Thanks for Reminding Me...

My good friend Alex just reminded me that I haven't updated in awhile. So here I am...
(By the way, that is Alex above with me in the ER after a roller skating accident. Busted tailbone. Lots of fun. Thanks again, Alex, for driving me to the ER)

After my previous post, I finally got in to see a great orthopedist and got myself a fancy space boot.

Had a two week check up the other day and the x-ray showed it is healing slowly. Probably due to my prednisone. I will probably have to wear the boot for 6-8 weeks as opposed to 4-6. Worst case scenario, I could require surgery, but I doubt that will happen. I did speak to the orthopedist about my SI joint and any ideas he might have for helping with the pain. He wants me to speak to his physical therapist about back bracing. Worst case scenario here, a couple of screws in my joint to keep it immobile. All in all, fun day at the hospital.

This appointment was my 4th of the week, starting with a trip to the lady doctor. That same night I had a post-op follow-up sleep study to see if the septoplasty fixed my apnea. The following day I had a Remicade treatment and then the ortho. But let's go back to the sleep study. This study was in a different location to the two previous sleep studies. I arrived at 9pm and was told I would be escorted in by security. Security stayed inside and on a personal phone call, appearing annoyed when I asked him a question. I found the study location and quickly realized I was the only person being studied that night. And the technician in charge of the study was male. He had to hook me up to the machines with many electrodes on different parts of my body. Everytime I needed the restroom he had to come unhook me. He was supposed to watch me sleep through a camera in my room. It was just me and this guy watching me in my most vulnerable position. I was so weirded out that I could not fall asleep and finally had to take a Xanax at 1:30am. I was awakened at 5am by the technician and he promptly removed the electrodes while I was more than half asleep and groggy from sedatives. I went to the restroom to change and when I returned to the room the technician was making the bed. I found this disturbing as he kept the sheets on which I slept rather than removing them completely. So did I sleep on used sheets? The whole operation seemed sketchy.

The difference between the first two studies and the latter study is that the latter was conducted by a private company outsourced by my doctor. The first two were conducted directly by the hospital. I think I know which I would prefer in the future.

To a Mouse

The best laid schemes of mice and men
Go often askew,
And leave us nothing but grief and pain,
For promised joy!
--Robert Burns from "To a Mouse"

This blog post is an apology to a friend of mine. I promised her something that I did not deliver, and for that I am sorry. I let my fear of failure stop me from following through.

I had grand plans to use my experiences with health care to help others via this blog. But life and laziness got in the way. Surgery, death, grad school, new puppy, and now a broken foot. I keep using these events as excuses not to get on with my writing. But my recent break reminded me why I must keep posting. Our health care system is a mess. For instance...

Last Friday I stupidly horsed around with my very strong, ex-Marine brother. As a result, I broke my foot. I say this is stupid because I have osteopenia which increases the risk of fractures and breaks. I did not think it was broken at first, so I waited a day before seeing a doctor.

I went to an Urgent Care facility and did not have to wait too terribly long. Much better than the 8 vomit-filled hours I have had to wait at the ER. But even though the x-rays definitely showed the clean break, the doctor only gave me this flimsy ortho shoe.

Now, I know feet are hard to treat when broken, so I did not expect a proper cast. But I certainly expected something more substantial. I was told by the doctor that I would get crutches with this shoe, but when the nurse came in, she said that she was not informed of this and would not bring me crutches.

Today, I spent the day on the phone trying to get in the see my primary care doctor, but she can't see me because it is broken and I need to see an orthopedic surgeon. Her nurse called around for me but cannot find a single ortho surgeon that will see me this week. Not a single one. In the meantime, what am I supposed to do? I can't get around. Am I supposed to put my broken foot on hold for a week until I can see someone? And I don't even know if I will be able to see someone that early. Could be a few weeks. And what is the most common complaint when discussing health care reform? That there will be long waits. Well, I think fixing my foot over a week after it was broken is not a short wait.

To wrap up...to my friend, I am sorry. To my foot, don't expect to be fixed anytime soon.

Arthritis Break

Let's take a quick break from arthritis. I want to post some photos from the 3-Day Susan G Komen Breast Cancer Walk that took place this past weekend in Georgia. I'm extremely proud of my dad who represented the men and walked with his co-workers.

