The start of the waiting game...

Howdy folks,

     Here’s the latest update…

     I asked my doctor on Wednesday if he could find an outside orthopedic surgeon I could see so I could get an independent second opinion on what is the best solution to this bone infection in my left leg and left pelvis.  He couldn’t find one for me, so I called a company made up of a group of orthopedic specialists, (including joint and spinal specialists,) to see if they’d take a look-see at my case and give me an opinion with fresh eyes.

      I have to call the back on Tuesday to find out if one of their joint specialists thinks he can give a proper, (meaning truly independent,) second opinion on what my best course of action is with this bone infection in my pelvis.  I need to call back on Tuesday in order to get my answer, and if one of them does feel he can help, make an appointment to see him.

     When I asked about how much a consult would cost, I found out something very interesting about how private medical care works.  First of all, the charge for an office visit runs from $160 to about $350, (and in my case, I’m expecting the higher charge since my situation is kind of complex.)  When I told the I don’t have insurance and would be paying in cash, though, I was told that I’d get a 20% discount for whatever the payment ends up being.  So if an insurance company were being billed for this visit, they’d charge more than just getting a cash payment at the time of delivery of services.

     While I’m opposed to Obamacare, there’s something very wrong with this picture to me.  I could understand a small extra charge with insurance since there’s extra paperwork involved and a delay in getting paid, but a 20% larger charge for the exact same services being given, (including surgeries, which very easily run into the tens of thousands of dollars,) just because an insurance company is being billed, (minus whatever one’s deductible is being paid by the patient,) just doesn’t make any sense.  THAT’S why people’s insurance rates are so high, IMO.  I could understand a slightly larger fee because of the paperwork involved and a delay in payment being rendered by the insurance company, but not 20%, especially on very expensive procedures.  That should be a flat fee since the paperwork involved would be the same whether the patient is just going in for an office visit, (like I’ll be doing,) or getting some massive surgery performed.  THAT is something that could be fixed legislatively that would do a great deal to help keep insurance costs from going through the roof.

     Anyway, I digress…   I’ll be picking up copies of my medical records and a CD with all my X-rays, CT and PET scans, Ultrasounds, etc., burned onto it on Monday to take with me for any appointment I do get, (if they don’t feel like they can help me at this place, I’ll keep trying to find another doctor for a consult until I can get those fresh eyes on my situation.) 

     Meanwhile, the chief of orthopedic surgery convinced my doctor that putting a gauze wick into that hold that’s draining pus is a bad idea, and even flushing it out with saline is somehow bad because somehow this is going to create pressure in there and just make the infection spread more, so instead, they’re putting in just 3-4 cm of the gauze wick and, essentially, (if the assumption that this gauze wick, acting as a drain and keeping that tunnel open is actually blocking drainage,) still blocking up the hole for the pus to drain out of.  I asked my doctor about that today, and told him that this didn’t make any sense, and he agreed so most likely in the next few days, they’ll stop putting anything into that hole to give a medium for the pus to drain through and just hope the hole doesn’t close itself up, (and again, it’s 8cm deep but barely larger in diameter than a toothpick.)

     I also asked my doctor how long it should be before the antibiotics I’m on should start killing the infection and reducing the amount of pus that’s draining, and he said about a week, which was yesterday, (Friday.)  There’s been no decrease in either the discharge from this little hole or the burning sensation in my thigh from the infection, so I’m thinking that they’re idea of just leaving it alone and my being on antibiotics to keep it from spreading isn’t going to work.  (The IV antibiotic I‘ve been on for this past week, vancomycin, is one of the strongest there is.)

     I also got the doctor to say he’d think about giving me another CT/PET scan in another month or so in order to see how fast this infection is spreading, whether the antibiotics are doing anything to slow it down, etc., which will affect my final decision on this hemipelvectomy surgery.  If the antibiotics aren’t working, I’m definitely going to get it done before it gets to my spinal column or over to my right pelvis.  If the antibiotics do halt it’s progress, (they’ve already said that nothing will kill it off completely since the bones don’t get much blood supply, so the antibiotics can’t get to it very well, which makes me wonder why they think putting me on antibiotics for the rest of my life to keep it in check will work,) it may change what I end up doing.

     And, of course, I got what’s become the usual answer when I asked why putting me on oral antibiotics for the rest of my life would keep this infection in check if much stronger antibiotics can’t get into the bone to kill it off, I got what’s become the usual answer from VA docs in general, which is some variation of, “if it gets worse, THEN we’ll have to do something about it.”, except that it getting worse and spreading is precisely what I’m trying to avoid having happen.  I want the infected bone and soft tissues GONE completely and for good, not to wait until they have to cut me in half above the pelvis to get rid of an infection that’s spread to both sides of my pelvis.

     On the plus side, on Monday, I’ll have all the records to read through myself, as well as all the scans I should be able to look at on my own computer to see just how far this infection has penetrated my pelvis already, which will also affect my decision.

     SO…  it’s basically a waiting game for the moment.  I’ll get an outside opinion on this, give the antibiotics they’re giving me now another week or so to see if the drainage from that hole slows down, and go from there.  I’ll keep posting to this blog every couple of days on how things are going, but I’m also going to profile some of the people I’ve met, both good and bad, and for the good ones, what makes them so amazing, and for the bad ones, what makes them so bad, (mostly people who abuse the VA system in order to get drugs or try to get benefits they don’t truly deserve, etc.)

      For those who are popping prayers upstairs on my behalf, what I need most at the moment is the wisdom to make the right call on this, because no matter what decision I do make, the risks are high for things to go wrong and me ending up far worse off than I am now, or in a worst case situation, just plain dead.  So please pray for God to grant me the wisdom I need to make the best decision on this.

Dave