So far the days in the hospital were tolerable, but the nights were near unbearable with pain. My blood pressure was more stable and the nurses were able to give me more pain meds, but it would take them several visits to get enough in me to allow me to sleep. Each morning I would wake up feeling great and do really well all day long until the sun went down.
The food was amazing and the nurses were all so good. I only had one nurse that seemed to doubt my pain. I am not sure why. Maybe it was because I tend to joke a lot and I always smile and laugh a lot when I am in pain. Possibly she expected me to be like the other ankle patients my first nurse was telling me about. Well this particular nurse got her wish on her shift, because that night I had to call her several times to get a hold of the pain.
On Saturday the PA came in and took my drain tube out and told me that PT would be in before to long to change my compression wrap. She told me that I would more than likely have some increased pain with this new wrap, but it would only be temporary. Before leaving she told me she would be back later in the afternoon to remove my popliteal block.
Sure enough PT showed up and gave me some new bandages, which actually felt really good to have the increased compression. I was hoping that this meant the warning the PA gave me would not be nearly as bad as she expressed. Later in the afternoon she came back and I was still doing fine with the wrap. She took out the block and told me that it probably had worn off, but I may have a little more pain now with it gone. But once again an hour passed and I was still doing really well.
The sun started to go down and this prickly tingling feeling started to creep into the top, bottom, and outer edge of my foot. Up until now I hadn't felt a thing on those parts of my foot. All the pain I felt had been a deep ache and the stabbing feeling in the medial malleoli. Now this new pain was progressively getting worse and worse. I still had an hour before my next pain meds and as the pain increased I watched the clock more and more. The time came for more meds, but the nurse did not come in. Five minutes passed, ten minutes passed, then fifteen...I finally called.
The nurse came in and I told her about the pain getting so much worse. She gave me the mild pain killer and said that if it was still bad in 30minutes to call her for more. For the next 4 hours I called her every half hour for more. The pain this time around was the worst yet. She gave me everything she could and finally it was enough to put me to sleep.
Once again I woke up just fine and this day was exciting, because I was going home today.
Sunday, December 15, 2013
3 day all-inclusive vaca
After spending some time on Facebook and texting everyone with all my post-surgery good news, I started to get sleepy. Pain wasn't to much of a problem and the nurses were in and out with both oral and IV pain and other meds. They were checking my vitals frequently and everything was looking good, but my blood pressure was low and getting lower with each check. The nurses seemed to be getting concerned and told me they would have to scale back on pain meds a bit to stop my blood pressure from dropping any more. I tried to get some sleep, but with them coming in every half hour and the pain creeping up on me, sleep wasn't happening to well. The nurse's aid emptied my drain tube and the container was near full and had more than a pint of blood in it. She looked at me with a raised eyebrow and said "That is a lot. That's not good." She emptied my catheter bag too, which was also full. That helped to explain why my blood pressure was so low. The nurse also increased my IV drip to give me more fluids and I tried to keep drinking my ice water. I know that being in bed for an entire day to this point, the blood loss, and the pain meds all make blood pressure drop. So I kept telling myself not to worry and that once I got more fluids, some sleep, and a good breakfast in the morning, my blood pressure will be good as gold again.
The nurses were getting ready to change shifts and my main nurse came in to see me before leaving. She turned to me and said "I just have to tell you, you have been the most gracious and polite ankle patient I have seen. This kind of surgery is really painful and most patients are just miserable with the pain and most often make everyone around them miserable too. But you have been handling it so well." I was so touched and thanked her. I also explained to her that at this point it did not hurt to bad and that I think I just got plenty of practice with ankle pain over the past 12 years. My brain is nice enough to shut it off for the most part. She was so nice and that was the last I got to see of her for my stay.
Finally I was able to sleep a bit and as the sun started to come up the new nurse brought me in a new menu with real food listed in it. The menu was like one you would see in a restaurant with a huge selection of all kinds of foods. I narrowed in on the breakfast section and planned out my much anticipated meal. They call the meals "room service" and you have to call in your order for any meal between the hours of 6:30am to 7:30pm. As soon as the clock turned to the six and half hour in the AM I was dialing the number to get my grub. The lady taking my order said it would arrive in 45minutes or less. This would have been a good time to get more sleep, but I was to excited to get food and coffee that sleep was the last thing on my mind. So I turned on the morning news and found out that Nelson Mandela had died the day before.
