Day 88 - Appointment Rescheduled

The doctor's office called on Wednesday and we now have an appointment for Jan on April 1, 2009, at the children's hospital again. I've emailed them to find out about getting x-rays since we took the CT scan on CD that we had done in Bowling Green.

The cold weather has put a damper on her walking outside so we went to Sam's last night to get some things and let her walk around indoors.

She continues to exercise her neck in small increments when we change the collar in the mornings.

Her church brought over two kinds of chili last night. It was very good. There was also a pumpkin creme pie, too!

Standing for any period of time still tires her out pretty quickly. Moving isn't as bad. Pain pills are less frequent and valium is about the same. Tylenol is her current pain pill of choice.

Day 86 - Appointment Cancellation? NO!

Yesterday was the first day I returned to work. Jan spent most of the morning working on homework while I went to the office. We IM'd and I picked up lunch at Zaxby's. She's walking just over a mile each day.

She is showering daily even though it is strange for her after three months without one. Her pin sites are cleaned three times a day and are healing well but the depressions are still quite deep and pink.

My work changed the FMLA date on my form to yesterday and informed me YESTERDAY! To get me through the expected recovery period, I faxed another form to the neurosurgery clinic to get it filled out since she still can't drive or turn her head.

I emailed the clinic to follow up on the fax since they have been horrible about getting anything completed. You can measure their response time with a calendar. Within an hour of the email, I received a call to cancel Jan's April 2nd appointment! No reason, only that the doctor's office would call to set up an appointment instead. I can't say I'm sorry we won't be seeing her again. After all, she'd still have had Jan in the halo for nearly another week.

Next, I faxed the form to be filled out to the doctor's office since the nurse canceled her. I faxed it in around lunch and I got it back by 3:30 PM! Amazing! Unfortunately, we did not get the replacement appointment call. I'll call at noon tomorrow if they haven't made a new appointment by then.

For show and tell we have the halo and vest assembled off the patient. It can be assembled symmetrically but it never was.

The back and front of the vest should have been positioned at the same level on the body. Instead, the back was at least a few inches above the front and it rubbed the area at the back base of Jan's rib cage nearly raw. I suspect she was only a few days away from a pressure sore.

Day 84 - 12 Weeks Since the Accident

How would you like to have this framing your view for three months? Never changing, never shifting, literally a portable prison with no escape. You can't see your body from the waist up except in a mirror or the ground in front of you as you walk. No looking over your shoulder at all! This is the view from a halo wearer's perspective.

Not much new to report. Pain is much lower and Jan's sleeping in the bed now. She's walking at least half a mile a day and building up to more. I suggested she use the treadmill since it is right next to my office but I think she's afraid of the stairs.

I came up with another idea to allow her to wash her hair easier. The back of the collar is quite large and comes up over halfway between the ears and the top of the scalp, making it nearly impossible to wash the back of her head and neck. I took a long velcro strip and fastened it to just the front on both sides so that her neck is exposed in the back and all of her hair can be washed. This keeps her neck and chin supported since she mostly leans forward while washing her hair and the time without the back is about the same as when we change it and dry her hair.

She thinks she still looks a little right when she is sitting in a neutral position, caused by having her head pointed right for 80 days. Time will tell. I'm sure Nurse Ratched (One Flew Over the Cuckoo's Nest reference) will have an excuse and equally useless explanation of why it doesn't matter and it had to be that way.

If we had let the NP decided when to get the CT scan instead of pushing for what Jan wanted, she'd still have another eight days in the halo instead of three days in the collar already!

After much thought and careful consideration, I've decided to contest the emergency room charges for the 16th of December. It is too bad the insurance company already paid their part because had the doctor, nurse, hospital or anyone that came in contact with us noticed Jan's higher respiration rate and lower blood oxygen levels due to the vest being too tight, it would have been completely avoided. To drive an hour, spend three hours in the hospital and be charged $2,300 to have the vest waist belt loosened by four notches when it was improperly fitted in the first place, is beyond my ability to swallow.

You can tell, I can't let it go. I get that but they won't learn unless someone makes them listen. Maybe it is me that makes them take notice. I seriously doubt it will have any effect but I'm too hard-headed to give up and they did not perform the required tasks nor give us the most rudimentary of halo-vest instructions.

