Surgery+4wks — No More MTX!!!!

Tags

don cheatum, hip replacement surgery, hip surgery, methotrexate

Great news! I went for my follow-up with my rheumatologist, Dr. Cheatum this morning and I convinced him to discontinue the Methotrexate. Nearly all my RA symptoms were associated with my ex-right hip, which has been replaced, so those are now gone. We’ll continue to treat the remaining, minor inflammatory issues with Mobic. I go back next March unless I start having problems before them.

I am SO happy to be off that drug! Not only is it very toxic, it zaps your energy. I felt like I’d completely lose Friday nights and I’d feel like a laggard the rest of the weekend. In addition, I can now have that glass of wine or sip of single malt Scotch again. While I haven’t missed it that much, I have missed it and it’s nice to know it’s something I can enjoy again.

At week four, I’m walking with the cane (no walker) and walking around the house a lot without any support. I’ve started taking walks outside the house and my goal is to get my strength built up enough that I can drive (at least short distances) by the end of the week. Jack’s been pretty good about running my errands for me, but it’ll be a relief for both of us if I’m able to go to the bank or store myself. I still have some problems getting comfortable enough for sleep at night, particularly since I’m not supposed to sleep on my right side for another couple of weeks. But it’s a short-term problem and I know that I’m on the home stretch for that.

I did an analysis of my health insurance claims and it appears that I’ve overpaid my deductible by over $1000 so far. I’m going to start with chatting with the insurance agent and see if I can get them involved between me and Blue Cross/Blue Shield. One of the issues is that I have to assume that the insurance company is doing the same thing to the insurance claims of the other members of the firm. I’ll start that conversation this afternoon.

So that’s what I know. I started this blog semi-depressed, but am feeling more like my old fiesty self again. Once I get completely mobile, I’m sure I’ll be dangerous.

I’ll probably continue to update the blog on a semi-regular basis, again, more for a diary for me than the fact that I expect anything momentous to happen.

I appreciate all the love and support from those friends and family that have tuned in.

Surgery: T+3 wks+2 days and counting / The Great Escape

Tags

hip replacement surgery, hip surgery, rheumatoid arthritis

I was thinking about milestones today. When you have surgery you tend to cross what seems like major milestones — getting your tubes out, leaving the hospital, the first time you eat at the table instead of propped up in bed. These milestones seem to come at a rapid pace and help buoy up your spirits and give positive reassurance that you’re on the mend.

As you recover, however, there aren’t as many milestones. Well maybe there are, but they come in a different form. Instead of being able to do something you hadn’t been able to, you simply do them a bit more easily. Therefore you don’t notice the progress as much.

I think this feeling of lack of progress has been contributing to my recent ennui. Not to put up with such a dismal feeling for long, I took matters into my own hands. (Need I say that Jack is out of town?)

Baby steps at first. As of this morning the shower chair has gone missing. I’m now walking around some without my cane, so I decided that I no longer have to use the shower chair. Ah sweet freedom. Few things make you feel more human and happy than a good, hot shower, and taking one sitting in a chair isn’t nearly as satisfying. So my morning was off to a good start.

Then it got dangerous. After lunch I was going out to the alley to take some trash to the dumpster and there, in the garage, was my poor neglected little SmartCar. It hasn’t been started, much less driven, in about two weeks. I swear it whimpered as I walked by. Talk about cabin fever, my poor little car has it worse than I do.

So I grabbed my purse and my cell phone and away we went.

Well, “away we went” might be a bit of a stretch. I very carefully manuevered myself into the car seat and we drove quite slowly and cautiously around the block and back to the garage, whereupon I equally as carefully manuevered myself back out of the car.

Regardless of its brevity, it was a delicious escape for both of us. The SmartCar purred along and I no longer feel like I’m trapped in the house.

The truth is, I’m not quite ready to be driving around. It was uncomfortable getting in and out of the car and I don’t have a lot of strength yet in my right leg to press on the brake or even switch from the accelerator to the brake. However, I now know how much more strength I need to build and I know that if I really, really had an emergency, I could drive without killing myself or anyone else. (As long as it wasn’t too far.)

But you gotta admit, for just over three weeks after hip surgery, I’m doing super. Most people haven’t even graduated from their walker yet and I’m already sneaking out of the house.

