8th Ave. Once there, I walked a mile on the treadmill, then walked home with a small bag of fruit. My butt and legs have been sore since Tyler and I walked over to Bed Bath and Beyond on Sunday (four crosstown blocks from our apt., my farthest walk yet!) and took a cab back home (when I realized with a start of horror that I wasn't supposed to be in a car, but by then we were almost home, incident-free, thankfully).

Still, I've kept up with the walking every day this week. The soreness feels good; it's a different kind of achiness, a different kind of pain. This pain is from use, from increasing strength. It feels good. I'll let you know tomorrow if it still feels good, but whether it does or not, I'm still going to walk. Maybe just not as far.

Shout outs!

Now that I'm one month past my surgery, I'd like to give some shout outs to the hospital staff that made impressions on me during my stay.

A big shout out to Angela, the Physical Therapist on my floor. She insisted that I practice getting in and out of a car (they had half a fake one in the rehab room) even though my post-surgery instuctions say "absolutely no automobile travel until your follow up appointment." She also said I had to try steps. Again, the instructions warn against steps.

A shout out to my nurse the first day after my surgery. I still don't know her name (in my mind she is "Dumb Dora"), as she consistently refused to write it on the little whiteboard by my bed for that purpose. She never came to check on me that first morning, as if she had, she would have seen that I was laying (on my side, thankfully!) in my own puke. Instead this was discovered when Dr. Balderston and Theresa came in for rounds first thing. Someone must have gotten reamed a new one from Dr. B. and Theresa because as soon as they left there were about seven people in my room, including the Nurse Manager. Dumb Dora then stuck her face next to my ear and shouted, as though I was a deaf, mentally challenged 4-year-old that didn't speak English, "Do you want something for nausea?" I think I rolled my eyes and said "what do you think?" I had to really bite my tongue, as I'm sure you can imagine what I wanted to say.

A second well-deserved shout out to Dumb Dora, who, when I asked for something for pain after I had been taken off the IV Demerol, refused to read the second page of my chart where the previous nurse, Patrice, had noted that I was getting Darvon, not oral Demerol (which is ineffectual). It wasn't until I picked up the phone and started dialing Theresa that she miraculously summoned the energy to flip the page and find the most recent additions to my chart and get the correct pain meds.

A shout out to the Nurse Assistant (or whatever they are called) who was attending to my roommate the night of my surgery and who double dipped with her bare, ungloved, probably unwashed hand into my cup of ice chips.

A shout out to whoever the nurse was for my roommate who left her stuck on a (full) bed pan for 18 minutes (we timed it).

A shout out to the Physical Therapist who was on duty on Saturday and came right after I went through the horror of having the tube thrust up my nose and down into my stomach and then, ignoring my wishes to not get up right then (the tube was really, really uncomfortable plus I would have had to carry the cannister with the black, red and green slime in it around with us!), asked the nurse if it could be disconnected "for a few minutes" so I could walk around the floor with her and presumably practice getting into a car and going up and down steps.

A shout out to my nurse Barbara, who left the clear plastic container with the black, red and green slime in it hanging on the wall above my bed for three more days.

Yet another shout out to Dumb Dora, for standing over me with her arms folded across her chest not helping or offering any comfort whatsoever while I cried out in pain, unable to move myself from my bed over to the gurney that was waiting to take me to xray the day after surgery. Once I manoevered my way over without her help, she dashed back to her seat at the nurses station stating loudly to the other nurses, "She had her arm in the wrong position." Yes, that was it and it was all my fault, Dora.

And still another shout out to Dumb Dora for, when I asked for something for heartburn (my acid reflux was killing me as I had to lay flat to comfort my back), telling me that laying flat to comfort my back or propping myself up to relieve the heartburn was "a decision I would have to make." Again with her arms folded across her chest, like she was mad at me for having had heartburn.

A shout out to the entire nursing staff who ignored three calls from me for pain medication over a two hour period between a quarter to six and eight fifteen in the morning on Saturday. By the time someone came in (incidentally, NOT a member of the nursing staff, an NP with orthopedics who was doing weekend rounds) and summoned the nurse (and no, it wasn't Dumb Dora), I was in tears and incoherent with anger.

I'm really not a complainer but come on; some of this stuff is just beyond the pale. I do have some positive shout outs, unfortunately not very many. I'm researching an essay on the health careless situation in nursing, and wanted to get these out there first. Stay tuned for my take on the "nursing crisis."