Day 82 - Halo Minus 48 Hours

The halo has been off for two full days. As she prepares for bed, she has only had two halves of a pain pill and a valium and a half. That is a significant improvement in the pain.

I got her out for a little shopping at Krogers. She had already done two laps around the driveway. Between the two walks, she did just about a half-mile. As her strength and stamina returns, we'll push it farther as she can tolerate more.

Her second shower was less eventful. I've pretty much got the collar swap down. She can hold her head up by herself for the minute or two it takes to get the collar off, finish drying her neck and putting a dry one on. The pads easily dry overnight so there is always a fresh set of pads to go into the plastic when it dries.

She is still debating on trying the bed tonight or to stick with the chair. She's become comfortable with the chair but I suspect it is allowing her to be a bit lazy since it will lift her up. She's going to throw something at me for saying that. If I have a black eye, she did it!

After this post, updates will probably go back to every couple of days unless something significant happens. There is a new countdown for the next visit to get past the collar and into physical therapy. Just 26 days to go!

Day 81 - The First 24 Hours With A Collar

After one full day without the halo, the pain has eased. She is still hurting in her neck where the halo-vest had been pinching a nerve but we are hopeful it will recede quickly. So far she has only had one pain pill, broken in half and taken at two different times. After getting her up and cleaning her pin holes, I felt bad and was curled up in bed until almost 3PM with a stomach ache and killer headache.

The doctor did give her another collar. He was originally just going to give her another set of pads but just gave her the whole collar. So, now we have two collars so she can shower in one and change into a dry one afterward.

Speaking of the first shower, she was pretty apprehensive about her head while taking the collar off to wash her hair. In the end, it was pretty simple. The pin sites need to be cleaned three times a day and he told her to wash her hair every day and to just use plain shampoo. I'm also massaging the pin sites so they do not adhere to the bone.

Pain medication is way down again, thankfully. Less is doing more for her at the moment, which is a plus. We are breaking the pills in half, except for the time-release one, which is a bad thing to do.

A few more thoughts from the doctor visit yesterday that I didn't think to post. I wish she could have seen him from the very beginning instead of the rigid and utterly clueless nurse practitioner.

First, when I asked the doctor if I could take pictures, he said it was an odd request and nobody had ever asked that before but he didn't see a good reason not to allow it.

Second, he said she would need to see the same nurse practitioner next time at the same old place. I'm not thrilled but she can't do much wrong at this point since the halo is already off. If we'd have listened to her, the halo would still be on! She didn't want to see Jan until March 16th! If the nurse had ever had to wear one of these, she'd be more than willing to work with a patient to get it off as quickly as safely possible.

Third, the doctor said she would need the collar for only a month when the NP had said it would be six weeks in the collar. Physical therapy will be after she's regained some muscle strength.

The doctor cleared her for light-duty if she felt like it. Her weight limit has been increased from five pounds to 10. She's still pretty weak and tires easily but I'm hoping to get her out of the house on Friday. It is supposed to be 70 degrees tomorrow! The doctor said to walk as much as possible, it would be good exercise.

Finally, the doctor was surprised I wanted to keep the halo. I told them I was going to put it on eBay although it is generally instructed by a lawyer to retain all "evidence" until the claims are handled in case of legal proceedings. We haven't retained a lawyer and I hope it is not needed but that's no reason to be poorly prepared.

Day 80 - How To Remove A Halo!

Day 80 started with Jan still in her halo and vest. This is the last picture taken of her in it. We arrived at 3:45PM for the 4:15PM appointment. Registration was really quick and we had hoped to be back home quickly.

The doctor was running late due to a surgical emergency. Did I mention we spent two hours in the pediatric neurosurgery waiting room with children all over the place. She, literally, was the last patient he saw.

After the meet and greet, he started showing her the latest images. We pretty much knew what they showed and so did you reading this. The doctor then tried to show her the old images but could not pull them up. I offered to let him borrow my CD, which I conveniently had with me.

