Day 199 - The Final Journey!

Here we are at nearly 200 days and it was the last visit to Bilkmore. Jan's questions were mostly answered. The only restriction she has it to not have any ligament adjustments by a chiropractor for another six months. Other than that, he said he did not need to see her again.

The rest of it is they FINALLY got the imaging appointment down correctly. We arrived exactly 30 minutes early as I was bound and determined to hold them to their word. The appointment went very smoothly and she had her images done in 15 minutes. We were upstairs and in the waiting room by 1:20PM and then taken to an exam room by 1:45PM.

He wrote her another prescription for six weeks of physical therapy and basically said she may still improve some. He dismissed the pin scars completely, saying they were fine. Obviously, he's never had a halo! For that matter, neither have I but I certainly know the scars are not what I'd call "barely noticeable" unless you are nearsighted and are viewing from more than 20 feet away!

The most annoying part is when we asked for copies of the images, which we already pay for the imaging, they want $15 for copies. In the end, the desk person basically told us to lie and say they were for a second opinion so they would be free. Is that not the most screwed up thing?

I pitched a fit via email with the doctor's office because they did not want to allow Jan to get her images at WKDI. They promised to have all of the previous images available for us when she came for this visit is the only reason we agreed to allow Bilkmore's imaging lab another chance.

THAT WAS THE LAST TIME WE WILL SET FOOT ON BILKMORE!

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 183 - Lightning Strikes Again!

I received a call late yesterday from a very good friend I've known since high school. He did not sound like his normal, chipper self. He recently went through a bought of cancer with his throat and tonsils. Even during that ordeal of surgery, chemo and radiation, he was always in good, positive spirits. I was initially afraid he was going to tell me it was back.

Some of the first words he said were, "My dad has been in a car accident." After finding out he was alive but in the hospital, the second statement that floored me was, "He is getting the same treatment as Jan." This elderly gentleman was in a head-on collision and has a broken neck. The difference is they took him to Louisville and they evaluated him for a day before deciding on a halo with the family. When they finally put the halo on, they had a team of neurosurgeons put it on him, not just a single, unsupervised resident without a clue!

Jan's experience prepared my friend and the rest of the family for what was to come. He asked all kinds of questions and the family entered into this journey with volumes more information that Jan and I did. He said he knew what to ask thanks to our (in)experience.

Needless to say, our prayers, and I hope yours, are with them during this difficult time.

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.

Day 158 - You Do Look Like Him

I picked up Jan, to take her to physical therapy, on Wednesday afternoon. I was in her car and she attempted to drive to the PT office from her work. It is any easy drive without much traffic. She did OK but driving stretches her neck more than she would otherwise. She stresses over backing up and tries to find a spot where she can pull through.

When we arrived, she went on in but I had to make a conference call. I sat in the car for about 45 minutes to conduct business. Afterward, I went into the office to check on her progress. She was still getting the electro treatment on her shoulders and neck.

When she was done with that and the young lady was putting ice on her shoulder, she looked at me and said, "You really do look like Jeff Foxworthy."

Her father is the physical therapy business and he told her a few weeks ago that I was Jeff Foxworthy. She did a double-take but didn't believe it, thankfully.

I don't know if they put her up to it or not but it is just another episode in the comedy that is my life.

Day 154 - 22 Weeks Later

Today is 22 weeks since the accident. Things are still not back to normal. For one, Jan's neck is still not as mobile as before. As a result, she still is not driving. She does her physical therapy and it is improving slowly but surely. She also works out on the Wii Fit and it helps with other aspects of balance and strengthening.

We are still trying to nail down a vacation. Cancun was scratched for swine flu even though I think it is overblown and all. Statistically, some 30,000 people die in the US from the annual flu. There have been less than 70 deaths worldwide with most of those in Mexico. It must have been a slow news week!

