Monthly Archives: May 2012

Surgery Day for Desperate Hubby

Once we had the diagnosis from a real doctor and the referral to the practice of Dr. Coughlin, we were once again thrown into the maelstrom of waiting for the referral to be processed by the new doctor’s office. DH subsisted on a combination of Celebrex and ibuprofen, staying fairly comfortable until we got word of who would be doing the surgery and when it would occur.

DH went to the consultation alone again (I’m apparently pretty busy for someone who doesn’t have a job), and met his surgeon Dr. Hirosi, a rising young protégé of the esteemed Dr. Coughlin.  DH liked the doctor immediately, and trusted him so much that he did not feel it necessary to ask even one question.  Not one question.

The information that he did manage to glean from the appointment was that he would have to have bone marrow removed from his hip to place inside the fusion (the doctor did impart that that would be the most painful part of the procedure) and that he would have a series of casts on for three months.  This three month recovery period would require absolutely no weight bearing at all.  Great.

When DH got home that afternoon he was jubilant that the surgery was scheduled and there was a plan of action for him to get better.  I asked a few questions.  It went something like this.  Me:  “So how long do you have to stay in the hospital after the surgery?”  DH:  “I’m not really sure.  I think he said two days.  Or maybe it was three days.”  Me:  “OK, so what do we need to do to prepare for you to come home?”  DH:  “I’m not really sure.  I don’t think he said anything about that.”  Me: “How long do you think you’ll have to be off of work?”  DH:  “I’m not really sure.” 

My very smart mother-in-law said she thought we might need an ice machine boot thingy of some type for the first few days.  I asked DH about that.  He said “I’m not really sure.”

It was obvious we were going into this thing fairly blind.  With all the unknowns, I wondered aloud if we needed to make an appointment to talk to the doctor some more before the surgery date, so I could be prepared to handle child care and all the other household requirements while DH was recovering in his hospital bed (complete with room service).  I asked DH what he thought about that.  He said “I’m not really sure.”

We decided to just wing it.  It will be what it will be, as I’m fond of saying.

We arrived bright and early (6:15 am) at the Day Surgery Building of the St. Al’s campus in Boise (day surgery……kind of implies maybe no overnight stay, yes?)  I asked Desperate Hubby if he really had to say overnight. I bet you can guess what he said.

When we went into the lobby we saw this beautiful fish tank.  Very soothing.

Fish Tank

The first question the receptionist asked was if DH would be staying overnight.  I guess she had the same source of information that we did.  DH answered:  “I’m not really sure.”

Our lovely intake nurse took us back right away and started preparing Greg for the surgery.  I immediately started taking pictures.  She thought that was pretty hilarious.

First off DH got his leg shaved.

DSCF1542

And his  IV in.

Checking out IV

After about half an hour our nurse shooed me back to the fish tank lobby to wait.  She said the surgery would start in 45 minutes, then take about an hour and a half, and that the doctor would come and get me when it was finished.

When I returned to the lobby I sat and started to wait.  I had brought Greg’s laptop, so I surfed the net for awhile and looked on e-bay for show shirts for Horsecrazy.  I started to notice that I was really, really hungry.  I drank three or four cups of the super bad coffee they had at the station around the corner, but that didn’t help. 

Then I noticed something that perked me up.  A candy machine.  I promptly rifled through my wallet and found all my change.  I bought a bag of trail mix and a diet coke, then at the last minute added a box of Junior Mints to freshen my breath.  I was golden.

After a couple of hours or so I was bored and feeling a little weepy.  I felt sorry for myself sitting all alone in the hospital waiting room.  At just that moment I got a text from my mother-in-law.  She was in the parking lot.  I told you I loved her.

Right after she got inside the lobby the doctor came out.  He told us the surgery went very well, and showed us x-rays of the before and after.  After I saw the huge ridge of bone spur that had formerly traversed my beloved’s navicular joint I was doubly glad I had not done a pre-purchase exam.  He would have never passed a vet check.

