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Well, I figure I've hijacked Maggie's thread on good patient care (thanks for sharing it, Maggie!) enough and I'd start a new one on my recent foot surgery.
I do have one CS story, though it didn't involve me.
So, on Monday I had a TOPAZ fasciotomy on my left foot. Basically, my podiatrist poked about 20 holes in a grid pattern on my left foot, then inserted a wire in each hold through the tendon (fascia), through which she ran a radio wave. The purpose of this is to stimulate the inflammatory response, to increase blood flow to the tendon (which normally has a poor blood supply) to encourage it to heal.
My doctor had me quit taking NSAIDS such as aspirin and motrin two weeks ago, which really sucks for me. I take a lot of them because of chronic muscle pain.
The procedure itself went fine. The only suck was from the office people. I was supposed to call a week ahead to find out how much of a deposit I'd have to pay in advance based on my insurance coverage. The gal I talked to said based on my insurance, I didn't have a co pay, that I didn't owe anything. So I think Great! I don't have to think about how this will affect my finances.
The Friday before the surgery they call me to tell me when my appointment time is. They tell me I will owe $500 when I arrive.
Oh, shit. I don't have $500 right now. I would have to cash a bond, and that will take time I don't have. Fortunately, my FSA still had that much left in it (I got one for the first time this year and oh man am I glad I did). So I complained when I showed on Monday; they were nice about it, but I wished they'd made it clear ahead of time so I could make sure I had the money on hand.
The suck for me was in finding an IV site. I have awful veins. Fortunately, Dr. C, the anesthesiologist, told me "I'm the 2nd best IV starter in the world" (I should have asked who was first, but was too nervous). He got me first try in my right wrist. It hurt but could have been a lot worse.
He had a couple of cool stories. As a resident, he interviewed with Dr. Swan, of the Swan Gantz catheter (a common central line used in ICUs). He talked about how humble Dr. Swan was, who said his name shouldn't even be on the catheter, that Mr. Ganz (an engineer) had invented and done all the work; he just made sure it worked in humans.
He knew I was a nursing instructor. So when he was mixing Demerol for my pain with saline, he asked me how many times I should invert it to mix it. I honestly didn't know . . . so I told him 3 or 4. Nope, he said. 10 to 20. He suggested a cool experiment to demonstrate to students what it takes to mix something: take a few drops of methylene blue (a common dye used in biology) and mix it with saline and see what it takes to mix it completely. It was a cool idea and I'm going to try it with my students.
They did a good job putting me under. It stung when I first got the pain meds, probably because there were a lot of nerve endings where, eliciting a startled "Ow!", but then I was OK. Next thing I knew, I was trying to pull this dry thing out of my mouth (a bite block, it turns out), so they moved me to recovery. My foot started hurting within minutes so Dr. C gave me some Demerol . . . and next thing I know my arm itches and my friend Dan (who gave me a lift to the center, and is also a nurse) says, "Uh, her arm is getting really red." I look and see the welts. So Dr. C gives me some Benadryl IV, and that turns it around.
But . . . damn. One more narcotic I'm allergic to. This is important later. I go into the surgery allergic to hydrocodone (Vicodin) and oxycodone (Percocet), and with a sensitivity to morphine (high anxiety). So my doc had given me Tylenol #3, which is normally plenty to deal with my pain.
Shortly thereafter, I'm sent home. Dan takes me to EvilEmpryss's house to recover. I start having more pain, and the T3 isn't touching it. So I call my doc. I'm a bit annoyed because it takes her an hour to call me back. I ask for Ultram, but she says if T3 isn't working, that won't either. She says most patients don't have pain very long, 36 hours tops, and suggests I stick with the T3 because she doesn't know what else to give me because of all my allergies. She's reluctant to give me any stronger narcotics because of my allergic reaction to Demerol. She suggests that the boot is too tight, and mabe the ACE wrap as well. This makes sense actually. So she tells me to loosen them and call her back if it doesn't help.