A nurse interrupted and Jan noticed she had a cervical collar with her. That made Jan smile as the doctor stepped out of the room to speak with her. When he returned, he then proceeded to explain the report and to compare the images. The statement we were looking for was announced, "The report doesn't seem very positive but it is healing nicely."

Jan was ecstatic! Then he said we just need to wait for the wrenches to which I said I've got them right here! Then he said she would be getting a collar and I produced the one we brought with us. He was starting to think I was reading his mind.

First, he removed the bolts that connected the halo ring around her head to the brackets that are supported by the bars. Now she was wearing a vest that was ready to come off. Her head was slowly tilting backward and the nurse braced her.

Then, they put the collar on her to help her keep her head up. She wasn't thrilled with it but she was just happy to not have the halo on anymore.

Finally, the doctor and his assistant removed the ring around her head by working at opposite corners and loosening the pins together. Funny, that's how I said it should have gone on! They held the ring in place until the last pin was removed and lifted it off of her head! The left front pin looks quite deep but the right one looks like it might actually heal without too much of a scar.

Yes, day 80 ended without a halo!

Day 79 - CT Results

She was pretty worried she wouldn't be able to lay still for the CT scan. Thankfully, that's over with and it wasn't the much longer MRI. The scan was done today at 2:15 PM. The interesting part of the report says:

1. Healing changes are evident within the comminuted C2 vertebral fracture with no change in position of alignment since 12/14/2008.

2. Nondisplaced fractures of the anterolateral aspects of the posterior arch of C1 remain unchanged.

Compared to the prior study of 12/14/2008 obtained from Bilkmore, there has been no change in position or alignment, and there is some evidence of healing at the fracture line at the base of the odontoid and within the anterior mass of the Cs vertebra.

The part that doesn't sound as good is this part:

There is no significant callus formation.

Other than that, I'll post the newest images. I see definite material where there was clearly open space. The part about no significant callus formation is not too troubling because as a healing indicator, that often trails real-world bone healing by a few weeks.

Here's the latest little movie.



The quality is low to save bandwidth but if you look at yesterday's movie, you can see noticeable changes that look encouraging.

Here are some more images. This first one is a side by side of the front of the C2 fracture. The first CT scan from the accident is on the left and the same images from today's CT scan on the right. The images are not as clear as I'd like but the obvious black (fracture) is much less visible in today's images.


This is the side view of the same C2 vertebrae with the fractures oriented the same, old on left, new on right. The gap has nearly closed and there is material filling the gap. I'm no doctor (or nurse for that matter as the medical profession likes to remind me) but this looks like substantial bone healing to my untrained eye.

For the final piece, here's the top-down slice that is pretty evident of the damage. You can see that it isn't completely healed but then again that really isn't expected. It just needs to be strong enough to allow the halo to come off and for her to transition to a collar.

Pray the doctor sees it my way! I don't think she can take much more. Her pain is off the chart. She has had as much pain medication now as when she first came home. She just sits in the chair and rocks back and forth in a zombie state. I've given her pain pills as close together as allowed, valium whenever she asks and the time-released pill at 7:30 PM on top of all that. She's got heat packs on her back, shoulder blades and right arm in hopes that will alleviate at least some of the tension and pain. Sunday and yesterday both were bad but not as bad as today.

Jan is in so much pain that she can't stand it. The narcotic pain pills fail to provide significant relief. It dulls it but it isn't knocking it back to a functional level for very long. She thinks it is more muscle spasms than anything but the valium isn't helping as much as it did before. She used to average two a day or less and now she is up to four and five a day without the same level of relief. The prescription says one every six hours but the NP verbally told her she could take two at a time. We haven't resorted to that yet because she resists it. Similar change for the pain pills, too. She used to be down to nothing besides Tylenol and now she's at five or more narcotics a day plus the time-released to sleep.

When she's awake she's been pacing the floor, trying to find a comfortable spot to rest with no relief. I've been helping her put heat on her shoulder blades and at the base of her neck/shoulders, which is nowhere near her injury.

Day 78 - The Scan Is Tomorrow!

Tomorrow is the day for THE SCAN. Day 78 with only about 50 or so hours to go.

