Surgery without friends again

November 17, 2010 2:04 PM

Two weeks ago I asked about having surgery without anyone to accompany me. Based on the advice there and my reading elsewhere I thought I had a solution but it didn't work.

I really appreciated all of the very kind offers for help. But none of them were in my city, so I had to find another solution.

I had spoken to three nurses on three occasions at the hospital before the day of my surgery and each of them told me that the staff there could arrange non-emergency ambulance service to take me home and that it would not be a problem. When I got to the hospital for my surgery, I asked again and was told the same thing.

After I had an IV in and was prepped for surgery, the surgeon showed up and refused to operate without someone to stay with me at home for 48 hours. He had previously mentioned that having someone stay overnight would be helpful but never that it was a requirement of the surgery. Never at any point did he mention anyone stay with me for 48 hours. Nothing about anyone staying with me for any length of time, even as a suggestion, was on any of the papers he gave me telling me what not to eat, what to bring to the hospital, etc.

Before he refused to operate he and the staff were conferring outside and I could overhear them wondering what was wrong with me that I was [age removed for anonymity] and didn't have any friends.

Needless to say, finding someone to stay with me for 48 hours is even less likely than finding someone to give me a ride home. I don't know what to do. This surgery is not necessary to live but it will relieve a chronic condition that I am really tired of living with. But this experience was so humiliating that I'm afraid to try again. Obviously I will not return to this doctor. But what should I do next? Is it even worth trying to find another surgeon, or should I just stop paying for insurance that is no use to me?

Confidential responses can go to [e-mail]

posted by anonymous to Health & Fitness (39 answers total)

Please ask a mod to update this post with the city you are in so that you can get some actual, concrete help this time.
posted by DarlingBri at 2:08 PM on November 17, 2010 [15 favorites]

Well that sounds a little crazy. My hubby just had abdominal surgery, and beyond ensuring that he would have someone drive him home, the hospital didn't give us any requirements regarding post-surgery companionship. So I think what happened to you sucks.

Some thoughts on how to go forward:
-- If you're going to go with another doctor, maybe he/she won't have that 48 hrs. requirement.
-- Did you get any sense that they needed proof that you'd be cared for for 48 hrs? Maybe you can say yes, even if the true answer is no.
-- Do you have any helpers who can participate in this process, even if just for a little bit? Maybe not one person who can handle the 48 hours, but one person who can be there the evening of the surgery, and a different person who can pop in the next day?
-- Do you have any pals/co-workers/teachers/etc who have nannies, babysitters, housekeepers -- any kind of household help? One or more of these people may be a solution, and if they're referred by someone you know you could assume that they will actually follow through.
-- Lastly, I would go with Craigslist. You might find some nanny/babysitter types who would be able to do this job for a reasonable rate. I doubt you will need actual medical attention, so a nurse might be overkill.
posted by BlahLaLa at 2:13 PM on November 17, 2010

The fact that the hospital did not properly prepare you for this situation is unpleasant and the fact that they were unprofessional talking about you behind your back is equally uncool. However, if you want to get this procedure done, I'd just look at this all as your problem to solve. I don't know where you are geographically and I don't know what procedure you need [the fact that this is an anon question means that it might have been helpful to include that information, you can add it via me if you want to]. There were several MeFites who offered assistance if you were in their region and I'd do the same if you are in mine. At some level, you just need to find someone to solve this problem. You need to have a conversation with the surgeon or someone who can speak for the surgeon and I'd suggest

- This is an inconvenience having to reschedule and this experience was unpleasant and entirely unavoidable
- Please let me know everything I will need to know as far as what I will require once I am sent home. [i.e. do you just need someone there in case something happens, or will you need some sort of personal care]
- Speak to your insurance if you have insurance and ask them how this should be dealt with. Obviously if this is a medical requirement then you should have a discussion with them about how a nurse should be covered. People have private nurses tend to them at home all the time. Do YOU need to pay this if the nurse is medically necessary? Unclear.
- Call your local visting nurses program and see what they suggest, you might find someone who can advocate with you with your doctor.

