Day 392 - NORMAL AT LAST!

Jan finally said she feels like she is back to normal. Thank goodness!

However, the hospital sent a bill and insurance hasn't paid them yet so I'm not giving them a cent yet. I called and asked for an itemized bill. Mistake! Ticked me off royally. They charge $835 for 24 hours in the hospital. Despite the fact that she sat in the waiting room for an hour, they say she was in the hospital for over 24 hours, which amounted to an additional $507 for the alleged one to two hours! I've instigated an audit because she was out at around 5:30PM when the doctor left.

We went to visit a friend in the same ward that was having heart issues. He didn't have a heart attack but it was chest pain, numbness and shortness of breath.

Luckily, Jan has not had any more episodes.

Day 364 - One Year Later: Deja Vu

As Yogi Berra is reported to have once said, "This is like deja vu all over again."

Later today we are going to my aunt's, the same one we were returning from when the accident happened last year. It has now been one year since the accident and over a year since the ER visit for her PSVT episode, give or take a day. There will NOT be a repeat of the events of last year, despite the recurring theme that has already started.

Part of the recurring theme is Jan was admitted to the hospital for the second PSVT episode that would not go away. Since she now has a cardiologist, she called the office. We went there to get an EKG of the PSVT rhythm. Her regular doctor wasn't in and the other doctor in the office admitted her to the hospital for observation.

From there, people didn't have a clue. We thought they would just get her heart rate down and send her home like the last time. Instead, they kept her overnight when we were told the doctor would make rounds in the morning. Wrong again. The nurse came in and gave her a non-related medication that Jan told her she didn't need. She didn't want to take it but the nurse said it was ordered. As she took the pill, the nurse told her she could refuse it. Ah, a little too late!

And trust me, this pill is as related to a heart problem as eye drops are to a hangnail.

The next morning the cardiac nurse practitioner order her an antibiotic and said the doctor would be in at 3-4PM. Great, I went to work but we texted a few times throughout the day.

I returned at a little after 3PM, by 4PM there was still no doctor. Almost a full day in the hospital without a doctor. I started to get a bad attitude because too many people in the medical field answer questions they should not, their answers are so optimistic as to be fairy tales.

The second problem with medical treatment is patients, in general, are too timid or in such compromised situations that they will not speak up for themselves. I think doctors and nurses have gotten away with being subtle bullies for far too long. As I age, I need to keep this in mind.

I had Jan page her nurse and I wanted REAL answers. I told her in no uncertain terms that she was not staying another night. She couldn't rest, which is what she needs most, and they had to stick her four times for an IV! They brought her a dinner meal just as the doctor was arriving, which she did not eat. I'm obviously going to fight that one.

The doctor finally showed up around 5:15PM and stayed about 30 minutes. He said he would not have kept her overnight and would have sent her to the ER to get the heart rate down. GREAT! Another lesson learned the hard way. At least I can be the jerk and let Jan remain mostly unscathed by my dip into vitriolic behavior.

As soon as the doctor left, Jan was discharged. I think the nurse wanted me out of there because I was not satisfied with having to wait 4 hours for an ice pack or 2 hours to be told she can take her nightly meds when the doctor had already told her that several hours before. They wanted to dispense all of her meds, which I had retrieved so they could have the dosages, from pharmacy. It isn't about money, except to the hospital. Why would she pay $40 for a pill from the hospital when the whole prescription for 30 days was $10 and she already has it and takes it normally? Communication is the problem with medicine today. They talk and seldom listen.

Life has, more or less, returned to normal. She's very tired, bruised where the IVs were botched, blew a vein and she still has some neck pain if she sleeps funny, but don't we all? I'm not pushing the plastic surgery for scar revision. It is her decision on the incision for revision.

On a funnier note, we went out to eat at a Japanese place last weekend. It was one of those sit-down-at-the-grill places and it was very good and I ate too much. Several people commented out of the blue that I looked like that guy that does Are You Smarter Than A Fifth Grader. That is usually a signal that I need a haircut.