I figure I’ve got the rest of this week, then probably two more weeks of staying home. I don’t want to start working at the office until I’m ready to move all my computers and files back and until I’m really comfortable driving, and I think that’s what it’s going to take.

Thanks for checking in with me. I appreciate everyone’s good thoughts.

$63,349.27, Insurance Woes and MTX

Tags

hip replacement surgery, hip surgery, insurance, methotrexate

So I got the statement from the hospital for my hip-replacement surgery and 4-day hospital stay. Without the negotiated insurance price, the number was $63,349.27. This doesn’t include surgeon’s fees, pathologists, etc. After the negotiated insurance price, it’s $40,454.72. Theoretically, I should owe somewhere in the $3K neighborhood.

However, I got a benefits statement from the insurance company for the pathologist. It indicated that I had only met $72 or so of something called “in-hospital deductible”. I’ve been having problems for months trying to figure out how much of my deductible I had met. The EOB (explanation of benefits) from the insurance company didn’t always show it, and sometimes it conflicted. I’d call and I’d get a different answer each time. I thought I had a $1500 deductible, then I was told I had a $1500 deductible for BOTH in-network and out-of-network providers. Now this “in-hospital” deductible showed up, so I called yet again.

Turns out that I only have one $1500 deductible for everything — in-network, out-of-network, everything. However, the system has been applying charges to these other imaginary deductibles, which means I’ve been paying the difference. I have been assured that Blue Cross/Blue Shield will get all of my claims reviewed and reprocessed in the next few days, but what a scary thing. With a $63K hospital bill staring me in the face, the last thing I need is a screw up with the insurance company. When this gets all settled, I’m going to ask for an accounting of all my claims — what was applied toward the deductible, what was paid to the provider and what I should be liable for. I can’t believe that I am the only insured person this has happened to and I wonder if there’s not an insurance board or some one that ought to be providing some oversight. I’m always cautious about being a whistle-blower, though, so we’ll see how BCBS handles this situation. The good news is that I probably will get at least $1500 back because I’ve met my imaginary “out-of-network” deductible.

On another subject, I took my 7th dose of MTX last night. As usual, slept like a baby. I didn’t get the headache, but my stomach was a little queasy this morning when I woke up. Might have been the XXTravaganza Pizza I ordered last night since I didn’t feel like eating leftovers or any of my homemade soups.

Thanks for checking in.

Two-Week Surgery Follow-Up

Tags

hip replacement surgery, hip surgery, rheumatoid arthritis

Well, went to the doctor today for my two-week follow up and things are looking good. Got to see my X-ray with my new hip joint. Dr. Tucker installed three screws in the “socket” part of the joint into my pelvis just as a safeguard. It looks like I have a satellite installed.

He’s pleased with my progress and is comfortable with my starting to walk some without the cane, particularly around the house where I have counter tops and furniture within reach for support. It’s still basically progressing at my own pace as I feel comfortable.

I listed my range of concerns,the main one being the length of my right leg. He measured the X-Ray and he says that it might be a couple of millimeters different, but certainly not the 1.5 inches it feels like. He gave me basically the same explanation that the PT guy gave me and tells me that when things adjust over time that it will feel less and less uneven.

I also discussed the idiot PT guy that first came and he’s going to have a discussion with the provider about not assigning him to any of his patients. He didn’t say much, but you could tell from his expression he was not pleased with what the guy did either.

I also now have a card for the Homeland security guys when I set off the airport metal detectors.

I go back to see the doctor in a month (October 7). By then I expect to be driving and back to work at the office.

Jack leaves tomorrow (Thurs) and won’t be back until late Saturday evening, so I’ll be on my own for about three days. I’m sure I’ll be fine. The PT guy will be here Friday morning, so if I have any issues, at least I’ve got someone scheduled to come by and check on me. But I’m sure I’ll do fine.

Thanks for checking in with me.

Messrs Oaty and Petey, MTX and Blue Monday

Tags

hip replacement, hip replacement surgery, Lovenox, methatrexate, rheumatoid arthritis

There is a novel about a woman that “wakes up” in a mental institution and, of course, is totally disoriented. She keeps hearing references to oatey and petey and how she must get ready for them. It turns out that “oatey” is OT or occupational therapy and “petey” is PT or physical therapy. I know how she feels because I have both.

