Surgery or the Twilight Zone

As I write this from the living room couch with my right leg strapped into the sling of the CPM machine with Sammy comfortable perched on my hip and the laptop on the other, I am truly thankful to be at home. It is early Wednesday morning and I have already completed 30 minutes of the 2 hour treatment. I have come to realize that I have been undergoing a whole change in my thought patterns. It has helped me get through the past 6 days. I had my concerns about this 2nd knee replacement from the beginning but I knew that it had to be done and that my insurance being Medicaid would be challenging at best. With the whole health care debate going on at present I will write a whole piece on my experiences and my feelings regarding it in another blog. For this installment I would like to write about my experience.

I have been too many hospitals in the metropolitan area and I have also had this procedure done on my left knee 6 months ago at another area hospital with a different surgeon. One of the first differences was that the 1st surgeon had very few Medicaid patients and so I was treated with respect and my questions were answered and my preferences heard. The 2nd surgeon 90 % of his practice is Medicaid, Medicare & workmen’s compensation. The difference in treatment as a patient was significant. In the first surgery I received the Cadillac of care and in the 2nd it was more like rent a wreck.

My experience this time was the large gaps in communication. I met the physician once, he was brusque, told me to lose weight and that he didn’t think I should have the procedure. I found it interesting that he was significantly more overweight than I was and that his 5 minute overview was not sufficient to determine whether I needed surgery or not. It was because the other surgeon had agreed to do the surgery was all he needed to go forward. It was with equal surprise that after the surgery the Surgeon informed me that I had worn through the cartiledge in my knee and wore a hole in the top of the femur which had to be repaired before the replacement could be placed. Imagine if I had listened to him and continued to damage the femur in my leg.

I did not hear from the hospital at all and on the day before surgery contacted them to see if it was still scheduled. They told me that I was to be there at 10 am and that surgery was scheduled for 12 noon. They also informed me that there was no needed be concerned as they were going to call me later that afternoon to let me know the schedule. The first hospital had a joint clinic in which you went in had your blood drawn and were given a tour of the facility. They introduced you to the Social worker who would be scheduling your rehab and answered any and all questions regarding your upcoming surgery.

Throughout my experience with the 2nd hospital, I was greeted by surprises. I had spoken to the surgeon about having a femoral artery block and he told me to just talk to the Anesthesiologist. On the day of surgery I was informed that the hospital didn’t provide that type of procedure. I was then rushed along so I could get into surgery. I was told that the epidural would be sufficient and that there was a small possibility of awakening during the procedure. Well, halfway through I awoke to the sound of a mallet hitting my leg. I remained awake through the rest of the procedure. When I reached the hospital floor the nurses were shocked that I had awakened during surgery.

My concerns about healthcare reform is that it has already become a system of the haves and the have not’s. It seems they cannot refuse you the basic requirements of a procedure but they can perform it in such a way as to treat the patient as a 2nd class citizen. The overall care was the same its just the concern for customer service doesn’t exist.

During the first night it seems that the epidural had worked its way out of my back and so I was experiencing a very high pain level of about 12 out of 10. Imagine my surprise when they decided to replace it at 1:30am in the hospital room with my roommate a curtain away. I was also informed that I would be transferred to the joint floor that morning but found myself having a femoral artery block placed, again in the hospital room and not being transferred until 6 pm that evening. This of course meant that the Social worker had not started on my transfer to Rehab on Friday so nothing could be done until Monday.

The most important difference with Medicaid is that you as the patient no longer need to be informed or decide what your medical treatment will be. I was informed throughout that it was decided that I would be going to CareOne and when I told them that no I would be going to Kessler they all seemed surprised and stated “well of course you can chose your rehab, especially if you have been there before”. I had requested to speak with the Social Worker at 9 am Monday morning and by 11 am I was beginning to get annoyed, wondering why I had not spoken with anyone. Finally I requested again to see her and she appeared at 11:30 and told me she was working on it. I stated I wanted to go to Kessler and she noted it and left, she reappeared with her supervisor to tell me that I was denied rehab because I now had a good knee so I didn’t need acute care. Since my coverage didn’t cover sub acute care I would be sent home and a visiting nurse would see me on Thursday. At 2 pm I prepared to go home, got dressed and packed my things to be told by 4 pm that they were 50 % sure that I would stay the night. By Tuesday morning at 9:30 am I was told I was going home, I made my arrangements and then proceeded to wait….. At 12 noon, I wanted to know why I couldn’t leave, well I had to wait to be signed out. My surgeon was in the hospital and he would come up between surgeries, by 2 pm I requested to sign myself out. This brought in a nursing manager who then worked for the next hour trying to get me out. It was just neglect and incompetency that held me up there.

At 3 pm the paperwork was finally done and I couldn’t get a wheelchair for 20 minutes so I started to walk to the elevators with a walker. It finally arrived at the elevator but it took me 30 minutes to just leave the building. God I hate hospitals!