Day 350 - 50 Weeks, Second Surgeon

We visited the second plastic surgeon about scar revision last Monday. She liked him better but still is unsure if she wants the revision. I can't say I blame her but I would want the daily reminder of seeing the scars removed. I don't have to be cut and heal though. I can't do it for her either so there's not much else I can do but offer encouragement.

We are still trying to find out where our escrow money went from our refinancing last month. They did send us a check for something but we can't figure out the difference between the pay-off (lower) and the amount being refinanced (higher). It is about one house payment so it is definitely worth looking for. As a matter of fact, it is halo scar revision money if you want to look at it that way!

If she decides to have the surgery, I will take before and after pictures.

Day 343 - Scalpel!

Last Monday we went to a plastic surgeon to see about scar revision on her forehead. He was nice enough and he indicated it was a simple procedure to be done in his office, but Jan is a little leery of being cut intentionally. As part of our new rules of medicine, as prescribed by me, we have a second opinion with another surgeon this coming Monday. I do not expect much of a different treatment plan, possibly only the price, which was actually cheaper than any of the follows up at Bilkmore.

Day 329 - Kicked Out!

Jan has been kicked out of PT. The PT guy says he can't really do anything more for her. We thank him for his help and support!

Day 315 - Jan's 30 Year Reunion

It has been 315 days since the accident and Jan had her 30-year reunion in Owensboro last night. It was actually a gathering of several years, encompassing the 70's and 80's Ohio County High School grads. There were about 100 people there so it was a good turn out.

Day 308 - Legally Speaking

We have passed 10 months since the accident. Things are mostly back to normal as much as anything is ever normal. We are refinancing the house to get a better rate. We are going from 27 years remaining at 6.675% to 15 years at 4.375. So we are dropping 2.3 points, shaving 12 years off the time and keeping about the same payment!

Jan has started going to church again. I, not being an overly religious person, do not participate in organized religion. I used to think I was agnostic but now I think that while God exists, he doesn't interfere with the affairs of man any more than we interfere with the single-celled life forms. That's just me, though.

The lawyer sent a letter telling Jan that they have sent the request for her insurance claim off and that should be resolved within 45 days. Additionally, the medical claim is being studied. We will see if there is anything to be done there. Frankly, I just want them to not be able to do what they did to Jan to anyone else. No further word from the Tennessee Medical Board on the outcome of their investigations into the doctor and the nurse practitioner.

Day 294 - 42 Weeks And Life Moves On

It has been over 200 days since the halo came off and Jan is still in physical therapy. She says her neck pops and cracks when she turns her head to the right. The scars look about the same, white dimples in her forehead the size of pencil erasers.

We just had the driveway sealed and still can't drive on it. They called early Saturday morning and said they could do it later that day if we wanted. So they did.

We also went to Nolin Dam for a cookout with my Dad. He was attending a Cattleman's association cookout and invited us. To get there we had to drive on the road where the accident happened. Jan realized shortly after we turned on to it. She said it made her a little sick at her stomach. I have the same feeling about Bilkmore.

Day 280 - 40 Weeks Still in Physical Therapy

Here we are at just over nine months later and Jan is still going to PT. Her PT guy was out part of last week so she only went last Friday. She developed an issue with her lower back and was in quite a bit of pain. That was unfortunate as there was a family get-together at the old family farm.

She took some pain killers and managed to get through it pretty well with some heat thrown in for good measure. She was doing much better this morning.

Not really much else to report, still trying to get Bilkmore billing sorted. That is a pain. If I were really worried about it I'd just pay it off. As it is, I hope I'm causing them more trouble and costing them more money than it is worth to them.

They send a statement and I call because it isn't right. Someday they will get it right but I won't live that long.

Day 259 - 37 Weeks and Jan's Birthday

Yesterday was Jan's birthday. We didn't do a lot. She's not really thrilled with counting numbers. To me they are just numbers, one more doesn't mean that much as long as people don't treat me differently because they think I'm old!

For her birthday we did go to her church ice cream social with our daughter, her boyfriend, his two sisters and one of his cousins. The burgers were good and the ice cream was homemade. Lots of people and plenty of entertainment for the little ones.