Or actually I have one. Mr. Oatey came quite unexpectedly on Thursday. After a flurry of activity all week, my brother who was staying with me and I were looking forward to a day of no schedules. Jack was out of town and we didn’t have to be up and around for the cleaning lady, the therapist, or any other reason. We had planned a blissful day of lolligagging followed immediately by rest, some lunch and then more lolligagging.

About 11:00 am I get a call from a gentlemen who informs me that he’s my occupational therapist and wanted to be there between 12:00 and 1:00. I assured him in no uncertain terms that was completely out of the question. I had actually been doing some billable hours and hadn’t even been in the shower. We compromised on 2:30.

Mr. Oatey actually turned out great. He was a very nice man from the India/Pakistan area who diligently put me through my paces, gave me straight A’s and, even though Blue Cross/Blue Shield had authorized four visits, declared quite happily that I was getting along famously and he didn’t need to see me again.

Check off that box.

If you’ve been following the blog, you may remember that there was a mixup on PT providers. At any rate, one guy showed up (Anil) and we sent him away because he was not with the original firm that was authorized. However the guy who showed up from the approved agency was a complete idiot. He had me doing all kinds of things before he even figured out that I was a hip-replacement patient. (Shouldn’t he have known that first?) My husband wants me to file a formal complaint, which I probably won’t do, but gives you an idea of the magnitude of the issue. Anyway, we got rid of him and I’ve been working with Anil now since last Tuesday. He’s a very careful, caring therapist who keeps being impressed that I can wiggle my feet and bend my knees. Unfortunately, he’s a workaholic and even though Monday is Labor Day, he’ll be here with bells on helping me count the number of glute squeezes that I do.

I restarted the Methotrexate last night. I didn’t notice the headaches or other side effects that I normally have. I suspect that it’s because it’s been out of my system for a few weeks now. However, I did have a terrific night’s sleep — which is normal because MTX tends to zap all your energy. My girlfriends came over today at lunch and brought pizza and laughter. I was a bit concerned that I might zonk off in the middle of the festivities, but all went well. It was great to see them. One of my friends is facing surgery of her own next week, so much of the conversation was on surgeries that have been as well as surgery to be. It used to be on men and margaritas — but that was then and this is now.

I’ve dubbed this coming Monday as Blue Monday. And since blue is one of my favorite colors, Monday is turning out to be one of my favorite days. I mentioned that Anil will be here for my PT session. He’s also going to remove all 23 staples out of my butt. He’s suggested a pain pill and ice packs before he does it, but still it will be good to get unstuck. They’re starting to loosen and every so often it feels like someone is sticking a pin in me.

Speaking of sticking pins, Monday is also the last shot of Lovenox and I’m also done with wearing the miserable TED hose by then as well. The socks have been my bain because (besides being so fashion forward) they are so hard to put on. They were my one concern about Jack being gone for three days next week. Now that’s off the table and I’m even more confident I won’t have any issues being on my own for a few days.

I go see Dr. Tucker Wednesday for my follow-up visit. I’m going to have Jack take me by my office for about an hour first to get my quarterly taxes filed and send out August invoices. Hopefully I won’t have to pee during the trip because I’m supposed to be using the special potty chair, but if I do, I guess I’ll try out the handicapped stalls and handrails.

It was terrific having my brother stay with me. I think this is the most we’ve been together since we were in high school together and we’re not even going to discuss how long ago that was. (Although they had his 40th year reunion this past April ….) He’s an excellent person to have around. He doesn’t hover, but was around to help if I needed something. More than anything, I’d sit up in the living room and we’d chat or watch movies. Friday afternoon after he went home, I pretty much just stayed propped up in bed and I realized how good it was to have someone in the house that would get me up and moving instead of laying around on my staples. :-)

That’s all I know for now. All the news is good. After a week of solid travel, it’ll be good to have Jack at home for a few days.

I’ll check in when I know more, certainly after the visit with Dr. Tucker on Wednesday.

1 Week Later, Physical Terrorists and Other Updates

Tags

hip replacement surgery, hip surgery, methotrexate, rheumatoid arthritis

Well, here it is a week later and all’s well, mostly. I’m doing super. This afternoon I even chucked my walker for a bit and got around using a cane. I’d do that all the time, but Jack is keeping an eagle eye out on me. He’s out of town on day trips the next few days and my brother isn’t quite as certain about telling me what I should be doing. I guess he’s known me longer and even knows better that telling what I can and can’t do is a futile exercise. However, I am trying to be good, so I’ll probably continue to give lip service to the walker for a day or so. It’s just so awkward compared to getting around with just the cane. Dr. Tucker told me to do whatever I felt comfortable with, so I will (as if I’d really consider anything else).

