Of course, the journey was not completely over. True, I no longer had to be driving to and from places or waiting for filled prescriptions. But the story isn’t quite over…

I have not had any additional issues that have needed addressed by a professional since my appointment on December 1st, so this last post about my “journey” will be odds and bits or different things, out of context of the actual travel of this journey, that I thought I’d share. When I say, “have not had any additional issues”, I mean issues needing medical care. I get what I label as “ghost toothaches” from time to time. It feels just like a toothache feels, but it’s usually mild and lasts less than 15 seconds. I’ve only had one instance where I felt that sensation and while still mild, it lasted for several minutes. I was able to work through the sensation of pain without help, but I also knew that I would pop a couple of OTC pain relievers if it didn’t go away on its own.

I am writing this post several weeks earlier than the day on which it will be scheduled to post. I’d given myself 5 days between posts once I started writing them so that I would have the opportunity to sit down and write them without feeling pressure to get them done. Nonetheless, the entire journey I shared in these posts happened over the period of many weeks from the day I fell to the day of my last appointment. Now it was just waiting for all of the paperwork associated with the injury from the hospital, the surgeon and the insurance company to see where things stood.

Let’s start here: The total hospital bill at St. Luke’s Bethlehem, from the moment I was moved into a room in the emergency room area until I exited my hospital room, was a whopping $106,432.71. No, that is not a typo. It does include the surgery, a billing for post-op recovery area, every little pill or shot I was given, every prick of my finger to check my blood sugar, etc. But still, over $100,000 for less than 48 hours’ stay? The number astounds me. Now, granted, there is a negotiated rate with my particular insurance on what they pay for each and every item, and the insurance did not pay nearly that amount. And, of course, with Medicare, I am responsible for 20% of the approved costs, but the EOB only shows right now that my share using Medicare insurance totaled $266. (These billings did not show up as entered until December). I do have a secondary medical insurance that I carry, so I’m hopeful it will pick up much of my 20% co-pays for all of this. I’m not happy that, on the EOB, that I can’t see each item’s individual billable and payable amount, just the total, and I’d be interested in knowing how much the surgery cost versus the hospital room versus the medications, etc. I’m just not yet able to wrap my head around it, all in all, being billable at that incredible total.

Just over a week from my hospital release date, I received a printed card from the unit I was on during my hospital stay. It was generic in the way that it basically said, “Thank you for letting us take care of you during your stay” and it was hand-signed “8th floor unit staff”. I have to say that, with the exception of one staff member, I felt really coddled the entire time I was there. The one member I’ve excepted was not in any way rude, but the rest of the staff really felt like they went above and beyond to make me feel like my well-being was their #1 priority, and the lack of that feeling was obvious with that one staff member. I can still think back to being in the hospital and how cared for I felt. When you’re used to taking care of yourself and no one is around to provide any sympathy or nurturing, those simple events that are routinely a part of their jobs were the best part of my stay (if one can find a good part of a hospital stay!).

While most of us lay people will have to fake our way through reading this, that nice thing about this hospital’s network of allowing patients to access their records means that I can see my surgeon’s notes. They read as this:

Procedure and Technique:

The patient was greeted at the bedside in the prep and hold area. All risk, benefits, alternatives to open reduction internal fixation of bilateral mandible fractures, closed reduction maxillomandibular fixation and surgical extraction of any necessary teeth discussed in detail.  All questions answered. Patient is amendable to treatment and signed informed consent.

The patient was brought in the operating room and placed in a supine position on the operating room table. A time out was performed with surgical, nursing, and anesthesia staff verifying patient procedure and laterality. Anesthesia placed appropriate monitors and intubated patient nasotracheally without issue. The patients lower jaw and neck were prepared with chlorhexidine solution and dried. The patient was draped in the usual sterile fashion.

A throat pack was moistened and placed in the oropharynx. 1% lidocaine 1:100,000 epinephrine was used to anesthetize bilateral inferior alveolar nerve, lingual nerve, buccal nerve, superior alveolar nerve, greater palatine nerve. Injections were reinforced with 0.5% marcaine 1:200,000 epinephrine.

A 15 blade was used to make an incision on the height of the edentulous ridge with mesial and distal releases. A full thickness mucoperiosteal flap was reflected. The fracture was visualized, mobilized and debrided using a rongeur and bone file. The fracture was reduced and secured using a 1.25mm Synthes plate with four 8 mm screws. The flap was irrigated with normal saline and closed with 3-0 chromic gut sutures. Attention was then directed to the left subcondylar fracture. A bovie electrocautery was used to make an incision in the left buccal mucosa to expose the ascending ramus of the left mandible. A full thickness mucoperiosteal flap was elevated and the dissection was carried up the coronoid process, the temporalis tendon was released and the dissection was carried to the posterior border of the left ramus. The sigmoid notch was identified and the subcondylar fracture was identified, there appeared to be a callus and the segments were not mobile, the bone was smoothed using a rasp and the site was irrigated with normal saline and closed with 3-0 chromic gut sutures.

