December 28, 2013
Damn, didn’t realize it’s been so long since I posted here. But there may still be some people who only check this site, not my FB page, so here we go.
About nine months ago, Beth was strongly encouraged to look into gastric belt surgery. Her medications and other medical conditions make it effectively impossible for her to lose weight, and her weight was causing severe physical and mental consequences (which tended to require more medications and treatments, which induced more complication, etc.)
She went through an extended battery of tests, forms, classes, forms, required approvals, forms, evaluations, and forms. Finally, around early November, we were told everything was good, all they needed was final approval from the insurance company, and we’d be off. The doctor wanted to do it by Thanksgiving.
Then followed three weeks of not hearing anything, despite repeated calls. Finally, we discovered the doctor’s office had never sent the forms to the insurance company for approval. According to them, they’d never received them. Now, they were gathering information from several different medical offices and doctors. It is hardly implausible one of those many might have failed to fax, send, or otherwise follow through. It’s extremely implausible every single one of them did. So, point blank, the office lost or misfiled them all.
Beth fortunately did not have to repeat the tests, but did have to contact everyone involved and get them to send in the paperwork all over again.
Beth has suffered severe depression for years; the only drug which even partially counteracts this is Nardil, an MAOI inhibitor that is rarely prescribed, despite its effectiveness, because it requires strict adherence to a dietary regimen. One of the many effects of depression is a very poor tolerance of frustration; if something is at all difficult, it will often be abandoned. Getting through all of this rigmarole was not easy for her, myself, or her mother. We kept pushing at it because we believed it was absolutely necessary for Beth’s long-term health, physical and mental.
So we finally, after far too long, got the final insurance approvals, and a surgery date.
(In the meanwhile, the company I worked for was being transferred to another company owned by the same uber-corporation. When this was announced back in August or so, we were told it would be mostly a matter of changing who signed the checks and moving the code over to the other company’s servers. Can you guess where this is going? Everyone in my division was a telecommuter; we were all over the place. The new company didn’t want telecommuters. They wanted us to re-apply for our existing jobs, and, if hired, to move to White Plains. Basically, they just tossed the entire accumulated knowledge base and skill set out the window. So, in addition to everything else, I am now unemployed.)
Friday, December 20th, I got Beth to the hospital at 5:30 AM. (Anyone who knows me will consider this proof of divine intervention, as “not a morning person” doesn’t begin to cover it. Then we got our first Fun Shock. Since Beth hadn’t hit her out of pocket maximum, the hospital wanted us to pony up over two grand, right then, minutes before her scheduled surgery. No one has told us this; it apparently wasn’t something anyone knew until they input her admission data. Fortunately, we had an “In Case Of Extreme Emergency” credit card.
Then, we got another problem. Despite the aforementioned many months of tests, surveys, forms, and so on, and despite the fact her long list of medications was always, continually, given to every doctor, nurse, orderly, and passing stranger during all of this, suddenly, they decided that they wanted her off the Nardil before surgery. This would take 10 days, minimum, and would lead to a Catch-22 of epic proportions. She was only approved for surgery because she had not been hospitalized for mental illness for a full two years prior. (This is close to a record for us for the past decade.) Without the medication, she would need to be hospitalized within 3 to 4 days, tops, based on what had happened the last time she’d had to go off it — which would mean no surgery. The doctor explained that if there was any indication of problem with the anesthetic, the surgery would be halted, and we were fine with that.
There were no problems with the surgery. The doctor said everything went fine. I stayed until she was out of surgery and was waiting to be placed in a room. At the time, she was groggy, but seemed to be doing alright.
It took a long time to get her into a room. Since this was ostensibly an outpatient procedure, we were worried she’d be there longer than 23 hours from admission, which could cause some hassles with insurance.
I spoke to her later than evening. The painkillers had worn off, she wasn’t being given more. She was in excruciating pain, and was pretty much in tears, saying she wished she hadn’t done it, that she just wanted to go home. I told her it would be for the best.
Later the next day (12/21), she was discharged. Tests had been performed that showed there was no leakage in her stomach, that the surgery had gone well. She was still in overwhelming pain, and could not keep down anything, or swallow. We hoped bed rest at home would help.
The next morning, after a miserable night of vomiting and pain, we called the hospital, which told us to bring her back in, as this didn’t seem normal. So she was re-admitted on Sunday, 12/22. That was, and trying not to be too melodramatic here, the last time I saw her conscious, as of this writing (12/28/2013)
On the 23rd, she was an a BiPap machine, and we were told she was severely dehydrated, was not getting enough oxygen, and between the surgery and her being unable to swallow, she’d been off her meds for several days.
On the 24th, I called the hospital, and was transferred to her ward, and I got the following response when I asked for her:”Oh, you didn’t know she was transferred to the ICU?”
No. I didn’t know. Oddly, no one seemed to think that was worth calling us about. Funny, that.
She was having difficulty breathing and was running a 102.something degree fever. She was basically unconscious, though from painkiller or the fever or the lack of oxygen, I am not sure. They were still trying to figure out what was wrong with her.
Early in the morning on the 25th (Anyone who says their Christmas was “ruined” because they got the wrong color iThing, please, come over here and say it to my face. I’ve got some repressed rage to work off.), we got another call. Beth had “coded”. She’d stopped breathing. They intubated her, got her going again, but obviously, whatever was wrong with her was very serious and getting worse. We went to the ICU and stayed there.
Midway through the day, they finally found the problem. Her sutures had been torn out, probably from her vomiting. So for several days, she’d been leaking stomach fluids, etc, into her body. They performed more surgery, to remove the gastric band, and to insert drains into her stomach. The damage done by tearing out the sutures was severe enough that they couldn’t just repair it, or at least that’s the impression I got. I assume they did something to close it up, but they needed the drains because it wasn’t sealed completely.
She still wasn’t conscious. There were no indications of brain damage (no blood clots, no signs of anoxia), but the doctor was “concerned” she wasn’t waking up.
We got home, tried (and failed) to relax. I was just barely getting around to accepting that while her recovery (from what was supposed to have been routine outpatient surgery) may now take several weeks, we were probably past the worst of it.
Then, we got another call. This was from the kidney specialist. We need to give permission to put her on dialysis, because her kidneys were not working. We’d been told there were some issues with her urine, but nothing had indicated she was suffering kidney failure. Then we got a call again, a few minutes later, saying we needed to give permission for something else dialysis-related; Beth was so weak they needed to do the dialysis slowly, through a tube in her neck, to see how she was handling it.
That was a bit of a breaking point. I’m now at the stage where every time the phone rings, I panic, because I have no more confidence things will either stay stable or get better.
We are visiting her every day, even though she’s not aware of us. She occasionally partially opens her eyes, or seems to react, but there’s no way to tell if it’s due to our voices or just random neural action. Supposedly, she is showing slightly more responsiveness; we’re going back again tonight (12/28) and we’ll see.
We don’t know if she’ll have long term problems, short term problems, or no problems. We don’t really know why she’s unconscious. I have no idea, really, what’s going to happen now.