So, again, sucks that people were jerks about this but really I'd move forward straightening this situation out and handling the problem. You not having someone who can stay at your house for two days is not that terribly unusual and if it's medically necessary for this to happen there are medical ways for this to happen. Determining what's just weird prejudice and what are the medical facts of the situation is what needs to happen now.
posted by jessamyn at 2:17 PM on November 17, 2010 [2 favorites]

You need to say where you are.
posted by fire&wings at 2:17 PM on November 17, 2010

But what should I do next? Is it even worth trying to find another surgeon, or should I just stop paying for insurance that is no use to me?

Yes you should find a different surgeon, and yes you should keep your insurance.

The key to your next round is that you need to be very clear with your next surgeon. Explain to him/her exactly what support system you have or don't have around you and what options you have. There are definitely services that the social workers should be able to help you with so that you can be checked on for the first two days out of surgery.

You may also want to go to a different hospital as well. The surgery staff acted unprofessional by discussing whether you had friends or not, and will likely treat you differently (in a bad way) on a return trip.

Get a new doctor, get your treatment, keep your insurance, get better.
posted by Mister Fabulous at 2:20 PM on November 17, 2010 [5 favorites]

You should hire a home health aid. You can hire a skilled or unskilled person to sit with you for two days (and spend the night). There are probably many home health providers in your area. Look here.
posted by Fairchild at 2:22 PM on November 17, 2010 [2 favorites]

Also, do not cancel your insurance and your insurance might cover some cost of the home health aide.

Good luck.
posted by Fairchild at 2:24 PM on November 17, 2010

I think the hospital really mishandled this. And I would suggest you talk to the Patient Advocate or Ombudsman or whoever about how seriously they mishandled this.

Moving forward, the weird shame thing they tried to put on you is weird. I have a lot of friends and a lot of close friends, but many of them live far away and/or have young children and/or have chronic health issues of their own and/or have demanding jobs that they can't really take time off from without a really long window of notice. I am sure that your situation is probably similar, and the people who translated that into "X has no friends, what a freak" were incredibly insensitive and inappropriate.

Okay. Now we've got that out of the way:

a) You can hire home health staff in most areas in the US. It's really easy in major metropolitan areas, and still possible in many rural areas.

b) You can self-pay for a two-day stay at a rehab facility if your insurance won't cover it. Again, not knowing where you are, I will give you an estimate of between $250 and $750 per day, probably most likely to run you $300 to $400.

If you can't find volunteer help, you're looking at paying an extra $500 to $1,000 for 48-hour assistance. That's not small change, especially in these economic times, but it's not second-mortgage territory, so perhaps you can save toward that goal if that's your best bet.
posted by Sidhedevil at 2:24 PM on November 17, 2010 [9 favorites]

And if you look at "this is going to cost me $500 to $1,000" then maybe that opens up other options for you, like paying airfare for a friend who can't afford to travel to help you?
posted by Sidhedevil at 2:26 PM on November 17, 2010

Submit a complaint to the hospital as well. Complain that you were denied service because *the surgeon* did not specify what he would require (despite you attempting to find out and make arrangements), and complain that the staff were audibly gossiping about you. Both of these are unprofessional.

I was going to suggest a health support worker, too, but Fairchild got it already.
posted by galadriel at 2:28 PM on November 17, 2010 [3 favorites]

And if you feel comfortable with this, MeMail me. I have had a lot of experience of navigating health-care options for myself and my family and my friends, and I might be able to suggest more possibilities for you the more I know.