The throat pack was removed and the oral cavity suctioned.

Sterile drapes were removed and the face cleansed with normal saline and dried. All sponge and needle counts were correct and verified with the nursing staff. No complications encountered. 

I was present for the entire procedure and A qualified resident physician was not available.

Signed by: Rhonda R. Rohloff, DMD

And, as of this writing, I am still sans dentures. I’m doing what I’ve done for many, many months now – putting in my top denture to go out in public or if I’m going to be chewing something I can’t just gum to masticate. I just feel like I need to put this whole fiasco far back in the rearview mirror before I take on another series of appointments, etc.

I did have a moment of clarity (out of nowhere) when I wondered to myself why dental professionals didn’t use a topical product like Anbesol on the gums to cause a temporary numbing sensation before stabbing the patient with a Novocain needle. Someday maybe I’ll run into an appropriate professional to ask…

One last, in the scheme of things, truly a small thing – – – the beeping battery in one smoke detector that I came home from the hospital to is, in fact, still beeping. It requires me to get up on the top step of my stepladder and it makes me very nervous. I mean, do I need another fall so soon? I hardly notice it anymore, and I’ll get my beloved brother to take care of it next time he visits (as well as the light over my kitchen sink because that bulb has since burned out) because he’s tall enough to reach these from the middle step!

As Forrest Gump said (only three times in the film, believe it or not), “And that’s all I’ve got to say about that!”

I am not a fan of Novocain shots. Well, actually, I’m not a fan of any kind of shot or situations where a needle pierces my skin (which is why I am tattoo-free). But I can handle the quick prick of a vaccine needle or one inserted to draw blood for various testing. I have donated a pint of my blood 15 times over the past few years, and while that can sometimes be a little more painful, once the needle is inserted and blood is flowing freely, I don’t think about it anymore. But Novocain? I know that I automatically close my eyes when a hand moves within my vision which I know is headed for my mouth. I don’t think I’ve ever seen the shape/mechanics of the equipment that provides the shot, but in my imagination, it’s like a miniature caulking gun with a big trigger.

So, eyes automatically close, and I feel the pressure against my inner mouth as the hand of the doctor moves in. My body automatically tenses from knees to neck in anticipation, and when the shot hits, I let out a groan of displeasure. (This is pretty much my normal routine when getting Novocain.) A moment later, when the sensation of pain has subsided, I relax, almost telling myself how proud I was to have made it through. And then, ping, the needle hits me again! I grabbed the ends of the armrests with my hands and let out a louder groan. I hadn’t seen that coming and I wasn’t happy about it. And then, ping, ping, ping, ping – another 4 shots administered with less than 10 seconds between and each one now causing me to lift up my butt from the chair and each groan getting successfully louder and more intense in sound. And in between each shot, from #2 through #5, Dr. Kim acknowledges my discomfort by saying, each time, “I know, sweetheart”. It was a good thing my mouth was open with his hand and his device of torture filling it, because there was a not-so-ladylike response I’d have had to fight to hold in had I had the option to say it.

His hand and torture tool finally leave my mouth, and I suspect that I was glaring at him by then. However, I just let him do what he had to do as quickly as possible so I could get out of there before I lost my cool. Once he was done sewing me up and leaving a large tail of thread in the front of my mouth, he set me up for another appointment and told me I had prescriptions for more of the same antibiotic and mouthwash at my pharmacy. Well, since I still had the mouthwash, and since a visit to my PCP on November 3rd indicated that my sinuses were quite red (this may have been the result of the surgery), she had sent a prescription for 2 weeks of the same antibiotic (for which, if you’ve been paying attention, already know that I had to wait 20 minutes longer after I pulled up to the drive-thru window at the pharmacy). I simply chose not to pick them up after this oral visit.

A few days later, sharing the details of this visit with my bestie, I first became aware of the feelings I associated with his repetitive comments of “I know, sweetheart”. Honestly, as I thought about it, I felt very much like he was being condescending and patronizing towards me. I was able to think of alternative variations of statements if he was attempting to calm me. As I said to my bestie, I wasn’t offended in a sexual way by the repeated use of the word sweetheart, but thought that, not only was it not at all appropriate in this kind of setting, it also could feel a little creepy to a younger patient who would feel uncomfortable having a stranger repeating a personal term of endearment. I realized that I would like to share those feelings with him, not in a way to criticize him but to help him. However, of course, I was not even in the room without his assistant present, and I didn’t want to embarrass him by saying anything in front of her. I thought I’d have another opportunity when I went back for my follow-up visit.