I am home now instead of in a rehabilitation facility because my insurance doesn’t cover it. If I hadn’t been through this before going home would have been very scary. While my 2 daughters still live with me they are very rarely home. I knew what to expect at the facility so I can do some of the PT myself but having just had the knee replacement moving around it difficult. The visiting nurse will not be here until tomorrow so it will be 2 days without a bandage change. Of course I will change the bandage but the first time around I don’t think I would have.  I will manage to get through this but the circumstances and challenges have been constant and frustrating.

Taking care of business

I have been home 6 days and I have spent 8 hours at NJ Motor Vehicle. On Monday, I arrived at 10:38 am to join a line of about 50 people waiting to get in to the agency. I had my license renewal and the papers to title the Rialta, after waiting 45 minutes to get into the building I was given a number and went to another line only to find out that they couldn’t title the vehicle but they could renew my license. It took just less than 3 hours to get my license renewed which is lunacy. I was given a piece of paper with a 888 number to call which I did while waiting for my number to be called. It took 11 minutes for Trenton to pick up to tell me that I would have to travel an hour and a half each way to get the Rialta titled. So that became Tuesday’s work and Thursday I got the Rialta inspected which took longer because every inspector at the station had to walk through it. So much work to do 2 simple tasks. It really shouldn’t take parts of 3 days to get 2 simple tasks done.

I have less than a week to have everything in place before my knee replacement surgery. The outside is ready and the garage is coming along. I have to get the inside painted, which I have been putting off. I just needed time to get my personal space where I want it to be. I have the next few days to organize the papers and have a sensible system to work within. I can’t explain why I feel the need to move at this rate but I do. I was planning on signing 6 month contract with the realtor tomorrow but for some reason I am hesitant. Maybe it is because I don’t have the house ready or maybe I’m just not ready to commit.

So much is happening so quickly. I feel like I’m chasing the time frames that I have set. Let’s hope I can manage it.

There and Back Again

As I sit in the lounge of the Rialta flying along at about 75 mph with less then 400 miles to home, I marvel at the last 6 days. So much has happened and all is fine.

We managed to make it to Elkart, Indiana last night at about 8 pm. We settled in and got to bed the earliest since we left NJ. It was early to bed and early to rise as we hit the road at 6:25 AM CDT, showered and ready to go. We have made amazing time through Indiana, Ohio and now we are cruising through Pennsylvania.

The things that I have learned on this trip is:

Everything is fixable, from the vehicle to relationships, if you are open to the possibility then it will come.

Fear is a very strong emotion, it can stop you from succeeding if you let it.

People are the same everywhere, if you approach them with a smile, you will receive a smile.

Help is available if you ask.

If you microwave your tea water and spill it on yourself it will burn you. (I’m fine).

Pilot Service stations from California to Ohio have 10 choices of coffee and in some of them you can take a shower.

This country has some really big Wind Mill Farms in Utah, Wyoming, Nebraska and Iowa.

I can now say that I have traveled the entire country on Route 80 (no wait, I didn’t see the pacific ocean so there is about 80 miles that I haven’t traveled.

Even when you think you know what is being said, it doesn't always mean what is being said.

I haven’t calculated what I have spent yet over the past 6 days but I will let you know soon.

A Test in Courage

This morning we woke to driving snow with drifts about a foot deep on the ground. Route 80 was still closed heading East and we couldn’t access the internet. When we went to the office to ask about conditions on 80 we were told that it was pretty dangerous and that we might be snowed in for a few days. We wanted to shower but were told to come back after 2 pm when the staff was around since the showers were in the office, so we decided to go to town, find an auto parts store and get new wipers and fresh supplies of food. Just driving into town we realized that we didn’t even have all season tires. Now we are not idiots but the thought of being stuck in Rawlins for a few days was really unappealing, so we decided to go food shopping and ask God for a sign as to whether to go or not. As we came to the food store we saw the entrance to 80 East. We went shopping and talked to some locals to find that the road was open but only to high priority traffic. We decided to chance it but I will admit I was scared. I called the girls and I hate to say it but I was weepy and told them what we were going to do and that if anything happened that we loved them and how to get into the safety deposit box and where the important papers were.

I decided I had to drive to face my fear of going. For the next 96 miles I faced some pretty tough driving but nothing that I couldn’t handle. Yes, we did experience wind gusts of 45 mph and some slick road surfaces and snow, but to be honest, I imagined much worse then what it turned out to be. In the past few years, I realize that I have been fearful of so many things, diagnoses, finances, jobs, starting a business and in each case what I imagined has been far worse than what has actually happened. I have been living my life preparing for the worst and while that has been helpful considering the state of things in the world right now, I wouldn’t call it living.

