THE AFTERMATH THAT IS HOSPITAL BILLING! CHAPTER ELEVEN

It was August 23, 2010 when I got my first phone call from Sharp's Customer Care department, asking if I intended to pay my $2560 share of the hospital bill.  Mind you, I still had my leg in a cast...up in the air...was off work, collecting State Disability...and I was barely able to make it to the bathroom on my walker most days.  Nice day for a collection call, eh?  And here I thought they were calling to check on my well-being!

As the conversation proceeded, I was informed that I was now 30 days past due, even though I had only received one bill.  My surgery was on June 30 and I was discharged on July 1, so it was possible that I had missed the July billing cycle...but certainly this was not intentional nor my fault.  The Sharp Customer Care lady, Farisha, continued with her spiel, ending with offering me a fairly attractive deal.  If I could pay "today", my $2560 bill would be reduced to $1792, which was almost 30% off.  Thinking that maybe I could/should take them up on this, I asked for a short reprieve to see if I could make arrangements for an interest-free balance-transfer deal from one of my credit cards, and called Discover to see if they could help.  I told Farisha I would call her back within the hour with my decision.

Discover was more than happy to help, but the caveat to receiving their interest-free balance-transfer rate was that it would take 8-13 business days to process a check to the payee. The lady at Discover, who was also named Jackie, was really helpful in telling me not to take what Sharp offered as gospel, and that there was always room to negotiate, especially on that "today" part.  So while this payment arrangement was not exactly what Sharp had offered, I decided it was worth making a counter-offer that this would be what I could deliver and when.

Next, I called Farisha back and made my counter-offer that the full discounted payment would be made, but that Sharp was going to have to be patient while the check was processed; in turn, she explained that although it was not Sharp's policy to wait for a discounted payment, she would check with her supervisor and one of them would get back to me by the close of business that day.  I waited all that day, and the next, and never received a call to let me know that they had accepted my counter-offer, so I assumed that since I had heard nothing, all was well.

And so the nightmare began...

The check was produced and sent to Sharp, but the collection calls did not stop.  Evidently, the fact that I had "counter offered" was highly unusual and someone had dropped the ball in not responding to me.  But this was not my problem.  Sharp had cashed the check for the amount of the agreed-upon settlement, and no one had told me that my payment arrangement was unacceptable to Sharp.

I investigated what I should do on-line, and found out that you have the right to tell a company to stop calling you for collections, if you put it in writing and send it certified mail.  And if you wish to dispute a hospital bill, and you duly inform them of that in writing, they cannot proceed to the next step of sending you to collections.  So that is exactly what I did, in addition to copying the CFO of Sharp Healthcare, to see if I could get a seasoned executive involved in whose bailiwick this particular matter occurred.

The first letter, which I did not send certified, fell on deaf ears; I received no response except more collections calls, now being placed by "Unavailable."  Once I realized my error, I issued a second, follow-up letter to Sharp Customer Care and copied the CFO again.  In this letter I threatened to file a complaint as to their "financial bullying" with the State Attorney General's office.

For the following couple of weeks, I continued to live in fear of what Sharp was deciding, and the calls did not stop.  I was wondering what I should do next when...

At long last, my letter was answered with a letter from Sharp saying that the bill was paid in full and that I owed no more!  Best of all, I also received a personal call from the head of that division, Dick Britigan, apologizing for the miscommunication and assuring me that there would be no more harassing calls from Sharp.

Final Score:  Sunshine Girl:  2 (I won my point.) - Sharp:  1 (They got paid what they asked to be paid.)

YES!!!

FREE AT LAST! CHAPTER TEN

Yesterday I received the official release from Dr. P!  I do not have to return to see an orthopedist for another six months!  So that was quite landmark for me.  He told me the greatest concern he had for me was that I was doing SO well that he was afraid I would exceed my limits and "over-do."  So his last few words of caution were exactly that:  "Don't over-do."  But he did tell me it was time to start walking without the AirCast, so I'm taking it off at 1:30 every day and seeing how I the ankle feels at the end of the work day.  So far, so good.

To celebrate, my sweetie and I WALKED to the North Park Farmer's Market (3 blocks there, 3 blocks back, plus all that shopping...and okay, I did use the AirCast)!  All I did was have a nice conversation with the salt seller and buy a couple of persimmons and pluots, but still a Red Letter Day overall!  I haven't been to a Farmer's Market in over a year and it was grand to experience the fun again!

I want to take this opportunity to thank my WONDERFUL boyfriend, Clay.  He wore himself to a frazzle on my behalf, running up and down stairs, taking care of me, the pets and the house single-handedly for almost 3 months.  I don't know what I would have done without him, but I'm sure it would have entailed a lot more pain, peril and hassle.  Hopefully I won't ever have to find out.  Love you, honey!

FOLLOW-UP: CHAPTER NINE

It is now the beginning of November.  I have attended a total of 12 sessions of physical therapy twice a week and I have finally lost the cane and graduated to a little AirCast and a tennis shoe.  This took 16 weeks to the day from the date of my surgery.  

I also continue to use acupuncture, as I have for many years, to control some slight on-going swelling, along with anti-inflammatory Chinese oil (“Hysan”) that I rub all over my foot before bed at night.  I alternate that with Emu oil, available at Henry’s Market, as I have heard it is quite remarkable for scar reduction and also makes a ducky nighttime eye cream.  I have exercises to do every day to build my calf and foot muscles back.  I stretch my hamstrings and crinkle up towels with my toes and stand on my toes and ride the exer-cycle.  My strength is returning quickly and my energy level is almost back to where it was before the chronic pain set in.  If I have any lingering problems it is only a swatch of skin that doesn’t have a lot of feeling on the inside of my left foot.  While this is annoying, it’s not overly concerning.  I am pretty sure the sensation will come back with time as the nerves repair themselves.