In between that visit and the next one scheduled, I developed another, new problem on my lower left jaw. It felt like something was sticking up from my jaw, near the front of the sutures. It felt like a piece of a toothpick, maybe a third of the length of one and half the width. It didn’t hurt and it wasn’t terribly sharp. I still wasn’t chewing on that side of my mouth, so I wasn’t worried about it breaking off. But still – we’re now a month past the surgery and I’m still having issues?

When I went back on December 1st, I had a different dentist. If he gave me his name, my brain didn’t retain it. I knew he was a different person because, while also of Asian race, he was taller and wore glasses. I actually took charge of this appointment in terms of how I wanted and expected to be treated. I explained my low tolerance for pain in general, my intense dislike of Novocain, and that I needed to know what was going on each step of the way to avoid anxiety and an unpleasant experience. He explained to me that there was a fragmented piece of bone that was sticking part way out of my gum which was dead and not attached to anything that mattered. He said that I would only need one shot of Novocain and that the process would be simply to grab the piece of the bone above the flesh and “wiggle” it out. I asked if I needed to have Novocain and his response was to the effect of “I wouldn’t get it, but I have a moderate pain level.” I asked him to give me a moment or two to think about it. When I’d thought about it, I had one more question and asked him how long it would take, in his opinion. He told me that it should only take a few seconds and so I elected to forego having the Novocain shot. And so he began.

I felt his hand in my mouth although I couldn’t feel the wiggling. Before 10 seconds were up, he removed his hand from my mouth and I asked, “Is that it?” It wasn’t… of course it wasn’t! He said that the bone was pretty tight within the flesh of my gum and he had gotten some movement, but he didn’t want to wiggle too hard and rip the skin. He went back in the second time, and again, seconds later, he pulled his hand out again. I made eye contact with him and he told me that one more tug was all he needed. Well, I was at a disadvantage, so I had to let him continue. Next thing I knew, he was showing me this tiny little piece of bone that had been causing all of the trouble. It was over, and I did it without Novocain! He told me there was the tiniest little hole that needed to heal, but it should be completely healed within about 3 days. No additional antibiotic prescription needed (thus, no more waits at the pharmacy to get it filled). He suggested a salt-water rinse after I ate for a couple of days but I didn’t need any further follow-up unless I had any problems.

I walked out the doors to my car and was overwhelmed with a sense of relief that, unless something else developed, it was finally over! No more schlepping to and from Bethlehem! No more sitting in the drive-thru at the pharmacy only to be told, when it was finally my turn, that the prescription wouldn’t be ready for another 20 minutes! It was finally time to be hopeful that full healing would come, and that my Medicare plan would cover replacing my lower denture which no longer even fit the profile of my lower jaw, much less stay in place with adhesive! The relief was almost palpable! The journey was over!

On that Thursday, the day after I came home, I did a more thorough reading of the seemingly too many pages included in my discharge packet. On one page, I was told to schedule a follow-up appointment with the surgeon for the week after. On a different page, I was told to wait a week and then schedule a follow-up appointment with the surgeon. My pain was so minimal that I was willing to wait a week before scheduling that appointment. Meanwhile, on Friday morning, just 2 days post-surgery, this was the face that looked back at me from the bathroom mirror:

Man, I thought the bruising I experienced from the fall was ugly enough, but it was no match for the bruising I got from the surgery! This was much more bruising and much darker, but it did not last as long as the previous bruising had. Meanwhile, ever grateful that no one would look at me like I was crazy, I donned my mask whenever there was a chance I would see someone (even in the communal lobby when I went to check the mail). I did manage to make an appointment with my mechanic, who was crazy busy as it was, and learned that the check engine light was on because I needed to replace a camshaft solenoid (whatever that is!) to the tune, with tax, of almost $165. When it comes to vehicles, it’s been my experience that anything maintenance is always going to be costly, so I actually was almost pleasantly surprised at that cost only being that much.

On the Wednesday that marked a week since I’d left the hospital, I called to schedule my follow-up appointment. While I suspected I had gotten dissolvable stitches, I could still feel them in some places. I also had a place on the left side of my lower jaw that felt like the stitches had come apart and when my tongue ran over that space, I could tell that it felt different than the rest of my jaw. When the person answered my call, I explained that I was calling to schedule a follow-up appointment with my surgeon. The response I got was something to the effect that they normally don’t schedule follow-ups for the surgeons. I explained that I had paperwork from the hospital stating in two places that I needed to follow up with the surgeon, and that I had concerns about the stitches that hadn’t dissolved and the potential hole in my flesh where the stitches did not hold the spot together.