The news coverage of Nelson Mandela's death kept me preoccupied until my food arrived. Once I lifted the cover to see all the breakfast I was allowed to have, I felt like I was in breakfast heaven. The coffee was good and strong, and they had real sugar and creamer. The lady forgot the syrup for my pancakes, but I did not care, I ate them delightfully dry. After eating, I started to feel so much better and more energetic. Sure enough, my blood pressure started to improve after getting some food and caffeine in my system. The numbers were still low, but they were getting higher rather than lower. The lowest it got the night before was 85/40 and was lingering around 90/50 or better for most of the day.
With more desire to keep myself entertained, I was moving around in bed more to reach things here and there. The more I moved the more I noticed pain in my ankle, which was propped up on a foam wedge that was about a 45 degree angle. The wedge was only just slightly wider than my leg, so it was a balancing act to keep it up there when reaching around to my side tables. My professional mind thought, this is great for my core! :) One nurse told me she was amazed at how I stayed upright on that things so well. She said just about every other patient had trouble and had to use a bunch of pillows to keep it propped upright. That explained why there were two stacks of pillows in each end of the room. Somehow I managed to keep it up there, even in my sleep.
Throughout the day I was able to nap here and there, and the nurses were giving me slightly more pain meds. But as the night wore on and my popliteal (nerve) block was working less to control the pain, I was starting to suffer more. The nurses were still trying to be very conservative with my pain meds due to my hypotension (low BP).
When it came time to sleep, the pain was getting more intense and interfering with dozing off. I was starting to feel a bit exhausted too with not sleeping well for 3 nights in a row now. The first night was Tuesday night as my last night at home, the anxiety and surprise of getting to have the surgery after all, then trying to think through everything to be sure I had all I needed where I needed it. The second night, Wednesday night, was in the hotel, where I was extremely nervous and in a strange bed. Then last night being woken every half hour for a vitals check. The three sleepless nights were starting to take their toll on me.
The nurses were getting ready to change shifts and my main nurse came in to see me before leaving. She turned to me and said "I just have to tell you, you have been the most gracious and polite ankle patient I have seen. This kind of surgery is really painful and most patients are just miserable with the pain and most often make everyone around them miserable too. But you have been handling it so well." I was so touched and thanked her. I also explained to her that at this point it did not hurt to bad and that I think I just got plenty of practice with ankle pain over the past 12 years. My brain is nice enough to shut it off for the most part. She was so nice and that was the last I got to see of her for my stay.
Finally I was able to sleep a bit and as the sun started to come up the new nurse brought me in a new menu with real food listed in it. The menu was like one you would see in a restaurant with a huge selection of all kinds of foods. I narrowed in on the breakfast section and planned out my much anticipated meal. They call the meals "room service" and you have to call in your order for any meal between the hours of 6:30am to 7:30pm. As soon as the clock turned to the six and half hour in the AM I was dialing the number to get my grub. The lady taking my order said it would arrive in 45minutes or less. This would have been a good time to get more sleep, but I was to excited to get food and coffee that sleep was the last thing on my mind. So I turned on the morning news and found out that Nelson Mandela had died the day before.
The news coverage of Nelson Mandela's death kept me preoccupied until my food arrived. Once I lifted the cover to see all the breakfast I was allowed to have, I felt like I was in breakfast heaven. The coffee was good and strong, and they had real sugar and creamer. The lady forgot the syrup for my pancakes, but I did not care, I ate them delightfully dry. After eating, I started to feel so much better and more energetic. Sure enough, my blood pressure started to improve after getting some food and caffeine in my system. The numbers were still low, but they were getting higher rather than lower. The lowest it got the night before was 85/40 and was lingering around 90/50 or better for most of the day.
With more desire to keep myself entertained, I was moving around in bed more to reach things here and there. The more I moved the more I noticed pain in my ankle, which was propped up on a foam wedge that was about a 45 degree angle. The wedge was only just slightly wider than my leg, so it was a balancing act to keep it up there when reaching around to my side tables. My professional mind thought, this is great for my core! :) One nurse told me she was amazed at how I stayed upright on that things so well. She said just about every other patient had trouble and had to use a bunch of pillows to keep it propped upright. That explained why there were two stacks of pillows in each end of the room. Somehow I managed to keep it up there, even in my sleep.
Throughout the day I was able to nap here and there, and the nurses were giving me slightly more pain meds. But as the night wore on and my popliteal (nerve) block was working less to control the pain, I was starting to suffer more. The nurses were still trying to be very conservative with my pain meds due to my hypotension (low BP).
