Preparation for Surgery – Shoulder Surgery

Shoulder surgery is never a fun experience but at least with these tips you can be more self-sufficient and prepared for the basics.

I’ve had 7 shoulder surgeries, all as a single working woman. Thank god for my friends who helped out when family was several states away.

Let’s get right to it!

Things to get BEFORE surgery:

Hygiene Helpful Items:

  • Electric Toothbrush – cheap children’s one will do for 2-3 weeks (especially if your surgery is on your dominant arm)
  • Flushable Wet Wipes – yep that bathroom thing isn’t easy with the non-dominant arm
  • Pump Bottle Shampoo, Conditioner and Body Wash – flipping and squeezing a shampoo bottle and catching the contents will feel be hard without 2 hands
  • Shower head with a hose – takes 5 minutes to remove your standard shower head and replace with a cheap $15-20 head with the hose (don’t forget the plumber tape so the threads are ok for ease to switch it back later) – Purpose of this is the after surgery ability to shower, feel clean at least from the waste area down all on your own, no more hospital smell or that orange betadine staining your clothes and sheets. ** This also becomes handy when you have longer hair for others to help of you to flip your head and shampoo with minimal shoulder use.
  • Waterproof Large Bandaids – Generic Drug store ones work just fine, but have plenty of them around.
  • Hair dresser Appointment – Ladies that have long hair or just can’t stand to have dirty hair….make an appointment 2-3 days post-op with a cheap local hair salon for just a wash and blow out. Try to go when they aren’t busy and let them know you’re post-op. Typically they will give you a nice head massage which always feels good.  And if you have ridiculously long hair like I do, get them to french braid it so the clean feeling lasts longer and you don’t have to fuss with it at all.

 

Recovery Items to have on hand:

  • Compression Sleeve Ice Machine – THIS IS YOUR LIFESAVER!!! These can be bought on eBay or borrowed from friends, or your doctor’s office will sell you one at $250plus….Either way so worth it! This baby will reduce your pain 10x more than the pills!
  • Lots of ICE – get extra bags. Your ice machine will not keep up and you don’t want to run out.
  • A good comfy couch or recliner to set up in for 2-3 days
  • Good tv or movie selection – though you will likely sleep through half
  • A table or station set up so you don’t have to get up and down. With your pills, lots of water, snacks, tissue…etc.
  • Good comfy pillows and blankets.
  • And just in case a bucket/trash can.

 

Attire: (this one is more geared towards the ladies)

  • Bras: Easy to slip on and off with one arm, like a straight not racerback sports bra or bralette style or even a bandeau. Clips of any kind are hard to do with one hand to work them. After a while you can clip in front with two hands and spin to the back. It will likely be months before you can clip behind your back.
  • Tops: tank tops, button downs and full zip up tops are your new wardrobe. Anything going over your head will need to be loose enough to maneuver back out of later and that isn’t easy and can be painful…recommend avoiding over the head tops for several weeks.
  • Bottoms: Loose fitting is best, as tight pants are hard to wiggle into, buttons and zippers will not be easy either with one hand. I lived in my gym shorts and yoga pants!
  • Work Attire: If you can’t get away with loose yoga pants, tank top and a long button down sweater, then go with sleeveless loose dresses with the sweater option, but remember no backside zippers or anything overhead unless very stretchy to get back out of later.
  • Shoes: Slip on all the time! If you want to be able to wear athletic shoes at some point without the reaching and tying of laces – I recommend race laces, like Yankz or Lock Laces (see amazon) — Not Hickies, I could never get these to feel snug in the right places and loose in the right places (way to fidgety).

 

Food: (this one is more geared towards the single people)

  • Stock up on bland simple foods you don’t need to cook but will satisfy you.
  • Make sure the bags are open ahead of time or in easy to open with one hand containers.
  • If you do plan to cook, microwave! Lifting pans and pots even with the good arm will cause some pain in the other. At least the first couple of days, everything will be painful/uncomfortable.
  • Or plan for food delivery – Doorstep Delivery is a great option to not have to bug friends for every meal.

