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  • #46
    Thanks for the info, Ed! I wasn't aware of a state insurance commissioner. I hope I don't need it, but my ins co seems to have do a denial before they do an approval! I'm carefully monitoring all the paperwork.
    Peg
    61 yrs old
    75 degree lumbar curve with thoracic kyphosis
    T3 - S1 surgery with Dr. Buchowski in St. Louis, on 10/27/14
    Working on healing in Columbus, Ohio!

    Comment


    • #47
      It does seem as though it's common practice among those who recently had surgery for the insurance to pre-approve a 5 day stay. That doesn't mean that you couldn't get approved for a longer stay once admitted, but it might mean your doc has to be proactive in getting it approved or you will have to fight to have it paid for afterward if it was not approved. I wonder for you Peggy, since you knew ahead of time that you were definitely going to rehab that they would need to keep you in the hospital until you met the criteria for discharge to rehab. I have no idea what the criteria are for rehab but obviously you would have to be stable. I suspect they will end up paying up for your extra days. It's not like you refused to go home when asked.

      I don't know how the reimbursement for private insurance works (which I have), but for Medicare, the hospital is paid a set amount of money for each diagnosis code the patient has (DRG). So there is a huge pressure to move people out and start discharge planning on admission as the hospitals can easily lose money if people stay beyond the usual length of stay.

      Peggy or anybody, did you receive any injectable pain meds in rehab? Or were you weaned to oral prior to d/c to rehab? Like Ed mentioned, weaning to orals quickly is really rough. When I went to my pre-op appt, I asked a lot of questions about pain control as I have had surgery before and know that morphine and Percocet are not good drugs for me. Morphine just doesn't work very well, although I suspect they didn't give me enough because it drops your blood pressure and mine is on the low side to begin with and Percocet makes me do really inappropriate things (like dangerous). I found out they don't make IV Demoral anymore (sad face), too bad, as that worked much better for me. So I will be getting IV dilaudid, which I have not had before.

      I still can't believe they think 5 days is enough. With having a staged procedure, that means I would go home on my 2nd post op day after surgery #2. I think rehab is in my future. Do they have nurses on staff there?
      Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
      ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
      Fused T-7 to S-1 with pelvic fixation

      After 38* lumbar

      Xrays
      Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

      After: http://www.scoliosis.org/forum/attac...6&d=1424894360

      Comment


      • #48
        Hi there,

        those are great questions to ask about pain control. It is frequently helpful to have a family member or friend who can advocate for you when it comes to pain control.

        I am surprised you were told IV demerol is no longer made. I am a hospital nurse and we have IV demerol on our shelves. Dilaudid is very potent and effective. I think you will find it is much better than demerol!

        Best of luck and let us know how things are going.
        Gayle, age 50
        Oct 2010 fusion T8-sacrum w/ pelvic fixation
        Feb 2012 lumbar revision for broken rods @ L2-3-4
        Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


        mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
        2010 VBS Dr Luhmann Shriners St Louis
        2017 curves stable/skeletely mature

        also mom of Torrey, 12 y/o son, 16* T, stable

        Comment


        • #49
          I had IV dilaudid. Worked well, made me itchy as heck. I needed constant IV anti-itch meds while on IV dilaudid.



          OH! I wanted to add. This is important, make sure you take your pain meds to a pharmacy you have prior history with.

          I had just moved before surgery so I took my big amount pain med scrips to new branch of big chain pharmacy. They flat out lied to me and said they didn't have any oxycodone. It's hilarious thinking about it, 24hr big chain pharmacies tend to have higher amount of drugs in stock vs normal business hour ones. In hindsight they felt uncomfortable -- new client, bit script, looking relatively 'pain free' (no one paid attention to the walker...)

          I had to goto three different ones before one near my home would fill it.
          30 something y.o.

          2003 - T45, L???
          2005 - T50, L31
          bunch of measurements between...

          2011 - T60, L32
          2013 - T68, L?

