Sunday, February 17, 2008

having it done

Preliminaries:

In order to make sure my insurance would cover the cost, my doctor worked with me on a pre-approval process. About 4 weeks before the surgery, he had me in for a blood flow test. This was pretty simple – he injected me with a small dose of Caverject to cause an erection, took ultrasound pictures of the penis and the area just under the penis, waited about 15 minutes, and took additional images. He said it clearly showed that my blood flow was good, very good even, but it was not being held in the penis. He showed me the images, which didn’t make too much sense to me, but I could see some of what he was talking about.

My doctor said what he saw suggested that a previous injury may have been the origin of the problem, which is the first time I every had someone say it’s other than a typical side effect of high blood pressure and diabetes. In some way, that makes me feel a bit better about the whole thing. It also makes a bit more sense with the fact that it’s been a problem to some extent for such a long time. I did have a crush injury to my scrotum and pelvic area years ago on a bike. I remember being bruised and sore for days. I wonder now if that was the root cause.

In any case, this step was simple and painless, except for the discomfort of the injection.

One thing that reminds me to mention, though. I have had to get used to lots of people looking at and touching my penis and scrotum. Kind of weird. For example, for this procedure my doc was assisted by a lovely young African American nurse from whom I now have no secrets. Not that people don’t try to give you as much privacy as the situation allows; they certainly do. The situation just don’t allow for very much.

So we got insurance approval without difficulty and went on.

About 10 days before surgery I had to go through pre-surgery testing at the hospital. It was the usual stuff – the 27th medical history, the next repeat of the same blood tests everyone does every chance they get and so on. I tell you, this has been a really eye opening experience so far as why we have a health care crisis going on. So much is simply repeated over and over again, and we pay for it every time. And, in this particular case, it really got stupid. One of the tests showed I had a low platelet count. That means I would be a high risk for bleeding excessively during surgery. Everything was suddenly on hold.

I knew this was absurd. I have never, ever had a bleeding problem. I get regular tests as part of my diabetic checkups, and it’s never been an issue. So, I had ample information to support the idea that this was a mistake. However, those things have no meaning in situations like this. I just had to suck it up and deal.

I went back to my regular doctor. He tested me and the platelet count was, of course, fine. He arranged for me to go to a blood specialist, who tested me yet again and found the platelet count was fine. He was annoyed (though not with me) at the having to have me come in for what was so obviously a bad test to begin with. Why didn’t the hospital retest in the first place? Because they don’t have to and it’s easier to put the problem on the patient. So I (or more properly my insurance company) had to shell out a chunk of money and waste my and various doctors and other people’s time rather than retest. How stupid can we collectively be?

Sorry – I digress

I was lucky that I was able to get all this done and get the sign off I needed to keep on schedule.

Surgery Day:

So, we come down to it. The day of surgery I was a bit nervous, of course, but ready. I wanted to get this behind me.

After some unremarkable waiting and check in stuff they took me back to the pre-op area. More people examining my privates. I wish it had been more fun. :) One minor snag was that the prep nurse wanted to cut off my wedding ring and another ring I wear, neither of which I have had off for at least 15 years. They were certainly not coming off on their own. Luckily for me, the anesthesiology nurse came in, who was pretty rational. She had the prep nurse just tape them over so there would be no chance of conducting a static charge, which is what they worry about. After a time the anesthesiologist came in and interviewed me to figure out how to knock me out. My wife came back to visit a few minutes. Then the anesthesiologist came back and they put a mask on me.

I mentioned before that I was a bit nervous about being put under. A totally new experience for me, and I had this vague idea of it being something like going to sleep without wanting to. Actually it was like flipping a switch. One minute – heck, one second – I was aware and talking with the folks around me, then next second it was two hours later and I was in a different room with different people. I had no sense of ever going to sleep or any passage of time. Rather than a pleasant or unpleasant experience, it was almost no experience.

At first I was a little groggy, naturally. But pretty quickly I was clear. My doctor came by and told me everything had gone well. An hour later I was on my way home, and feeling fine. Total time at the hospital was about 10 hours.

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