The summer of jigsaw puzzles, Obamacare and a “new” nose
[I’m taking the plunge to write about the accident so this will come in spurts]
The summer after the accident was the summer of Obamacare and I spent countless hours doing jigsaw puzzles and listening to public radio. I was grateful to be on the healed side of the equation and not fighting insurance companies while also fighting a disease like cancer.
I had a lawsuit and a lawyer so I knew down the line I wouldn’t be bankrupted but I was impacted by insurance issues on a few occasions. I’m from Australia where we have universal healthcare. I would have left the hospital and left rehab probably without any bills mounting up. A few years after the accident I was back in Australia and I needed some work done on my eye. It was under elective surgery but was covered by private health care, at least some of it was. I got an infection from this surgery so I had to go back into the hospital. I initially went to the private hospital where I’d had the surgery done but was told I would be better off in the public hospital (treating the infection being a non-elective procedure). I had the exact same doctors, I was in a large room with four beds (I didn’t really need a private room), and the four hours of IV antibiotics I needed each day wasn’t going to cost anything. I was about a week in the public hospital and I walked out owing nothing and having paid nothing.
Six months after the first facial reconstructive surgery I needed another one. I was told that because my oral and maxillofacial surgeon was “out of network” my health insurer (through my job) wasn’t going to cover the costs. This is a surgeon who was there when I was admitted to the hospital, who was there when I had the first CT scan, who spent who knows how many hours planning the 12 hour surgery I underwent. This doctor was at my bedside in the ICU when my parents arrived. He was there with the OMFS chief resident and both of them assured my parents that there was no brain damage and no spinal cord damage and that they could fix everything else.
Before the planned second surgery I went to get an MRI of my right knee where there was chronic swelling. I had a document from Bellevue that I thought meant I could pay $350 and have it done. That was still a lot but Bellevue is public and private insurance doesn’t work there. I had to meet with Jonathan who was the financial person. He told me that because I had private insurance I couldn’t pay the $350. I said I’d pay whatever was needed and he said it would be $10,000. I probably started crying at this time. Jonathan told me I needed to go back to Brooklyn to my Primary Care Physician to get a referral to an imaging service in Brooklyn. This was about a week before the surgery was scheduled to take place. I couldn’t see past the fact that the doctors and nurses at Bellevue saved my life and I wanted the scan to be done there. Jonathan is forever in the column of those who helped me out. He could have ended it on that’s that and you have to go back to Brooklyn. Instead he went into the computer and put in my wage, which was pretty low as a preschool teacher, and somehow he was able to put me through the system, ignoring my private health insurance and I could pay the $350 (or less, I can’t remember) and have the scan done there at Bellevue. I was grateful for the effort Jonathan took with me and it was reassuring to know someone with his mindset was in the role of billing manager.
Back to the second facial reconstructive surgery. My OMFS surgeon was “out-of-network” so the cost of the surgery with him would be all out of pocket and it would be astronomical unless we had a work around. So a week before the surgery I started taking Lovenox instead of Coumadin as a blood thinner because I needed thicker blood for the surgery. You inject yourself with Lovenox. Sometimes people take it before flying and I did that for a while. Two days before the scheduled surgery I went to the emergency room at Tisch (the private hospital linked to Bellevue) and said that I was worried about an implant and that my surgeon said to come in. I would never want to lie to a nurse but I had to in order to be admitted. I was admitted through the emergency room and then two days later I had a second facial reconstructive surgery that I think was about 6–7 hours long.
When I was in rehab I did all sorts of internet searches and the more I learned about what had happened the more I looked up. Somehow I got a hold of some of the surgical reports and I looked up Le Fort fractures. I had a couple of those but I can’t remember the numbers off hand. I also had a naso-orbitoethmoid fractures that affect the eye sockets, the nose and the sinuses. With NOE fractures even the most experienced surgeon can have trouble repairing this fracture and if they don’t get it right the first time there aren’t any modifications you can make at a later date. My plastic surgeon commented on how well the work was done on my face before he came on in the second facial reconstructive one.
The second reconstructive surgery was to take bone from my skull to give me a nose. There were other things done as well. I had scars revised and I had the staples taken out of my sternum. I don’t remember what else but I had a second coronal incision done. This is what they do for face lifts. They cut from one ear to the other across the top of the head. They needed to do this to harvest the bone for my nose and there might have been other reasons they did it then. They seal the incision mostly with staples. It’s a very strange feeling that comes back to me in an out-of-body way. As a school teacher I had used staple guns to put art work up on the wall and similar displays. I don’t like to think of a similar tool being used on me but the chances are high.
more to write at a later date….