I finally got a scheduled appointment by phone for 3:30 PM on Friday, November 18th. About an hour later, I got a confirmation text of the scheduled appointment – same date but at 3:40 PM. It’s become obvious to me that the right hand doesn’t know what the left hand is doing from having two different sets of instructions for when to schedule a follow-up appointment, but I decided I’d stick with the 3:30 PM time because I don’t mind being early somewhere, but I get anxiety if I’m not there a few minutes early, never mind late. It was supposed to be another 45-minute drive, so I left home at 2:30 PM. Since I was heading to the same town as the hospital, I did feel like that much of my driving felt a little bit more familiar. My GPS got me to the address on Eighth Street with about 7 minutes to spare (again, construction, one-way streets and school buses). I pulled up, to the address but was concerned, because the numbered building was merely a duplex house with no signage. I pulled out my paperwork and realized that it was I who had erred, that I’d let the GPS default to Eighth Street but the address I wanted was on Eighth Avenue. I corrected the information in my GPS and it reported back to me that I was 8 minutes away (so I would arrive at 3:31 PM). Of course, the GPS does not take into account the traffic, road construction and school bus continual stops. At 3:35 PM, I started calling the main phone number, wanting to alert someone that I was just a few minutes out but was on my way. I kept getting the message telling me to leave a message for a return call. After getting that same message three times, I dialed the main number and tried a different option from the menu and managed to get a live person. I was informed that I was already late, and I needed to get there before 3:45 or I would lose my appointment time. (It was another not rude but certainly not nice person I spoke to – perhaps that’s a qualification that employees have to have before they can be considered for a job?)

I got there at 3:41 PM and registered. Because I’m a bit anal-retentive, I had extra copies of every piece of paperwork I had been given since entering the hospital, so I save them time and cost by needing to make their own copies. I didn’t have a very long wait before I was called to go into an exam room.

Less than 10 minutes later, a man of obvious Asian heritage entered my room and introduced himself as Dr. Kim. I was expecting to see my surgeon but agreed to allow him to look inside my mouth. There was, indeed, a place on the top of my left jaw that had pulled apart and he said that what I could feel was a bit of a metal plate that was used to help connect my jaw. I obviously couldn’t see it, but I was pretty sure it was about a 1″ length that hadn’t closed correctly. Dr. Kim said he would give me Novocain and re-stitch it for me. And then the real fun (hear that word with sarcasm) started.

Once the staff was informed I was staying, they started coming in to see me. My blood sugar was checked and was high (not surprising considering all of the sugar from the juice). Someone came in with needles and told me they were going to give me two needles in my belly. One was a shot of insulin and the other was a liquid blood thinner to help protect me from getting any post-surgery blood clots. I wasn’t happy about getting a shot of insulin, since I manage my blood sugar well with oral medication, but hey, if you were going to give me a shot in my belly anyhow, now is the right time to do it.

Another person came in with the cup of 3 Tylenol and a larger styrofoam cup with a lid and a straw. Eeech! The larger cup had thickened water in it. I got the pills down and handed that cup back to the attendant. I (nicely) said something about not being able to enjoy the thickened water and also, I didn’t think a straw was a good idea since I had stitches across my entire lower jaw.

About 2 hours after that, just after lunch, an attendant came in to tell me that they were going to start me on a painkiller. Now, I hadn’t asked for one, even though, when asked, I did say my pain was pretty constant at a 6 level, even with the Tylenol, but trust me, I wasn’t going to turn it down. She told me that I would be taking oxycodone, with which I was quite familiar. Oxycodone is what I was prescribed after I’d had my teeth removed prior to getting dentures, and it basically replaced what used to be called Tylenol 3, which was Tylenol with codeine. I didn’t want it for pain as much as I wanted it to knock me out and give me some real rest. The good news, in addition to that, was that I was now allowed to have non-thickened liquids (I may have said aloud, “Thank you, Jesus”). I immediately asked for a large cup filled first with ice, to the brim, and then filled with water, no straw needed. I guzzled so much of it that it gave me a case of brain freeze, and yes, I’d do it again!

Shortly after that, another attendant came in with a little cup of what looked like mouthwash and a plastic bin. I was supposed to gently swish it from side to side over my lower gums and then very gently spit it out. I was told I would have to repeat the process after I ate dinner. Not a biggie to me.