When it came time to sleep, the pain was getting more intense and interfering with dozing off. I was starting to feel a bit exhausted too with not sleeping well for 3 nights in a row now. The first night was Tuesday night as my last night at home, the anxiety and surprise of getting to have the surgery after all, then trying to think through everything to be sure I had all I needed where I needed it. The second night, Wednesday night, was in the hotel, where I was extremely nervous and in a strange bed. Then last night being woken every half hour for a vitals check. The three sleepless nights were starting to take their toll on me.
Surgery is a success!
Waking up from surgery is always a weird thing for me. I always seem to have very vivid dreams under anesthesia and this time in my dreaming I was working at writing a progress note for a (fictional) stroke victim and it seemed very real. So when Eric was talking to me, I am not sure what I was saying to him at first, but being a surgical recovery nurse, I am sure he gets all kinds of crazy conversation. He was super nice and we chatted quite a bit. Only thing I remember physically is how wonderfully warm I felt under the heated blankets, but it felt like I had a knife jabbed and stuck deep in my right medial malleoli, commonly known as the right inside ankle bone. As coherent as I was, the reality of my brand new ankle was still drowned out by the grogginess of the anesthesia.
As Eric and I chatted, I was watching the screen with my vitals and listening to all the other voices I could hear, taking in all that was going on around me. I heard my doctors voice in the distance and lifted my head a bit. Eric noticed and smiled saying "Yep that's your doctor. He'll be over to see you in a minute." Soon he was, and he asked how I felt, then told me everything went really well, and with excitement asked if I wanted to see pictures of my new ankle. He pulled the x-rays out of his back pack and showed me one in dorsiflexion and one in plantar flexion and said with even more enthusiasm "Look at all that ROM!" Then he told me he would be leaving for LA in the morning to teach a course, but would be back on Sunday and his PA's would be around to check on me until then. He left and I drifted in and out of sleepiness until it was time for me to move to my hospital room.
The ride to my room didn't seem like it took very long at all and as I rounded the last corner I could see Donavan and my folks sitting in chairs waiting for me. The nurses got me all settled in the room and then my family came in to see me. They were happy I was doing so well and that the surgery was a success. They had a long 2-4 hour ride home and it was dark out, so they gave me their love and headed home.
After they left I thought I would drift off to sleep, but I wasn't even tired, however I was extremely hungry and thirsty. The nurse came in and I asked when I would get to eat and she told me only liquids tonight and if I do okay, then regular diet tomorrow morning. She gave me a menu with all liquids, but the large selection of broth just did not sound good, so I went with a diet lemon-lime soda and some Cherry Italian Ice. Also by my bed was a glass of ice water and that was probably the best water I have had in years. My phone and tablet were close by, so I got on them to update the rest of the circle of my family and friends on how well it all went.
As Eric and I chatted, I was watching the screen with my vitals and listening to all the other voices I could hear, taking in all that was going on around me. I heard my doctors voice in the distance and lifted my head a bit. Eric noticed and smiled saying "Yep that's your doctor. He'll be over to see you in a minute." Soon he was, and he asked how I felt, then told me everything went really well, and with excitement asked if I wanted to see pictures of my new ankle. He pulled the x-rays out of his back pack and showed me one in dorsiflexion and one in plantar flexion and said with even more enthusiasm "Look at all that ROM!" Then he told me he would be leaving for LA in the morning to teach a course, but would be back on Sunday and his PA's would be around to check on me until then. He left and I drifted in and out of sleepiness until it was time for me to move to my hospital room.
The ride to my room didn't seem like it took very long at all and as I rounded the last corner I could see Donavan and my folks sitting in chairs waiting for me. The nurses got me all settled in the room and then my family came in to see me. They were happy I was doing so well and that the surgery was a success. They had a long 2-4 hour ride home and it was dark out, so they gave me their love and headed home.
After they left I thought I would drift off to sleep, but I wasn't even tired, however I was extremely hungry and thirsty. The nurse came in and I asked when I would get to eat and she told me only liquids tonight and if I do okay, then regular diet tomorrow morning. She gave me a menu with all liquids, but the large selection of broth just did not sound good, so I went with a diet lemon-lime soda and some Cherry Italian Ice. Also by my bed was a glass of ice water and that was probably the best water I have had in years. My phone and tablet were close by, so I got on them to update the rest of the circle of my family and friends on how well it all went.