We are either looking at Florida or Kauai (the northernmost Hawaiian island) for destinations. We have simple requirements:

• Timeshare availability
• Beach
• Reasonable airfare (or driving distance)
• Scuba diving available

So far, we can usually get two or three but all four have been a challenge with the time tables we are working with. Between school schedules, other people's vacations and high airfares for certain times, it has been a real puzzle to fit it all together.

Day 151 - Restless

Jan has been doing PT for a few weeks now and it is starting to show results. Her mobility is improving and her posture looks a little better. She still is not driving yet.

The Buick Gran Sport Nationals, a large event for the Buick muscle car types, are in town this week and I, a Buick owner, have been at the track for a few days now. Due to this, Jan is going to PT in the morning for Wednesday and Friday.

Tessa takes her to work most mornings and will continue to do so until the end of the school year. After that, we are hopeful that she can again drive. At this point, the halo has been off for 71 days.

Day 146 - Flower Power

We went to Jan's floral class final on Wednesday, which is actually just a party where the classes made the floral arrangements. It was at a house downtown known as the Greer House. It was built in 1906. We took the grand tour. It is a very interesting home. The folks that live there are very interested in preserving the history of the house.

I finally got tired of waiting for Bilkmore to call me back and called earlier in the week. I spoke to the same patient advocate, which won't really amount to much, but it makes me feel better. Cheaper than therapy. Plus, as long as I'm disputing things, I'm not going to pay them, especially for such shoddy service and poor care.

It is still a few weeks before the plastic surgeon would want to look at Jan's forehead. I'm hoping something like laser resurfacing can be done as an outpatient procedure. I'm not sure that will fill in the divots or not, though.

The doctor had gloves on when he removed the halo with his assistant but the nurse never had gloves on any time she tightened the halo. No wonder Jan's pins became infected, which have made the scars I've posted in earlier posts. Most people only have scars the size of pencil tips but Jan's are deep and the size of pencil erasers.

Day 143 - Wii Work Out

I had some reward dollars from one of the big chain stores that were expiring. After last Friday's PT sessions, we went to the store and bought a Wii Fit. It is supposed to help with balance and strength, two things Jan needs to work on. I'm going to count it as a Mother's Day present!

So far, the whole family has played with it. My Wii age started at 51, then went to 55, 45, 38 and then 32. I'm not sure of the value of the Wii age but it is a yardstick to compare results by.

Jan is really good at the hula hoop, initially beating Tessa's high score. The game does require specific activities that raise your heart rate. Time will tell but preliminary results are encouraging.

Late last Sunday, but well before dark, Jan drove to the grocery store with me and back. She says it still pulls and causes some slight pain to look left and right but she is trying. The bad news is the PT guy says she should not drive. I respect his opinion but by the same token, she needs short trips to build her confidence back. Heck, she still has more neck mobility than half the old folks driving today! The doctor just told her not to drive with the collar.

Day 140 - The Road Less Traveled

Twenty weeks ago today, it all went wrong. My curiosity got the best of me and I rode over to the accident location on my motorcycle last weekend. I had to look around, to help me understand. The GPS coordinates are N37 17.239 W86 19.229 if you are the least bit curious.

Jan has expressed no interest and even stated she doesn't want to revisit the site. I can't blame her.

This is the view of the road right before the infamous curve. There is a long straight before the curve. It appears we made it part of the way through the curve before it got out of shape.

The mailboxes in the upper right, just to the left of the tree, is where the gravel in the road came from. Click on any of the pictures to see the enlarged version.

We were only four miles away from my Dad's house, even less as the crow flies.

This is the same place but from the other side of the road at the intersection of Highway 238 and W. Vincent Road.

The next picture is of the road and the driveway. The late hour, similar to the lighting on a late fall evening, casts shadows where the gravel is on the road. It hasn't rained for several days and there is still gravel in the road. From the dispersal pattern, it may be pushed onto the road when vehicles exit the driveway.

We had already started the skid before the "School Bus" sign but had not left the road. We never touched the sign but I can't even remember it. We never even got close to the outside guard rail. I doubt we even crossed the center line except when the skid started.