I will probably be posting every day for a bit as this is a transitional phase. Things will be happening much quicker for a bit. If this bores you, Tuesday, Wednesday and Thursday will be the days to check the blog for definitive information. They will be later in the day so as to get the pertinent information included.

Here's a little movie I managed to construct of the scan images taken the day of the accident. It is only of the first and second cervical vertebrae (C1 and C2 respectively) and only takes 12 seconds total. I've learned a lot about spines and the upper cervical structure in the last few months, mostly out of necessity.

The circular bone in the first few seconds is C1 with two fractures at roughly the 4 o'clock and 8 o'clock positions. These fractures are very visible at the two second mark. Pausing it may help. C1 is the base on which the skull moves about at the top of the spine. This is how you make the 'yes' gesture.

You can also see the top of C2, the odontoid, as the round object at 12 o'clock. This vertebrae is what allows the head to rotate left and right as in the 'no' gesture. As the image progresses, you can see the odontoid fracture from about five seconds to 10 seconds. Look at the 11, 12 and 1 o'clock positions to see these C2 fractures.



This is where we find out if the vitamins, calcium, yogurt and not the least of all, prayers worked! The obvious voids of dark area on the 12/14/2008 scan should show some gray and even flecks of white where the bone has healed and started to mineralize. That is what we are hoping for. By the end of tomorrow I should be able to post the updated version with any healing indicated.

Interestingly enough, I am having a hard time finding a definitive answer about the strength of a bone after a fracture. Some information says it is not stronger, which is certainly true in the first few months after a break. Still other information says it will be stronger than before.

Exercise and especially weight bearing workouts done properly will cause the bone to be stronger but that is also true of non-fractured bones. Bones are not static, they are constantly being remodeled due to loads and use. It may take up to a year or more for the bone to be fully remodeled but that does not mean it isn't completely healed. It should already be very strong and most reports state it should be 80% of pre-injury strength by the eighth week. After the eighth week it slows down dramatically. So, here's to stronger bones and more yogurt!

Prayers and good thoughts much appreciated!

Day 77 - Reflections And Regrets

11 Weeks today! Day 77, three to go. The ending to this book has not been written but this chapter is nearly over.

I've been doing what I usually do late at night, reading. This time I'm reading up on doctor-patient relationships. Jan has the right to be an integral part of her treatment. So far she has been treated like a passive bystander. I've printed the patient's rights and responsibilities information and will be taking it to the appointment with us. If she is given any flack over her requests, I'm going to show them, in their own black and white document, where her wishes must be considered equally. So far, I would have to say I do not believe these people are challenged very often and certainly not very aggressively.

Speaking of aggressive, I've been accused of being very aggressive about my wife's treatment. To those critics, I ask what you would have done differently if your loved one was in a similar situation? I certainly have asked myself that many, many times. There are certainly things I could have done and should have done differently.

If we had been fully informed of the consequences known to be associated with halos, I'm pretty sure that other options would have been thoroughly discussed before this thing was put on in haste. Pin loosening is the most frequent problem followed by site infection, neither of which are pleasant. Nobody described this vile thing to Jan or I before it was assembled. The sheer shock of seeing it on a person is enough to scare someone. You'd have to agree, any time the medical world does anything in six hours, that was lightning fast compared to the first two week appointment taking three weeks and the second two week followup appointment at the six week, four day mark, only to be outdone by the third two week appointment at 11 weeks, three days!

The use of the halo in the first place is my biggest regret. While a halo might be standard treatment for upper cervical fractures, it is not the only accepted treatment. There are other options for completely non-invasive immobilizations like a minerva collar that are better tolerated and certainly have lower risk of infection since the skin is not violated. Of course there is surgery if it were bad enough, which the NP stated she would have had herself. I still can't believe she said that. How do you trust people like that? Perhaps you can see why I have doubts about the validity of the limited information we've been given. I truly believe they saw a training opportunity for a wannabe doctor and let the dog loose on fresh meat.

Did I misplace my trust in doctors? Did I put too much faith in the wisdom of others? Was I not a strong enough advocate? Should I have been an even more demanding bastard to get what she deserved rather than what they were willing to give? I tried my hardest and best with what I was given and could learn. Was it not good enough? I certainly was lacking in my ability to get her the best care she could. The choices we make limit our options.