The rest of the afternoon was pretty uneventful. I was offered assistance with a sponge bath, but I declined. I’d taken a shower on Monday morning and didn’t think I’d gotten that dirty, plus I had a shower in the bathroom and was perfectly capable of bathing myself if I needed to. (Also, I know they are professionals, but I have body issues and prefer not to expose my body unless absolutely necessary). Meanwhile, I kept watching the clock, wondering when Dr. Rohloff was going to show up and let me know how the surgery went and what I needed to do and what I could expect in the next few weeks. There was a TV in my room, for which I had the remote, but I watch so little TV anymore that I wasn’t really interested in it. The pain pill didn’t make me drowsy, nor do much for the pain, but I got my Kindle out and would read a couple of chapters, then turn it off and close my eyes for a bit.

The three Tylenol tablets were dispensed every 8 hours, the pain pill was dispensed every 5 hours, my blood sugar was checked every 8 hours, and I received two liquid blood thinner shots that day, though I can’t remember how far apart they were. Donna, next door, was still coughing, but not as often and with a much drier cough, meaning not much of the continuous hacking. No one ever looked inside of my mouth or asked me if I had any issues. While the staff was amazingly kind and caring, I honestly could have been a patient with absolutely no recent surgery because no one seemed concerned about the fact that I had just had surgery other than to give me blood thinners and dietary restrictions!

Meanwhile, I spent much of the day awaiting a visit from my surgeon to talk to me about the surgery and anything good and/or bad associated with it. I didn’t totally give up on a visit until after 9 PM. By that time, I was back in the chair instead of on the bed, finding it much more comfortable once I realized it had a footrest like a recliner. I also had a pretty view out of my 8th floor window, at least until sundown. I sat there, feet propped up and blanket wrapped around my bare legs, dozing off at times and at times just resting. This was my view:

It was around 10 PM when my next dose of a pain pill was brought in. I actually turned it down and said that it wasn’t having any kind of effect on the pain, so I didn’t see the point of taking it. The (cute and charming) male nurse said that he could double the dose, since it was just a 5 mg. pill, and he nudged me into understanding that I had nothing to lose by trying it. So I agreed to the double dose.

And then, I slept. Sitting up in the chair with my feet propped up, a light blanket covering my legs, I slept. I slept for about 4 hours without waking for any reason, and when I woke up, I felt like a different person! I stayed in that position, still resting but not sleeping. When the (cute and charming) nurse checked in on me about 4 AM, I gave him a thumbs up sign and said, “Thank you. I slept.” He asked if I needed anything else, and I told him that I would love to have a cup of coffee but I doubt that the kitchen had any ready that early. He said he could get me coffee and asked me if I wanted 6 oz., 10 oz. or 12 oz. Of course, I went for the 12 oz. size, with 3 creamers. Oh my gosh, one sip and I wondered if I could get some coffee upon entering heaven, because it was heavenly good! When the nutritionist came in around 6:30 AM, I asked for 2 cups of coffee (thinking they would be small) and a bowl of grits. Now, suddenly, I couldn’t have grits, however! I ended up ordering oatmeal, and it was as bad as the coffee was good. It was very sticky, and the texture felt like it was only half-cooked. I took two bites, pushed it away, and prepared my two fairly large cups of coffee to enjoy, which I did. Meanwhile, with the uncertainty of discharge, I had to order lunch and dinner at the same time. Now being able to have regular liquids, I ordered some chicken broth, but when I asked, was told I could have neither crackers nor a plain piece of bread to put into it to add some texture. I was going to have the baked tilapia but was told that it would still need to be pureed. Seriously, tilapia is a very flaky fish and falls apart with the least amount of pressure to its flesh, but they still had to puree it? No thanks. (Fortunately, I would not be staying for lunch or dinner!)

About 10 AM, a person I wasn’t familiar with (which made me assume he was a doctor) came in with a bunch of paperwork, which was passed on to me with the statement that these were all of the papers needed for my discharge. I wasn’t surprised by being discharged. I’d already gathered up most of my belongings in preparation. I got out of the hospital gown and into my own clothes, then sat down to read all of the discharge paperwork. I was expecting someone would be coming to get me – with the standard wheelchair – to take me down to the lobby. I read the paperwork again, including the fact that I needed to be out by noon to avoid an additional day’s charges. 11:30 AM came and I’m still in the room, bag packed and ready to go. At 11:40 AM I stripped the bed and pillows of linens (hospitality training never fully dies, I guess) and at 11:50 AM, I grabbed my bag and left the room.