I learned early on in my driving career, before the advent of ABS brakes, that if you are skidding, you have to ease off the brakes to regain control. I doubt even ABS brakes work well once the vehicle has turned sideways.

Last, we have the final resting place of the little red Mazda Miata. There is now a limb from the ice storm in pretty much the exact spot the car came to rest. The grass has grown up, hiding the ditch but it nicely defines the drive that leads off into the woods.

Heading back to Bowling Green, I drove this road very carefully. Even so, I did not feel the least bit afraid of this particular strip of blacktop. I am not superstitious and don't believe in fate.

As Jan has noted more than once when she expresses her trepidations about returning behind the wheel, I crashed the Miata and then had to drive an hour to Nashville. Then, a mere 15 hours later and with no sleep to speak of, had to drive her home in the halo.

People keep telling her she was lucky. I would have to disagree. Lucky would have been to have never had the accident. A bit less lucky would have been to have damaged the car and walked away, as I did. Lucky would have been getting an all-clear diagnosis at the first hospital. Lucky would have been getting a good doctor at Bilkmore. Lucky would have been getting a sympathetic and effective nurse practitioner. Luck had nothing to do with it. Sure, it could have been worse but it could have gone so much better. I think this accident is the antithesis of luck.

Oh, Bilkmore still hasn't called back from the Day 126 report. Anyone surprised? They do send bills, though. No luck there!

However, the drier is fixed and so quiet we can hardly tell it is running if there are no buttons pinging around in the drum.

Day 136 - Dry As A Bone

Jan has had two more physical therapy sessions since last time. TENS with heat then exercises and ice. The PT guy says her posture looks better. The changes are subtle and I don't notice the changes. Kind of like you don't notice your hair growing.

We are looking for a profile picture to see how her posture is now compared to before the accident to get some measure of what we are working with. Here's a picture from 2006 that was taken for our 20-year vow renewals. Not sure it shows a lot but it is the only one I can find.

She hasn't driven any more since the one short trip to Sam's but I keep prodding her to see if she wants to try a short trip here or there.

After Jan's most recent trip to physical therapy, we arrived home. Clothes were in the dryer so I went to start it. It sounded funny, all to quiet. Upon closer examination, the belt broke and the drum doesn't turn.

As I type this, the dryer is in a state of severe disassembly, scattered all over the utility room, awaiting the procurement of a new belt. The bright side of this affair is the new level of cleanliness. After 15 years of lint build-up, it is now as clean as new.

I suspect it will work better with a new belt as the old one had been shedding material for quite some time. I had no idea what the black powder under it was when we moved almost three years ago until now. Once inside of it, I could tell the belt had frayed, leaving a fine black residue all over the inside of the dryer.

Day 133 - On The Road Again

It is 19 weeks since the accident and Jan drove for the first time since December 14th, 2008. It wasn't far or fast but she drove from my work to Sam's Club, which is maybe half a mile. She was nervous, even a little anxious, but did fine. I don't know that she will be driving to work any time soon but a little progress is still progress.

PT is going well and she gets through it mostly pain-free. He adds a new exercise each visit and she is supposed to do them a few times a day between PT visits. She does the TENS and ice at the end of her visit lately. Sometimes she does the TENS first but ice is always the last thing.

Her pain level fluctuates but she manages it with Tylenol and Advil. She complains about her sleep not being restful as well. I'm not sure what we can do about that.

We've been trying to find a summer vacation destination. Cancun, Mexico was our preferred destination since it has a beach and scuba diving. I'd found a nice place and cheap airfare but the $200 round trip airfare was short-lived. It has more than doubled. Florida is looking like the next viable option since we would drive there.

Day 130 - Rehab After One Week

Jan has been getting rehab every other day for a few days now. Things are going well but the progress is slow. The physical therapist's view is that it should not hurt. She can stretch but should not cause pain. She has added a breathing exercise and a pushing the chest out exercise. She has been doing these exercises daily along with getting two to three miles of walking in every day.