In the last month, I've made three visits to funeral homes. My friend's father that was in an accident and put into a halo (the proper way) finally succumbed to his injuries. Next, my uncle of 91 went downhill quick and left us. Finally, Jan's second mother had become frail and passed away just before her birthday.

She is still going to physical therapy although I'm sure the insurance is about to kick her off. The physical therapist is a great guy and has never sent us a bill for any co-pay or anything. The lawyers want to wait until maximum medical improvement before they present the claim.

I just can't seem to put this behind me. I have blinding rage every single time I have to deal with anything related to Bilkmore. The reason is the bills, they keep coming in. Bilkmore does an even lousier job of managing their bills than they do with medical care. It turns out each visit is a new account number so the automatic payments I've been making are going to the wrong account. Not to mention the fact that we get four bills for each visit; one for the hospital/clinic, one for the doctor, one for the x-ray and one for the x-ray reader. Each of them gets a co-pay so we wind up paying nearly $100 each visit for the privilege of being frustrated to the point of screaming.

There can be only one solution: brainwashing to get it out of my head. While Jan was drugged and merely had to survive it, I was awake, sober and traumatized psychologically by the whole thing. I'm not squeamish in the least. I can dig into my own flesh to retrieve an impaled object but watching them treat her like that for 80 days is impossible to take without a lot of anger.

I called to find out why the account hasn't shown a posted payment in two months and I was informed the account had a hold on it while they attempted to move the funds to the proper account. Incredibly, the lady could not make the numbers she had match the ones displayed online. What were the odds? Based on previous experience, I was not surprised. She said she could send me a detailed statement but she would have to remove the hold and stop the money transfer. As a former computer programmer, that just goes all over me as being the dumbest thing I've ever heard.

We do not need socialized healthcare in this country or any form of single-payer. What we need in this country is a good system of billing and standardizing forms. Different accounts for each visit is BS. Paying a copay for four different things under the same roof is BS. Billing two different amounts, depending on the way it is paid is, you guessed it, BS. Maybe this should be an episode of Penn and Teller's BS show on Showtime.

Day 224 - 32 Weeks and a Cookout With Friends and Family

Jan continues therapy. We went to a cookout at a friend's house. This is the friend who's father was in a head-on crash and is also in a halo. He is making progress but at 82 years old, it will be difficult for him. Our prayers and thoughts remain with him.

Day 217 - 31 Weeks And Home Again

We are finally back home after a very long three flights. I have just about caught up with all the yard work and such. Things are pretty much back to normal. Jan resumed physical therapy.

One more picture from Hawaii, Tessa surfing.

Day 210 - 30 Weeks and Submerging

We are still in Hawaii for a few more days. I had a few scooter dives today and became certified for their use. We got Justin, Tessa's boyfriend, to take the introductory scuba lesson. He did well enough that he went on a shore dive with us and the instructor.

We have seen Waimea canyon and been to a Luau. Kauai is much more laid back than Oahu or Maui.

Day 203 - 29 Weeks and Aloha!

We traveled to Kauai, Hawaii yesterday and boy was it a long day, literally. We left Nashville at 10:00 AM and arrived in Kauai at 7:40 PM but you have to add five hours due to time zones. We did get to see a few fireworks in Hawaii but we were tired and finally arrived at the resort around 9:00 PM. To our bodies, it felt like 2:00 AM SUNDAY!

Now we have nine more days of Kauai before we have to do it all again in reverse. Jan is doing some of her exercises in the shower every day but not her full therapy.

This is a picture from our room, facing the ocean.

Day 196 - 28 Weeks And Nobody Can See Me!

Just three more days until the next doctor's visit! We believe Jan is nearing maximum medical improvement. That is a technical term meaning little if any new progress will be achieved. She is still doing physical therapy but anything now will be very slow to return. Most of her mobility is back, just that last little bit is all she lacks. She complains that backing up her car is still a problem. Obviously here pin scars are not going to get much better. They have gone from red to pink to white.