I found the elevator, took one to the first floor, and ended up in the main lobby of the hospital. I asked at the desk how I could get over to the emergency room area because that was where I was parked. Guess what? You can’t get there from the main lobby except by going outside and going around the building to the ER entrance. Fortunately, because of the size of the hospital and its parking lot, there were courtesy drivers to take people where they needed to go because the main parking lot was across the street, so I requested one. Mr. John took me around the building (it took 4 minutes driving time, so I’m glad I didn’t opt to hoof it!) and I breathed a sigh of relief when I saw my car. I tipped Mr. John $3.00 and went to my car, unlocked it, threw my things inside and climbed into the driver’s seat. At that point, my mind repeated the words, “Be it ever so humble, there’s no place like home.”

The check engine light, of course, came on and stayed on and all I could do was hope that I would make it to the drugstore to pick up prescriptions (pain pills and mouthwash) and home. My mechanic’s garage is just a little over a mile from home, and if worse came to worse, I could get towed there using my AAA, so I just wanted to make it home. Thankfully, mid-day traffic wasn’t too bad and I was at the drugstore about 45 minutes later. I waited at the drive-thru window. When it was my turn, guess what happened? If you’ve been paying attention, you probably guessed that I was told the pick-up wasn’t ready yet and I should wait about 20 minutes.

I got my prescriptions after the wait, got home, grabbed my belongings and walked in the door. Belongings got dropped on the floor of my bedroom, coat hung on the doorknob of the front door, shoes kicked off and slippers acquired, a large glass filled with Brita ice cubes and cold Brita water was also acquired. and my butt hit the recliner. The rest of Wednesday and all of Thursday was resting, doing a little bit of reading, watching some movies (in pieces on Amazon Prime) and napping if I could. By Thursday morning, I was able to treat the pain with Tylenol and only took the pain meds at bedtime for Thursday and Friday to make sure I was able to sleep, and even weaned myself back to two doses of Tylenol, one when I got up and one mid-afternoon.

I assumed the worst was over… (and you know what assume does, right?)

I am going to assume that post-op, someone checked to make sure I was ‘awake‘ enough to be moved to recovery, though I don’t remember that at all. The next thing I remember was a dark curtain being pulled back, letting some light into a very dark area was when I first opened my eyes. A female determined that I was awake enough to tell me, “We’re just waiting for a bed to become available for you.” At the time, I heard the words but nothing really registered. It was only much later when I considered why surgery would have been performed without knowing whether I would have a room to recuperate in afterwards or not! That sent up a bit of a red flag, but I obviously was helpless to do anything about it!

The next time I remember waking up, I was in a patient room. There was a clock on the wall across from the bed, and it was almost 7:30 PM. My belongings had been moved from the bottom of the bed to a chair across the room. My patient room door was open, and I could hear the patient in the room next to me (her name was Donna) coughing almost continuously, that kind of wet cough associated with pneumonia or bronchitis, and then finally she’d get it coughed up. I tried to doze, but all I could do was doze because her coughing was loud and disruptive. At some point, I dozed off deep enough that I didn’t hear someone enter my room to leave me a tray of food. Now, it had been 12 hours since I’d had anything to drink, and longer since I’d had any solid food. I expected I would be given liquid and/or soft food because of my jaw having been operated on. On a plate under the dome was an ice-cream scoop size of mashed potatoes and a few small pieces of cooked carrots. I managed two small bites of the unseasoned potatoes but I really wasn’t hungry. What I did want was a cold drink.

I am anice person. I am anice person. Those two sentences initially appear identical, with the same spelling error. But one is subjective and one is objective. Sentence #1 should read “I am a nice person.” I want to assume that to be a true statement at large, but I know that I am not a 100% nice person 100% of the time, even if I don’t act upon it my “not nice” feelings. Sentence #2 should read “I am an ice person.” This sentence is 100% true 100% of the time. I will admit that, as I was mentally preparing for this hospital stay, one of the things I was looking forward to was being able to have ice chips as desired. I’d seen plenty of movies and TV shows showing these little cups of what looked like shaved ice served with a spoon, and I planned to take advantage of them during my stay. Later that evening, I asked for some ice chips, my mouth almost watering with anticipation. What I got was a cup – sans spoon – of what looked to be small, thin squares of ice (about 2/3rds the size of a Chiclet, if you’re old enough to remember what they were). Not at all what I was expecting, and despite being grateful for them, since I’d had no liquid to drink since at least 10 hours before, it was disappointing that they weren’t the kind of crushed, snow cone ice I was expecting and hoping for.