Also, if it's possible for you to travel to Boston to get the surgery, I am volunteering right now to be part of your support team for that 48 hours and I bet there are other MeFites who'd be in. It is not unusual for people to get referrals for surgery to other cities where they have a support network in place.
posted by Sidhedevil at 2:29 PM on November 17, 2010

Mod note: From the OP:

I realize that it makes it more difficult to answer the question without knowing the location or the surgery but including that information would to make me very identifiable to the people from whom I am trying to keep this anonymous.

posted by jessamyn (staff) at 2:29 PM on November 17, 2010

Before he refused to operate he and the staff were conferring outside and I could overhear them wondering what was wrong with me that I was [age removed for anonymity] and didn't have any friends.

Jackasses.

Call your insurance company -- when I bailed out of the hospital early after a c section, because it was that or just start randomly killing the staff, insurance provided a nurse to come in and check in on me, make sure I hadn't developed an infection, etc.

You do not need to tell your life story to the company, or apologize for the circumstance. The circumstances are what they are, and if I didn't Mr. Llama it would be really hard for me to find someone to be with me in that kind of circumstance -- my family lives six hours away and between having them with me after surgery or being in a hospital, it's a tough call. Other people have, you know, jobs and things that keep them from 48 hours of down time.

Also, when someone tells you something, always get their first name, last if you can, and the date and time you called -- it gives weight to the eventual argument about how X told you Y.

Sorry you're going through this; it sounds really frustrating. I agree with the advice to treat this strictly as an operational concern but I understand why it would be hard emotionally, especially when you're sick and vulnerable.

I hate hospitals, too.
posted by A Terrible Llama at 2:30 PM on November 17, 2010 [1 favorite]

Before panicking about how much this is going to cost you, I would call around to some other doctors who do this surgery and try to find out if this 48-hour monitoring thing is a standard requirement for this procedure or just something this one guy likes to do. If you happen to know someone who can recommend a babysitter, that might work for you too (and be relatively cheap).
posted by amethysts at 2:32 PM on November 17, 2010

A trustworthy babysitter, who has a Senior first aid certificate[1] should be enough to look after you, as long as you have the numbers to call in case of medical emergency in a prominent spot that your babysitter knows about, and the address of the ED / taxi fare in case of emergency.

[1] That's the AU term, don't know if it's different in the US? Basically a two day course for laypeople covering CPR, mouth to mouth, staunching bleeding, etc: all childcare workers and teachers must have them.
posted by Hot buttered sockpuppets at 2:51 PM on November 17, 2010

FYI - In Canada, that would be Standard First Aid with CPR-C (or CPR-HCP, if the person is a Health Care Provider).

You might check with local community colleges offering RPN and/or PSW courses - you may be able to hire a student at lower cost (since it seems like, if "any" friend would be okay, you may not need someone who is fully qualified in either of these areas).
posted by purlgurly at 2:56 PM on November 17, 2010

"Before he refused to operate he and the staff were conferring outside and I could overhear them wondering what was wrong with me that I was [age removed for anonymity] and didn't have any friends. Needless to say, finding someone to stay with me for 48 hours is even less likely than finding someone to give me a ride home."

This man is such a giant jackass that he has recently been elected mayor of Jackass Town. (And dude, I have plenty of friends and would be super-hesitant to ask someone to stay with me for 48 hours. Maybe I'm too reticent, because I'd certainly do it for a friend, but that's a big thing to ask!)

Definitely complain to the hospital and everywhere else complainable -- this is terrible that they were unclear on the requirements, and HORRIBLE that the staff was talking that way.

I Nth the call for a home health aide, but if that isn't possible -- another option might be a post-partum doula -- women who come and take care of new mothers for a week or two. For 48 hours they're probably cheaper than a home health aide, and if you don't need specialized care (which it doesn't sound like it), they could probably meet your needs. A couple of my friends doula and they'd certainly do this kind of care -- having it scheduled in advance and having just one patient (no spare baby to take care of!) with fewer needs would be a nice change for them. And most of them are very motherly types, I find them comforting. You can google doulas in your city.
posted by Eyebrows McGee at 2:57 PM on November 17, 2010 [4 favorites]

From the OP:

I realize that it makes it more difficult to answer the question without knowing the location or the surgery but including that information would to make me very identifiable to the people from whom I am trying to keep this anonymous.