Thursday, December 12, 2013
Surgery back on as scheduled
After hearing the news that I would be back to having surgery on Thursday December 5th, 2013, I was in a mad rush to get everything back in order and ready to go. The amount of details that need attention is really quite amazing. Things you would not normally think of like, where your toothbrush is located or where your comfortable after surgery kind of clothes are and if you will be able to get to them are all factors in the whole scheme of convenience post surgery. From previous experience, I know how having everything within reaching distance is important. Having a caretaker who can do everything for you is great, but in reality the more you can do for yourself the better off you both are. I am not very good at being a dependent person, so I like to plan ahead and have all the things I need ready so that I feel more in control of my own recovery.
So the day before surgery we drove up to Glenview and stayed at the Wyndham hotel, which was very nice. The hotel had a 50% discount for patients, so we were in very nice suites for a really good rate. The morning of surgery we went to the hospital and I was 2nd in line for surgery, which meant I would be waiting a bit in the preparation area before my time came, with no food or water (UGH!). The nurses went over all the details and put in my IV, gave me some pre-surgical medications, and swabbed my leg with the lovely orange antiseptic. They decided to do a popliteal block and so I was taken back a half hour early to have that placed. I don't remember much after that because I am sure they gave me some sedatives. I do remember going into the operating room and seeing Dr Haddad all prepped and looking at a laptop viewing my ankle CT scans. He looked over at me and gave a little hello wave, then the anesthesiologist said "OK Angela, have a good rest and we will take really good care of you." Then I was out like a light.
So the day before surgery we drove up to Glenview and stayed at the Wyndham hotel, which was very nice. The hotel had a 50% discount for patients, so we were in very nice suites for a really good rate. The morning of surgery we went to the hospital and I was 2nd in line for surgery, which meant I would be waiting a bit in the preparation area before my time came, with no food or water (UGH!). The nurses went over all the details and put in my IV, gave me some pre-surgical medications, and swabbed my leg with the lovely orange antiseptic. They decided to do a popliteal block and so I was taken back a half hour early to have that placed. I don't remember much after that because I am sure they gave me some sedatives. I do remember going into the operating room and seeing Dr Haddad all prepped and looking at a laptop viewing my ankle CT scans. He looked over at me and gave a little hello wave, then the anesthesiologist said "OK Angela, have a good rest and we will take really good care of you." Then I was out like a light.
Tuesday, December 10, 2013
My HERO saves the day!
After spending Thanksgiving and the following weekend depressed and deeply concerned for what I would have to do to continue to last on this ankle, Monday morning finally came and my phone finally rang. I was driving to work, watching the clock contemplating the time all the key people in the process to do this appeal would be in their respective offices tending to my situation.
My phone rang and it was my work office wanting to divert me to another clinic to fill in for the day. The clinic was an extra 45 minutes away, so that gave me more time on the road, which was good for me to clear my head more before seeing patients. As I got closer and closer to the clinic I watched the time inch closer and closer to the possibility of more news. My gas gauge was blinking at me on empty and I still had 10 miles to go, so I had to stop for gas. After filling up, I got back in my car to head further on down the road, my phone rang again and this time it was my doctors office. This call was from the billing gal and she asked if I could contact my insurance company for the information my doctor would need to send the insurance company a request for a "Peer to peer appeal". This appeal is where my doctor is given the opportunity to consult with a doctor staffed by the insurance company to review procedures and determine medical necessity when the parameters are outside standard procedure. She told me this was his only day in the office to get this done and we needed to get all the necessary information quickly to take care of it in time. I immediately called the insurance company and spoke to a representative who worked diligently to find the number my doctor could call and have the process expedited via telecommunications rather than by mail. My anxiety was through the roof and the small spark of hope buried deep down came alive. I relayed the information back to my doctors office and played the waiting game again.
About two hours later the doctors office billing gal called again to say they could not get through to anyone with the numbers I gave her. My heart sank, I had no solution for her, she said they would just keep trying. I continued to work with my phone attached to my hip, waiting, and waiting, and waiting for another call. Nothing by lunchtime, nothing by 1pm, nothing by 2pm, nothing by 3pm. At 3pm I finally had some time between patients and decided to make the call myself. I rang through to the billing gals voicemail, so I called the doctors administrative assistant next, who very plain and matter of factly said "let me see, I did get an email from Dr. Haddad earlier that you were approved." That was it. I was stunned and said "I am...are you sure?" she replied with "if you want Barb (billing gal) to confirm it I can transfer you." I told her no, that I just called and she did not answer. I was numb once again.
