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I have been attempting to post daily reports, which is a more practical way for me to inform my (deranged?) family, friends, and coworkers of my recovery progress. Looking back over my previous posts I have realized that my awareness of times and dates has been rather wonky. Between the medications, pain, sleep deprivation, and resulting bouts of exhaustion, my posts here may or may not have made much sense. I called my boss today to let him know I definitely will not be functional enough to work from home this week. Apparently I spoke with him yesterday, yet I had little recollection of that conversation.

My master plan to manipulate my body into behaving in a predictable manner was a dismal failure. My best guess is that attempting to schedule my BM to a specific time of day by drinking prune juice and milk of magnesia was one of the most idiotic ideas I have ever had. That is the only thing I can figure caused the multiple uncontrollable spasm induced pain riddled BMs yesterday.

Set an alarm for 5AM to take a valium and lortab, in hopes I could go back to sleep, wake up around 7am, and have a manageable BM experience. Woke up with no pain or spasms, prepared my sitz bath, but no BM. Oh well, can't win them all. I guess I am going to have to resign to the fact that I can't schedule them. By 9AM or so my I felt coherent enough to start back to my previous routine. Ingested stool softener, citrucel, small bowl of fiber-one, and took the dog for a short walk, made some phone calls.

I am praying that yesterday's nightmare experience didn't cause any setback damage. My pain level feels acceptable right now, but I won't really know until the next BM. Before yesterday the pain associated with BMs was getting better and better, I just hope that continues. Trying to keep my mind occupied enough to not fall into anxiety awaiting the next BM is my challenge for the day ;-)

Down to one remaining valium, so I called the doctor's office. As usual the doctor is not available, so they took my number, "his nurse will call you back". Out of about 10 calls I have made to their office this has been the response, and maybe twice they have actually returned my call. So I guess I can also keep my mind occupied for the rest of the day being irritated waiting around on a call back...

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Finally, some good news to report!

Didn't hear back from the doctor's office for a few hours so I called them back. Apparently that did the trick so my refill has been taken care of.

Collateral damage from yesterday's disaster was apparently been averted. I managed to have a rather puny BM this morning and the pain level is continuing to get better. I am trying to become a zen master when I sit on the toilet. Relax, breath, let nature takes its course, think of butterflies and puppies, no matter what don't try to squeeze ;-) It has helped. I believe I am starting to heal, and perhaps getting better at dealing with the anxiety causing spasms and the resulting pain. I was a little concerned constipation was looming due to the small BM and continuing to feeling pressure, so I made a couple more attempts throughout the day, without trying to force anything to happen. My body finally let me know this evening when it was time to go, and again the pain was nowhere near as bad as yesterday. On a scale of 1 to 10 I would call today's activities about a 6, adequately taken care of by sitz baths and ibuprofen.

I see hope on the horizon!
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It sounds like things are looking up for you! I didn't realize that you'd been having so much trouble from your doctor's office so I'm glad that's going well too. Good for you! Keep these up :-)
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Hi badpenguin,
It is nice to see this detailed thread. Many will appreciate this while going through the same thing. Good work. You have a good plan for your recovery, and as I can see you are sticking to it everyday.
Why are you getting bad feedback from your doctors office? Is he usually like this?

Cheers
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Throughout this entire ordeal, whenever I either get into the same room or on the phone with an actual physician or surgeon, I have actually gotten very good results. I work in the medical field and have what I consider to be a realistic expectation of a usual patient/doctor relationship. Surgeons tend to be rather good at what they do, which is cut, and little else. Don't get me wrong, when it comes to someone cutting on me, particularly on probably the most sensitive part of my body, I want them to be damn good at what they do and could care less about their bedside manner. I believe that when it has come to actual professionals laying hands on me in one way or another, my treatment has been great. Both the surgeons I have met with, surprisingly, have actually had what I consider to be excellent "bedside manner".



The numerous problems I have experienced have been with the health care management system itself, primarily the processes, staff, and bureaucracies that I have had to deal with to get access to the surgeon or actual hands-on care. If my experiences are anywhere near typical for patients who need anything beyond what can be taken care of in a general practitioners office, it is no wonder the American health care system is delivering such poor results in spite of the outrageous amounts of money thrown into the system. 100 monkeys in a room full of typewriters could probably do a better job. My rant in another post about the front office from hell pretty much covers in general my complaints about failures in the system.