I'm in Philadelphia. I'm not sure what you are going through, but memail me if you are in Philly/the surrounding area. I can try to help!
posted by two lights above the sea at 2:58 PM on November 17, 2010

jessamyn: "I realize that it makes it more difficult to answer the question without knowing the location or the surgery but including that information would to make me very identifiable to the people from whom I am trying to keep this anonymous."

Nobody cares in the least about the surgery - your body, your business. But the location really would help. I know you feel like you don't have any friends but you are part of a community of friendly people who would like to help you.

I have enough information to know you're not in Cork, Ireland, but if you were, I'd absolutely come babysit you for 48 hours.
posted by DarlingBri at 3:29 PM on November 17, 2010 [2 favorites]

Home health aides get paid $10 to $15/hour in the areas of the US where I've hired them. Going through an agency, of course, adds some money on top of that, but home health aides don't get paid all that much more than babysitters in my experience.

Again, not to jump ahead to a place where you'll have to solve this problem by applying money, but if it does come to that I thought it might be helpful to give some ballpark estimates of how much money could be involved.
posted by Sidhedevil at 3:37 PM on November 17, 2010

Jessamyn can post the state, and anybody in that state who wants to help can contact Jessamyn, if she's willing. She's usually a good egg about that sort of thing.

The hospital should have
a. A social worker, who can help you locate resources. It's appalling that they did not assist you before you left, which leads me to
b. A patient's rights representative, to whom you complain about the waste of your time, and the insensitivity of the staff who made you feel awful. I'd have to scramble to find someone to care for me for 48 hours. Lots of people have complicated lives, and you deserve better care, better planning, and Respect.
posted by theora55 at 3:43 PM on November 17, 2010 [1 favorite]

I didn't offer in the first post, but if you are anywhere in the southern US, I would do this. Memail me if that works for you.
posted by raisingsand at 3:46 PM on November 17, 2010

"I realize that it makes it more difficult to answer the question without knowing the location or the surgery but including that information would to make me very identifiable to the people from whom I am trying to keep this anonymous."

How about giving a broad geographical area -- country if it's a small country or otherwise a province/state/region. Then people who would be willing to help can post where they are and you can memail anyone close by.
posted by If only I had a penguin... at 3:48 PM on November 17, 2010

DarlingBri and theora55, I don't think OP was saying that the Metafilter community is going to get up in his/her business about the surgery, but instead that there are certain people who might come across these AskMes whom s/he wishes not to know about the surgery. (My understanding is this is part of why s/he doesn't have anyone to accompany him/her to the surgery - s/he wants to keep it very private.)

I think Sidhedevil is right, anonymous, you need to get in touch with the Patient Advocate or Ombudsman at the hospital. Not just because of the garbage the surgeon pulled, but to get access to some non-judgmental assistance with this. Clearly your surgeon isn't going to be of help. It's possible your insurance company will help, but I wouldn't be surprised if they resisted - ultimately, for structural reasons, their job is to limit the cost of your care where possible, and your privacy isn't likely to be a high priority.
posted by gingerest at 3:51 PM on November 17, 2010

The only thing I can offer is DO NOT give up your insurance if you are indeed in the US.

Having any kind of coverage gap can exclude you from coverage later due to loopholes about "pre-existing conditions" and how exactly those are defined. You never, ever want a lapse in insurance if you can help it at all.

Perhaps it would be worth looking for a different plan, if that would help you (certainly look for a different surgeon!), but do not, absolutely DO NOT let your insurance lapse if you want to be able to be covered in the future.

Best of luck to you!
posted by sonika at 4:56 PM on November 17, 2010 [1 favorite]

Also: your need for privacy and your needs for help are, unfortunately, at odds. If you can find a way to give the community information about your location (we certainly don't need to know the type of surgery), the odds are much greater that someone can either personally help you or knows someone else who can. You may even find that someone knows a surgeon in your area or who you should speak to at the hospital.

