Posted 6/10/2022 5:34 PM (GMT -7)
So as I was driving in, I felt like I was driving to an interview: Talking to myself in the car. "If I start out by saying I don't want this to be confrontational, it will be." "If I don't mention it all, he may become confrontational, which is what I don't want." It was ridiculous. I said to myself, 'What do I want to achieve with this meeting", and so I settled on, "I've taken the time to write all of these topics down to discuss with you to get your insights" but I want to start with your staff."
So I got there at 0815. The meeting was supposed to be at 0830. He doesn't show until 0845. I know you're pissed about not respecting people's time, considering I'm the one who had to drive all the way out there, but he was the one who initiated and told me about the meeting.
I took the extra 45 mins to use Waze to book the rest of my day's contractors meeting, realizing I'd left my glasses w/ the Valet. Smart.
He finally comes in looking like cheerful like Santa Claus and he pulls up in his surgeon's circular seat, 5-10 inches from my face. Don't you love it when they crowd your personal space? I've got my 3 pages of questions and comments and I start with "names'.
Rhonda, she is a superstar. Noah, is a superstar. Allison is flat out amazing. Jessica is simply beyond amazing!! And I thought you even did a great job and that's where my questions start. So I wanted to name names of his staff who were wonderful and I think that put him at ease and took any "sting" out of the air.
My points, I went right in channeling Straydog. So let's start with who was in the room besides all of these I just mentioned because there were people who I didn't meet prior ot pre-op, who ignored me and treated me like a 3rd class citizen. He explains: There were IV specialist, technologist, one-learning student, one manufacturer/vendor, etc. None of them were allowed to touch me or talk to me. They were watching and took no part in my care. I remembered that from a tenectomy I had last June. The vendor's were everywhere but weren't allowed to engage, so that made sense.
He stated, I did the entire surgery, no one else was involved in your care except Tran (the anesthetist whom you met in pre-op). So I was satisfied with his answer there and why they were "hands off". He managed the whole surgery from beginning to end and said that sometimes the flow of the blood may occur and since he was the only one working the procedure and monitoring for any anomalies (like you brought up, did the MRI's match what he saw prior to incision, etc.) he wanted to be as meticulous with the details of the discectomy and fusion because of my bone density and maybe some additional blood flow occurred, but as he mentioned, it wasn't a lot in the whole scheme of things and has seen this on many occasions and worse in others. He said that I did have a lot of swelling on my left side (I suspected that prior to surgery) that may have drawn his attention, where I was primarily losing strength and feeling and wanted to address that immediately and thinks that's where some of the extra blood flow came from. That's what was the delta in time between what he quoted me (2.5 hours vs. 4 hours). Understand, when he initially took the MRIs it was weeks before the surgery. Two weeks prior to the surgery, I started experiencing a lot more problems on my left side; I mentioned to you the other day, I completely lost control of my left hand and there was some radiating down my left arm. That was a developing factor AFTER my two consults with him in March and April after I started coming onto your website. The surgery came right on time as my symptoms were developing rapidly leading up to the surgery. So I can't blame him for that, but I did tell him in pre-op what had happened since the two consult visits. So he was "as prepared" as he could be. But still, he wasn't surprised by those developments. I also was told by my pain doctors to tell the pre-op nurses, Jessica, Rhonda, etc. that I had been given steroid injections, facet blockers, trigger points, etc. up until April, for their own situational awareness. So all considered, I think I'm satisfied with how he responded to that serious of questions.
So we pivoted to the next serious question about the lack of food and hydration. He stated because I had some swelling that often does accompany these types of procedures, we weren't sure if there was any infections. So I called the Infectious Disease Team to assess your dysphagia, breathing and swallowing and we didn't want you to choke on anything we were giving you and so we hung the IV anti-biotic drip (I remembered that part too) for 1-2 days to ensure there was on infections. Next, we called in the speech therapist to check your vocal cords to ensure that they were working because I couldn't speak or eat and they/she wanted to make sure they were not inflamed to cause me to have food caught in them, choke or die.
Got it. They just didn't want anything in my system or wanted to ensure anything (steroids, etc.) that were in my system were completely flushed out and wanted to rule it and everything else out as to what was causing it so that they could attribute it only to known causes of the procedure, which I can now understand.
Next, the blood clot. He wasn't even really sure that was a blood clot, after I described the event to him. He think it was dried blood that he says he has seen during procedures that sometimes form and eventually work themselves out of the system and I've only had one, which he said is more than normal.
We then discussed the nurses care, because they "don't work for him" he can only bring it to the hospital's attention. He advised me that Georgetown does NOT use latex gloves anymore at all but I told him that I had an allergic reaction to someone's gloves, albeit, minor but very strong, erythemic and wheel-like reaction with itchiness, but he stood his ground and advised me to try to use some hydrocortisone on it. I have and it has reduced almost down to zero itching now. But I was stood my ground on the catheter treatment and he was as apologetic as he could be because they're not his girls. So I guess that was a draw. And as long as the itching is gone and he does indeed let the hospital know (I gave him the nurses name who did it) and it gets reviewed, that's all I can do. You mentioned that that would likely be an outcome: that I would just "be heard" and I'm OK with that at this point.
Ongoing care. He is taking the lead. He wants to see me back in 4 weeks for another round of x-rays. Just as you said he would. My pain doctor, whom he knows (and referred to me to him) will assist with meds while he is on vacation in Central Florida for the next two weeks. I see him on next Thursday for him to review and discussion. I have the O/R notes and the Final Surgeon's Report, that my computer will not let me scan in and send to him for whatever reason. But the surgeon will take the lead, the pain doctor will be working to assist where and when he is needed and my PCP will be the core repository of my history of procedures and notes for his own situational awareness, blood work, labs, etc. as he should be. A complete, holistic team effort.
Your point of contention...lol. Weight lifting.
Once again, Straydog is top dog. The answer was a straight No. LOL! He says, cardio: 3-4 months (September-ish). Weight-lifting, he completely understood my concerns as I laid them out with you and the benefits, but he held his guns. He does NOT want me near weights until at least December! And I was crushed. But he says, as he did another thorough examination of me this morning, my strength and all of my "decreases" in responses were excellent, when/where I failed them prior to surgery (you know when they hit that rubber hammer on your limbs? I failed that before. I succeeded today!) They've all come back. Some areas are moving faster than he has expected. He really wants me to slow down and hire the contractors to do all of my remodeling and no lifting at all but to get more rest than I'm getting now that I'm off the Decadron, which like you, he really hates but had to do it. I told him you said to flush it out with lots of water and he agreed with you. Start flushing immediately.
The purple glue is gone. He said for me to start using Vitamin E and silicone. Any brands you recommend?
We're not starting the rehab yet. He wants to have another round of x-rays first once he comes back, to make sure more of the swelling is down before we really get into the rehab but that's a subject for another day. I have an appt already scheduled with him for those x-rays 18 JULY and we go from there.