Friday, October 9, 2009

Excitement - a shower & thoughts on healthcare

It is sad when the big thing in your life is taking a shower. That was the excitement for me today - doing my CPM machine and then taking a shower. Getting in and out was a bit hard, but feeling fully clean is wonderful. I didn't even mind the trash bag taped to my left leg.

I had another low grade fever last night. I wonder if that is just part of the process. When you have a cold your fever will often be higher in the evening - at least mine tends to be.

It seems to me that in addition to physical therapy after the surgery the patients should be given a physical therapist to get in shape for the surgery. I have good core muscles and they have been very helpful. Being able to sit up in bed and get out of bed, sofa and chairs you need good abdominal muscles, especially with the weight of the braced leg. Having good thigh muscles. I had to lift my braced leg up to get the garbage bag on and taped before my shower. The other thigh is getting a workout since I can't put weight on my left leg while getting up and down. (The problem is that I can hear and feel my right knee grinding and popping, but that is a whole other story.) The other pain is the crutches, my underarms and the heels of my hands are sore from getting around.

I think surgeons or their PAs should give all surgery patients an exercise list - like they do with your physical therapist - to prepare you for surgery and the aftermath.

I got an e-mail from my cousin that got me thinking about universal health care again. Wendy is a University professor in England, so she has their NHS coverage. She is having knee issues too, but according to NHS guidelines is considered too young for replacement surgery. She now has to see a specialist, I guess the equivalent of Dr. Williams. It seems to me in some ways it is very similar to an HMO. I had to get a referral from my Primary to see the Surgeon. She may have a longer wait time to see the specialist. I originally had about a month, but was able to fill a cancellation.

But would NHS have approved this surgery? I certainly consider it medically necessary and I don't think Dr. Williams is the kind of surgeon who cuts just because he can, whether or not it's in the best interest of the patient. But would I meet the criteria used by the British system? This is going to pester me. I will have to ask Dr. Williams if he has any colleagues in England he would be willing to ask.

I whole heartedly believe we need some sort of public option for people who can't afford private insurance but don't qualify for Medicaid or Medicare. I have spent time without insurance and know the fear of having an emergency and not knowing how I will pay the bills. I also believe health care costs are out of control and the whole system needs an overhaul. My Godmother had a massive heart attack this summer, she had emergency surgery and spent over a week in the Cardiac Care Unit. Her insurance sent her a statement of the bills submitted by the hospital. Not including her surgeon the bills run about $160,000. She has a small co-pay and I suspect her insurance pays the hospital less then half of that figure. So how is that cost realistic and how does anyone without insurance even begin to deal?