If I shined a flashlight up my left nostril, I could see the tip of what was originally diagnosed as a 6cm x 4.6cm x2.1cm nasal polyp. My husband named it Jackson, because it was certainly large enough to warrant a name, and Jackson Polyp seemed a respectable enough word play on artist, Jackson Pollock. After literally years of discomfort, it was a relief to have a name for what ailed me. How had I been living so long with this grand slug in my nose? Could it have been the cause of the other issues I’ve had on the left side of my face for a while? Whatever the case, one thing was clear: Jackson had to go, and surgery was the only answer.
It’s a blessing to have lived a fairly uneventful medical life. To suddenly be a participant in a system understood mostly from a distance was enlightening. Though it’s universally accepted that money should not be an issue when a person’s health is concerned, it quickly emerges as an issue, especially when a person’s health is concerned.
The first thing that became apparent as I lingered in the lobby of my ear nose and throat doctor was the grim selection of magazines available. Maybe I just got unlucky and all the interesting reading was surreptitiously tucked into the carry bags of prior patients. In short order, I also realized my specialist co-pay was comparatively high at $50.00 a visit. After being assured my insurance was of very good quality, it was somewhat galling to hear so many other patients pay only $25 or $30 at the front desk. Of course I reminded myself that my co-pay hardly mattered when there was a giant slug up my nose that had to be removed. And then there’s the testing. Testing, as it turns out, it also quite costly, particularly when the annual deductibles haven’t been met. Although I resisted the CT scans and the MRI, I knew they had to be done for diagnostic clarity, just as I knew the second CT scans, which were ordered for the purposes of "image guidance" during surgery, would provide my doctor with the necessary maps to avoid piercing my brain or severing my vision tubes, or other such horrors I’d read about on the internet. So yes, it was all costly, but necessary, and money really isn’t important when a person’s health is concerned (except when it is).
The period during which a surgery is scheduled but has yet to be performed is an interesting one. Each day is a grab-bag of dread and hope and fear and calm and panic and mania and control. The veneer is one of control, and it was, in fact, somewhat calming to know my procedure was considered outpatient surgery that would require no overnight hospital stay. This point was clear because I was given a white folder with blue letters on it that clearly spelled out, Same Day Surgery.
But it wasn’t Same Day Surgery. And it wasn’t a nasal polyp. It was, as it turned out, a meningocele – essentially a sack of cerebrospinal fluid that leaked through a hole in the bone of my skull and into my left nostril. It was a rare condition, quite serious, and my doctor (whom I should have said from the get go is really quite extraordinary) knew immediately he had an entirely different situation on his hands than had previously been planned for when he pierced the faux-polyp only to see spinal fluid flow out of it like water from a balloon. No matter for him. Apparently, my nasal cavity is rather like a big salvage yard, and he was able to gather bits of bone and tissue and I suppose the biological equivalent of duct tape to fashion a patch and stop the leak. As is apparently protocol for CSF (cerebrospinal fluid) leaks of this nature, he called in a neurologist to put in a lumbar drain, which added a more personal relevance to one of my favorite movies, Spinal Tap (it goes to 11). Before long, I was like a limp rag doll with a patched head and a bunch of tubes stuck in my stuffing. My Same Day Surgery turned into a five day hospital stay, the first two of which were spent flat on my back with my spinal fluid purposefully drained every hour on the hour so a build up of pressure wouldn’t blow loose the patch in my head. It was upsetting, but I also felt a strong sense of relief. It seemed like (and, in fact, was) a blessing in disguise.
The hospital stay itself was a study in complexity that to this day, I don’t fully understand. Hospitals are beautiful and massive and striking and sad, and very hard to get a handle on emotionally. My epicurean highlight occurred when the wrong dinner was delivered to my room. There was a brownie on the tray, with a dollop of whipped cream to the side. It represented the first "naughty" food I’d seen in some time, so I naturally kept it, and ate it, and it was delicious. Overall, the food was far more palatable than I expected it to be, though I was surprised and a little appalled to see high fructose corn syrup on some of the ingredient labels. On balance, my experiences with the staff were overwhelmingly positive, though there were a few moments when I did feel reduced to nothing but parts and plumbing. Worth noting is that there were many many people of varying levels of expertise and competency who apparently make a decent living by caring for the unwell.
And then there’s the bracelet. Have I not yet mentioned the white bracelet? Apparently, whenever anything is done in a hospital, a white bracelet is attached to the wrist with name, birth date, doctor’s name, and a bar code on it. I learned early on how important the white bracelet was, because everyone kept asking me to check it for accuracy. During my hospital stay, every time a nurse came in with a new bag of antibiotic drip, or a pain killer, or anything else that escapes me at the moment, she scanned my bar code. Presumably for billing purposes. I was a can of peaches. A cereal box. Black bars of varying thickness on a glossy white background.
And now I’m home. And there’s all the stuff of being home – the follow-up appointments, the medications, the "don’t lift anything heavier than a telephone book" mandate, and the cautionary, "If you taste a salty discharge in the back of your throat or notice clear, salty fluid draining from your nose, call immediately." So we’re in the guardedly optimistic phase of my recovery, and I’m happy to be alive, happy to take it easy over the course of the next few weeks. It saddens me some that I won’t have a Christmas tree, since a Christmas tree and sundries are all heaver than a telephone book. But I do have a gorgeous eucalyptus tabletop tree my mother made me years ago that will add a festive twinkle to what will be a restful holiday.
Meanwhile, the bills haven’t come in yet. And I admit it, I’m dreading them. But over and over again, I think to myself, "The money is nothing when weighed against my health." And make no mistake, I’m ever aware of what a pure luxury it is to feel that way. What a fortunate place I’m in to be among those Americans for whom an unanticipated hospital stay is not a ruinous financial crisis. Oh, it won’t be painless, of course! Even with insurance, this all represents a huge financial hit. But it’s a hit I can absorb. And some people aren’t so lucky.
What if someone is uninsured and they suddenly fall ill?
What if someone has no savings and they suddenly get sick?
What do those people do?
Or more to the point, what do we do about those people?
PS: I’m also aware of how fortunate I am from a medical perspective. Hopefully (knock wood), the worst is behind me and I’ll recover in full.
PPS: I’m also aware of how fortunate I am from a husband perspective. What an absolute amazement he was (and continues to be). Who knew he had such a way with bedpans? My mother, too, has been nothing short of brilliant, and she had the added challenge of physical distance to contend with. It’s humbling to be so beautifully loved.
UPDATE: Several of the comments clarified the purpose of the bracelet bar code:
FYI: the bar code scan (13+ / 0-)
isn't for billing purposes. In many hospitals, it's been added to make sure they've got the right patient. Accuracy checks have become a bigger and bigger deal over the last 10 years, after studies found that 1/3 of all hospital patients were subjected to some kind of error, most of them of the "wrong patient" type.
by DrPlacebo on Sat Dec 11, 2010 at 08:18:31 AM PST
I'm now a strong advocate for the bar code, and my thanks to those who have corrected my misimpression.