Her single biggest complaint is the inner ear and balance issues that she first developed about halfway through the halo confinement. It will go away for a time but it never fully resolves. We do not know if it is accident or halo related or if it is just a coincidence. I tend to not believe in coincidences since I'm a technically oriented person that solves problems for a living.

She has been on five different antibiotics this year alone and is now on a steroid to see if that will clear it up. Her blood sugar spiked considerably the first day on the steroid but has returned to more normal levels.

I have filed a complaint against the nurse practitioner since there is, literally, nothing more she can possibly do to keep Jan from getting what she deserved all along in medical care. The NP purposely deterred Jan from seeing the doctor when it was well within her rights to see a doctor from the very beginning. Only a fool believes others are looking out for there best interests. Everyone tries to maximize their own return. The goals are certainly different. Jan wants to recover and the NP wanted to make as much money as possible from the treatment. The fact she was ineffectively dispensing care was Jan's misfortune.

I was requested to take the blog down from public view by legal counsel so I assume nobody else is reading this but Jan and I for the time being. At this time, only authorized persons can view the blog. If all goes well, I will turn it back on for public view after things are settled. I doubt that will be before the end of the year though.

Day 189 - 10 Days Until Bilkmore Again

We are at 27 weeks post-accident and 10 days until the next visit to Bilkmore's Children's Hospital. She is not looking forward to it but we hope this is the last visit there.

We had a cookout party to celebrate Tessa's graduation yesterday. We bought a grill and patio furniture to make sure everything was as good as it could be. Jan had a good time and a good day. Lots of family and friends showed up and we had a good time.

My mother's birthday is today and we had a cookie dough ice cream cake for her as well. A friend said that was the perfect dessert on so many levels. It is cake, ice cream and cookies.

It was very hot so we wound up mostly inside. I cooked on the grill in the front yard because the shade is much better there than in the back at that time of day.

We should have taken pictures but I was so busy it never crossed my mind. Maybe next time!

The improvement in Jan's neck is about as good as it is going to get. The PT guy thinks she will be finished with PT by the time we leave for Hawaii.

Day 182 - Six Month Rememberance

Today is exactly six months since the accident that left Jan with a type III C2 fracture. Things are nearly back to normal but only about 90%. We are still 17 days away from the next visit to the neurosurgeon.

On a sadder note, Tessa's hamster, Drizella, fell ill on Thursday night. Wednesday she was fine and seemed normal. They took her to the vet on Friday and the news wasn't good. She was 19 months old. She had a tumor behind an eye that caused it to bulge and put pressure on her jaw so that she could not eat. In just one day she lost a lot of weight and became debilitated. The vet helped her go peacefully.

This is a picture of Dru when she first came to our home in November 2007.

Day 175 - Lesson Recap

It is 25 weeks since the accident. Jan is driving and nearly back to normal but the last little bits of normal are the hardest to get back. She still has pains in her neck and shoulders and takes a fair bit more pain relievers than pre-accident. There are still several activities she has not rejoined, such as Jazzercise.

This whole ordeal has taught me several things that may be of value to others. I will try to relate them to you so that other people may learn from my mistakes. If just one person is spared the misery and suffering at the hands of the medical profession, it will have accomplished my goal.

1. If it is not a matter of life and death, get a second opinion
2. If it is an auto accident and there is PIP (personal injury protection) involved, let any other insurance pay first
3. You have a choice, don't be bullied
4. If you are given a nurse practitioner and don't feel comfortable, you can get the doctor scheduled instead
5. Do not let a resident perform complex procedures without an attending

Simple rules and I'll explain each of them in more detail and my thoughts for each. You will, hopefully, understand my reasoning for each and how it may affect you or a loved one in a medical emergency.

Beginning with the second opinion, this is what I think. In the case of Jan's injury, after the fact, we got a second opinion and that doctor said it might have been treated with just a brace. In the UK and other places, halos are rare. Had we had a discussion with a real doctor and not the resident just throwing the thing on her body and skull, things most certainly would have been different. If we had been part of the decision, I would have no room to complain.

