The Surgical Trifecta

In the clusterfuck that has been 2018, I have had two surgeries (so far), taken the first two ambulance rides of my life (the first, for what turned out to be a giant kidney stone; the second for having been crushed by, and concussed by a large, full and vicious, bookshelf), been without a voice for nine months (as noted in previous blogs), and, altogether, spent most of the year in an exceptional amount of pain.

I know compared to some, my problems are miniscule. Hell, I’ve lost two childhood friends this year — one to cancer, one to heart failure. But we all tend to focus on what’s happening to us, personally, and I’m no different (or, better).

Anyway, as followers of this blog know, I did something to my shoulder on my birthday (August 1^st). Thus began a four-month ordeal of repeated doctors visits, physical therapy, & an insurance company that kept denying my primary care physician’s and two orthopedic surgeons orders for an MRI. Needless to say, after the third rejection by the insurance company, I was furious.

As noted in my last blog, It took the scheduler in my throat surgeon’s office to point out, as I’d already met my deductible for the year, my insurance company was simply trying to run the clock out on me. They managed to stall the MRI until the 2^nd week of Nov., before finally caving, and allowing me to get what I should have had months ago. Naturally, when the results came back, it showed exactly what my PCP said it would, way back in August — I have a torn rotator cuff.

So, playing it conservatively, the orthopedic surgeon I was seeing wanted me to go back to the physical therapist for a couple more sessions, to see if we could avoid surgery. While I was more than happy to try avoiding surgery number three, I also pointed out to the orthopedist, if I needed the surgery, I needed it done before Dec. 31^st, because, as of Jan. 1^st, I would have to go back to scratch, & pay my entire deductible (meaning, thousands of dollars I don’t have). So we scheduled three physical therapy sessions, prior to the day we would make the decision — surgery or no. That day was today.

9:30am sharp, I’m at the orthopedists office. I’m quickly ushered back to the exam room, and a minute later the doctor walks in & says, “well, you need surgery. Unfortunately, since I’m moving offices, I’m closing my practice for the rest of the month, & won’t be able to operate until January.”

“Uh, do you remember our last conversation & why I told you I couldn’t wait until January?” So he gives me the name of another orthopedist, tells me they’ll give me his contact information at the desk, and walks out. That was it.

As I walked to the parking lot, my fury grew. MOTHERFUCKER!!!! If you knew you weren’t going to be able to operate until January, why didn’t you fucking tell me this two weeks ago? Did it not occur to this fuck, it might be a little difficult to go to another surgeon, cold, & schedule surgery for this month? As I drove home I found myself getting angrier & angrier. This sonofabitch’s irresponsibility toward me, his patient, could have screwed me, royally. My surgical co-pay this month — zilch! Next month, thousands.

Enter my beloved spousal unit, who made a call to the office of the surgeon who had done her rotator cuff surgery. She spoke to the doctor’s surgical scheduler, and got me an appointment for Tuesday morning. So long as the doctor agrees with the findings of my physical therapist, as well as my former (asshole) orthopedist, the scheduler says I will be able to get the surgery this month. But, for cryin’ out loud!!! Between insurance companies and doctors, if I didn’t already support universal healthcare, this would have made me a true believer!

My Year of Maladies — Vs. 2.0

Yoni, in the bubble-wrap suit, presented him by friends, for Halloween, 2018.

I last published this particular post on November 8th of last year. At the time, I was looking at the possibility of ending the year, as I’d started it — with another (third) surgery, this one on my shoulder. As it happens, the orthopedic surgeon who ended up being the one I stuck with (there were three prior to him), decided he wanted to play things conservatively. I saw him in December. Instead of surgery, he gave me a shot of cortisone (I’d had two, previously, neither of which did anything to alleviate the pain). He determined the two previous injections were given in the wrong place. 48 hours later, I was pain free, and thrilled beyond my ability to express. There would be no third surgery in 2018.

Two weeks ago, my shoulder started to ache again. I had good days and bad, but the bad ones were excruciating. Over the past few days, I was having good hours and bad ones. But since my follow-up with the orthopedist was already scheduled for today (February 14th), I decided to just wait and see what he thought.

Well, this may not be the beginning of 2019, but it looks like I’m getting that third surgery, after all. Although the doctor believes I may need an entire shoulder replacement at some point (oh joy), this time out we’re just gonna go with a “simple” rotator cuff surgery. If you know what that entails, no explanation is necessary. If you don’t, I’ll sum it up like this — three to six months of hell! So enjoy the story of how we got here, and please send good vibes. This shit is getting old!

For those of you who subscribe to my blog (and bless those of you who do), you probably know how physically traumatic 2018 has been for me. I’ve written about the complications caused by my first surgery of the year, what should have been a fairly simple, double hernia. Unfortunately, as I learned subsequently, it seems I have an unusually small larynx, something the anesthesiologist failed to note when putting whatever contraption he placed down my throat to inject the anesthesia.