 

Day of Surgery:

  • Day of Surgery Attire – Simple is Best!
    • Slip on gym shorts or pants (depending on time of year and your preference for warmth) – shorts with the panty liner built in make it much easier to get dressed post-op….one less step to navigate (and if you are single with a friend doing the driving that you’d rather not have dress you, nurses will gladly help instead)
    • Nothing will go over your head! So, if a bra is a must – then get the sports bra or bralette with straight straps (not racerback style) and plan to only use the one strap and tuck the other one in. – NO underwire as you’ll likely fall asleep in these clothes. I’m on the smaller side, so I always preferred something I could step in and pull up, but the clip kind works if you have help to clip it in front and the spin bra around. This takes a little practice but is handy when going back to public settings and a bra is needed.
    • Tank Top – Loose enough to step into and pull up one strap on good arm, but let other strap hang under the other underarm
    • Comfy Full Zip Up Sweatshirt or Button Down Sweater – Again nothing that goes over the head, even later you may get something on but will not be able to get it back off without major stretching of the attire.
    • Slip On Shoes – No lace tying will happen for weeks. So, prepare to wear flip flops, sandals, boat shoes, Crocs or tennis shoes with no laces or race laces (more on this later)
    • Hair – loosely braid it with no metal bands – comfy enough to lay down on but keeps it out of the way of the cap and won’t be matted when you wake up….brushing it will be the last thing you want to deal with.
  • Make the Nurses your new Besties! Food and coffee go a long way to say thanks for caring about me. I always brought with me a box of coffee and a dozen donuts for the staff, along with one donut in a separate bag with my name on it for my post-op meal. The nurses and staff appreciated this gesture and are more maybe just a little more attentive to you post-op. Plus Ginger Ale and a Chocolate Cake Krispy Kreme Donut are so good when you wake up starving.
  • Things to ask your doctor(s) to provide:
    • Anti-nausea Medication (Pre and Post Op) – if you are anything like me heavy painkillers make me feel sick or get sick, and the day of surgery with an empty stomach lots of medication…the last thing you want is to get sick (it will hurt!) or feel sick for hours.
      • Pre-OpAnti-Nausea Patch – makes post-op much easier to manage
      • Post-Op anti-nausea pills to take with every painkiller – makes the first few days better

 

That should get you set up for a simpler recovery. If you have a specific situation and want advise, please message me. I’ll gladly give more information and tips.

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Opioid Crisis in US

Today I woke up and turned on the news to hear more about the Opioid Crisis hitting the nation and more specifically NC, where I live. However, rather than hearing that doctors are going to be more cautious in prescribing opioids for every ache and pain someone has, the insurance companies are now denying any prescription greater than a 7 day supply for new users only.

So, my issue with this “fix” to such a large and growing problem is why limit new users of these drugs from a legitimate prescription? Why leave out the existing users from any limitations? And most of all, why is this being done by insurance not legislation or physicians?

I know when I had major shoulder surgery I asked to not being given such a strong painkiller and even told the surgeon’s physician assistant that I already had another pain killer they had prescribed when my shoulder was injured that was more than effective for me. I was told that I might as well fill the prescription, since I might need it. Since I was on my 7th shoulder surgery and had learned many ways to manage the pain through the first six surgeries, I knew icing, heat, compression sleeve and tylenol would be all I would need by day 2 post-operatively. So I need maybe 4-5 pills total of a stronger painkiller.

I wonder how many are like me and anything stronger either makes me itch (thanks to generic drug preservatives), makes me loopy, and then puts me to sleep, so why do I need 30-60 of these pills prescribed? So they can sit in my medicine cabinet until they expire, just in case I ever have that horrible pain again.

How many people could be given a good anti-inflammatory and access to other pain reducing equipment, passive treatments, etc. and not need opioids at all? I’m thinking quite a lot! How many others have only wanted to pay for 5-10 pills but get no discount for that from the almighty insurance company, so go ahead and get the 30-60 pills since it cost the same amount? Why isn’t the insurance system acknowledging their role in putting more pills in future addicts hands by having a failure of a system that encourages over prescribing?

But now to go to the extreme by the insurance company denying coverage for prescriptions that exceed 7 days is just going to make those who truly need an opioid for a legitimate reason have to jump through more insurance red tape/hoops and obstacles to get the care needed.

The system is broken…..fix the root cause not piecemeal together actions that make statements and have little to know true benefit. Those already with prescriptions continue to get them and new folks who want to abuse will work around the 7 day limit.

Tying this back to my point of having 1 doctor who you know and knows you versus who is “in-network” this month, year, or with the new job, insurance provider, someone who knows if you need or just want such medication and knows how much you truly need. Patient control of access to care and physician knowledge of patients and control of what care is appropriate for each individual patient, not what code is best for reimbursement.