For this trip, unless she is now a surgery candidate due to non-union, the halo will come off on Wednesday. She has actually gone backwards on pain. She went from no narcotics for a few weeks to now using multiple pills a day and the timed release one again at night. And once she starts the narcotics we have to reintroduce the additional medications that are required to keep her digestive tract functioning.

The attitude has been, "she's in a halo, she's not going any where, see you in 12 weeks." Never mind that she broke four bones in her spine and she's developing problems BECAUSE of the treatment method!

I probably could have had her seen more often but the results were so universally frustrating and pain inducing that I figured the fewer exposures to anyone related to Bilkmore was less of a chance for them to inflict misery on her. With their scheduling and appointments, it seems like they wanted to see her less than they did. At least she will be seeing the doctor for the final visit with the halo.

I really desire for her to be done with them when the halo comes off but I know it will only change the mode of torment rather than end it. The weight and rigidity of the halo will be gone but the stiffness and pain will remain until the neck muscles recovery from lack of use.

Some medical professional will eventually have to release her from the collar, although it will merely be a documentation formality since the collar is velcro rather than bolts. The whole thing is a catch 22. She can't remain off without confirmation she's being treated by the doctor but she can't return to work until the doctor releases her!

I just wish the fear, uncertainty and doubt had been this easily cleared away in the beginning instead of at the end.

Congrats, Bilkmore, you now rank lower than Greenblew on my list of places I'd die before being taken to under any circumstances, including an emergency! You can put that on my tombstone.

Day 76 - This Is How It Works With A Halo

Day 76 and just four days to go. Four days! We've started a list of things to take with us, like a shirt that isn't slit down the back and has buttons for ease of dressing.

On the pain front, she's pretty much back to taking narcotics to sleep and some during the day for pain. It is not her neck like it was in the beginning, where the injury was. The pain now radiates from her back, around her shoulder blades and her arms. After a night of rest, it is better until about dark then the pain returns as bad as ever. Four more days.

Yesterday, she dropped something and bent down to pick it up. She said the room started spinning and she yelled for me. By the time I got to her, she was sitting in her chair but said she was dizzy. No idea what that was about. Probably something with the inner ear again.

This is in case anyone with a halo or supporting a halo user stumbles across this. This is how we wash her hair with a halo on. We are currently trying to decide when to wash her hair before the scan and halo removal. We've been doing that every two days since it is so exhausting for her and requires something for dizziness.

This is the chair setup we use so she can lay back with her head over the tub. Before this she was laying over the bed with her head suspended over it and pouring water from a pitcher over her. It was OK but took quite a while and I had to refill the pitcher multiple times. This takes about five minutes with her on her back. Wet, lather, rinse!


This is how we thread a towel through the back of the halo in order to keep the vest dry. It is best to use a smaller towel or an older towel that is not too thick as the extra bulk makes it difficult to not get it soaked.


This is the adapter I fashioned from a quick disconnect. It allows me to get the hot water to the faucet and then connect the hand shower head without having to wait for the water to reach a stable temperature.

Day 74 - Robocalled

Just six days and a few hours left.

We were robocalled last night from Bilkmore to confirm the appointment next Wednesday. I wonder if we will be robocalled again tonight for the second appointment on Thursday? I intend to cancel that one once the halo comes off next Wednesday.

She's been in almost as much pain over the last three or four days as she has been in since the accident. She's reverted back to taking stronger medication every day at least once. Her neck and shoulder muscles are so tight and sore that she can't stand it. They feel rigid despite muscle relaxers. I don't see how her muscles can be atrophied with so much tension in them. The halo must come off and in six days I think it will have been long enough!

It still annoys me that Bilkmore is such a well thought of facility yet they treat a very serious injury like nothing. No interest in patient health or well being, just where do we send the bill!

Day 72 - Scan In One Week

Just one more week until The Scan that will confirm the bone has healed! Eight days until the infernal contraption is actually removed! She says she just wants if off and one more day might as well be forever when you live day to day. She only cares about the day when the thing is going to be coming off!