We made it through to Cheyenne and beyond. Having gotten a late start we kept driving and managed to reach Grand Island, Nebraska. Once we were out of the Rockies, the terrain changed to rolling hills and we were at the beginning of the plains. We still experienced high winds but the Rialta handled it like a dream. I relinquished the wheel and had a series of phone calls with all 3 daughters. The realization that no matter where I am, I am still connected to these wonderful and fascinating people is very reassuring to me. I am realizing that they can reach out to me for advice as well as just to check in to see how I am. Where I am will not matter to the relationship that we have. That is a huge revelation for me and very comforting.

I also realized that my partner in crime has had my back from the beginning. He has not allowed me to fail. He has supported me in this decision without trying to smother me. Everything we have encountered we have sorted out together and his ideas and perspective has been invaluable. I thank him for that.

I will sign off, having had my shower and ready for bed in a lovely KOA campground in Grand Isle. Our hope for tomorrow is to push through Iowa, Illinois and find a camp ground in Indiana tomorrow night.

The Good, The Bad and the Broken

The good part was that after the salesman arrived late by 20 minutes, we finally got to see the Rialta and it was everything we imagined. It drove so well I forgot about its size. And the interior is beautiful. The bad part was the salesman who sold it to me. I had asked why the mileage was so low and all he had said was it’s a one owner RV. I found when I arrived that the unit had been a repo, which means that it had been sitting in the elements, while it went through the bank repossession. This of course is not good for any vehicle. After completing the paperwork it was nearly 10 PM EST and we had woken up at 6AM. We left his office with me driving, feeling real good. The broken was when I hit the cement posts by the gas pump. I pulled into a gas station and all the pumps where occupied and so I had to go around in circles to find an open pump. Being tired and not familiar with the width of the vehicle I hit the pump protector cement barrier. I hadn’t owned it an hour and I had already christened it. After stumbling around Sacramento looking for the campground we finally found it in West Sacramento, parked it for the night and set up the electric. The lights came on but within 20 minutes they dimmed to nothing. We had lost 12 volt battery power which runs the lights and the heater. Thankfully I had brought an alpaca blanket that my thoughtful daughter had brought back from Ecuador and it really saved us as the temps dropped to the low 40’s.

After speaking with the salesman, who was clueless, and who reminded me there was no warrantee, we finally found an RV/truck repair place on the internet and we arrived at 8:30 AM. They took the Rialta and tried to locate the 12 volt charger, which took forever. Long story short, they called Winnebago for advice, took apart the bed to find it and replaced the unit for a mere $600 something. They really were wonderful and we finally got on the road at about 2 PM, which really put us behind in our schedule. We pushed on through Donner Pass (elevation 7227) and, fortunately, we didn’t have to use chains we were advised to purchase to get over the pass. It was beautiful and crisp. The Rialta, even though it had not been cared for, was still driving like a new car. The handling is great, the power is strong and the drive is comfortable once you realize the size and the need to swing wide around things like gas pumps.

We crossed the California/Nevada state line to find ourselves in Reno at about 5 pm. We were so amazed by the views that we didn’t see the road sign that stated it was the last gas for the next 55 miles. I have to say that there is really nothing after you leave Sparks, Nevada except scrub brush and the desert. As you travel through the Sierra Nevada mountain range there is nothing to break the monotony and you begin to realize the vast emptiness of the land. It was about 20 miles after Reno that we realized that we were running low on fuel. The few exits that we came upon had signs that said no services. When the low gas warning sign came on, we still had about 35 miles to go to civilization and nothing between there and where we were. I found a rest area and pulled in to find a family convoying with 2 cars to Utah who were gracious enough to follow us until reached to the first town with gas. We literally just made it to the pump and both of us were so proud that we managed to remain cool and have faith that we would make it. As we were congratulating each other we hadn’t noticed that we were speeding through this small Nevada town at a high rate of 37 miles until the siren went off. A handsome young deputy from the Pershing County Sheriff Department came up and checked our temp license plate and asked for our paperwork. He came back shortly to the passenger side and asked how our trip was going. He was sweet and looked in and expressed his delight at our find in Sacramento. He sent us on our way ticketless and with a Pershing County Sheriff’s emblem to put on the window of my new home.

April Fool’s Day found us in Winnemucca, at a large campground, being offered a work camping position there. We thanked the owner for his interest but I couldn’t imagine spending a whole summer working there. We managed to leave Nevada without gambling a cent. We pushed on through Nevada, Utah and half of Wyoming today. Seeing the Salt Flats was interesting. It was so flat and desolate, I could imagine racing a car or a motorcycle there. The Salt Lake has a distinct smell to it, almost like the ocean but not as fresh. We had a really great lunch/dinner at the Squatters Brewery in Salt Lake City and as we left we were notified that Route 80 between Laramie and Cheyenne was closed. Not knowing what to expect we pushed on through the mountains and across the continental divide to Rawlins, Wyoming. As I finish this we are sitting in the Rialta with the winds buffeting around us and a light snow falling. It has been a good trip so far with a lot of adventures and sights. The pictures will be posted when I figure out how. Good night to all. Tomorrow we push on to Omaha, Nebraska, and another 650 miles.