So I try to tough it out. Big mistake. That first night was sheer agony. I don't call her because I know she can't call a Rx into a pharmacy; for narcotics you HAVE to have a written prescription. I don't want to go to the ER . . . I can't afford to pay $1200 to $1800 to get a shot of Dilaudid, knowing the ER doc won't give me a prescription for it (it's hard to get a script for unless you are a hospice patient).
I finally try to call around 6:30am, but get her voice mail.
So early in the morning, I call EE cuz I know she's getting the kids ready for school. I ask for a ride to my doc's office after she drops the kids off, and she agrees. I get there before they open and go in the door as soon as her medical assistant opens things up. The MA was really nice about it and put me in a treatment room, but warns me the doc won't be in for 40 minutes. Well, nothing I can do about that.
However, just then doc calls me back and apologizes for the delay . . . she'd been working out at the gym and didn't get the call until just then. She's about 10 minutes away. She gets in, takes the dressing off to look at the surgical site, and puts a new dressing on. Then she agrees to give me a script for the Dilaudid. I can tell she's still not thrilled about the idea (and I can't blame her, it's very addictive) but I tell her I can't go through another day like this, so she agrees.
Well, it took EE and me a couple of hours to find a pharmacy that carries it, and the only reason we found one is because I knew of one we used with hospice that carries it. But it did the trick. I slept most of the rest of the day.
Today, I'm in no pain at all to speak of, other than a migraine from the weather. I did notice that the pain in my foot would spike with the thunderstorms we had rolling through our area yesterday and last night, so I do think the weather impacted my pain post op.
There was some customer suck at the surgery center. Another lady who had a procedure (don't know what) was fussing about this that and the other from the moment she woke up. I'm looking over towards her, when one of the techs reassures me, "Don't worry, she's always like this when she wakes up."
Her biggest bitch was wanting a cigarette. She wanted so smoke as soon as she woke up and of course, she can't because of all the oxygen in the room. She was so ready to smoke that she had a cigarette dangling from her lips as they wheeled her out (boy that looked classy . . . not).
I do have one CS story, though it didn't involve me.
So, on Monday I had a TOPAZ fasciotomy on my left foot. Basically, my podiatrist poked about 20 holes in a grid pattern on my left foot, then inserted a wire in each hold through the tendon (fascia), through which she ran a radio wave. The purpose of this is to stimulate the inflammatory response, to increase blood flow to the tendon (which normally has a poor blood supply) to encourage it to heal.
My doctor had me quit taking NSAIDS such as aspirin and motrin two weeks ago, which really sucks for me. I take a lot of them because of chronic muscle pain.
The procedure itself went fine. The only suck was from the office people. I was supposed to call a week ahead to find out how much of a deposit I'd have to pay in advance based on my insurance coverage. The gal I talked to said based on my insurance, I didn't have a co pay, that I didn't owe anything. So I think Great! I don't have to think about how this will affect my finances.
The Friday before the surgery they call me to tell me when my appointment time is. They tell me I will owe $500 when I arrive.
Oh, shit. I don't have $500 right now. I would have to cash a bond, and that will take time I don't have. Fortunately, my FSA still had that much left in it (I got one for the first time this year and oh man am I glad I did). So I complained when I showed on Monday; they were nice about it, but I wished they'd made it clear ahead of time so I could make sure I had the money on hand.
The suck for me was in finding an IV site. I have awful veins. Fortunately, Dr. C, the anesthesiologist, told me "I'm the 2nd best IV starter in the world" (I should have asked who was first, but was too nervous). He got me first try in my right wrist. It hurt but could have been a lot worse.
He had a couple of cool stories. As a resident, he interviewed with Dr. Swan, of the Swan Gantz catheter (a common central line used in ICUs). He talked about how humble Dr. Swan was, who said his name shouldn't even be on the catheter, that Mr. Ganz (an engineer) had invented and done all the work; he just made sure it worked in humans.
