If insurance companies rule the world, and sometimes I think they do, then I’ll be in the surgical center for two days. I got the authorization letter from Aetna yesterday and they’ve authorized two days of hospitalization. Past experience tells me that the doctor will keep you in the hospital for as long as the insurance will pay for it, so we’ll see.
Shoulder replacement surgery is less than a week away and I’ve got several of the pre-op check marks ticked off my list. For one thing I’ve spoken with the anesthesiologist’s office and was extremely pleased to find that my co-pay for them is a whopping $198. When I’ve paid literally thousands for out-of-network, out-of-pocket anesthesiologist fees before, this is amazing. I’m hopeful the rest of the procedure (both physical and financial) will be equally easy.
I’ve also asked that my previous physical therapist be assigned to me once I get home. I was supposed to go to some type of rehab class, but I got the instruction letter too late to attend the class. On Thursday I go through the pre-registration phone call with the surgical center admitting office.
As I was telling my husband and my brother (and my friends and anyone else who will listen) I can’t seen to get my head around needing this surgery. Unlike my hip which hurt with every step I took, I’ve learned to not use my shoulder in certain ways, so it doesn’t hurt day in and day out like my hip did, so it’s not driving me to seek this kind of drastic relief. However, there’s no arguing with the test results and delaying it will only make it harder to repair. I know all of these things intellectually, but I still can’t emotionally embrace the fact that I’m facing another joint replacement surgery.
I’ve been off my arthritis medicine (Humira) for about five weeks now and I stopped taking my anti-inflammatory (Celebrex) on Sunday, so I feel like … well, I feel like I’ve got a case of the flu because I ache all over. My rheumatologist prescribed some pain pills, which I took on Sunday. However, they make me really goofy, so I’ve decided that I’m going to try to tough it out with Tylenol. Although as uncomfortable as I am already, in another couple of days I may be chugging those new pills — goofy or not.
I’ve got a busy week before surgery, and a busy weekend with getting ready for surgery and the Texas Motor Speedway NASCAR race on Sunday. I guess that’s good. I won’t be sitting around fretting about it.
Actually, the only thing I really dread — and anyone who knows me will tell you this — the only thing I really, really dread is starting the IV. As I said in an earlier post, they only have one arm (my “bad” one) to try to stick, and I’m very concerned. Once they get that started, it’s all downhill. They pour in the drugs and off to wonderland I go. When I wake up, all I have to do is get well.
That’s it. I’ll probably check in once more before surgery. I’m actually hopeful that I will only have to spend one night at the surgical center, so I may not update the blog while I’m in the hospital. I’ll take my phone with me though, so I can take pictures if there’s anything worth doing that.
Thanks for your good wishes and for checking in.
Undifferentiated Spondylarthropathy, rheumatoid arthritis, arthritis, Carla Kienast, replacement surgery, Humira, Wm. Tucker, Williarm Tucker, Banerjee, Shoulder Surgery, wayne burkhead, shoulder impingement, Osteoarthritis, dr. burkhead
Well yesterday I saw my internist for my pre-op physical and general annual check up. No surprises there unless something comes back in the blood work.
This morning I went in for a follow-up visit with my rheumatologist. She was appalled that I’ve been off the Humira as long as I have. Ideally she wants her patients to be off for four (4) weeks before surgery then start again two (2) weeks after surgery if everything is healing and progressing like it should.
She was also concerned that Dr. Cheatum prescribed two Celebrex a day. She said I should be stopping the Celebrex any day now prior to the surgery and when I start back up again after surgery, she wants me to only take one. In the meantime she has prescribed some pain medication for me to take when I get of the Celebrex that won’t interfere with any of the surgery stuff. I don’t know that I’ll take it. I’ll probably stick with Tylenol. I have too much to get done to be dopey headed. But if I have problems sleeping or whatever, it’ll be nice to have them.
I think I mentioned in an earlier post that my knees have been bothering me. When she examined me today, it was apparent that my right knee was swollen. She wanted to draw off some of the fluid then inject the knee. NOT! I guess it would have made my knee feel better over all, but I don’t have the time to deal with it if it hurts due to the procedure. She offered to let me come in at any time before surgery and get my joint(s) injected and/or put me on a low dose of prednisone, although she’s not real keen on the prednisone because it can interfere with healing. She’s afraid that I’ll have a flare being off the Humira and I don’t doubt that she’s right.
I still haven’t gotten my head around this surgery. I know without a doubt that this is the right answer, but knowing and feeling it are two different things. They had to stick both arms yesterday just to do a simple blood draw for my physical. That just brings home how difficult it is to get an IV started in me and all those fears about the surgery came flooding back.
I called the surgeon’s office today because I haven’t gotten the disability paper work back so I can get paid while I’m off. They’re going to get it to me later today (probably). I still haven’t gotten my packet of information about the surgery and check-in procedures, so hopefully that will show up soon.
Tomorrow I go to Houston all day on business, so I’ll get to beep through two new airports — Dallas Love and Houston Hobby. I can’t imagine how many bells I’ll set off when I have both the shoulder and the hip.
I expect things to be pretty quiet between now and surgery, but if anything new pops up, I’ll update the blog.
Thanks for checking in.