In retrospect I have realized that at least one mistake could have ended up with a serious problem. When I wrapped up my meeting with the surgeon who ended up doing my surgery, he sent in a (nurse?) to give me pre-op instructions. The only thing she told me was not to take any medications before the surgery, particularly anti-inflammatory medications because they can cause bleeding complications during surgery, and she gave me a card with the time and date of the surgery and told me to show up 2 hours early.



Over that weekend I started researching what I might need during my recovery and noticed that in almost all of the forums I found like this one, people were given specific instructions about not eating, flushing their systems the night before, etc...



Monday I went to work and made a futile attempt to try and find out what my out of pocket expenses might be from this entire ordeal. I won't even go into how futile that effort was, it would be easier to find out what created the universe. I was also concerned that maybe I needed to be doing something more to prepare for the surgery on Tuesday so I called the surgeon's office, I also wanted to get any prescriptions filled so I could pick them up the day before the surgery. This time I got a different nurse, and she told me I needed to be taking magnesium citrate and not eating or drinking after midnight. This was news to me, but apparently damn important news. I had to leave work and go to the pharmacy to pick up my scripts and some magnesium citrate. When I got home the instructions on the magnesium citrate said the adult does is 1/2 to a full bottle. I wondered to myself, why am I taking this stuff to flush my system, yet I can eat up until midnight? I call the surgeon's office back to get further instructions, they take my number and tell me they will call me back. Wait a couple of hours, no call back. Drink 1/2 the bottle, call them back again, same deal, they will call me back. They never called me back, so I just drank the rest of the bottle and figured when I showed up 2 hours early for my surgery they would take care of whatever needed to be done. Apparently I had guessed right because during my pre-op preparations they only asked me if I had any eaten or drank anything after midnight. They didn't do any kind of enema or any flushing of my system during my pre-op, maybe they did it while I was under or something?



Things like billing snafus and appointment mistakes are one thing, failing to give a patient instructions that can cause them life-threatening complications while being under general anesthesia is a serious problem in my opinion. I think I will write up a nice little letter to my surgeon once this is all over, and then never remotely consider going back to that office. Surgeon - great, give him an A, management of the practice and processes communicating with their patients, a big fat F.



The hospital itself and all of it's staff and procedures, they get an A+. This was the single part of the entire process I felt like me, the patient, was the most important concern. From the moment I walked in those doors I felt suprisingly comfortable during probably one of the most frightening experiences I will ever go through... My only complaints with them are a) set your clocks right for daylight savings time!! and b) let me stay inpatient a couple of days after a surgery!
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The miss information of the patient is a very serious thing. One thing done wrong, and bad things start to happen. I can not understand that they just couldn't answer one simple question that you had, and that they just told you that they will call back later. Very unprofessional if you ask me.
Now how are you doing today? Recovery going good?
Give us an update when you have time.

Cheers.
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My thoughts exactly. I don't even know who is responsible to make sure the patient is prepared? The surgeon? The surgeon's professional staff, their office staff? Someone from the hospital where the surgery is scheduled? Ultimately I believe the buck stops with surgeon, that is the individual who should have processes in place to make damn sure the patient's needs are taken care of. A simple standardized form with all of my pre-op preparation instructions would have sufficed.



At the hospital I was thoroughly questioned by three different medical professionals, including the anesthesiologist, during the pre-op procedures. I have to assume the worst case scenario would have been a canceled surgery if any of them had become aware of preparations I hadn't properly taken. Luckily for me the hospital and most it's staff is not affiliated with or managed by my surgical practice.



The difference in the the management of my care between the hospital and the surgical office is stark. The Thursday I finally got to meet with my surgeon so he could check me out before scheduling the surgery is a good example. He asked me if I wanted to go through with it, I said "as soon as possible". He stepped out of the exam room for a moment to have his staff call the hospital to schedule the surgery. Within 5 minutes he came back with a schedule set for the following Tuesday. I drove back to work and within an hour I got a call from someone with the hospital to pre-admit me! Talk about an efficient machine ;)









Thanks for asking dark, I will go ahead and start my days blog entry in another post ;)
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