Around 10 that night, a staff member came into my room with a small cup that held what I was told was three tablets of Tylenol and a little cup with red juice in it. I took the pills and popped them in my mouth, followed by lifting the juice and taking a sip. Eeech! It tasted like cranberry (it was) but had the consistency of applesauce. I was not expecting that, and it took me a long moment before my mind could convince my throat to swallow. I questioned what I was drinking and was told that all post-op patients were subject to non-thin but still liquid diets because it had been determined that post-op patients tended to choke on liquid items. This was, indeed, cranberry juice, but it had a thickening agent added to it. (NOTE: By pure accident, I was on Amazon’s site and saw that there were several brands of food thickener available for sale there. It kind of freaked me out that this was a product that was popular enough for Amazon when I’d never heard of it before.) Fortunately, it was a small cup, and it was cold, so I convinced myself it was cranberry applesauce and quickly finished it off.

I dozed on and off all night. Strange bed, strange sounds, coughing neighbor and flat and plastic covered pillows all contributed to me not being able to fall into any kind of restorative sleep. By 4 AM, I was tired of lying in the bed, so I got up and sat in the comfy chair next to the bed and grabbed the menu that was on the bedside table. Yes, indeed, the hospital had a menu, just like a restaurant, and the variety was surprising considering that it was actually a hospital. I looked through all of the options. I wasn’t really hungry, but I was looking foward to coffee. The nutritionist came in about 6:20 AM (the menu said between 6 and 6:30) and would be taking my order for all three meals for the day. I had decided that I wanted coffee – 2 cups if I could – and a bowl of mixed fruit. I was told that I could have these items, but the coffee would be served with the thickener added to it, and the fruit would be pureed so that it was also thick and didn’t need to be chewed. It took every ounce of willpower not to throw a tantrum. I had to relook at the menu and mention items to see if I could have them, and finally decided on a bowl of butter-flavored grits (I like grits but seldom get them) and asked for apple juice. I figured I could convince myself that thickened apple flavored juice would be applesauce. After asking several questions and finding out I couldn’t have any kind of broth, I ended up ordering applesauce and cottage cheese for lunch. (NOTE: The cottage cheese was the large curd variety, which required me to do some mashing with my tongue against the roof of my mouth to break it into smaller pieces, thus not something that I, personally, would label thick and easy.) For dinner, I wanted mashed sweet potatoes, but was told I wasn’t allowed to have them, even though I could have regular mashed potatoes (HUH?). I ended up ordering mashed potatoes and pureed green beans (they looked like a small, green lump on the plate but tasted like green beans).

Breakfast arrived around 7:45 AM. I have to say that I loved the bowl of buttered grits! I got through the apple juice as well, and thus, earned the “clean your plate” award. Around 10:30 AM, after I’d crawled back into the bed to try and doze off again, a doctor (introduced himself as Dr. so-and-so) entered my room. I wasn’t asleep so I opened my eyes the moment I heard him entering. After introducing himself, he told me that, if I wanted to, I could go home that day.

Did your chin just drop and/or did your eyebrows furrow? I was in surgery at around 3 PM and it was okay if I went home less than 24 hours later? This is the face he was looking at as he said this (I took this at approximately 9 AM, after breakfast and had washed the dried blood off of my lips):

I was probably a little more terse than necessary when I explained that, #1), I had not slept the night before and felt exhausted and #2), I had yet to have had a follow-up visit with the surgeon regarding my surgery and prognosis. The only “treatment” I had gotten since the surgery was 3 tablets of Tylenol and I didn’t think it was appropriate for me to leave at that time.

He didn’t say much, just made a notation on his paper and left.

For my own sanity, after the lame visit at the oral surgeon’s office (which was on a Thursday afternoon), I decided to put the whole broken jaw issue aside and start again fresh the following Monday. I’ve learned that the worst days to make phone calls to any kind of business are Mondays and Fridays. So, in actuality, I waited until the following Tuesday.

Armed with the paper about the OMS division from the oral surgeon’s office, I called the centralized office. I was glad that it was a centralized phone number because I wasn’t at all certain which would be the location that was closest to me. I got a voice mail and left my name and telephone number. I did not hear back from them that day, even though I had called around 10 AM in the morning. I called again the next day, and the call was answered by a live voice. I explained why I was calling and that I needed to schedule an appointment at the closest facility.

The female, though not actually rude, was a bit terse as she told me that wasn’t how it worked. She informed me that I had to go to the emergency room of one of the St. Luke’s hospitals, that they would be able to take care of the issue of the dislocation, and it would be up to them to determine if I needed treatment from the OMS. Well, gee! She made me feel like I should have known how the system worked. I asked her which of the four listed hospitals I should go to, and she said I could go to any of the St. Luke’s hospital’s emergency room. This was the first piece of good news I’d gotten, since there is one very close to where I live that was only built 2 or 3 years ago. I’d been inside once to visit someone, and I liked the atmosphere and brightness, as well as the somewhat spacious private rooms (in 1987, when I was in-patient the last time, I shared a room with another patient). And again, I didn’t rush about getting there. I’d scheduled some other appointments that I wanted to get out of the way first, including a hip and spine scan and an eye appointment. I chose to wait, as both of those were late on a Friday morning, and head to the hospital’s ER afterwards.