The result of this faux paus was the loss of my voice for the better part of nine months, including a second surgery, this time on my throat, to try and mend the left vocal cord, damaged by the anesthesiologist during surgery #1. It took another five-plus months after the surgery on my throat, before I started to see beneficial affects, and was able to start talking again. My voice is now somewhere between 60 and 70% recovered. If I talk for long periods, it gets hoarse again, and begins to fade. And I still can’t sing, something that disturbs me to no end.

As those who’ve known me since childhood will happily tell you, when I was born, I was most likely vaccinated with a phonograph needle (for any young’uns reading this, ask your elders about that reference). Talking (and singing), is, and has always been, a major part of my life. It’s also been my prime source of income since I was 20. So not being able to talk was not only frustrating, it was terrifying.

Had that been the only problem I suffered this year, I might not feel so much like someone put a hex on my body. But it didn’t end there. On my birthday — August 1^st — I was reaching for something on the butcher-block unit that sits in the middle of our kitchen, when I heard a snap in my left shoulder. I thought to myself, “well, that can’t be good,” so I started testing my arm, to see how it felt. Surprisingly — no problems. An hour or two later, I was sitting at our dinner table when a stabbing pain went through my shoulder, like someone sticking a knife in, and twisting it all around. Whoopee! A birthday trip to urgent care.

The P.A. who saw me, put my arm in a sling, and ordered an X-ray, which, as expected, showed nothing. As suggested, I followed up with my primary care physician later that week. He did a 15-minute evaluation, moving my arm (as best he could without me screaming in agonizing pain) this way and that. At the end he said he thought I might have torn my rotator cuff. He ordered an MRI for me, which my insurance company promptly rejected. They wanted me to do six weeks of physical therapy first, to see if that would help. So I made an appointment, and went to see the physical therapist whose office, as it happened, was directly across the hall from my doctor’s.

The therapist was a very nice woman, who spent about half an hour testing my shoulder, seeing where my pain was, moving my arm about, assessing what she thought could be done to help me. At the end of her evaluation, she asked me to wait a minute, and disappeared. Ten minutes or so later, she returned, my doctor in tow. She had actually gone across the hall to his office, and asked him to come over, which he did, even though he was in the middle of a very busy day. For the record, my doctor is the kind of guy you could imagine still making house-calls (again, kids, ask your parents and grandparents).

Anyway, the physical therapist told us there was nothing she could do for me. The damage was too extensive, she said, and physical therapy would only increase said damage. My doctor, being the wonderful person he is, gave a little whoop of satisfaction, and said, “well, now those bastards at your insurance company have got to approve the MRI.”

They didn’t.

It seems, United HealthCare — my insurance company — has a policy that once they reject a request, you have to wait 45 days to make the request again (I can only imagine how that policy might affect someone suffering a potentially terminal illness). So my doctor referred me to an orthopedic surgeon, figuring, if a specialist ordered an MRI, policy or no, they couldn’t deny those findings.

Say it with me — oh yes they could!

The orthopedist I saw, did a somewhat cursory (I thought) evaluation, gave me a shot of prednisone (a steroid meant to relieve pain) in my shoulder, and ordered the MRI, which was promptly rejected by UHC.

So we’re now into October, my arm is still in a sling, and the voice that’s only now returning is going raw from my screaming bloody murder about the lack of care insurance companies — again, in this case, United HealthCare — extend to sick or injured patients.

By this point, I was so disgusted by the entire mess, I was ready to walk around with a bum shoulder for however long it took for it to just fall off. I decided, fuck it! I’m not even going to wear my sling inside the house any more. What’s the point? It only get in the way.

Fast forward to Sunday, October 28. I was already in a volatile state of mind, which is putting it mildly. But the added rage I felt over the massacre which had taken place at Tree of Life synagogue, in Pittsburgh, the day before, as well as the Nazi-like ginning up of hatred and violence toward minorities being used as propaganda by the current occupant of the White House (whose name I refuse to say or type), had me somewhat out of my mind.

So much so, when I tried to reach for a book on the top shelf of a tall bookshelf in our family room, and couldn’t quite reach it, I was so insanely angry, I jumped for it and just yanked the fucker!

Not my greatest move, ever.

Along with the book, the entire shelf, obviously not well balanced to begin with, toppled over, falling directly on me. I was slammed with books, shelves (one of which, hit my head, causing me to black out), and other items we had on the shelves. But here’s the kicker — as the bookshelf was falling, my immediate instinct was to raise my now slingless arm, to try and protect myself. As the shelf hit, it also slammed my arm and, in turn, my shoulder.

When my wife, Tanya, walked into the family room looking for me, all she saw was a toppled bookshelf. It took a second before she realized I was under the shelf, at which time I believe she screamed, before rushing to pull the shelf off me.

A short ambulance trip later, I found myself in the E.R. at a nearby hospital, where a CT scan was taken, to make sure my brain (such as it is) wasn’t bleeding, internally. Unfortunately, by the time the E.R. doctor ordered an MRI for my shoulder a number of hours after I’d arrived, the entire radiology department had gone home for the night. So even in the E.R., no MRI.