There are several people that have appointments at or around the same time as Jan. We've gotten to know them in a casual sense. Everyone is laughing and cutting up. One guy had a knee replacement, another has a prosthetic below the knee and several receive treatments for things that aren't as obvious.

Everyone seems to really like PT guy. Jan and I like him, too! A friend's daughter works for him. She's much more talkative at work than I've ever seen her at church or out anywhere else.

Not much of an update tonight. Still no callback from Bilkmore. Surprised?

Day 126 - 18 Week Journey

It has been 18 weeks since the accident, almost seven since the halo came off and things are slowly returning to normal. She rarely wears the collar but tends to carry it with her just in case.

Yesterday she had a haircut by her good friend that came and cut her hair while in the halo. The short hair that has grown in where she was scrubbed bald is now about two inches long. It sticks up a bit. You can also see blond hairs around the rear pin sites where I was treating it with hydrogen peroxide.

After the haircut, she had her night guard altered to keep her teeth set when she sleeps. It helps her TMJ. I noticed she does not move her neck when she turns to look left or right. She turns her whole body. She can move her neck, she just hasn't started to do it again. Hopefully, PT will improve that.

Another oddity was when she was reclined in the dental chair, her head doesn't lay back on the headrest. That is probably from her halo forcing her head so far forward. It didn't help her posture at all, either.

Since she has started PT and there is absolutely nothing that can be done to harm her by Bilkmore, I've been dealing with the patient advocate office again. The doctor admitted that the halo should have been put on by two people. That and the fact that the NP would not make any attempt to improve the situation and scared her more than she helped is fuel for my campaign against Bilkmore. Allowing a second year resident to perform a surgical procedure on Jan unassisted and unsupervised was terrible, allowing the NP to compound it was insulting!

I wish I had more to report on the Bilkmore issue but guess what? They haven't called me back in more than three days. The problem of returning calls by Bilkmore people is chronic. Completely unacceptable.

As a side note, I watched an episode of Fox's Fringe titled Inner Child that originally aired on April 7th. It is an X-Files like show and they used a halo with the vertical bars as part of a prop device. To someone familiar with them, it was obviously a halo ring and bars.

Day 123 - First Physical Therapy Visit

Wednesday, tax day, was Jan's first day for physical therapy. It was pretty easy. He showed her an exercise she can do now called the "I don't know and I don't care." She needs to lift her shoulders up, the don't know part, and to try to squeeze her shoulder blades together.

She only had heat and electrostimulation yesterday and it did make her feel better. She still tired out early. The visits are Monday, Wednesday and Friday for the time being.

Tuesday was her return visit to the heart doctor. She was really worried about it the whole day before her appointment. She took a half valium before the trip and it helped. There was a two hour wait because the doctor had an emergency pace maker procedure.

He explained her echocardiogram and said it was fine. Her valves are good and he mentioned, only because it was on the report, that there was slight leakage. Nothing to be concerned about because 70% of the people on the street have the same thing and will never know it. Other than that, he said she has such long times between the PSVT episodes he wouldn't put her on medication and the cath-electrode (ablation) procedure is only a last resort if medication doesn't work.

Day 120 - First Day of Work!

Easter was yesterday and today is Jan's first day of work.

To start with, the hour long trip to the middle of no where went without a hitch. There was still a lot of storm damage evident. The tops of almost every tree of any size was broken off. First we went to the church where Jan visited the graves of her parents while the children of the congregation hunted for Easter eggs. After that, we returned to Caneyville to Jan's sister's house for lunch. Everyone brought something and it was a pretty good meal.

The first day of work was a bit of a challenge. For the most part, everything went well. Tessa took her to work on her way to school. Jan made it to lunch but she tired out a little early. I picked her up at around 2:00PM. She rested pretty much the rest of the day, taking it easy.

She was hoping to get into physical therapy this week but she doesn't feel she's strong enough yet.

Keep your fingers crossed. She returns to the heart doctor tomorrow.