          Posterior Fusion Sept 2014 -- T3 - L3
          Post - op curve ~35


          Comment


          • #50
            I found much better care at the rehab center than the hospital. They were quick to respond. Yes they were RN. I saw the rehab doctor every day. He was contacted at times to adjust meds. Or order other care. I was off of IV and rehab monitored fluids just like the hospital. I was on or a l pain meds and had a 50 fentanyl patch. Once that was in place and the body absorbed it ,I found it very effective. In addition to more help with moving than the hospital was able to do. Find a good inpatient rehab in your area. It is not at all like a nursing home. They do decide who to take as a patient. You have to be able to keep improving while there.
            T10-pelvis fusion 12/08
            C5,6,7 fusion 9/10
            T2--T10 fusion 2/11
            C 4-5 fusion 11/14
            Right scapulectomy 6/15
            Right pectoralis major muscle transfer to scapula
            To replace the action of Serratus Anterior muscle 3/16
            Broken neck 9/28/2018
            Emergency surgery posterior fusion C4- T3
            Repeated 11/2018 because rods pulled apart added T2 fusion
            Removal of partial right thoracic hardware 1/2020
            Removal and replacement of C4-T10 hardware with C7 and T 1
            Osteotomy

            Comment


            • #51
              Originally posted by Lizardacres View Post
              My upcoming surgery is starting to feel real; I have my pre-op clearance visit today. But what is really on my mind is how you deal with a pet that sleeps with you (in my case a large house cat who is a big baby). Now that winter is here and the temp here has dropped into the 60's (please don't hurt me), Freddie doesn't just sleep on the bed, but has to be right up against me hard all night (poor thing must be freezing).

              The problem is that he pushes me all over the bed as I try to escape this hot, heavy cat and I end up in some rather contorted positions. If I shut my door, he will cry all night. Fortunately we have long summers here and this is only a winter problem but my surgery is in Jan.

              Anybody have experience sleeping with pets post surgery they can share? If I kick him he will go, but come back as soon as I go back to sleep.
              Hi, there -

              I can tell you what I did. I have a 15-year-old West Highland White Terrier who weighs about 22 pounds. He loves nothing more than to snuggle up as close to his human as is possible. Hubby and I like to sleep at different room temperatures, prefer different mattress firmness, etc. When the scoliosis pain and my ability to get comfortable while sleeping increased about four years ago, I bought a Tempurpedic mattress with the articulating frame that raises the head and foot (and also has a massage option, which I rarely use because it sounds like an airplane is taking off nearby....seriously, the whole house vibrates). Anyway, in the instructions with the bed, it said not to use an electric blanket on the mattress. I hadn't done so up until I came back from the hospital. For some reason (maybe the meds??), I tend to freeze all the time. The temperature in my room right now is 75 degrees and I'm under the electric blanket, which is set on high, a down-alternative comforter, and a small fleece blanket to cover my arms and shoulders while I type.

              So, the Westie has a tendency to want to sleep next to us, and he also has a tendency to "throw" himself against us when he changes positions. He doesn't care which one of us he sleeps with - sometimes it's me, sometimes daddy. (smiley) Daddy solves this problem by using a body pillow so the dog only "thinks" he's right up against his daddy. I've gone for the evil alternative...I keep the blanket on high all the time, and frankly, the dog gets too hot during the night to stay as close to me as he would like. (evil smiley face) I love him to death, and that little fella literally hasn't left my side since I came home from the hospital. I also make sure to leave him a cool spot with his favorite blanket up near my head so he has somewhere to go when he gets too hot. He spends the night rotating from hot place to cool place, and it doesn't bother me because he's not butting up hard against me anymore. That first night I came home, when he settled in for the night and threw his backside against my fresh incision, I knew something had to be done. (smiley)

              So I suggest creating a really warm spot and a really cool spot and seeing what happens. Otherwise, the body pillow buffer works very well for my hubby.

