Just received the invoice from University of Wisconsin Hospital and Clinics for the emergency room use from 12:30 am to 4 am on Thanksgiving morning.

$10,382.38
Not priceless

$ 410.00 repair superficial wounds (stitch brow lacerations
$ 209.00 apply splint plaster
$1,113.15 laboratory (don't know for what)
$6,232.00 radiology (CT scans despite no pain/disfunction
$ 53.10 supplies
$ 104.13 pharmacy (which they said was closed)
$2,261.00 emergency room

I was not able to take any of the xrays or CT scans to Dean providers when the insurance company said it would not cover me at UW. They cannot transfer digitally? EPIC, what the heck? Both Dean and UW use My Chart.

I asked to hand carry the records. UW apologized that their records department is no longer in the hospital. It is far west on Excelsior Drive. Bit of a challenge for hop-a-long, with a fractured foot and inability to drive to get there before the next week. So Dean Orthopedics took more x-rays.

Just for shock value:
Here is the invoice from Milwaukee Hospital from May 26 - May 31 of 1965 when I had surgery on my little face.

Five days in room #441, $26.25 per day.
Anesthesia materials $11.00.
Labs, $2.00, three times.
Here's the biggy - Operating Room, $46.25.
Grand total $208.85

Surgery/Home

Sedation starting 8:00 ish am Monday Dec 9.

Anesthesiologist is adorable and too young.
Uses ultrasound to find the nerves and I'm having fun watching the Vastus Medialis line up against Sartorius.   He uses a purple pen to pinpoint where he will inject a 'caine' kind of neural block at the Saphenous nerve, inner thigh above the knee, and Sciatic nerve through popliteal fossa, lateral thigh,
after I am out.

Dr. Scerpella meets briefly with me to reiterate where he will cut and some options on keeping the bones together.  He is a little disgusted that he cannot make the correction on the work order but has to hand it to a nurse to have it rewritten - they have omitted any reference to the 4th metatarsal, the most shattered bone.

I wake at 2 pm.

Six hours of sedation and surgery.

Nerve blocks inhibit all pain and external sensory sensation.  I can not feel my toes or feel my hands on my calf or toes.  But it's not pleasant.  The sense of tingling and fear that something is happening that I can't feel is ominous.

Surgeon did a tremendous amount of repair. 

Screw at first metatarsal tarsal joint space.

Plates and screws at 2nd and 3rd metatarsals

Screws at fifth metatarsal proximal to joint and through 4th.
Plates and pin in fourth bc so comminuted and did not want to take bone pieces out and remove muscle.

He looked at fracture in anterior calcaneus and opted not to do screw.
Surgeon notes said to get me off the table.  Notes indicate exsanguinated for 60 min, 40 min, and 43 minutes, with 15 minute releases of the tourniquet between bloodletting.

Four incisions. Over 1st, 3rd, and lateral to 5th, and little entrance inferior to the latter.  But I am casted and cannot see them.

They move me to the overnight room in this Outpatient Clinic about 7 pm, after everyone else clears out.  The nurses assure me that security will come through and make sure no one else is in the building and that we are there, and then they will lock down.  If we have any issues, St. Mary's is just across the street.  The MOthership.  It is not comforting to be in lock-down with two young women in a building full of drugs and shiny high-speed drills and I can't get out of bed by myself.  Well I can, but they have sent my crutches home so I need the nurses to help me transfer to a wheelchair to do anything.

Blocks inhibit all pain and external sensory sensation.  I can not feel my toes or feel my hands on my calf or toes.  But it's not pleasant.  The sense of tingling and fear that something is happening that I can't feel is ominous.

There is a welt in the back of my head.  Nurses have no idea what.  Actually I'm not even sure those girls that stay over night in outpatient surgery are even nurses.  I lie there freaking that there is an aneurism under the skin. When I turn my head to the right I feel cool water running down the left side of my nose.  Not.  I have been dizzy since emergency room, 12 days ago.  Chalked it up to dehydration and low blood pressure and not being used to lying around so much.  But now I wonder if something is really wrong.