I'm not wearing it, I'm just supporting her but I wish she were more positive. She irrationally fears the doctor won't take it off and that he'll make us come back the next day to see the NP or that the bone isn't healed and she'll have to wear it another four weeks or worse, surgery. It is hard to fight the negative energy.

She seems to think I'm torturing her with the yogurt but she will thank me when the doctor delivers the good news that the bone is well healed and the halo comes off!

Speaking of Bilkmore, six and a half weeks later, they addressed the over billing issues. They stated they gave her nine shots of morphine every 25-30 minutes. They did remove the second collar as a billing error. In rereading the reports on the visits, the 1/5/2009 visit notes the fracture in the x-ray. The 1/29/2009 x-ray notes no such thing so I'm hoping that means the bone was healing on day 46. If that's true, a month later should be significantly healed!

Now, a few pictures for illustration. The two images below are the same pin from above and below. This illustrates the amount of skin bunched above the pin and the skin stretched below the pin. From the above shot, you can barely see any of the unthreaded pin. From the below shot, you can tell that there is less of the pin buried.

Day 70 - Ten Weeks!

Today is 10 weeks since the accident and only 10 days or less, depending on what time of day you see this until the halo comes off! Single-digit days from here on out!

On the pain front, she thinks she's spent too much time working on her homework at the computer keyboard and handwriting on Thursday. I'm hoping that is it. She's tried to be proactive about getting up, moving around and not sitting in one place too long on Friday.

Saturday we had lunch with some friends. Unfortunately, she wound up having to take more strong pain medication to get to sleep. Her neck muscles and both shoulders were causing her a great deal of pain. She woke up feeling much better. I'm hoping today is a less painful day. With only 10 days to go, it is a shame if the pain grows as it gets closer to coming off.

For show and tell today we have a pin, made of nonferrous titanium. All the metal in the halo is titanium, which is only the pins and adjusting screws. The uprights and actual ring around her head are carbon composite while the blocks that attach it all together are plastic. This image is what is currently embedded from a 1/8th inch to 5/16 inch into her head at four points. She will be so happy to have them taken out. It is much sharper than it looks.

Day 68 - Just Another Day In Haloville

Not much news at this time. Unfortunately, this has all become quite ordinary and routine except for the pain. I'm sure Jan will disagree. We are just counting down the days and trying not to jinx it. I've got a reminder set to go set up the insurance and paperwork a day before the scan so Jan doesn't have to wait around beforehand. I want this to go as smoothly and quickly as possible.

Her neck muscles are giving her more trouble than anything. I attribute most of this to, are ready for it, the ill-fitted halo. Her neck has to support the halo in addition to her head. The muscles from the base of the skull just behind the ears are so tight they almost feel like bone!

Her right arm is hurting, too! I can't explain all the new pains she's having. She has been taking half of a narcotic pill on the odd occasion when Tylenol and valium will not give her any relief. She averages two halves a week of late but she asked for another narcotic last night even though she took Tylenol instead. If it gets worse, she'll wind up with more pain at the end than immediately after the accident. If it keeps up, I can only suggest calling the Bilkmore Neuro Clinic. Of course, it will be two days later before she gets a reply.

On another note, the salvage yard that bought my car tracked me down. They have pictures up online for prospective parts buyers to view. I have one of the most telling shots here with a link to my Google photo page if you wish to see more. Some of them are hard to look at when you remember Jan was sitting there.

Here's the album on Google Photos.

Day 66 - TWO WEEKS TO GO!

YES! We are in the home stretch!

This is the Aspen collar Jan will be wearing for some period of time after the halo comes off. It may not look very comfortable but then it is all relative when you have been BOLTED INTO A HALO FOR 12 WEEKS!

The NP previously said she would have to wear the collar for six weeks without taking it off for anything except showers and then to not move her head. She even said we should have two collars, one to shower in one and one to transfer to once done. I'm hoping the doctor is more reasonable.

Wearing a collar without any neck movement seems like a step backward in treatment. If the bone is healed, she needs physical therapy sooner, not later. The doctor will explain it thoroughly and to my satisfaction or I'm not leaving. The NP was terrible at communicating reasons, only repeating what the doctor allegedly said. Well, this time it will be the doctor so there can be nothing lost in translation.