My 2 cents on this topic. Please share your thoughts!

Individual Mandate Repeal (NOT)

Like many of you I was very interested in the promise made by the President to repeal the individual mandate set in place by the Obamacare and Affordable Care Act, which essential forced me to either pay for a crappy health insurance plan or pay a penalty to the government.

This frustrated me as I don’t like health insurance controlling my heath care or denying me care, despite the high fees I was forced to pay them.

That aside after waiting anxiously for the final votes and news reports and googling to be sure the individual mandate was really repealed back in December when so I had the option to not renew for January the crappy over priced health insurance from the Marketplace, I’m now finding out and seeing reports that despite the victory sung by the President and the new reports the repeal is not effective for 2018. WTF!!

I’m sure I’m not the only one who chose not to renew the Marketplace health insurance in January after hearing the new of the repeal. I’m also sure I’m not the only one that was relieved since the same crappy insurance increased its premium by 30%. This would have made my month premium $500 per month for a plan that had minimal coverage (bronze) and a $6500 deductible that had to be met before anything was paid out.

Do that math, $500 x 12 months = $6000 plus another $6500 deductible, so $12,500 before they cover anything. Why is this something I’m going to be fined by the government for saying no this makes no sense for me financially??

Even though I thought I was free of the 2.5% penalty, this penalty still makes more sense financially for me to just pay. Since I’m self employed and a freelancer/consultant, my business expenses effect my adjusted gross income fairly substantially.

Just an example, say I do make an adjusted gross income of $70,000 the penalty of 2.5% of that is $1,750.00. Add on top of this the $50 a month I pay for my primary care membership (doctor I can call 7 days a week who calls back and sees me for free), $50 per month for the accident insurance and $55 per month for cancer insurance. And in total I’m covered for $1860 per year to my providers and $1750 to the government, so $3610 total. This saves me an out of pocket immediately compared to the Marketplace health insurance by $2400 (rounded).

If I do need to pay for some sort of healthcare, well the Marketplace insurance wasn’t paying until after I was out of pocket another $6500 and only if that provider was “in-network”, which no one was with my plan from 2017. That means I’d have to be out of pocket $6500 plus the $2400, so a total of $8900 above my costs and the penalty in order for buying the health insurance to make any sense financially for me.

How does forcing this on Americans make us better off? How does this improve our healthcare system? I’m not following the logic. But maybe that’s because I do the math and I prefer to be the one making the decision on who and what HealthCARE I receive.

Tell me your experiences. I welcome a discussion here.

And yes, I’m single with no dependents. I know this is a different animal if you are dealing with children in the family and their health coverage.

If you want to calculate your penalty go here: https://taxpayeradvocate.irs.gov/estimator/isrp/estimator.htm

Health Insurance Worth it or NOT?

When is health insurance not worth the cost you pay for it? Especially if you are single or have no children.

I’ve asked this question a lot over the years. I’ve had company insurance plans, I’ve had individual plans, I’ve had Obamacare from the marketplace and I’ve had no insurance.

What I have found is for the masses it depends on your individual situation, including general health, relationship status, family size, employment type, risk for health or accidents and more. But in the end, for a single, self-employed female with generally good health it was an easy decision to say no to the health insurance conglomerates.

If you have an employer offered plan or if you go to the open market for a provider, the plans are general and usually not very customizable. You likely have to pick a plan that may or may not have your primary doctor or other specialists as “in-network” providers. Then there is the navigating of the premiums versus deductibles, co-pays and co-insurance. Throw in the in-network, out-of-network categories on medical providers and tier categories on prescriptions. How are you suppose to keep up with all of this? And it changes constantly at the insurance companies discretion.

The major flaws I experience with health insurance plans is they change every year. So as soon as you figure out how one works, it changes. Then you get established with a doctor or specialist and they no longer accept that insurance, so now you have to pick to either keep the doctor you like and pay or go to someone new and start the process all over.

This seems counter productive to the goal of healthcare and healthy living, but health insurance companies haven’t done anything to change this constant changing cycle. My final decision came down to ultimate control. I prefer to be the one in control of what care I have access to, by whom and at what cost.

 

So, I chose to simplify and focus on my healthcare. Yes, CARE, instead of the insurance. Now this may not be the best choice for everyone, but if you take the time to do the math on the premiums, deductibles, copays, co-insurance and compare to what you could get instead with that same amount of money you may be surprised. Also, compare the level of care you have access to as well.