I think they dropped me in OR.  Left ass hurts.  Think I was on gluteus medius for most of the trip.  (I will find out from the surgeon notes a few days later that indeed they "put a bump under her right hip and buttock").

 Arms hurt like holy hell from the crucifix position all that time. 

Blocks started receding at 4:15 am.
Nurse-girls say to take ibuprofen.  This is dead wrong.  They say it again, say it helps reduce swelling.  Yes that's true but it's highly contraindicated for bone union and healing.  Who are they?

Tyrodol (sp?) pain-med by IV just before IV was taken out at 5:15 am.

Discharged 5:45 am.  

23 hours and 59 minutes 

Confluence of Medicare regulations in and Outpatient Building and insurance parameters.  This was not outpatient surgery.  But they didn't have OR open until next Friday.  

1 degree above zero.  8 inches of snow the weekend before and still dicey driving.

First Percocet at 3:15 on Tuesday, December 10.

Clinic calls about 4 pm to see if I've gotten home alright.

I'm out.

December 7th, Saturday

Yesterday the nurse called to say they were delaying surgery from 2:45 to 5 pm

Dont' eat.

I asked about scheduling a different day.

Nurse said the next available was NEXT FRIDAy, December 13, no less, and that day's OR schedule already worse than yesterday.   I said I would come in as late as they needed.

Then the SURGEON called and said he was frustrated.  Because of equipment problems in

the OR he had not started his first case yet and it was 10:30 am.  There were two big cases

scheduled ahead of me and he said he couldn't rearrange those, apparently because I was

the most healthy.  I have had intake conversations once or twice a day every day last week

and all are astonished that the only scrip I have is birth control (too much information but I 

really don't know what my mood will be when I go off that estrogen balance).  

No other health issues.

They didn't even do lab work bc so  "bored" (someone said that) with my wellness.  

Surgeon asked if I wanted to wait until Monday.  He rearranged outpatients in his

day surgery clinic.   I am scheduled for 7:50 am Monday.  Up to this point he has said

this is a big case and I should plan on one night in the hospital.  When the surgery was so late, 

he said it might well be two nights.  Now, insurance says  I have to be out in  23 hours.   I said to the nurse "that means I will be discharged at 5 am on Tuesday?"  She hesitated and then said I would

have to discuss that when I get there Monday.  What is likely to happen is they will

stretcher me across the street and admit me to St. Mary's hospital.  Really.

Meanwhile my general health and mental state are declining.

Surgeon assured me that the wait is not bad for the foot or detrimental to the surgery.

And will not materially delay recovery.   He still says I will be ready to lead the retreat

in February.  Though in a boot.  That'll be a fun walk to the ocean.

Tomorrow

And tomorrow and tomorrow. . . .

The surgery is delayed.

Surgeon called me mid-day to say he had not started his first case yet (two big cases before mine) because of equipment problems in the OR. He sounded frustrated. 

He rescheduled some outpatient cases and I am now slated for take-off Monday AM. Please keep your seatbelt fastened low and tight around you. Especially since they may stretcher me across the street to stay overnight in the hospital. 

I wait.

I know the name 'patient'. Though I have it not.

. . .

"She should have died hereafter:

There would have been a time for such a word.

Tomorrow, and tomorrow, and tomorrow,

Creeps in this petty pace from day to day,

To the last syllable of recorded time;

And all our yesterdays have lighted fools

The way to dusty death. Out, out brief candle!

Life's but a walking shadow, a poor slayer

That struts and frets [her] hour upon the stage

And then is heard no more. It is a tale

Told by an idiot, full of sound and fury

Signifying nothing. - Macbeth (Act 5, Scene 5, Lines 17 - 28)

Image is Kathleen before the Monona Terrace fountain before the Capitol. Photo, Dean Kesler