Thursday, April 26, 2012

The Day After

It's the day after surgery and things appear to be going well.  Doing this surgery outpatient has been so nice compared to the previous two times when I had to stay in the hospital over night.  I got a lot more rest last night than I would have had I been in the hospital, so that has made me feel much better.  Additionally, it allowed me to participate in work activities today instead of missing a second day.

Arranging this surgery with work was somewhat interesting.  I didn't get it 100% finalized that I would be doing this surgery until almost 5PM on Tuesday afternoon.  Besides just being scheduled, I had a lot of issues to take care of insurance wise that could have been deal breakers.  The facility in which I had the surgery is called the SurgCenter on Dry Creek.  It is a very small surgical center with only 6 pre-op/recovery bed and 2 operating rooms.  The majority of the cases that they do there are steroid injections into the spines of people with back problems.  The do a much smaller number of surgeries like mine.  The nurses told me on any given day they might do 5 or so surgeries and as many as 20 steroid injections. Yesterday they were only doing 3 surgeries and had something like 15 steroid injections.

Given the size of the facility and just the nature of it, I suspected that it was a physician own facility.  For all I know the surgeon who operated on me and his partners may own the place - I don't know.  But because of the small size and nature of the place it is out of network for many insurance companies - including mine.  The estimated cost to have the surgery there as an out of network facility was $1700.  On top of that many of the providers except for my surgeon would have also been out of network.  This could have resulted in a very substantial price tag for me.  I wouldn't have minded paying the money, but if I waited or went with Dr. Prall for the surgery, I would have had to pay nothing since my in-network deductible has already been met.  For example when I did the first back surgery at Littleton Hospital, I had to cough up $4500 on the day I went in for surgery.  The second surgery, which was also at Littleton Hospital I didn't have to pay one cent because my in-network deductible was met.

The bottom line is it took a lot of haggling, but the people at the surgical center realized what the situation was and decided to charge Aetna at the in-network price.  On top of that, if Aetna comes back and doesn't pay them $1700 because that was the portion of my out of network deductible to be paid to the facility, the surgical center agreed to write off that amount of money.  All this took a while so it was formally decided I was having the surgery until 5PM the day before.

Because of all of this I didn't get any prior notice to tell my manager that I would be out of the office on Wednesday.  I had a ton of work to do for her on Tuesday night so I was up pretty much the entire night.  When I sent here the completed presentation at 1:45AM, I included in there a description of the situation.  I do not like being seen as unreliable.  Sending that message with such short notice made me feel unreliable, but I really wanted to get this surgery done!

Getting up at 5:00AM so that I could be at the surgical center at 5:30AM kind of stunk.  I also got Zack up and made sure he made breakfast for himself and that he got a good combination of clothes to wear to school that day.  He gets he own clothes out every morning but I got to say, some of the combinations that he comes up with are unorthodox to say the least.  At that point, I tend to step in so he doesn't go to school with an orange shirt and a red pair of shorts.

My brother got to the house promptly at 5:25AM and once I finished relaying all the instructions to Zack we took off.  He just dropped me off and didn't stick around as there was no purpose to it.  Arriving at the center was some what odd as there were really no one there.  When I walked in ta receptionist was on duty and there were two nurses in the pre-op area and that was all that was there.  They had me do all the normal stuff like get undressed and put on one of those ever popular hospital gowns. The took my vitals - which despite not having taken my body pressure medication, my BP was excellent.  I guess I have grown use to the surgery as I don't even get worked up about it any more.  The worst pain of the day was encountered when they put the IV into the top of my hand - and that really doesn't hurt hardly at all by the way, but it really is the only pain I tend to feel with the surgeries I have had.

The anesthesiologist was quite unusual.  Instead of looking like he belonged in an operating room environment, he looked as though he would be more at home at a construction site or on a Harley Davidson.  He was a huge hulk of man with blond hair and a blond goatee on his chin.  To ensure the difference of his looks instead of the typical cap/hair net thing most nurses wear, he had on a "dew rag" that gave you the impression he was a member of a biker gang.

Another unorthodox thing that occurred was that before they did anything with the anesthesia they gave me an oxycotin 10 mg pill.  I had never seen that before where they would give you a pain pill by mouth before surgery.  After that it was all business as usual.  I only had to sign one consent this time as I had signed all the other consents late Tuesday afternoon at the doctors office.

Surgery was scheduled for 6:30AM and things ran pretty much according to schedule as I was getting into the operating room at 6:40AM.  Being rolled into an operating room is an extremely interesting experience.  The first thing I always notice is the table that they put you on.  Thankfully this table was not like the rig they hard at Littleton.  The table for back surgery at Littleton looked more like a torture device in which you were splayed out in all four directions so that your body essentially forms and X.  This table was a plain old fashioned operating table on which they had a riser so that my back would be elevated above the rest of my body.  A couple of other interesting observations was how stinking cold it was in there.  Seriously the temperature could not have been too much above sixty degrees.  Wearing only a hospital gown in that temperature you are quickly freezing.  Lastly, the other thing I noticed - and this is the same in every operating room are the lights!  They are so huge - they must be so bright when they are turned around.