Jan has, what I deem, an irrational fear that the doctor won't remove the halo at the March 4th visit and will force us to return on the following day to keep the appointment with the NP for actual removal. Yeah, not on my life! By all accounts, it takes less than 10 minutes to get it off safely!

Day 64 - Presidents Day

The nine-week mark has passed and we are starting the 10th week. Halo time is 80% complete as I type this. Just 16 days to go. Calcium infusions via yogurt and vitamins continue! We tried out the magic bullet with some smoothies made from yogurt and fruit. They turned out fair but Jan says the formula needs something. I suspect the lack of liquid from yogurt made them thicker than usual, too!

The Valentine's Day dinner on Saturday was very nice and Jan is glad she went. Earlier in the day, I had warned Tessa to let Jan get the door if anything came up because a few weeks ago I had ordered a dozen roses to be delivered on Valentine's Day.

On a poetic justice type of note, the primary health insurance company paid Bilkmore, as I had previously lamented. The difference is we finally got the statement from the insurance company on what they paid. The beauty is they knocked the original $26,003 bill down to $4,480! That's the whole thing down to just 17% of the original bill! That isn't even what any two of the CT scans were billed at and she had seven. That isn't even the cost they billed for the halo!

The $309 x-rays Jan has gotten at each visit have been knocked down to $54. It sounds like congress needs to investigate the billing practices of the medical industry!

I'm still not happy with Jan's treatment or Bilkmore but I'm happy they didn't get anything close to what they billed. It certainly was sub-par care from the neuro visit at 2:00AM of 12/15/2008 on through the two NP visits she's had, including the lack of callbacks.

Is this what is wrong with health care? Is this why they say costs are skyrocketing because they bill exorbitant amounts that mere mortals cannot hope to pay?

If some uninsured person walks into the ER and has the same treatment Jan had, they would be billed $26,000. If you have insurance, the same treatment is only $4,400. Is that fair? We need truth in billing! We need a single price for everybody instead of $29 aspirin.

Day 62 - Happy Valentine's Day

Day 62 with just two weeks and four days to go!

If Jan feels well enough for the short trip, we are going to the Shaker Tavern for Valentine's Day dinner. A group at her church organizes one every year. We haven't gone to one for a few years. A couple from the church has been offering to take us out to dinner more than once but circumstances have not been with us. They were the ones that invited us to Valentine's Day dinner. I hope she feels up to it this time. I will post pictures if there are any that turn out well.

Yesterday I took Jan by her work to visit with coworkers and to do a bit of work. Any excuse to get her out of the house and walking around is a good thing. It is the only exercise she can do.

I'm working from home with the odd day at the office so I've not used up as much leave time as she has. Her work's policy is to use all paid sick leave and then paid vacation leave before going into unpaid status. We asked if she could go unpaid immediately since we don't need the money and I'd rather have her not use up her vacation time. After this is all over, we need some time out of halo away from everything. But, I don't write the policy and her last paid day is probably next week with no vacation time to speak of for the rest of the year.

While we were on campus, I suggested she go volunteer in the nursing class so the students could get an idea of how to deal with a halo. There is a dearth of information and education on the subject, especially in the medical community.

On the way home, we went by her favorite store and picked up a single-serve blender-ish device called a Magic Bullet. We are hoping it makes getting her daily yogurt requirement easier by mixing it with fruit and ice to make a smoothie.

Magic Bullet Website

The insurance is all screwy now. Our primary health carrier is paying the bills when it should be auto insurance. I've called, futile as it seems, to inform them they are not responsible for the charges due to it being an auto accident. All that got me was another form to fill out and the explanation that it would all be ironed out in subrogation. My only concern is they actually paid Bilkmore for stuff I have contested, such as two collars and too many morphine injections. At this point, I don't care enough to worry about it. My only focus is on March 4th!

She felt really achy on Thursday and I gave her half of one of her better pain pills. It really helped. I let her have the rest of it at bedtime and she is back to Tylenol all day Friday and nothing so far on Saturday.

Now for some picture updates. Here's how it looks when she stands, as viewed from all four sides. You will notice how far forward her head is craned to "preserve" the all critical, overriding and comfort-be-darned spinal alignment!