On the Friday that I’d planned for all of these ‘errands’ (October 21st), I made the spontaneous decision to get another COVID booster, since my previous one was back in February. Some little voice inside my brain was telling me that I didn’t want to go into any hospital where there were sick people without being current on the booster. So, I did that first. By the time I got out of my second appointment (good news, no real changes in my eyesight from a year ago!) and drove to the hospital, it was around 1 PM. I registered, then sat in the waiting room for 45-50 minutes before being led back to an exam room. The person who took me to the room told me that a PA (physician’s assistant) would see me first to collect information and then a doctor would come in. It was almost 10 minutes before the PA came in. (For those of you who remember the TV show Doogie Howser, MD, that’s how young he seemed!) I explained everything that had happened to date, from the x-rays to the oral surgeon’s office that wouldn’t treat me to calling the OMS division and being told I had to go through the emergency room, and therefore, that’s why I was there. I gave him the copy of the x-ray I’d had taken at the oral surgeons’ office, and because of the St. Luke network, I knew he could see the original x-rays that had been taken. He left the room after telling me he’d be right back.

This is where the story gets really frightening. I hear a female voice in the hall – not shouting but certainly not whispering – saying, and I quote directly, “Is that a jaw or a pelvis?” I assume the PA said (in a much quieter voice) that it was a jaw. This same voice, at the same level of sound, then said, “Send the patient to an oral surgeon”. I didn’t hear anything after that from her, though I suspect the PA told her that I’d already been to one, who sent me to OMS who told me I had to go through the ER.

The PA came back into the room a short time later and told me that the hospital there was not equipped for the kind of surgery I’d need and that the only hospital who could do that surgery was in Bethlehem (one of the four hospitals on the list). Meanwhile, this hospital wanted to get an IV started and give me a liquid dose of an antibiotic, and then I would leave there and was to go directly to the Bethlehem hospital’s ER.

I said, “No.” I told him that, first off, I wasn’t willing to have an IV to give me a liquid dose of an antibiotic that I could easily take orally. I also told him that I wasn’t able nor willing to leave there and go directly to this other hospital. In my mind, I had several reasons. First, I had no idea where it was but knew that it was far enough away that I would be getting there after sunset, and that made me uncomfortable. Second, I was not given any hint that I would be expected to travel directly to another hospital from there, and I was unprepared for any overnight kind of stay. I also alluded to the idea that, since I would be arriving there who knows how long after 5 PM on a Friday (having to drive to an unknown location during rush hour traffic, on a Friday, no less!), chances are that I would be admitted but not have surgery until the next day, causing an extra day’s stay that my insurance might decline to cover. I was willing to go the next day, but not that evening. Someone did come in and give me an antibiotic in pill form and told me a prescription would be waiting for me to pick up at my pharmacy (I don’t know, either, why they were giving me an antibiotic regimen without having done any kind of treatment but no big deal in the scheme of things).

I was told that was fine, but that they would have to discharge me, and I’d have to re-enter the system at the Bethlehem hospital when I got there. Only after getting into my car and looking at the paperwork did I see that, according to the hospital, I was being released AMA (against medical advice). What the_____?? Nonetheless, I was tired and frustrated and just wanted to pick up the filled prescription and go home.

(Side note: As is always the case, when I got to the drive-through to get the prescription, I was told it wasn’t ready and it would be about 20 minutes. That has happened to me with every prescription I’ve had sent there – I use mail-order for my regular prescriptions – and it’s always 20 minutes wait time to pick up a prescription no matter how long its been since it was sent!)

I dilly-dallied around and then returned to the window, picked up the prescription, and happily went home. I was mentally, emotionally and physically exhausted to the point that I ate a bowl of cereal, my only meal of the day. I started trying to pull things together for an overnight bag, but I just didn’t have it in me. I sat down in my recliner and thought about everything that had happened and everything that was waiting to happen. I ended up talking myself into waiting until Monday to go to the Bethlehem hospital. To me, it didn’t make a difference, but I convinced myself that the staff would appreciate not having to deal with a “non-emergency” patient on a weekend since weekends are always busier for the ER units.

I spend Saturday and Sunday over-thinking, and therefore over-packing, an overnight bag. I made sure all of my emails were caught up and I didn’t have any bills to pay, watered my plant, and all of those little things so that once I left on Monday morning, I didn’t have those things on my mind.