              Good luck, and good luck with your upcoming surgery. Gentle hugs to you!
              Fifa

              Comment


              • #52
                I love Westies, I'll bet he is adorable! He sounds like he is about the same size as Freddie and has the same habits. Wants to be as close as possible, especially at night. Thanks for sharing your experience, I felt silly bringing it up but it is a worry. It's not cold enough here to use an electric blanket, so I don't have one. Freddie actually prefers to crawl under the covers if he can and sleep next to me. He does not like to sleep next to my husband. That is where our other cat sleeps. I try and keep the covers tight around my neck so he can't get in as it makes it harder to get away from him and traps him if I try and push him away.

                I need to put the heating pad on the bed and see what happens. I kind of forgot about it as we had visitors here for xmas and I had put it away. Thanks for your kind wishes. I hope your life calms down and you continue to heal. I feel really fortunate that I have had the last two weeks off work to de-stress, treat myself well and get some things done. Next week is back to work on Monday and I'm actually glad as it will be crazy busy and keep me focused elsewhere. I have five employees I need to work with to ready them for my departure and do their annual evaluations.
                Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
                ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
                Fused T-7 to S-1 with pelvic fixation

                After 38* lumbar

                Xrays
                Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

                After: http://www.scoliosis.org/forum/attac...6&d=1424894360

                Comment


                • #53
                  I want to second what green m&m said about getting your post-op pain meds filled---I had surgery at a large university hospital 2 hours from our house. My husband was turned away by the Safeway pharmacy in Portland when he tried to fill my discharge prescriptions. We made the miserable 2 hour drive home, and he dropped me off then went back to the pharmacy in town (also Safeway, not our usual one but the closest). They refused to fill it and told my husband he would have to take it back to Portland (two hours away!!!) to get it filled. He came back empty-handed and I called Safeway in a hysterical outrage, in agony and now shaking hard from the start of withdrawals because by then I was quite overdue for my next dose. I was within minutes of having to go to the local ER. Once I impressed upon the Safeway pharmacist what kind of surgery I just had he told me to send my husband back to the pharmacy and they would fill it. I can not begin to tell you what an unpleasant and avoidable experience this was.

                  My advice is to have your family go out and fill your discharge prescriptions and have them in hand before you leave the hospital. What happened to me shouldn't happen to anybody.

                  Best of luck in keeping busy and getting things squared away at work. It is really good to keep busy as you get closer to surgery.
                  Gayle, age 50
                  Oct 2010 fusion T8-sacrum w/ pelvic fixation
                  Feb 2012 lumbar revision for broken rods @ L2-3-4
                  Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


                  mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
                  2010 VBS Dr Luhmann Shriners St Louis
                  2017 curves stable/skeletely mature

                  also mom of Torrey, 12 y/o son, 16* T, stable

                  Comment


                  • #54
                    I had a morphine button in the hospital, but I couldn't remember to push it! I was on oral meds before going to rehab.

                    In rehab., most of the nurses would come & find me in the PT room when it was time for pain meds. I was seen by 2 doctors each day. Meds were adjusted & tests were ordered, as needed. I used a 'note' app in my iPhone to keep track of when & what I took.

                    My prescriptions were filled at the hospital pharmacy before we left. When I ran out of meds after being home for a few weeks, my surgeon's nurse faxed & called our local Target Pharmacy (400 miles away).
                    Peg
                    61 yrs old
                    75 degree lumbar curve with thoracic kyphosis
                    T3 - S1 surgery with Dr. Buchowski in St. Louis, on 10/27/14
                    Working on healing in Columbus, Ohio!

                    Comment


                    • #55
                      Originally posted by Lizardacres View Post
                      I love Westies, I'll bet he is adorable! He sounds like he is about the same size as Freddie and has the same habits. Wants to be as close as possible, especially at night. Thanks for sharing your experience, I felt silly bringing it up but it is a worry. It's not cold enough here to use an electric blanket, so I don't have one. Freddie actually prefers to crawl under the covers if he can and sleep next to me. He does not like to sleep next to my husband. That is where our other cat sleeps. I try and keep the covers tight around my neck so he can't get in as it makes it harder to get away from him and traps him if I try and push him away.