The doctor told us to go to the main hospital orthopedic floor and wait.  Apparently where would be an overnight stay involved.  Maybe two.  We rushed through the pouring rainstorm outside to get to the right hospital tower.  Then we waited. This is my mother-in-law Becki.  Isn’t she pretty?

More Waiting

In due time DH was wheeled up to the room and transferred into his bed.  We met the nurse on duty that day.  His name was Jamie.  He too was a guitar player, and he and DH hit it off immediately.

Talkin Guitars

DH had a great first day in the hospital. Unbelievable as it sounds, he was laying there working in bed just an hour after getting out of surgery.

Working in the Room

DH’s foot had been treated with a nerve block before surgery, so it didn’t hurt at all.  His hip was another matter though.  With no pain meds on board, that started to smart as soon as the anesthetic wore off. 

Nice nurse Jamie took care of that with some good drugs.  With DH pretty comfortable and settled in, I headed home around mid-afternoon to get the kids.  They were OK when we first got home, but by dinner time and the hour to get ready for bed they were missing their daddy a whole bunch. 

Batman cried and cried.  That made Horsecrazy cry. 

It made mommy drink wine.

I talked the kids into making daddy a get well card before bed.  Here are their creations.  Batman’s is the double amoeba drawing on the left; Horsecrazy wrote her name and drew a picture of daddy.

Then we all climbed into my king sized bed, where the kids slept sideways and parallel to each other, leaving me hanging off of the far edge like a climber halfway up the summit of Mt. Everest.

Kids Cards

By the next morning the foot block still had not worn off.  Dr. Hirosi told DH that he would have to stay another whole day and night in the hospital.  I decided to take the kids in for a visit.

They were happy to see daddy.  He was happy too.

Kids Visit

They all took turns playing with, I mean trying out, the breathing machine.  First daddy demonstrated.

Daddy does Machine

Then it was Annabelle’s turn.

Annabelle does Machine

Then Zachary tried it out.  I’m pretty sure he blew more spit than air.  But daddy didn’t mind.

Zach's Turn Machine

They gave daddy the cards they made him.

Daddy's Cards

Then after they played with the TV controller for awhile and drank all of daddy’s ice water I took them home.

The next day daddy was released.  When he told Dr. Hirosi that morning that he was still pain free the doctor almost didn’t believe him.  He said if he hadn’t done the surgery himself he wouldn’t believe Greg had undergone the normally painful procedure.

As soon as DH got home he wanted to visit with his old familiar friend.  Notice the pristine white cast. That didn’t last long.

Welcome Home

The kids were eager to do some decorating.

Decorating Cast

Now it looks like this.

Finished Product

We took a look at the hip after a couple of hours of being home.  It is pretty nasty looking.

Hip Shot

We’re now into the process of recovery by nearly a week.  DH is still pretty much pain free, but as he cuts down on the narcotics so that he can do some work the hip and foot start to get a little painful.

He is a very good patient so far.  I haven’t had to withhold food or water hardly at all in order get him to behave.

As for the kids, well, Annabelle likes to pretend to be daddy.  He doesn’t smile quite that broadly most of the time though.

Pretending to Be Dad

Both Zach and Annabelle are a little out of sorts because I have temporarily increased their preschool/daycare schedule to full-time while daddy is confined to the house.  They aren’t used to being away from home that much.  I miss them too.  But I admit it is kind of peaceful around here.

Until DH rings his service bell to request coffee.

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They Shoot Horses Don’t They?

Well, as some of you know, I have spent the several days nursing Desperate Hubby through a painful surgical procedure.

This is the story of how and why it happened.  The ending is yet to be seen. Just kidding.  I have too much invested in him at this point to do anything silly.