Just narrowing it down to a region would help MeFites in that region know to contact your email address.
posted by sonika at 4:59 PM on November 17, 2010

If your insurance is through your employer, there might be an Employee Assistance Program that you can tap in to. There are patient advocacy services that provide exactly this kind of support. Have you talked to HR? If you want to memail me, please do, I know people all over the map with excellent resources.
posted by thinkpiece at 5:01 PM on November 17, 2010

On the off chance that you are anywhere near Madison, WI, I am also willing to either help or help you find a local organization that can work with you. Just let me know!
posted by mjcon at 5:23 PM on November 17, 2010

Whether or not you had people who you could ask to stay with you, NO ONE who wasn't already living with someone could arrange for a 48-hour stayover on the fly as they were being fricking prepped for surgery!
Your surgeon was not only an insulting jackass, he was unprofessional and his actions could be construed as irresponsibly endangering - if 48-hour company was so important, he should have made that very clear very early on.
nthing to contact the hospital ombudsman and hell, the medical board in your state because the doctor was irresponsible on top of being a tremendous jackass.
Now I just want to write JACKASS ten million times to attempt to express how fricking much of a goddamn jackass your surgeon is.
posted by L'Estrange Fruit at 6:59 PM on November 17, 2010 [2 favorites]

I can help you if you're in the Twin Cities metro area.
posted by padraigin at 7:16 PM on November 17, 2010

Does your hospital have a social worker or discharge coordinator you could speak with? These are the people who know what resources would be available to you.
posted by thinkingwoman at 7:46 PM on November 17, 2010

> Do nursing homes do short-term stays?

Yes, they do, and not just for senior citizens. OP, if you're in the US, try looking up nursing homes on one of those phone book type sites like this.
posted by The corpse in the library at 7:49 PM on November 17, 2010

I can help if you're in Maine or New Hampshire.
posted by JanetLand at 6:20 AM on November 18, 2010

If it is Michigan, let me know. I will help.
posted by chocolatetiara at 7:24 AM on November 18, 2010

Whiskey Tango Foxtrot!?

Your operation is to be performed in a *hospital*. The surgeon at the *hospital* refuses to perform your operation at the *hospital* unless you can demonstrate that someone will be able to observe and care for you for the 48 hour recovery period.

You know, the kind of observation and care that people recovering from surgery normally receive in a *hospital*.

Why was admission to the hospita* for observation and any needed care for the 48 hours after your operation not offered as an option here!?
posted by de void at 8:03 AM on November 18, 2010 [1 favorite]

Do nursing homes do short-term stays?

Rehab facilities would probably be a better bet, just because they have a more age-diverse clientele. But, yeah, one can self-pay for a rehab or a nursing home if necessary.
posted by Sidhedevil at 10:31 AM on November 18, 2010

Are you a redditor (and the people you are concerned with not)? I can't believe I got hooked on that site, but recently saw an askreddit of a similar nature: someone looking for a partner to and through a medical procedure.
posted by whatzit at 11:55 AM on November 18, 2010

I'm willing to help you out if you're in Northern California.

But seriously, at least a state or region would help. I get that you want to keep this secret, but it's pretty hard to give you any useful information without at least that much information.
posted by zug at 2:24 PM on November 18, 2010

de void: I think the 48 hours thing is just to make sure there's someone around who can call 911 if something goes wrong and the OP is unable to do so (e.g., unconscious). It's unlikely, so no point keeping her in the hospital for it. My wife had a procedure recently and basically I had to be with her for 24 hours afterward due to the anesthetic used. But of course we had lots of notice... completely ridiculous to spring this on someone at the just before the surgery!

Since I don't live in a place that has a hospital, I won't bother offering to help.
posted by Emanuel at 8:22 PM on November 18, 2010