He knew I was a nursing instructor. So when he was mixing Demerol for my pain with saline, he asked me how many times I should invert it to mix it. I honestly didn't know . . . so I told him 3 or 4. Nope, he said. 10 to 20. He suggested a cool experiment to demonstrate to students what it takes to mix something: take a few drops of methylene blue (a common dye used in biology) and mix it with saline and see what it takes to mix it completely. It was a cool idea and I'm going to try it with my students.
They did a good job putting me under. It stung when I first got the pain meds, probably because there were a lot of nerve endings where, eliciting a startled "Ow!", but then I was OK. Next thing I knew, I was trying to pull this dry thing out of my mouth (a bite block, it turns out), so they moved me to recovery. My foot started hurting within minutes so Dr. C gave me some Demerol . . . and next thing I know my arm itches and my friend Dan (who gave me a lift to the center, and is also a nurse) says, "Uh, her arm is getting really red." I look and see the welts. So Dr. C gives me some Benadryl IV, and that turns it around.
But . . . damn. One more narcotic I'm allergic to. This is important later. I go into the surgery allergic to hydrocodone (Vicodin) and oxycodone (Percocet), and with a sensitivity to morphine (high anxiety). So my doc had given me Tylenol #3, which is normally plenty to deal with my pain.
Shortly thereafter, I'm sent home. Dan takes me to EvilEmpryss's house to recover. I start having more pain, and the T3 isn't touching it. So I call my doc. I'm a bit annoyed because it takes her an hour to call me back. I ask for Ultram, but she says if T3 isn't working, that won't either. She says most patients don't have pain very long, 36 hours tops, and suggests I stick with the T3 because she doesn't know what else to give me because of all my allergies. She's reluctant to give me any stronger narcotics because of my allergic reaction to Demerol. She suggests that the boot is too tight, and mabe the ACE wrap as well. This makes sense actually. So she tells me to loosen them and call her back if it doesn't help.
So I try to tough it out. Big mistake. That first night was sheer agony. I don't call her because I know she can't call a Rx into a pharmacy; for narcotics you HAVE to have a written prescription. I don't want to go to the ER . . . I can't afford to pay $1200 to $1800 to get a shot of Dilaudid, knowing the ER doc won't give me a prescription for it (it's hard to get a script for unless you are a hospice patient).
I finally try to call around 6:30am, but get her voice mail.
So early in the morning, I call EE cuz I know she's getting the kids ready for school. I ask for a ride to my doc's office after she drops the kids off, and she agrees. I get there before they open and go in the door as soon as her medical assistant opens things up. The MA was really nice about it and put me in a treatment room, but warns me the doc won't be in for 40 minutes. Well, nothing I can do about that.
However, just then doc calls me back and apologizes for the delay . . . she'd been working out at the gym and didn't get the call until just then. She's about 10 minutes away. She gets in, takes the dressing off to look at the surgical site, and puts a new dressing on. Then she agrees to give me a script for the Dilaudid. I can tell she's still not thrilled about the idea (and I can't blame her, it's very addictive) but I tell her I can't go through another day like this, so she agrees.
Well, it took EE and me a couple of hours to find a pharmacy that carries it, and the only reason we found one is because I knew of one we used with hospice that carries it. But it did the trick. I slept most of the rest of the day.
Today, I'm in no pain at all to speak of, other than a migraine from the weather. I did notice that the pain in my foot would spike with the thunderstorms we had rolling through our area yesterday and last night, so I do think the weather impacted my pain post op.
There was some customer suck at the surgery center. Another lady who had a procedure (don't know what) was fussing about this that and the other from the moment she woke up. I'm looking over towards her, when one of the techs reassures me, "Don't worry, she's always like this when she wakes up."
Her biggest bitch was wanting a cigarette. She wanted so smoke as soon as she woke up and of course, she can't because of all the oxygen in the room. She was so ready to smoke that she had a cigarette dangling from her lips as they wheeled her out (boy that looked classy . . . not).
Sorry you had trouble with the billing department and pain meds but hopefully the pain has at least calmed down for you now that it's a few days post-op.
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