                      I need to put the heating pad on the bed and see what happens. I kind of forgot about it as we had visitors here for xmas and I had put it away. Thanks for your kind wishes. I hope your life calms down and you continue to heal. I feel really fortunate that I have had the last two weeks off work to de-stress, treat myself well and get some things done. Next week is back to work on Monday and I'm actually glad as it will be crazy busy and keep me focused elsewhere. I have five employees I need to work with to ready them for my departure and do their annual evaluations.
                      Hi,

                      I wrote you a giant post last night, but as has happened numerous times on this forum, I hit some key or did something that made it disappear. Since I’m lying flat and typing on my back using the laptop, I just gave up. I’ll try to post it again in my own thread – it had to do with insurance and stupid Barnes sending me home too soon with an obvious ileus. Thank God that is over. Thanks, Ed, for the advice to write in Word and paste it over. BRILLIANT!!

                      For not too much money, PetSmart and other places sell heated pet warmers…little heated pads for dogs and cats. Our Westie loves his. That might be of help to you if you don’t want/need a full-on electric blanket. Since we lost our other beloved Westie four years ago, we have discovered that our remaining Westie really likes to sleep covered up. He doesn’t burrow under the blankets or anything, but we have a bedtime ritual (yes, he’s spoiled and deserves it). So, I straighten out the bed and get all the blankets where I want them and turn on my electric blanket. Even though he prefers to sleep at my lumbar area, I make him his own place next to my head. He sleeps on top of all of my covers, and then I have a little thin fleece blanket that he knows is his, and I cover him up with it. It’s a small $5 fleece from Walmart probably four feet by four feet square. Once we go about the bedtime ritual of making “his place,” he can’t wait to get into it. This is his “cool” place…the one by my head where he can sleep and not bother me. Once he’s settled (he’s knows we’re making “his place” and can’t wait to get into it), when he settles in, I cover him up with his tiny light fleece blanket. He rarely moves all night long with this method. If he moves during the night, the first thing he does is stand up and shake, and the sound or his collar wakes me. Shaking during the night means he needs to go outside, so we do that and come back to bed. That’s when he’ll head straight for the “electric blanket spot." That’s probably too much info - sorryl

                      The heated pet warmers are sturdier than a heating pad, so they can’t be “kneaded” through as easily. Also, the temperatures are not as hot as a heating pad, so there is much less risk of burning your buddy while they sleep. I fell asleep on one once and got blistered pretty good. I think now they’re made with an automatic off feature so that doesn’t happen.

                      Anyway, good luck with your surgery and your bed buddy. My fella definitely knows something has changed and a little more “tentative” with me since I’ve come home. One of the worst parts of my recovery so far is not being able to pick him up and love on him like I used to. Hubby brings him to my lap so I can hold him, but it isn’t the same. He doesn’t understand why I don’t pick him up anymore , but he’s handling things fine and I’m so happy to have him with me.

                      Stay well!. I’ll post my ugly Barnes “too early” discharge story under my own thread. I don’t know how old you are, but if Medicare is involved, they have to inform you twice in writing that you have the right to object to being discharged if you think they are booting you too early. Ask for your care coordinator (some places call them discharge planners and others call them social workers) to bring you the form if for any reason they are wanting you to leave and you are not ready. I don’t think non-Medicare patients have the same option. I apparently didn’t.

                      Take care and try not to worry. About four days before my surgery, I realized there was little else I could do or try to control, so I gave up and left it to God (or fate…whichever you prefer). There was freedom in giving up…in knowing that I had done everything I could do, and now all I had to do was get through the surgery and recover. The bills are going to come…you’ll get the care and drugs you need, and you’ll make it home to all your beloveds where the real healing can begin. You can't change much of what is about to happen - you just have to "cope," and you can do it!! Just hang in there and use the forum as much as you are able. I guarantee there is someone out here who has been through whatever you are experiencing. (big smiley)

                      Take care and keep us posted. I go back to work Monday, so I may not be on as much in the coming weeks, but will try.

