MENISCUS SCHMENISCUS

I’m sitting on my screen porch in a semi-stupor. Spell and grammar checker will be well employed today as I write this.

I have had my first surgical experience. I am documenting this now so that I may compare it to whatever the future brings in the coming era of health care reform.

My knee has been giving me increasing trouble and I pursued a diagnosis. My meniscus was breaking down and surgery was advised. I desire to continue with a long life of hiking and biking so getting this repaired in a timely fashion made sense to me. We figured that the longish Memorial Day weekend would allow my recuperation without missing too much work.

That arthroscopic surgery has become so commonplace, with athletes seemingly being scoped one day and back on the playing field the next, I was surprised at all the preliminary falderol that was necessary before the cutting actually took place.

First there’s the exam with the doctor. Then, there’s the MRI, followed by the consultation with the doctor and MRI results. Next came the lab tests, EKG, chest x-ray, and extensive health history forms. All this was followed by a phone interview reviewing the health history data. Finally, one week pre-op was another visit with the doctor’s assistant to answer questions and clear me for the surgery.

I have no complaints at all. All of this was done with the highest of competence. I spent little time in waiting rooms and all prep work went smoothly and efficiently. A tremendous amount of duplication and redundancy exists in medicine these days. I imagine much of it is to avoid human error and abide by risk management protocols. Basically, so things don’t get screwed up and people don’t get sued.

This morning I was asked to show a picture ID at the surgicenter. My imagination took flight, wondering as to the need for ID. Was there concern that I sent a proxy to have the surgery for me? Might someone walk in off the street to steal a meniscectomy in my name? Can you sell a stolen surgical procedure on EBAY? Or, could it be that a brother-in-law, who is uninsured, is actually having the procedure done and billing it to my insurance? Any and all are possibilities.

I was asked to sign the HIPAA privacy agreement, a two page waste of paper never read by anyone and signed to satisfy the bureaucrats. Why doesn’t the EPA sue these people for wasting valuable resources. This form along with the six inch sign affixed to my extension cords warning of the hazards of their use, but not warning of the danger of tripping over the sign qualify as my latest peeve toward an all too large government. But I digress. I signed the privacy form and return the HIPAA statement to the clerk so it could be re-used and ignored by the next patient.

The nursing staff was cheerful and competent. Their jobs are apparently very specialized. One nurse took vitals and started the IV. Another shaved my knee and did a preliminary scrub. I was handed an indelible marker to indicate on my thigh, which knee it was that was to receive the surgery. Both nurses re-iterated the same questions about allergies and stomach contents.

The surgeon popped in to greet me and initialed my knee to affirm which one got done. Finally, the anesthesiologist arrived to explain his special cocktail designed to render me unaware and comfortable during the procedure. He was followed by the scrub nurse and her introduction. Meeting this large cast of characters served to pass the hour and a half that I waited in pre-op similar to the way the snaking lines pass the time at Disney World.

All the nursing staff, auxilliaries, doctors and patients were dressed in color coordinated blue duds topped by blue hairnet/ shower cap things. Unfortunately, only the patients’ garb had the peekaboo back.

The surgeon has one different element of attire. He is wearing boots. I could exaggerate and describe them as hip-boots or waders, but they actually resemble the knee high rubber boots worn by the plumber cleaning out your sump pit. These serve to keep his tootsies dry from the overflow of the irrigating solution used during surgery. The boots added a bit of class to the standard issue uniform of the surgery center.

When my time had come, I was walked past the cells of the other inmates to the …whoa that’s a different story! I was walked to the frigid OR exchanged pleasantries again with the anesthesia guy, got an answer to why it was so cold in here and things went black like the end of the Soprano’s finale.

I awoke to the smile of my concierge nurse, the last in the line of contacts at the center. She gave me post op instructions and a snack and ushered me out of the building.

It is now three hours post-op and I am surprisingly comfortable. The medicine used for anesthesia these days is effective yet mild. I feel competent and alert, though a little unsteady on my feet. The pain has not yet hit me, but I am well prepared if and when it does.

My maiden journey through the current US healthcare system has been a good experience so far. If Blue Cross does its job and pays its fair share, I will say that this is a system that has done me well. I realize that surgical centers are different than hospitals. I also realize that I am not an ill person needing comprehensive care. So, my experience is very limited. It is my hope that our health care professionals receive the financial rewards, respect, and satisfaction in a job well done throughout their careers so that we all can have positive experiences in medical care in the future.