28 days later ...

28 days later ..., originally uploaded by Ingrid!.

Posterior incision. Looks ok, and at least it's less itchy than the one on my stomach.

Do The Twist

Here I am in my "bone growth stimulator." It sounds like a lot of hocus pocus; supposedly this apparatus (like having two picture frames strapped to my body) is supposed to send out micro-pulses that stimulate bone growth, helping the fusion to heal. OK. Hey they gave it to me in the hospital, so I'm using it.

It can't heal soon enough for me.

I'm not allowed to bend at the waist; if I want to pick something up off the floor, I have to squat down, plie-ing like a ballerina. An aching, sore, awkward ballerina trying to pick up her damn ugly-azz slippies (even my doctor made fun of them in the hospital, but they're so comfortable and they were only 7 dollars!) off the floor.

I'm not allowed to twist, even though I've woken up a few times in the night with my hips facing a different direction from my chest. I just now noticed that I'm kind of twisting in the photo above. It's hard not to twist.

I'm not allowed to pick up or carry anything over 10 pounds, though as I said before, anything more than a cup of tea or a book feels like a ton. And twisting and lifting and carrying is strictly verboten. Like something as simple as picking a dish up from the table and turning my body toward the kitchen with the dish in my hand is not allowed.

I can't swim, obviously due to the incisions mostly, but also because the weightlessness of the water, the thing that made me feel so good before, is now not my friend. I could overexert and snap a still healing muscle in a snap.

My recovery time would be much, much shorter if I had only had the ADR, but because I also had a fusion in two of the vertebrae, the healing and recovery will take months. At least it isn't as bad as when I had the first fusion for scoliosis 20 years ago. Then I had to wear an uncomfortable plastic "brace" (read: body cast) for six months. It was sweaty and at times unbearable. I had to wear a tshirt next to my skin under the brace, and anytime I went out of the house I had to carry a fresh tshirt and a plastic bag with me, ducking into the ladies room of whereever I was to take off my dripping wet sweaty tshirt, put it in the plastic bag (PU!), put the fresh shirt on and dry off the brace on the inside and put it back on. Then put whatever baggy shirt I was wearing over it all back on. Sometimes I'd need two clean shirts with me if I was going to be out for a while, and this wasn't even summer, it was October, November, December.

As much as I don't miss that, I do kind of miss the brace. Everytime I step out on the sidewalk now, I'm in fear. Fear of someone smacking into me, of tripping, of those damn delivery guys racing down the sidewalk on bikes, bags of food swinging like maces off the handlebars. Also, it would keep me from moving improperly, like the mindless twisting I do about a hundred times a day, like I'm twisting in the photo above. Not good.

What I can do is walk. And I do it everyday, either outside, in fear, or inside. We are so lucky to live in a huge building, an entire city block. We've got long interconnected hallways on the first floor so I can stroll around in my pjs and slippies and get my exercise without going out.

I've got my first follow up with Balderston on the 19th of this month and I'm hoping he'll give me the go-ahead to do more than walk then. But, I still may not be doing The Twist anytime soon.

Quest for Sweats

I'm on a mission to find a pair of good quality sweat or fleece pants that fit, and that don't have an extra tight waistband. After I discovered how comfortable the Old Navy Sleep Bottoms were (soft cotton flannel fabric with gentle elastic and a drawstring that doesn't irritate the incision) I sent Tyler to pick up the last two XS pairs in our local store. They are my uniform, and thank goodness all the pairs I have are new enough not to be ratty, so I can wear them when strolling around the hallways in my building.

But now that I am getting outside (trying anyway, once a day)I need something I can wear outside that is stretchy and warm and comfortable. Jeans are out right now, they would cut right into the incision on my stomach and probably my back too. I have two pairs of sweatpants but they got mistakenly put into the dryer, so they are now capri pants. My yoga pants are too thin to wear outside in the cold. Also, all these items have fairly heavy waistbands that, if they don't cut into the incision area, cause sweating in that general area, which leads to more insane itching than usual.

If anyone has any suggestions for a good pair of semi heavy-weight "activewear" (ha that's a relative term!)pants aka sweat pants that look decent enough to wear out on the streets of New York, and that don't have super tight waists, please let me know?