Once I was rolled into the OR and the gurney situated next to the operating table, the fun with drugs began.  The anesthesiologist started putting lots of drugs into my IV.  The first one to hit me kept me awake but definitely relaxed me.  Then he put an oxygen mask on my face at the same time he was putting another injection into my IV line.  At that point I started to feel the overwhelming feeling that the world was starting to be cut off around me.  I always like to try and fight the feeling of going under, but it is useless - you go to lala land regardless of whether or not you want to.Shelly Dierking

Next thing I know I am lying back on the gurney in the pre-op/recovery area.  The surgery as far as I know went without a hitch.  I didn't get any feedback on what was found or what was done because Dr. Elliott had already left.  My surgery was the only one he was doing at that surgical center on Wednesday.  All the rest were being done at other places.  The one thing I do know is that the incision from this surgery seems to be much larger than the previous 2 surgeries.  This time the incision seems to be about 6 inches - half a foot long!  Yikes is all I can say to that.  The following unflattering picture of me shows the size of the bandage and hence the size of the incision.  It's darn big!

(Ugh - this is a really ugly picture of me that catches me in an unflattering light, but I wanted to post it so that you could see the size of the bandage and hence the size of the underlying incision that I have on my back!)

All told I was under general anesthesia for about 5 hours.  I came out of the OR at 11:30AM but I didn't really start having any kind of recollection as to what was going on until about 12:30PM.  I was still bleeding a good bit from the incision so they decided to keep me until 3:00PM.  During that 2 1/2 hour stretch, I ate a few crackers and other snacks, proved to the nurses that I could walk and get around and of course the one that they insist upon - I proved that I could pee.  (There is something in the general anesthesia that stops your ability to pee.  So you have to prove to them that the anesthesia has worn off enough that you can pee before they will release you.)  There didn't really seem to be any negative side effects from surgery other than the fact that my uvula (the thing that hang down from the back top of your mouth) is swollen from the beating it took when I was incubated.Shelly Dierking

My brother came back to the surgical center around 2:25PM and we hung out talking until it was 3:00PM.  The reason that they made me stay was to make sure that the amount of bleeding/oozing from my incision was minimal. They discharged me promptly at 3:00PM and we were off towards home.  Tim just dropped me off because he needed to run so that he could get to his class that he is taking at Metro state on time.  However, Nancy was there and she stayed around and chatted with me for a good hour or so before she headed back to Cranbook.

About 30 minutes or so after I arrived home there was a knock on the door.  At first I thought it was Zack coming home from the bus and so I yelled a couple of times "The door's open".  But the person didn't come in.  After I looked closer, I realized that it wasn't Zack, it was some one I didn't know.  Nancy got up to see who it was and it was a delivery person bring me flowers.  Boy was I surprised to get flowers!  That was real special for me to know that someone cared enough to go out of their way and send me flowers.  I really appreciated it a lot.  As for who sent me flowers...  I will leave that a mystery for now but you can be sure I will fill in the blanks at a little bit later of a time.  I'll leave it at this for now - the sender was a she and she is really beautiful.  Enough said on that subject for a little while.

After Nancy left it was just me, Zack and the pups.  Obviously the pups weren't going to be doing much to help me out so I relied upon Zack to do the things around the house that I would normally do.  He did is normal chores (feed the dogs, do the dishes, etc) and other things too.  My limitations after this surgery are pretty basic - no bending, lifting or twisting (BLT).  So I should be able to still do a lot of things around the house like cook, do the laundry etc.  Yesterday afternoon I didn't want to do anything since I was just out of surgery, so Zack did pretty much everything for us.

Around 6:30PM Celinde and Cole stopped by and brought us dinner.  They got me Tokyo Joes and Zack they got Burger King.  Since Tim wasn't around and Cole had all his homework done, they stayed and visited with us for about 1.5 hours.  It isn't too often that I get to sit around and just talk to Celinde - so it was kind of cool to have a long conversation with her.  Zack and Cole of course played video games - imagine that!Shelly Dierking

Celinde and Cole left around 8:30PM and then Zack and I watched a bit of TV before it was time for him to go up and get to bed.  Being the stupid fool that I am...  I ended up stay up until 1:00AM as I got to writing and I didn't want to stop.  For whatever reason I am always writing and there was a lot for me to write about yesterday.  I put another e-mail out to my boss explaining the whole situation.  The good thing is she understood and was really great about the whole situation.  Having a really good person who you work for makes a world of difference in your life!

Today - Thursday has been low-key as I have kept my activity levels to a minimum.  I really want this to be the last back surgery I have so I want to make sure I don't screw it up by doing too much.  I did a conference call early this morning and I have stayed on top of my e-mail, but other than that - I haven't done a huge amount.

And with that I will wrap up this post.  There's a lot of stuff floating around in my head that I want to write about so I think I will be a relatively prolific writer in the coming the days.

Thanks and peace to all! ~J.

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