We were off to see the surgeon yesterday afternoon.
For reasons all his own, Fred chose to remain in the crowded waiting room, trying to read midst all the noise of the television, the chitchat, and the cell phone tag being played -- continually -- despite signs forbiding their use.
I am grateful to have been worked in. Okay? Very grateful.
Still, if only sleek competence might join that terrific availability!
The appointment was at 3 pm. I was called back at 3:50 and was stashed in one of the cast rooms (orthopedic surgeon). Then someone needed a cast, so I was switched to an open exam room. Unfortunately, when I was swapped out, my paperwork did not follow me.
Yup. They "lost" me.
Luckily, I had a good book to read -- an André Dubus novel. Even more fortuitous? I had water and pain medication -- some of that soon-to-be-banned Percocet. My surgeon is much sought out, and he had not planned on needing to see me, so I didn't start to feel uncomfortable in my little room until about... 4:45. The door suddenly opened and one of the doc's assistants poked his head in, said he was looking for the doc, then disappeared. A few minutes later, his nurse threw the door open (does no one knock?), made "Aha!" noises of discovery, and slammed my paperwork into the file holder on the door. As she was walking away, she called back to me, asking whether I "had my films."
Errrr. Well, I was returning the x-rays we took for the expert to peruse back on June 9, but got the sense those were not the ones about which she was asking. So I powered up my chair and chased after her.
Yes, an order for 2 views of the shoulder had been given, and no, it hadn't been done.
And just my luck to get the pissed-off x-ray tech who is alarmed by the look of what she develops, thinks it has to be because the x-ray (not my bones) is bad, and repeats, repeats, repeats the most painfully posed view of all. Finally, I ask her if she gets that there is no real bone in there, constituting a proper shoulder, to which she replies, "But you haven't had your surgery yet, honey. This is your pre-op visit."
Who was it who then fairly yelled something sort of obscene, but not entirely?
It took her 6 exposures to get her 2 views done, and it was well after 5:30 before I got back to my cell. At this point? I am having spasms in my legs and back, and my temp is doing its late-afternoon spike-thing. And I am hungry.
I had many questions and arguments I wished to present -- but by the time the obviously fatigued surgeon and I finally met? I didn't care that much about anything beyond getting home. The pain was out-of-control and the x-ray tech had done nothing but aggravate things.
Still, we managed to cover a few things. I won zero, nada, zip in terms of concessions I was seeking -- like No PICC line, no vanco, no to any iv antibiotics unless and until a pathogen is grown out of the cultures and a sensitivity test results.
Apparently, I am to change my mindset. We're suddenly going more for medicine as an art form than medicine as founded on scientific principles. He wants to go ahead and put in a total prosthesis, even in the presence of infection. Thus far, on this side: there was a hemi put in in 2002 -- a surgical failure; then in December 2008, he had to remove it as well as several inches of humerus, giving the lame excuse that it "exploded" with pus; in April 2009, he was sure things had cleared up (despite my fevers, sweats, and pain), but found more infection, and therefore inserted a second spacer. For the past one year+, everyone has been careful to tell me that a prosthesis could not and would not be put in when there was the least little doubt about continued infection.
Ah, but things changed. (don't ask me how, i dunno) As of yesterday, we are going to proceed and just hope for the best, by God.
I told him about the running joke here at Marlinspike Hall, deep, deep in the Tête de Hergé, wherein one of us (usually La Bonne et Belle Bianca Castafiore) pretends to page "Mr. Pus, Mr. Frank Pus!" -- and he didn't laugh.
His eyes widened, though.
Anyway, I told him that if there was frank pus, or any really overt signs of infection, I would not be comfortable receiving the prosthesis. His head went up-and-down but I am not convinced he really heard me.
Oh -- and it turns out that my acromion is fractured. That seems to have captured his attention more than anything. And would you believe that I forgot to ask him what he needed to do about that? I was so tired.
Based on the fact that this is not my first go 'round with an infected joint, I can assure him, you, and anyone who would care to listen, that this freaking spacer is definitely serving as a culture dish. It is the fever, the sweats, the increasing instead of decreasing pain upon which I base my wacky-wacky opinion.
Believe it or not, we never even got around to discussing what happened post op last time -- those annoying episodes of respiratory arrest. Three of them in 8 hours, the last not even remembered -- they just intubated and hooked me up to a vent. The theory back then was that I had pneumonia that went unspotted before surgery... So I guess the only relevant advice might be to not get pneumonia ahead of time, this time.
How was Fred when I was finally done? Testy. And let's just leave it at that.
Tomorrow, preop labs and ridiculous interviews at the hearsepital.
Anyway... not the greatest appointment just prior to surgery. I suppose I wasn't the best patient and clearly, he and his staff were in just-back-from-vacation mode.
I trust him. It will be okay. Right? Right.
For reasons all his own, Fred chose to remain in the crowded waiting room, trying to read midst all the noise of the television, the chitchat, and the cell phone tag being played -- continually -- despite signs forbiding their use.
I am grateful to have been worked in. Okay? Very grateful.
Still, if only sleek competence might join that terrific availability!
The appointment was at 3 pm. I was called back at 3:50 and was stashed in one of the cast rooms (orthopedic surgeon). Then someone needed a cast, so I was switched to an open exam room. Unfortunately, when I was swapped out, my paperwork did not follow me.
Yup. They "lost" me.
