“In these matters the only certainty is that nothing is certain.”

“In these matters the only certainty is that nothing is certain.” – Pliny the Elder

Day 70

Hooray. The re-test results are in and tah-dah: no kidney function problems noted! And who do you think I got the results from? My PCP who ordered the tests? Pshaw. Of course not. My (wonderful) endocrinologist had his office call as soon as he read the copy he received to let me know. Yippee!

Since last I wrote I’ve seen a couple of other docs. All have re-validated the quest for this surgery. It’s great to see the medical community in consistent agreement with something for a change!

I saw my wound specialist last Tuesday morning. He opened both wounds again – ouch. Warned me that he’s giving them another month and if not better he’ll excise all the tissue and sew me up. Ugh. He decided to add some new meds and cover the wounds up this time. I saw him again this morning and he only opened them a little today – thinks now we’re on the home stretch and both are finally responding. Culture came back with strep and staph… yikes. Treating with silver now – yes, the element! Amazing. Talked about the kidney test results. I mentioned before that he did his fellowship in bariatric surgery I think… he said the surgeon’s nuts. Advised me that if the surgeon won’t do it to let him know and he’ll find me someone who will… yay!

I saw my endo last Tuesday afternoon. Shared with him the PCP saga of the day before. He gave me a card of a new PCP who I’m going to meet this Thursday morning – yay! Can’t wait! I called and canceled the physical and echo-cardiogram that were scheduled for tomorrow with the old PCP – I can’t wait to work with someone new! Am hoping she’ll have a different sleep center recommendation – more to come on that. My endo said the only criticism anyone’s ever had of the new PCP is that she tends to get very involved with her patients and cares about their health… wow. What a delight that could be after this old guy!! And back to the surgeon – my endo echoed the PCP and the wound specialist. He said the surgeon’s nuts. If he won’t do the surgery, my endo will call him personally and tell him why he should! Yay!!

Saw the GI specialist for the EGD consult last week and was able to schedule the procedure and have it performed yesterday. Talked about the surgery and again, validation. Yay!!! EGD turned out to be no big deal, other than the RN that shot my systolic blood pressure (bp) number up to 190!! – I have a little bit of a sore throat today, but other than that no side affects. Back to that RN – OMG – if you ever have an EGD, you need better knowledge of the procedure going in than I had if you have an RN like her. Here I am on the gurney, can’t move more than a couple of inches… IV on my left hand, bp cuff on my right arm, oxygen blowing in my nose held onto my head with loops around my ears, and 4 connectors to the heart monitor. The anesthesiologist and I exchanging notes so he can take me under and bring me back… and then with no warning or explanation the nurse shoves this thing in my mouth and wraps it around my head and tightens it up so it can’t move – and mind you it looks like something out of an S&M shop (and like John’s mom, I’m into M&M’s, not S&M) – and I can’t talk and I go into a lovely panic wondering what else are they going to do to me pre-anesthesia. The anesthesiologist notes my bp and asks me what’s wrong. Like I can answer? He has the RN remove the mouth piece and finally gets it when I explain. He goes on to explain they have to put it in before they put me under else they can’t do procedure as jaw will clench once I’m under. I’m cool now – I “get it” once explained. He realizes it was too late so says “We don’t need to put it on until just before I add the happy juice to your IV – would that be better?” Duh!! Way better! He timed it great then – stuck the needle in the IV and told the nurse to put it on and that’s the last I remember – thankfully. Saw the GI guy afterwards and he reported no anatomical anomalies – no ulcers – no reason he can’t clear me for the surgery. Yay!! Took a couple of cultures – said I might have a bacterial infection and he might have to put me on some antibiotics but that’s very normal and not to worry. Double yay again! Another deliverable from the checklist signed off.

So what’s left? Still need by dietician consult, cardiac clearance and sleep study. I’m thinking the cardiac clearance will be easy with the new PCP. Dietician and sleep study a little more challenging. There are no providers for either in my new insurance network – amazing. Spoke with insurance company last week and thankfully they said they’d approve out-of-network exceptions. Got the letters Friday and they weren’t properly filled out (didn’t note approved providers or procedures) so asked for new ones yesterday… hopefully they’ll be here soon. Have dietician scheduled for this Friday and initial consult with sleep center next week. Spoke with billing person at sleep center and she said I need that letter – $5K to have a sleep study conducted. That seems outrageous to me – hence the above note that I want to check with the new PCP to see if she recommends someone else. This sleep center says you have to go back three times! John’s study (at a different center) was all done in the one night – and they selected the device he’s still using today right then and there.

Speaking of insurance, wow. We truly don’t appreciate it enough! We’ve been in an HMO for years so haven’t seen any of our bills other than hospital stays. Now we’re seeing them all. And I don’t know how anyone could be expected to have good medical care without at least the rates that the insurance company negotiates – if not the actual coverage. One example that still has me stunned is my first visit to the wound center – total clinic bill (excluding MD billed separately) $1,400! I pay $20 and insurance company is having clinic write off $500 per their contract!! Holy guacamole!!!

So my biggest learning from last week? Pliny the Elder summed it up: “In these matters the only certainty is that nothing is certain.” It seems it wasn’t certain that my kidneys were messed up and my surgery no longer viable. It seems that bills are just bills until the insurance company decrees what you’ll pay. I’m still not there – but it’s definitely not hopeless.

Wish me luck with the new PCP and the insurance company this week!! In the meantime, thanks for your continuing support… just knowing you’re here with me is a wonderful thing!!