Ah, the physical terrorist. Oh my gosh. As I indicated in my earlier email, it’s not quite a personality match. I won’t go into details here, but it’s not going to work out. A health-care provider is a very personal relationship and I firmly believe that there has to be a comfort level for it to work and it’s not. There is an interesting twist in all this however. The insurance inadvertently (I’m sure) approved two different providers for physical therapy. I called Lynn at Dr. Tucker’s office and explained my predicament, that I didn’t think I would be comfortable with this guy and also that Presby Health Services had also been approved. She indicated that they would do whatever I needed to make sure I was happy. Either ask the original provider to send a different therapist or switch providers completely. I’m going to call her back in a few minutes and get something else figured out. I do believe in PT in recovery (although I don’t think I need a lot), I do want someone that I can work with.

There is one fly in the oinment. It appears that my right leg is somewhat longer than my left. I haven’t measured it, although I think I’m going to get my brother’s help in doing that. I think it’s somewhere in the 1 1/2″ range, which is substantial. There’s always a chance that there will be a variation in leg length, but it’s normally minor. Jack seems to think that it’s just swelling, but that’s a lot to be just swelling. At any rate, that will give us something for Dr. Tucker and I to discuss next week.

But after the first week, things are great. I’m well enough to be bored and frustrated with the fact that I’m not supposed to bend over  90 degrees at the hip — which means I still need help getting dressed, drying off after my shower, etc. The worst complaints I’m having is that I’m really stiff and sore in the morning. On one hand, it’s partly from being confined to sleeping on my back. On the other hand, I wonder if being off Methotexate for a couple of weeks hasn’t caused my RA to creep back a bit. I should start back on that regimine this Friday with Dr. Tucker’s approval.

I’m enjoying having my brother hang out. Fortunately he’s not had to do much, just keep an eye on me. He has back pains and issues of his own, so we make a fine pair.

Thanks to everyone for the good wishes and ongoing interest.

Last Post Before Surgery

Tags

hip replacement surgery, hip surgery, rheumatoid arthritis

The surgery is day after tomorrow and I’ve started counting hours instead of days. This will be the last post until after surgery, although if Presby Dallas’ Wi-Fi works as promised, I hope to update the blog soon afterward.

I’ve got a busy day planned for tomorrow — all the things I won’t be able to do for a while: breakfast at the deli, movie at the mall, jazz and lobster at Nate’s, with a break in the middle so hubby can watch the NASCAR race and we can catch up laundry and other house stuff.

I have really short hair and, as of yesterday, I have really, really, really short hair. Since I’ll be using a walker after surgery, I need something that is just wash and wear. I also had my acrylic nails removed since I’m not supposed to wear polish in surgery and I won’t be able to get back to get them done for a while. I feel like surgery has already begun with all this cutting going on.

I’ve spent the day getting the guest room ready for my brother who is coming in the Sunday after my surgery, and also doing some initial packing for the hospital. I’ve labeled my walker and reacher and crutches. Packed all my electronics and some clothes like my robe and slippers.

I’ve decided to give up the fear. I’m really focused on the getting well. Jack was out of town last night and I spent much of the evening reading blogs of people who have gone through this. (I didn’t know Martha Stewart had hip replacement surgery.) I also played with the virtual hip replacement surgery at http://www.edheads.org/activities/hip/index.htm — which I recommend to anyone contemplating or undergoing this surgery. I’m very encouraged that my imagination has blown the whole surgery fear out of proportion.

For some reason both yesterday and today my hip has really been giving me trouble. May be the weather. We’ve been having rain for the first time after weeks of 100+ degree Dallas summer. However, I really think it’s the fact that my hip has figured out its days are numbered and is throwing a fit. At any rate, it’s slowing me down and keeping me from getting some things done that I feel like I need to — like grocery shopping.  I have to pick up some prescriptions and something quick for dinner when Jack gets home this evening, but I’m not going to be able to spend the time or energy to stock anything up.

So this is it. The quiet before the storm. I really appreciate all the support and good words. I especially appreciate those sending prayers my way. I strongly believe in the power of prayer, so thank you.

The laptop’s packed. I’ll write more after surgery.