Over the weekend I had resigned myself to not having surgery and stopped all planning and now, in less than 3 days I was going to have the surgery after all. As my mind ran a million miles a minute for about ten minutes I finally switched in to "get er done" mode. I had to kick the plans back in gear and get all the necessary details back on track for surgery as previously scheduled. But for sanity sake, I called the insurance company to double check and be sure they were registering the approval now also, and sure enough the girl on the phone gave me the details "I see that Dr. Haddad called in at 12:45pm and the appeal was approved at 1pm."
I have the best doctor ever. He is truly my hero!
My phone rang and it was my work office wanting to divert me to another clinic to fill in for the day. The clinic was an extra 45 minutes away, so that gave me more time on the road, which was good for me to clear my head more before seeing patients. As I got closer and closer to the clinic I watched the time inch closer and closer to the possibility of more news. My gas gauge was blinking at me on empty and I still had 10 miles to go, so I had to stop for gas. After filling up, I got back in my car to head further on down the road, my phone rang again and this time it was my doctors office. This call was from the billing gal and she asked if I could contact my insurance company for the information my doctor would need to send the insurance company a request for a "Peer to peer appeal". This appeal is where my doctor is given the opportunity to consult with a doctor staffed by the insurance company to review procedures and determine medical necessity when the parameters are outside standard procedure. She told me this was his only day in the office to get this done and we needed to get all the necessary information quickly to take care of it in time. I immediately called the insurance company and spoke to a representative who worked diligently to find the number my doctor could call and have the process expedited via telecommunications rather than by mail. My anxiety was through the roof and the small spark of hope buried deep down came alive. I relayed the information back to my doctors office and played the waiting game again.
About two hours later the doctors office billing gal called again to say they could not get through to anyone with the numbers I gave her. My heart sank, I had no solution for her, she said they would just keep trying. I continued to work with my phone attached to my hip, waiting, and waiting, and waiting for another call. Nothing by lunchtime, nothing by 1pm, nothing by 2pm, nothing by 3pm. At 3pm I finally had some time between patients and decided to make the call myself. I rang through to the billing gals voicemail, so I called the doctors administrative assistant next, who very plain and matter of factly said "let me see, I did get an email from Dr. Haddad earlier that you were approved." That was it. I was stunned and said "I am...are you sure?" she replied with "if you want Barb (billing gal) to confirm it I can transfer you." I told her no, that I just called and she did not answer. I was numb once again.
Over the weekend I had resigned myself to not having surgery and stopped all planning and now, in less than 3 days I was going to have the surgery after all. As my mind ran a million miles a minute for about ten minutes I finally switched in to "get er done" mode. I had to kick the plans back in gear and get all the necessary details back on track for surgery as previously scheduled. But for sanity sake, I called the insurance company to double check and be sure they were registering the approval now also, and sure enough the girl on the phone gave me the details "I see that Dr. Haddad called in at 12:45pm and the appeal was approved at 1pm."
I have the best doctor ever. He is truly my hero!
Next Chapter - bump in the road
Since I last wrote I was just getting to the stage of planning all the appointments and final details for the operation. I had received the surgery packet and was sorting through the string of events to schedule to get done before the big day. There were a lot of tests to have done and that was a challenge trying to get them all scheduled without missing to much work in the process. With the recovery period being 3 months long and not being able to work in all that time, I needed every hour on the clock and to save as many pennies that I could to keep my bills paid and my bank account in the black for the duration of the recovery.
There ended up being some time conflicts with some of my tests and I had to take off more work than I wanted too, but the tests got done and that is what matters. Those last few weeks were becoming very painful. I wore my TENS unit all day and still had a lot of trouble with pain. My general doctor gave me some pain pills and anxiety medication to get me through the last couple of weeks and that was helpful, but I did not like the foggy feeling it gave me. At this point I think if I put off the surgery any further I would be in real trouble and walking or being on my feet would be very limited.