There’s a reason a group of my friends in Chicago, gave me a bubble-wrap suit for Halloween, this year. I should worn the fucker, full-time!

Two days later, I had a previously scheduled surgical follow-up with my ENT (that’s the throat surgeon, for the uninitiated). This was the first time I’d seen him since my voice had started to return, and I was excited as hell to show him my progress. However, what ended up being even more interesting than the exam, was a conversation I had with his scheduler, after my visit.

The scheduler, a very nice guy, and I had chatted before because, like me, he used to play baseball, and had gone to a very progressive high school where he took classes in film production, giving us something else in common. But that day, he pointed something out, no one else had bothered to mention. What he said was, “you know why your insurance company is pulling this crap, don’t you?” “Cheap bastards,” I responded. “No,” he said. “You’ve met your deductible for the year. They’re putting you off, so in case you do need surgery, you won’t be able to get it until next year, when you’ll have to meet your deductible again.”

Well, my jaw just about hit the floor. I don’t have a lot of respect for the overlords of the medical industry in this country, specifically, the insurance companies raking in billions, under-treating and over-charging patients for something I believe we have an inalienable right to — medical care. But as much as I despise medical insurance companies, it had never occurred to me, the company my wife and I are paying a fortune to, on a yearly basis, would play that kind of game with my welfare.

Naturally, I did what I always do at times like this. I went fucking ballistic!

So, once again, back to my primary care physician, who, after hearing all that had occurred since last we’d met, reacted exactly as I expected — he went ballistic, too. He grabbed a piece of paper, quickly wrote down a name and number, and told me, “go see this guy — tell him I sent you. And I want you to tell him the entire story. He’ll make sure you get your MRI!” My doctor was sending me to another orthopedic surgeon, one he thought would be able to push through United HealthCare’s bullshit.

So, this past Monday, Nov. 5, I went to see the new orthopedic surgeon, telling him the entire story, as my doctor had instructed. As it turned out, the new orthopedist was a homey. He had grown up in Yonkers, NY, not far from where I grew up. He and I had even had our tonsils removed at the same hospital, so talking to him was like old home week. In any event, after doing his evaluation, he gave me yet another referral for an MRI. However, this time he said something the other orthopedist hadn’t — “don’t worry about your insurance company. I know the exact wording to use so they can’t deny you.”

And damn if he wasn’t telling the truth! At long last, tomorrow, Friday, Nov. 9, I will actually be getting an MRI, which United HealthCare finally approved! The only remaining question is, what will the results show? Will I need yet another surgery before the year is over? And if not, how the hell do I get myself off this fucking treadmill, with a working (and pain-free) shoulder?

My only thought — c’mon 2019!!!!

Addendum: As I was writing this blog, I found myself so hung up on my voice (or lack thereof) and shoulder problems, I forgot this was also the year of ambulance rides — two, in fact. The first two times in my life I’ve ever been in an ambulance. The Bookshelf Incident (as I’m going to call it), was the second. The first came early this past Summer. I was standing in my bedroom, one afternoon, doing G_d knows what, when I felt a pain in my side, like nothing I’ve ever felt before. I went down like a shot! And with no voice, I was screaming my ass off! And this pain kept growing and growing to the point, I truly thought I might die.

After an incredibly painful (and, thankfully, brief) Uber ride to my doctor’s office (we are a one-car family, and Tanya had the car that day), my doctor took one look at me, felt around the left side of my abdomen, and said, “well, you’ve either got a nasty kidney stone, or a burst appendix. Either way, you’re about to take an ambulance ride.” And then, my doctor just sat there, telling me jokes, trying to take my mind off the excruciating pain, until the ambulance could get there. The man should be nominated for sainthood (and that’s coming from a Jew)!

Interestingly, my first ambulance ride was not quite what I expected. As the vehicle headed toward the hospital, there I am, lying on the gurney, screaming (quietly) in agony, and the EMT sitting in the back with me, casually asks if I’ve got my wallet. He needed to see my ID and insurance card. Talk about surreal.

Fortunately, once they got me to the hospital (a relatively new facility, not even fully-staffed), I was hooked up to a morphine drip which, after the initial rush — a feeling I fucking HATE —the pain eased, somewhat. Following this, they took blood and did a battery of tests, coming back with the verdict I had a nice big kidney stone, which was working it’s way, down my body.  

For entertainment value, the E.R. nurse told me about her kidney stones (yes, plural). She said it was more painful than giving birth, and she had three kids! She also told me she needed surgery for the first one. Then, the week after the surgery, she had another kidney stone. If that was supposed to comfort me, we’d have to term it an epic fail!

In any event, they kept me hooked up to the morphine, waiting to see if the stone would pass, which, eventually, it did. If you’ve never had a kidney stone, and someone tells you it’s the most painful thing they’ve ever felt, believe them! I NEVER wanna go through that again. No one should have to go through that kind of pain. Now I understand why women in labor scream, “EPIDURAL, GODDAMNIT!!”