When you have a disease, it is easy to forget about other conditions and, instead, focus only on yourself and your problem. But you can't forget about the others who are fighting their own battles.

Dad, thanks for doing this. Boobs everywhere appreciate it.

Remicade Reaction

Lately, it has been a series of ups and downs, not just mentally, but physically as well. As I mentioned before, I had to go off of my Remicade for 3 months due to surgery. 8 weeks before the surgery and 4 weeks after. No methotrexate either. My joints were pretty damn inflamed as a result. This overshadowed the post-op pain, which, I have to say, was not that bad compared to my previous back surgery (which I will detail in a different post). It also made me extremely tired. So by the time my Remicade appointment rolled around, I was definitely ready for the infusion.

When I went in for the infusion, the nurses warned me that I might have a reaction because it had been so long and because they titrate the medicine much faster than before (1 hour vs 3 hours). Well, the infusion went by with no problems and I went home to sleep off the benadryl. Next day I had the usual benadryl hangover but nothing else was different. By Sunday, I was starting to feel a bit funny and on Tuesday I woke up feeling as if I had been on an all night bender. Excruciating headache, nausea, intense joint pain. Couldn't get out of bed. I did some research and found a number of people had experienced delayed reactions to the first infusion after a lengthy break. However, the doctor seemed to think it might have been a virus picked up from a post-infusion compromised immune system. His solution was to call in a Medrol (methylprednisolone) dose pack. This is a high dose, short course of steroids to be taken over 6 days. After one day I felt like a new person. But three days into the course I became puffy, irritable, and unable to sleep. I replaced one bad reaction for another.

Which is basically what this whole disease management process comes down to: figure out which set of side effects is the least annoying and go with it.

It's Been a Long Time, Now I'm Coming Back Home

I dropped off the planet for a bit. And for good reason. My beloved Nana died unexpectedly, and between dealing with that and recovering from surgery I have not felt like talking to blogosphere. Before I talk about health and medicine, I want to say how much I miss her. She was a feisty Irish woman, Dublin-born and raised, who never lost her quick wit as she got older. And although she had her own health problems, she was always more concerned with my health.

Nana with my mom in 1977. How cute is my mom??

I miss her terribly. Hopefully she is somewhere now with a few saucy romance novels and a cup of tea.

First Post-Op Follow-Up

Wow. I am shocked. I cannot believe the size of the splints that were removed from my nose yesterday. And, unfortunately, I did not get any video or photos of the removal. I almost fainted after the removal, which the doctor assured me was a normal reaction, and so I did not mess with any cameras. But I would say each splint was around 2 inches long by 1.5 inches wide. I had one in each nostril. Then the doctor vacuumed out all of the "debris". The release of pressure felt fantastic, but it caused some serious throbbing for the rest of the day. In fact, the pain after the removal was worse than my initial post-op pain.

But, in good news, today I feel great! There is only mild discomfort, and there are a few remaining scabs, but it feels so clear! Ahhh! I have two more appointments to be vacuumed out and then I will be done. Apparently the next session hurts even more as it is more invasive, but I don't care. I can breathe!!

Oh, and here is the bill:

Article Round-Up

I am far too tired, sore, and drugged up to comment on these articles. But y'all should read these:

Ezra Klein:
"Entrepreneurship and Health Care"
http://voices.washingtonpost.com/ezra-klein/2009/09/entrepreneurship_and_health_ca.html

"Why We Can't Have Bipartisanship in Two Easy Quotes"
http://voices.washingtonpost.com/ezra-klein/2009/09/why_we_cant_have_bipartisanshi.html
This is a brilliant observation.

Think Progress:
Article regarding a town hall in Atlanta paid for by Aetna:
http://thinkprogress.org/2009/09/23/aetna-cnn-healthreform/
If I was feeling better I might try to go and ruffle some feathers...

This is a couple weeks old but well worth it. Matt Taibbi is one of my favorite writers:
"Sick and Wrong"
http://www.rollingstone.com/politics/story/29988909/sick_and_wrong

And hat tip to Donnie for showing me this article:
"What's Most Likely to Bankrupt You"
http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/whats-most-likely-to-bankrupt-you.aspx