A long, long time ago, a mere week or so after celebrating his 20th birthday (I told you it was a long, long time ago), Desperate Hubby (I’ll just call him DH for short) had a very serious motorcycle accident.  In the dark of the early morning hours, while driving his Yamaha 750 at speeds estimated of between 80 and 115 miles per hour, he crashed.  Big time. 

After bumping his front tire into a sidewalk in downtown Boise, the bike slipped sideways with him underneath, sliding the entire length of the gutter until it came to a stop.  Against a big power pole. 

At that point DH was thrown completely free of the bike and all the way across the street, landing in a heap.

Yes, there were adult beverages involved.

His right foot was basically destroyed in the crash.  The big bone on top, called the Talus, was completely smashed.  All the tendons that ran from the ankle to the big toe were burned off, as was the skin and flesh on his leg from ankle to knee all the way to the bone.  It was a true miracle he lived.

The doctors reconstructed his foot at that time and he went through a several month- long healing process. During that time he discovered his deep inner love of Yarn Latch Hook projects.  You know……. where you take the mesh backing with a picture of a kitten imprinted on it, and then hook little pieces of yarn through each hole with a hook to make the design in yarn.  Kind of like “Paint by Number” except with textiles.

I’m not making that up, but for some reason the vision of it still makes me laugh, and no, he doesn’t do it anymore. 

Anyway, fast forward almost twenty years later.  When I met him I didn’t think of doing a pre-purchase exam.  He seemed healthy and relatively sound. 

He did have problems with his foot from time to time, mostly after too much activity like loading in and out for the band, or climbing a ladder to put up Christmas lights. He always worked out, and ran and did all sorts of exercise programs, and though he occasionally complained about his foot and often had to ice it after the end of a long day he seemed relatively unaffected by the old injury.

Last fall, after a new regime of cross-fit training and an increased running program, DH started having more problems with his foot.  He was sore more days than not, and the inflammation seemed to be increasing.  He decided to go and have it looked at to see if there was anything that could be done.  Against my advice (I am a big fan of “real” doctors) he decided to go see a well known local podiatrist for a consultation.  In doing so he embarked on a five month trail of agony.

From the initial (mis-) diagnosis of gout, to a subsequent taping and purchase of shoe inserts which changed the angle of DH’s foot so abruptly he was rendered completely non-weight-bearing and in total agony from Thanksgiving all the way through Christmas (no Christmas lights this year), the pretend doctor struggled with a diagnosis.  He admitted that he was stuck on the gout diagnosis, though all of the blood work to test for that malady was in the normal range.  He could see no obvious problems from his studies of multiple x-rays. 

He encouraged us to go to the next testing step.  Since the treatments for gout had been to no avail, an advanced testing protocol was needed to determine if there were torn or inflamed tendons in the foot.  Finally at a point of desperation, we agreed to pay for an MRI.  Our Blue Cross self-employment insurance is not the most robust, so it was a big expense, but we felt we had to know what was going on.

Guess who owned the MRI machine and administered the test?  Yep, pretend doctor.  He assured us that the MRI would give us a definitive answer; provide a treatment plan, and get DH off the crutches he had “borrowed” from our nice neighbors some months earlier.  He bragged and bragged about his radiologist, newly hired out of one of the large area hospitals.  He said having the radiologist on our team insured a speedy and accurate diagnosis.

Meanwhile, my mother-in-law, DH’s mom, kept mentioning she thought he should maybe see Dr. Coughlin, the top hand and foot orthopedic specialist in Boise (and a “real” doctor) who was in fact acknowledged to be one of the top foot docs in the Northwest.  I love my M-I-L.  She is the perfect combination of attentive and interested, happy to offer advice if asked, but not one to barge into your life if you aren’t interested.  And she’s always right.

I tried to encourage DH to listen to her and seek another opinion, but he was having none of it.  He is loyal to a fault, and wanted to give the pretend doctor a chance to figure it out.  I could see his point too; the pretend doc had all the background info, including an array of x-rays, history of the past few excruciating months, and the coveted MRI.