Luckily, I had a good book to read -- an André Dubus novel. Even more fortuitous? I had water and pain medication -- some of that soon-to-be-banned Percocet. My surgeon is much sought out, and he had not planned on needing to see me, so I didn't start to feel uncomfortable in my little room until about... 4:45. The door suddenly opened and one of the doc's assistants poked his head in, said he was looking for the doc, then disappeared. A few minutes later, his nurse threw the door open (does no one knock?), made "Aha!" noises of discovery, and slammed my paperwork into the file holder on the door. As she was walking away, she called back to me, asking whether I "had my films."
Errrr. Well, I was returning the x-rays we took for the expert to peruse back on June 9, but got the sense those were not the ones about which she was asking. So I powered up my chair and chased after her.
Yes, an order for 2 views of the shoulder had been given, and no, it hadn't been done.
And just my luck to get the pissed-off x-ray tech who is alarmed by the look of what she develops, thinks it has to be because the x-ray (not my bones) is bad, and repeats, repeats, repeats the most painfully posed view of all. Finally, I ask her if she gets that there is no real bone in there, constituting a proper shoulder, to which she replies, "But you haven't had your surgery yet, honey. This is your pre-op visit."
Who was it who then fairly yelled something sort of obscene, but not entirely?
It took her 6 exposures to get her 2 views done, and it was well after 5:30 before I got back to my cell. At this point? I am having spasms in my legs and back, and my temp is doing its late-afternoon spike-thing. And I am hungry.
I had many questions and arguments I wished to present -- but by the time the obviously fatigued surgeon and I finally met? I didn't care that much about anything beyond getting home. The pain was out-of-control and the x-ray tech had done nothing but aggravate things.
Still, we managed to cover a few things. I won zero, nada, zip in terms of concessions I was seeking -- like No PICC line, no vanco, no to any iv antibiotics unless and until a pathogen is grown out of the cultures and a sensitivity test results.
Apparently, I am to change my mindset. We're suddenly going more for medicine as an art form than medicine as founded on scientific principles. He wants to go ahead and put in a total prosthesis, even in the presence of infection. Thus far, on this side: there was a hemi put in in 2002 -- a surgical failure; then in December 2008, he had to remove it as well as several inches of humerus, giving the lame excuse that it "exploded" with pus; in April 2009, he was sure things had cleared up (despite my fevers, sweats, and pain), but found more infection, and therefore inserted a second spacer. For the past one year+, everyone has been careful to tell me that a prosthesis could not and would not be put in when there was the least little doubt about continued infection.
Ah, but things changed. (don't ask me how, i dunno) As of yesterday, we are going to proceed and just hope for the best, by God.
I told him about the running joke here at Marlinspike Hall, deep, deep in the Tête de Hergé, wherein one of us (usually La Bonne et Belle Bianca Castafiore) pretends to page "Mr. Pus, Mr. Frank Pus!" -- and he didn't laugh.
His eyes widened, though.
Anyway, I told him that if there was frank pus, or any really overt signs of infection, I would not be comfortable receiving the prosthesis. His head went up-and-down but I am not convinced he really heard me.
Oh -- and it turns out that my acromion is fractured. That seems to have captured his attention more than anything. And would you believe that I forgot to ask him what he needed to do about that? I was so tired.
Based on the fact that this is not my first go 'round with an infected joint, I can assure him, you, and anyone who would care to listen, that this freaking spacer is definitely serving as a culture dish. It is the fever, the sweats, the increasing instead of decreasing pain upon which I base my wacky-wacky opinion.
Believe it or not, we never even got around to discussing what happened post op last time -- those annoying episodes of respiratory arrest. Three of them in 8 hours, the last not even remembered -- they just intubated and hooked me up to a vent. The theory back then was that I had pneumonia that went unspotted before surgery... So I guess the only relevant advice might be to not get pneumonia ahead of time, this time.
How was Fred when I was finally done? Testy. And let's just leave it at that.
Tomorrow, preop labs and ridiculous interviews at the hearsepital.
Anyway... not the greatest appointment just prior to surgery. I suppose I wasn't the best patient and clearly, he and his staff were in just-back-from-vacation mode.
I trust him. It will be okay. Right? Right.
Wow. It sounds like you might have surprised them with what most people don't come to the doctor with....intelligence.
ReplyDeleteHaving two of my loved ones deal with infected implanted parts, I get the heebee geebees reading your post.
Lets hope the office and doc get their crap together quick and get it right.
Thanks for dropping by, OHN. The surgeon is a very nice and bright guy -- I think he is just at wit's end over what to do next. I had hoped not to end up at Hopkins or Mayo, but if this surgery, the 6th major operation in 9 months, doesn't prove definitive? I'll be "leavin' on a jet plane..."
ReplyDeleteHe even pointedly mentioned a previous case like mine and how that patient ended up at Mayo. I hear Minnesota is lovely in the summer...
How did your loved ones end up after dealing with the dreaded infected implants? Well, I hope.
Thanks very much for your good wishes (and yes, for them to get their crap together, too!)--
Retired Prof
Ha! Minnesota is a swamp in the summer, says one who knows (10,000 lakes, no kidding = humidity and mosquitoes); but I hear Mayo's has terrific air-conditioning, for the visiting *royalty*, you know, so I expect La Bianca would feel right at home, should it come to that.
ReplyDelete