                      Fifa

                      Comment


                      • #56
                        Your suggestion to get a pet heating pad came at a perfect time. Last night I moved the heating pad to the bed. The female cat loved it and slept on it all night and Freddie stayed glued to my side. This morning Freddie decided it was his turn and after a big squabble they both ran off. Obviously I need another heating pad. I ended up buying a Pedzzzpad online and this does look a lot better than a regular heating pad. For one thing it only turns on when the pet lays on it and it never gets warmer than 102, which is a typical cat body temp. Also has a chew proof cord. Thanks for the suggestion! I have a tiny blanket left over from when they were kittens, I think I'll go and get that out, too per your suggestion.

                        My goal this week is to stay well. Flu season is in full swing here and one of my employees called out with it Friday. I'm carrying hand sanitizer and using it everytime I touch anything in public, but mostly trying not to go anywhere I don't have to. I've had a flu shot but the shot this year is not a good match for the most common circulating strain. It would be a real bummer to have surgery cancelled due to illness.

                        There is no question you were discharged too soon due to your ileus which resulted in whole lot of misery for you. It serves as a warning to us all to be proactive and speak out if we are not ready for discharge. As Linda said, the insurance approves a certain number of days to start, but this can be extended if warranted (and requested) by your surgeon. You sound a lot stronger now and hopefully will have smooth sailing from here.

                        I can't believe you are going back to work already! I had to go back and see when you had your surgery. You are not even 2 months post-op. Please don't push yourself and take care.

                        Liz
                        Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
                        ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
                        Fused T-7 to S-1 with pelvic fixation

                        After 38* lumbar

                        Xrays
                        Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

                        After: http://www.scoliosis.org/forum/attac...6&d=1424894360

                        Comment


                        • #57
                          Today was my anterior fusion. I don' remember the surgeon speaking to my husband postoperative but I was told that my L5 was so mis-sharpen they could only use half a cage at one level but a full cage at the next level. The nurse said I'm not using much dilauded but I'm not having a lot of pain. The vascular surgeon said he wouldn't cut muscle, which seems kind of crazy. Sure wish I could eat and have a cup of coffee LOL
                          Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
                          ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
                          Fused T-7 to S-1 with pelvic fixation

                          After 38* lumbar

                          Xrays
                          Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

                          After: http://www.scoliosis.org/forum/attac...6&d=1424894360

                          Comment


                          • #58
                            to Liz and fifa
                            keeping you both in thoughts and prayers for
                            uneventful...(from this point on)....recovery....
                            i won't even comment on places that send patients
                            home too soon....
                            Liz....i hope your trip home from hospital is as smooth as is humanly
                            possible...and your recovery as uneventful as can be.

                            so glad you both have 4 legged family to watch over you and be there for support...
                            sometimes 4 legged folks are so easy to tell what is going on....
                            because sometimes they just know...
                            sometimes they just seem to KNOW what 2 legged people often need explained thru words....
                            sometimes our 4 legged family does not need any words of explanation at all.

                            wishing you healing and pain free days to come...
                            jess...and Sparky (still healing)
                            Last edited by jrnyc; 01-13-2015, 07:30 PM.

                            Comment


                            • #59
                              Thanks for your kind remarks, I am missing Freddie. The surgery today was the easy one, from a recovery point of view. Round two is Thursday.
                              Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
                              ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
                              Fused T-7 to S-1 with pelvic fixation

                              After 38* lumbar

                              Xrays
                              Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

                              After: http://www.scoliosis.org/forum/attac...6&d=1424894360

                              Comment


                              • #60
                                good luck, Liz
                                i am amazed you are able to post here...
                                thinking of you until you are home, healing,
                                with Freddie by your side...

                                jess...and Sparky

                                Comment

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