We eagerly awaited the results from the MRI, and arrived at the doctors office full of anticipation. Greg put his crutches down and hopped to the table. Pretend doctor came in with his clipboard, his free hand characteristically shoved down the front of his scrubs, which I always thought was pretty weird. 

Then he uttered these words.  “I hate to tell you, but I have definitely mis-diagnosed you.”  He talked about how he initially had been so sure the problem was gout, then since the normal treatments didn’t work had changed his mind to think there was something more going on.  The MRI, he told us sadly, showed no problems that could account for my poor hubby’s increasing pain and inflammation. There was some evidence of the contusions from the past trauma, but nothing he felt could be bad enough to cause the problems at hand.  The pretend doctor said he had to think about it; he really had no idea what was wrong.  His exact words were something to the effect of “I am used to hitting fastballs all day long but you threw me a curve!”   He prescribed the powerful anti-inflammatory Celebrex, and said his best treatment plan included the construction of expensive, non-insurance covered custom orthotics and long-term prescription anti-inflammatory drugs.  He told us he would continue to research and evaluate the options and get back to us.  We never heard from him again.

We left the office feeling defeated, DH crutching it through a light winter rain to the car in the parking lot. The next day I went to fill the Celebrex prescription.  My husband had been on numerous types of prescriptions over the past couple of months, both to treat the pretend gout and then just for the pain.  None of them had done a great job, so I wasn’t optimistic about this one either.

At the pharmacy counter of Wal-Mart I was informed that our insurance company had turned down the Celebrex prescription pre-authorization because DH had previously been diagnosed with……gout.  I was furious.  That was the last straw.

I filled the expensive prescription, paying the total fee out of pocket, and on the way home called my mother-in-law for support.  She again urged me to have DH get a second opinion from Dr. Coughlin, and I walked in the door armed to discuss it.  DH was in his familiar position, sitting in the recliner with ice on his foot, crutches leaning against the adjacent love seat, watching golf on TV. 

After a brief discussion, somewhat heated on my side because I was so angry at the incompetent doctor, he agreed to seek a second opinion.  I called Dr. Coughlin’s office the next morning, asking about the procedure for seeking a consultation.  They informed me that Dr. Coughlin was retiring and not taking new patients, but if I wanted to send the records over they would have them reviewed by the other doctors in the practice and get back to us.

That wasn’t good enough.  We needed instant action.  I discussed with DH the possibility of going to see an orthopedic surgeon in the practice that had cared for me when I broke my arm and back a few years ago in a horse accident. He agreed and the following Monday we made an appointment with Dr. Shevlin.

DH went to his doctor appointment alone as I had a prior commitment on that afternoon.  He called me from the doctor’s office.  The real doctor had not even needed to look at the MRI.  One x-ray view, taken in seconds at the office and viewed on the doctor’s cell phone, showed the problem.  A ridge of bone spur as high as the Himalayas had formed across the Talus-Navicular joint. 

Dr. Shevlin simply shook his head when DH asked him why the previous “doctor,” also purportedly a surgeon, had missed the diagnosis.  “Everyone sees things differently,” he said diplomatically. He expressed amazement that DH could even stand, let alone walk, with the degree of joint damage that had been done to his foot.  I knew from past experience that this type of diagnosis was life threatening for a horse.

There was only one choice, Dr. Shevlin said.  A double-joint fusion of the Talus-Navicular joint.  DH was relieved and enthusiastic.  Finally a real solution!  “When do we do it?” he said. 

Dr. Shevlin laughed.  “Oh, I don’t do it,” he said.  “Nobody in my practice does it. It is waaaaay too complicated.  There is only one doctor in the northwest that does these things.” 

Any guesses?

Of course if was Dr. Coughlin.  Told you my mother-in-law is always right.

Ready for Action

Stay tuned for a play-by-play of the surgery and hospital visit, and an update on how the impatient patient is doing.

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