JOAN’S BLOG – FRIDAY, MARCH 4, 2011 – CANCELLED!!!!

If I don’t have a nervous breakdown from being an AD Spouse, I am going to have one from dealing with hospitals and insurance companies. My Monday surgery has been cancelled - by me. Here is why:

I TOLD my orthopedic doctor that I have what is called “difficult intubation”, which means I have a narrow passage in my throat ( the only thing on my entire body that could be considered  remotely “narrow”). I TOLD him that I would prefer to have a total block and light sedation, rather than general anesthesia. No problem, I was assured. That is the way he does the shoulder surgery. I would be out, but not with a tube in my throat. Fine. The surgery was going to be performed, not in the hospital, but in a Day Surgery Center (what I like to call operating factories). My insurance company did not approve the one he uses, so he had to get permission to use the one approved by them. Fine. Done. Everything was approved by the insurance company.

Last Wednesday, I had my pre-op exam by my PCP, and I told him how concerned I was about the intubation, even though I was assured they were not going to do general anesthesia, so he said he would put it into his report. This Wednesday, THREE DAYS BEFORE THE SURGERY (the weekend days don’t count), the surgery center finally called and asked me the standard pre-op questions. I told the nurse that I wanted to talk to the anesthesiologist. She took down all of my information, and told me I didn’t need to speak to him. I insisted. She spoke to him, called me back, and said there was no problem. At 2 o’clock in the afternoon, as I was wheeling my cart through Walmart, the anesthesiologist called me. (How did we function before cell phones?). He said that although 99% of my type of surgeries went fine, there was always the slim possibility that something might go wrong with my breathing, which would require a tube being inserted, and he absolutely refused, for my safety ( and to cover his a….), to handle my case in the surgery center. It would have to be done in the hospital. As I was shopping, I was frantically juggling phone calls between my doctor’s surgery schedule nurse and the anesthesiologist. The nurse was able to schedule me for the hospital on Monday. Whew.

When I returned home, she called again. It seemed that the hospital that my surgeon uses is not in my insurance network. It took all afternoon Wednesday, and all day Thursday, with the right hand of the hospital staff not knowing what the left hand of the hospital staff was doing; the insurance company AND the hospital accusing each other of providing the wrong information; and me yelling at both of them, to finally find out that the hospital was going to charge (not including any of the doctor charges) a minimum of $25,000 for my surgery - most likely a lot more, but no one could be specific, , and the insurance company was allowing $8900. I would be responsible for the rest, including whatever the insurance company did not pay the doctors. Unless of course, I would cancel the surgery, start all over to find a doctor and hospital “in network”, in which case they would pay 100% of whatever the hospital and doctors charged.

By the time the phone calls stopped, and the decision was made to cancel Monday’s surgery and start all over again, Sid was agitated from the phone ringing so much, and totally confused about what was going on. I explained the situation to him as simply as I could. He did not “get it” at first, but after an even more simplified explanation, he got it. Whether he will remember it – who knows? At this point, I don’t care.

The whole stressful day left me with a massive headache and a major flare up of shoulder pain. I cannot believe I have to start this whole process all over again.

It is times like these that make me wish for a little boredom in my life.

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