Day 60 - Taxing Experience

Jan has only today and tomorrow to go on her latest antibiotic. Her neck muscles and the pins are all the pain she has at this point. The calcium intake and yogurt are continuing right up to the minute the halo comes off! I might let her slack off on the yogurt after the halo comes off but I'm still debating.

I took her to vote on Tuesday at Natcher Elementary. I'm sure a teacher had some explaining to do to her students as they looked at Jan walking the hall. We saw one of Tessa's former teachers and he recognized her and asked about Tessa. When Tessa voted later that same day he asked about Jan.

Then, the wind and rain were terrible on Wednesday! My mother arrived to stay with Jan for the day before it started the worst. She brought a pecan pie and a pumpkin pie with her. She also made supper before she left. It is a good thing Jan didn't get out that day. I went into work the whole day since I knew she'd have company. Her friend that originally cut her hair after the accident dropped by for a touch-up. It was a pretty busy day and she didn't even have to leave the house.

She wants to go grocery shopping today. If the weather holds and the day starts off well, we will go get some more yogurt that she loves so much.

If all goes well, on Valentine's Day we are going to a church function at the Shaker Tavern at South Union. She is a bit worried it will be a long trip but US 68-80 is a nice, smooth four-lane road and it is only 20 minutes away. I think she'll enjoy a night out, around other people.

Here's a picture of the halo and her head from the top. You can see that the left front pin has considerably more threads into the halo than the right front pin by a noticeable margin.



On a sad note, I finally started our taxes. How depressing.

Day 58 - More Antibiotics

Day 58, 22 to go until the halo comes off! Three weeks until the CT scan, also known as The Scan! I intend to have slides of the scan up before we leave for Bilkmore along with the report. There should be no surprise on the actual neuro visit.

I still have not received a call back from the doctor that we were promised last week by the Neurosurgery Clinic manager. His office called because he's the doctor Jan will be seeing at the children's hospital. There is only one acceptable outcome at this point.

While at the GP on Monday for lab results, the doctor looked at the pins and decided she could use another antibiotic. Third one in a month! These are not great pictures but they do exhibit what the back pins look like. I have trimmed as much hair away from them as I can from time to time but it is very hard to get to them. It is even harder to photograph. Her hair is a little damp from just being washed but that is the best way to see the pins. When it is fully dry the hair has to be held back with clips to even get a look at the rear pins.

The GP also had some advice for getting through the CT scan, take a whole valium an hour before the scan. He said it would be a better anti-vertigo pill than the plain dizziness pills she has.

Day 56 - Eight Weeks Later

Today is eight weeks since the accident. Jan doesn't take anything but Tylenol for pain for the last week. She can go almost all day without anything. I give her two Tylenol at night to get past the neck pain so she can sleep. She doesn't take anything stronger unless we are making a trek rather than a short trip. Unfortunately, the halo still causes her pain in her pins and the weight of it all is as tiring as ever. It was never properly fitted and pushes on her head rather than holding her head up. This, in turn, makes her shoulders sore from the constant shrug she subconsciously does to alleviate the pressure. So goes the endless cycle of needlessly annoying pain.

At present, Bilkmore is showing an appointment on March 4th with the doctor and on March 5th with the NP. We aren't going to cancel the appointment with the NP until we are certain that everything is falling in place. The last thing she wants is any delay getting out of the halo.

As an observation, I've noticed she no longer involuntarily moves her eyebrows and, by extension, her forehead. She still can if she tries but it doesn't happen automatically anymore. A smile doesn't result in any movement above the eyes. If you look at the previous picture at the WKU President's Recognition Luncheon, you can see it in her face. So, a halo has the same effect as botox! Doesn't everybody want one now?

She's been averaging at least one yogurt a day and sometimes two so that gets her more calcium! I'm positive March 4th will be THE DAY!

Jan had non-accident related lab work done on Saturday. She sees her GP to get the results late Monday. Nothing out of the ordinary. Routine cholesterol and glucose checks. While we are there she is going to get her inner ear checked as well as the pins looked at to be sure they are both OK. No more speed bumps to this recovery.