The time was getting closer and the last thing I needed to get done was ordering my knee walker. One day at lunch I went to the medical supply store to check out what they had and get one lined up. The lady was helpful and took all my information to get it setup, but recommended I call my insurance company to see if it would be covered and how much the copay would be. After leaving the store I got on the phone with my insurance company and after discussing the details of my durable medical supply coverage the girl wanted to check and make sure I was all pre-certified for my hospital stay too. She then sounded concerned and said that my approval for some things was still in pending and that I might want to see what the hold up was for. She ended up putting me on hold and was intending to transfer me to another agent for that department, but came back to tell me that I needed to call my doctor's office because there was some trouble with the codes and the doctor needed to address the issue or I was going to be denied. I called the doctor's office immediately after this and was transferred to the billing gal who told me she had submitted all that the insurance company had wanted and she would contact them again to be sure, then call me if there were any problems. Needless to say, I was a bit overwhelmed at the prospect that after all the preparations to this point that I may not be approved for this surgery and there were only a handful of days to get there, with Thanksgiving being one of them. Later that afternoon the billing lady called me back and told me that I was in fact denied for the surgery. She said she would inform the doctor's administrative assistant and next step would be to do an appeal. She told me I needed to get started on my own personal appeal letter to go along with the doctor's office paperwork to be submitted to the insurance company. My heart sank upon hanging up from that call. I was stunned and still had to go back to treat my patients for the remainder of the afternoon. I was numb just holding it all in for the last couple hours of work. When I got in my car the flood gates broke and all the way home I was in tears. This was one of the most overwhelming let downs I have ever experienced. I went home and went straight to bed and got on my computer to vent to all my friends and cry my heart out. While on the computer I started to write my letter and googled information on how the insurance works in situations like this and how this could have happened. I got all my ducks in a row and pulled myself together for the next day. I called the insurance company again and got more information and then called the doctors office and left a voicemail with the information I had from the insurance company. I followed up the voicemail with a fax to the doctor's office restating all the details that I had learned. My phone was silent all day Wednesday, then Thursday was Thanksgiving, and then still silent all day Friday. At this point I was completely discouraged and had resigned myself to the fact that this was not going to happen, at least not on December 5th, there just was not enough time to get an appeal done.
There ended up being some time conflicts with some of my tests and I had to take off more work than I wanted too, but the tests got done and that is what matters. Those last few weeks were becoming very painful. I wore my TENS unit all day and still had a lot of trouble with pain. My general doctor gave me some pain pills and anxiety medication to get me through the last couple of weeks and that was helpful, but I did not like the foggy feeling it gave me. At this point I think if I put off the surgery any further I would be in real trouble and walking or being on my feet would be very limited.
The time was getting closer and the last thing I needed to get done was ordering my knee walker. One day at lunch I went to the medical supply store to check out what they had and get one lined up. The lady was helpful and took all my information to get it setup, but recommended I call my insurance company to see if it would be covered and how much the copay would be. After leaving the store I got on the phone with my insurance company and after discussing the details of my durable medical supply coverage the girl wanted to check and make sure I was all pre-certified for my hospital stay too. She then sounded concerned and said that my approval for some things was still in pending and that I might want to see what the hold up was for. She ended up putting me on hold and was intending to transfer me to another agent for that department, but came back to tell me that I needed to call my doctor's office because there was some trouble with the codes and the doctor needed to address the issue or I was going to be denied. I called the doctor's office immediately after this and was transferred to the billing gal who told me she had submitted all that the insurance company had wanted and she would contact them again to be sure, then call me if there were any problems. Needless to say, I was a bit overwhelmed at the prospect that after all the preparations to this point that I may not be approved for this surgery and there were only a handful of days to get there, with Thanksgiving being one of them. Later that afternoon the billing lady called me back and told me that I was in fact denied for the surgery. She said she would inform the doctor's administrative assistant and next step would be to do an appeal. She told me I needed to get started on my own personal appeal letter to go along with the doctor's office paperwork to be submitted to the insurance company. My heart sank upon hanging up from that call. I was stunned and still had to go back to treat my patients for the remainder of the afternoon. I was numb just holding it all in for the last couple hours of work. When I got in my car the flood gates broke and all the way home I was in tears. This was one of the most overwhelming let downs I have ever experienced. I went home and went straight to bed and got on my computer to vent to all my friends and cry my heart out. While on the computer I started to write my letter and googled information on how the insurance works in situations like this and how this could have happened. I got all my ducks in a row and pulled myself together for the next day. I called the insurance company again and got more information and then called the doctors office and left a voicemail with the information I had from the insurance company. I followed up the voicemail with a fax to the doctor's office restating all the details that I had learned. My phone was silent all day Wednesday, then Thursday was Thanksgiving, and then still silent all day Friday. At this point I was completely discouraged and had resigned myself to the fact that this was not going to happen, at least not on December 5th, there just was not enough time to get an appeal done.
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