Next, PIP insurance is to ensure that immediate medical care can be provided without worry of payment. It generally covers the first $10,000 per person. Jan burned through that in little under three hours. After that, the health insurance started paying and they slashed the originally billed amounts to slivers of the billed amount. If we had left the PIP out and let health insurance first reduce the bill, the PIP $10,000 would have more than covered all of the accident-related medical costs. It is also permissible to reimburse yourself for out of pocket costs first from the PIP money, which can be a lifesaver should there be extraordinary out of pocket expenses, such as travel, medications and other related expenses.

Choice is the cornerstone of a free society. After the halo was installed, Jan's choices dried up to none. Even though she was stuck with Bilkmore, she still had choices but they were not presented to us until it was nearly too late. She did not have to endure the repeated inefficiencies of the Bilkmore radiology department. She could have requested and if not honored then demanded that her radiology studies be done at a place more convenient for her. Convenience to the doctor or nurse is immaterial when the patient is being beaten down by the system. Patient comfort and ease is the primary concern of anyone that cares.

Nurse practitioners are usually very good and often spend more time with patients than doctors. However, if you feel you are not getting the attention and concern you deserve, as in Jan's two visits in 11 weeks, then you have the right to request a visit with the doctor instead. I only wish we had known this from the onset. We would have had no visits with that particular nurse. When she took 13 days to return our first call, I knew we were off to a bad start but did not know our rights.

Residents are not licensed doctors and as such are supposed to be supervised. They need to learn sometime and you learn by doing but there are certain things you do not want to be the guinea pig for when the inexperienced doctor is learning, especially when he is doing it alone without the necessary supervision. Jan's intern was not prepared, not experienced and certainly did not administer the halo properly. It is a team installation and he did it alone. When you are looking at 12 weeks in a halo, you want the person putting it on to be professional and to fit it as comfortably as possible.

There are other lessons learned from this but they are more personal. For one, I should have become more insistent that Jan's wishes be the highest priority from the beginning. Second, how and what I feel is not important if Jan isn't at least comfortable. Additionally, I can't do it all, no matter how hard I try. Finally, the medical establishment is about making money first and helping people if it is profitable.

Day 168 - Graduation!

Yesterday, Tessa graduated from high school. All those long years finally recognized. The class of 2009, we salute you.

Later today, we will attend Tessa's tennis team picnic. We picked up all the meat, buns and charcoal yesterday. I just hope it is not too hot. There is a shelter reserved even though the chance of rain is almost none. At least it should be shade.

Jan is driving on her own now. That's a big improvement at 24 weeks since the accident! She, and sometimes me, thought this day would never come. It has been the hardest five and a half months of our lives. It isn't over but it is closer than ever.

We've decided that she will get her, hopefully, last accident-related x-ray in Bowling Green before her July 1 visit rather than deal with Bilkmore's radiology department. We have never gotten her in and out of the imaging there in less than an hour. Either there were issues with the orders or the shuttle was late or the lab was busy. They are three for three on screw-ups and delays.

I refuse to make her put up with their nonsense any longer. It is her choice to be as comfortable as possible with all of it and she has had so much better experiences locally than at Bilkmore.

Here's another picture of all of us after the ceremony. Jan's hair is growing back out and her bangs cover the pin scars. It looks like my hair is getting a little longer as I look at this picture.

Tessa had a little gathering of friends at the house where they played Guitar Hero until nearly midnight.

The vacation situation is finally arranged. It looks like we are going to Kauai, Hawaii later this year! Two bedroom, ocean view in paradise!

Day 161 - Long Time, No Halo

It is officially 23 weeks since the accident and this is a long weekend. Memorial Day came early this year. Tomorrow we honor those that have given of themselves so that our way of life may be preserved.

The halo has been off 1 day longer than it was on, 80 days on, 81 days off. With that, she is just about ready to start driving herself. She's been making short trips with me to the grocery, to PT and the like. Backing up is hard still but getting better. She turns her head better than a month ago but not quite to pre-accident levels.

Tessa's last day of school is Thursday and she thinks she will be driving herself by next Friday. She knows I'll take her if she needs it. She doesn't want to be a burden but I don't mind.