I do require new orthotics, and have learned that these are not covered by my insurance; ergo, I will wait another few weeks for the beginning of 2011 so I can utilize my pre-tax Flexible Spending funds.  My goal is to be able to wear a pair of small high-heels sandals again, and if things continue to go as well as they have lately, I may be wearing those cute shoes by my 50^th birthday at the end of this month!  To my credit, I have already managed to shop Wal-Mart and Vons without an electric cart; I walk the dog a couple of blocks once or twice a day; I’ve walked to the bar for Happy Hour; and we both took the dog to Dog Beach for a short visit where I was able to walk in the sand without assistance or pain. 

If you had told me two years ago that I'd have to wait that long to get my ankle replaced, I may have given up and had that fusion because the pain was just too great.  But I am glad I waited because I now have the best outcome I could have hoped for.

The human spirit is meant to overcome pain and obstacle, and overcome I have.  

Next installment:  2010 – “The Year of Waiting”  

PICTURES AT 11! CHAPTER EIGHT

Below are photos showing how quickly I healed once I was in my walking cast at Week 6 (Note: Walking casts do not automatically mean one gets to put full weight on the new ankle...this was a gradual process that took a week or two.)  I am at Week 13 post-surgery tomorrow, and as you can see from the photos the scarring is minimal.  Dr. P. seemed extraordinarily pleased with himself when I saw him today...as he well should be!  Because I am, too.  The photos below depict Weeks 7, 8, 9 and 13, and the walking cast, from the bottom up.  

Sexy walking cast : )

Week 13 - hardly any scar left!

Week 9

Week 8

Week 7

I know everyone wants to see photos of what my ankle looked like along the way, so I’ve posted the ones I took every time they changed my cast below (ah, the wonder of phone cameras…). Depicted are Weeks 4, 5 and 6 of the healing process.

Week 6

Week 5

Week 4

The joint installation involves a lot of what looks like Home Depot hardware; the best place to learn more about the process is the manufacturer's website, which they have recently re-designed so my really cool video link doesn't work anymore, but the Patient Information is on the right side for you to explore yourself at http://www.inbone.com/.  

Once I graduated to a removable cast that I could take off to shower (which is something I REALLY looked forward to), I began using scar-reduction medication. I used a new product called “Silvion” that worked very well; they have spray-on products for post-surgical cleansing and anti-scarring and moisturization.  I can say that both work extremely well.  

THE LONG WEEKS AHEAD: CHAPTER SEVEN

I was told to expect to be on non-weight-bearing status for six weeks minimum, nine weeks maximum, which meant laying on my back in bed or sitting in a reclined position for a very long time.  While it is hard to stay entertained, I am lucky because I love to read.  I stocked up on used paperback books and kept my favorite not-terribly-challenging-or-time-consuming board game nearby so that when friends stopped by we weren’t just sitting there staring at one another after we ran out of news to share.  If you are planning to undergo any kind of surgery where you will be limited in your mobility, be sure to ask your friends, neighbors and relatives for assistance and support during this time…it’s not a sign of weakness to need help after surgery.  They all want to see you get better, right?  I know I needed help with cleaning the house, changing sheets, doing laundry, getting groceries and mail and medical supplies, caring for pets, and with transportation.  This is when I found out who my real friends are.

I borrowed a laptop from work and once I started feeling a little more alive, it was nice to be able to log-on and keep friends and loved ones up-to-date on my progress, and it makes for decent entertainment, too.  At about 7 weeks, I felt like I was going to go a little crazy from lack of brain stimulation, so I checked in with work to see how things are going...and found out I had done an admirable job of setting things up so I did not have to be there!  Anyway, other alternatives are game magazines, art supplies, whatever will amuse you quietly for a while.  Pretend you are Rapunzel and that you are going to be held hostage in that tower until the prince shows up, so you best learn to entertain yourself.

And even though I am not a tough person and tend to be on the demanding side, I tried hard not to fight, complain, or whine out loud, as experience has taught me that behaving like that repels even the most patient of souls. Like Mama taught me, I always remember to say please and thank you, and be genuinely grateful for things people did for me along the way.

FIRST POST-SURGICAL VISIT: CHAPTER SIX

After 6 long weeks, I finally got to see what had become of my leg.  I was excited and nervous, anticipating a really ugly encounter.  I wasn't disappointed.  My poor leg was crusty with yellow ick and I was appalled at the dried blood, hair growth and skinniness of my limb.  Doc said that my stitches were in a "vulnerable location," so I got to keep them longer than usual.  But that’s okay…I left with a nice, clean, new half-cast that was lighter and harder than the post-surgical one, made of fiberglass.  I asked for extra cotton padding to combat swelling pressure pain, as I was told the ice packs no longer work with a fiberglass cast (which is unfortunately true).

Here is what my leg looked like fresh out of the post-surgical cast...euwww!!

And here is what my spiffiest "designer" cast looked like:

PAIN: CHAPTER FIVE

Yes, there was pain.  It was no fun the first week/10 days, but after I got the post-surgical cast off, it got a bit better.  In fact, I observed that while I was indeed in post-surgical pain, the arthritis pain was gone. Surely that was the first noticeable good sign!

I took my meds religiously and minimized my suffering as much as possible by not allowing the meds to wear off.  Only trick is not to lose track of the dosing.  But hey, that was the only thing I really had to keep track of at the time, right?  I kept my leg up as much as possible and kept Blue Ice handy.  I also learned to choke down as small can of prune juice every morning, which made it much easier with the BMs, as pain meds tend to clog a body up in short order.  Advice about prune juice would include mixing it with pomegranate or cranberry juice to make it (almost) palatable...otherwise it tastes pretty much like dirt.