I got the surgery scheduled for Monday, April 6. I will spend one or two nights at the surgical center then will be home for a while. Doing searches on the Internet, it appears to vary widely on when I’ll be allowed to drive, go back to work, etc. My doctor encourages return to normal activities as soon as the patient feels like it. I suspect that I will be working from home before I feel safe enough to drive on Dallas streets with one hand. Fortunately I have an employer that will accommodate those arrangements.
I have to say I am not happy about this development. I think my mind just isn’t ready to accept that I’m losing another joint to this horrible disease. However, it is the right answer. The damage to the joint is significant and it’s not going to get better. The best we can do is address the issue now before it gets worse and makes the surgery more difficult.
I had very little pain with the hip and the literature from my doctor indicates he is pretty aggressive about pain management. My previous shoulder surgery hurt like the dickens, but there were some issues with the pain delivery system, so hopefully this will be better. In addition to pain pumps, they provide a patient-managed pain dispenser. Morphine makes me extremely sick, so we’ll see. When I had my previous surgery, I woke up in the recovery room sick to my stomach. That’s one of the reasons they don’t let you eat or drink anything. When I had my hip done, the anesthesiologist gave me some extra drugs to help with the nausea and I didn’t have any problems at all.
I have to get in for my physical and I have to reschedule my upcoming appointment with my rheumatologist, but those are minor issues. I’m actually more worried about how I’m going to blow-dry my hair for six weeks. (Ha!)
That’s all I know for now. I’ll update the blog as I move forward and I am hopeful that the surgical center has WiFi available so I can update the blog while I’m there. With all those drugs in my system if I don’t write it down when it happens, I don’t always remember things.
Thanks for checking in.
Well, it’s official, although not scheduled. The left shoulder will be replaced. The CT scan showed that not only is the cartilage gone in my shoulder joint, the head of the arm (humerus) has slipped slightly and is grinding a new indentation into the shoulder socket (glenoid). Unfortunately, the longer we wait, the more deformed the glenoid becomes and the more difficult it is to repair for the replacement parts.
I’m really not happy about this, but it is the right decision. It just doesn’t seem possible that I’ve lost this joint in such a short time. It was fine before I had the hip replacement surgery. Then when I started using my upper body to push myself up in bed, use my walker then my cane, my shoulder started hurting. Unfortunately it never got better.
We’ll be doing a “regular” not “reverse” shoulder replacement and the success with the type of implant they’re using seems to be very good. My surgeon does more of this type of surgery in a month than most do in a lifetime, so I’m in good hands.
I think the surgery will be done in the surgical center, although that’s to be determined. It will be strange having surgery anywhere but Presbyterian Dallas. Normal time in the hospital is 2 days after surgery. I am hopeful to be able to start working from home the week after surgery.
Now that I’m an employee I have to figure out how all this PTO (personal time off), disability, etc. works. After 7 calendar days, I get 60% disability payment, but if I start to work, even part time the week after surgery, I don’t know that disability will kick in. Lots of things to figure out. Being a consultant was simpler. If I didn’t work, I didn’t get paid.
The good news is that they’re not going to recommend that I donate blood ahead of time. Those of you who have read my blog during the hip replacement surgery period understand what a trauma it is for me to give blood or have any type of needle in my vein.
I’ll update the blog as things get scheduled and we move forward. Thanks for checking in.
Well, tomorrow morning around 9:30 I see Dr. Burkhead and we determine what course of action we’ll be taking with the shoulder surgery. I have no doubt that we’re headed for the operating table.
The more I think about my option of cleaning out the shoulder with the scope, the less I like it. I think the inevitable conclusion is replacement and doing the scope will simply mean another surgery — and who knows how long any positive results will last.
The CT Scan was a piece of cake, but the X-Rays were awful. The technician couldn’t get my arm raised where she needed it, so she put me on the table. I still had to raise my arm WAY past the comfort zone into the “hurts like a son of a gun” zone. I was in tears it hurt so bad, then she had to retake the Xray. My shoulder was sore all weekend and still feels like something has been pulled or torn loose. We did the CT Scan after the X-Rays, so if something is amiss, it should show up on one or the other.
The other thing is I didn’t take my Humira shot last week. I have to be off at least two shots before I have surgery. I haven’t necessarily been able to tell that it’s done a lot of good — until I skipped a week. By Saturday morning, my joints were sore all over and I was really fatigued.
I’ll update this tomorrow after the doc’s visit.
Saw the shoulder doctor this morning (Wayne “Buzz” Burkhead) who is apparently one of the best shoulder surgeons in the nation, based on his Google hits. He wants to replace the shoulder. I countered with let’s go in with the scope and clean up the rotator cuff tears, smooth out the arthritis as best we can and hope for some improved mobility. My solution won’t produce as good as result, but it would perhaps delay the inevitable replacement.
We compromised. In two days (to allow for pre-certification by the insurance company) I go in for a CT Scan which apparently shows arthritic changes a lot better than an MRI. Based on the outcome, we’ll determine next Tuesday, 3/17, what kind of surgery we’re going to do. If it were my right arm or if I hadn’t just had my hip replaced, I’d be more agreeable to the idea. I’m just not sure I’m mentally ready for replacement surgery even if my shoulder is physically there.
I’ll keep you posted on what’s going on. Thanks for checking in.