Here are a few advantages and disadvantages to choosing to go without the status quo health insurance.

Benefits of Self Pay Healthcare

  • Full control of healthcare provider selection
    • I pick who I like
    • My providers know me
    • Building relationships with your doctors helps them better treat, recommend and prevent health issues
  • No referral needed
    • No paying a copay to a doctor’s office you barely know to get them to send you to a specialist you already know you need. An easy example is going to see a  dermatologist for a mole removal. Why do you need a primary to tell you it’s ok to go see someone?
    • As an independent payer you simply pick the specialist you like and want and go
  • Upfront Cost Transparency
    • I get to ask how much an office visit will cost
    • Everything is negotiable!
    • I’m not getting a statement saying it costs $500, but someone got me a deal for it to only cost me $250 and of that $250 I owe a $50 copay and 80/20 co-insurance….what???? No! Cost = Cost and no guessing.
  • No payments to a company that only gives you grief
    • Everything I pay goes directly to the provider

 

Pitfalls of Self Pay Healthcare (there are Pitfalls)

  • Cash Needed – Keeping an Emergency Medical Fund (just smart to do no matter what)
  • Emergency Situations – unknown cost – no cap
  • Major Medical Situations – unknown cost – no cap

Ways to Mitigate Pitfalls of Self Pay Healthcare

  • Budget Planning for your Healthcare
    • Ear mark funds for medical wellness each year, including: yearly physicals, paps, dental exams, eye exams
    • Emergency Fund – have a fund that you pay into yourself each month – set it up to make money for you (low risk market or money market)
  • Add medical coverage to your Auto Insurance
    • Most policies have this option and it pays no matter who’s fault an accident may be.
  • Purchase Accident Insurance (major medical no longer exist)
    • slip on a wet floor or trip over a dog bone – twist an ankle and need an x-ray – this pays you for the accident and you pay the provider (you still have your negotiating power and power to chose your care)
  • Purchase Cancer or other Major Medical Insurance packages

 

I’m sure there are other circumstances where you may have a chronic illness or a constantly sick group of kiddos that may make this option not appealing, but to those out there that are single, self-employed or just want to have the control of who they see without loss of benefits, then self pay may be the option to explore.

Please comment or ask questions. I have so much more to share on this subject. We are just getting started.

About Me

Where to begin? Well, first a little about me.

I’m a 38 year old, single (unmarried) female, self employed and self sufficient…for the most part. I have two engineering degrees and an MBA. I pride myself in being strong and independent, but not bitchy or isolated. I’m just not willing to settle and I’m not afraid to challenge the status quo. I know what I like and what I want and I go for it in all aspects of life.

I’ve spent 16 years as a medical device engineer working in orthopedic design and development. Many of my years were with start-up companies, so I’ve had all types of different health plans. Though I am an engineer, my friends often tell me, I’m not your typical engineer. I love talking to people, about everything. I love to learn and hear varying opinions and experiences. People intrigue me. And my second career as a real estate broker is only fitting, since it allows me to be creative, analytical, and talk constantly to new people.

Throughout the years I’ve seen the many sides of the US healthcare system, all of which has intrigued me, sparked curiosity and wonder and at times frustration and disgust. Initially I wanted to write a brochure or pamphlet to have orthopedist give out to women having shoulder surgery, since I’m on my 7th shoulder surgery. Yes 7th! Don’t ask….that’s another blog post. I wanted to offer the little tips and hints to make pre-op and post-op just a little easier for the next person. But the more I’ve seen and experience myself in the US healthcare system the more my friends, colleague and family have encouraged me to write more.

I hope to share all my experiences with helpful insights into solutions or work arounds to the complex US healthcare system.

So here is my blog….I hope you find it helpful.

Blog Purpose

Thanks for joining me on my very first blog!

My goal is to shed light on many facets of US healthcare, including actual health care, alternative treatments, preventative options, how to navigate health insurance selection, coverage, appeals, insurance alternatives, and ways to navigate costs, billing and care as a single person.

I’m new to blogging and wanted to get information out to others. The purpose of this blog is to share my experiences, challenges and ideas with others. I hope to grow the content as I learn more and as other provide feedback and/or requests.

I hope others will also contribute and add their experiences as well. Let’s help each other navigate the challenges of single life and being healthy in the US without being rich.

Alternatives to Health Insurance

What if you can’t afford health insurance? What if you just don’t want to be restricted by health insurance? What are your options to be sure your protected in both health and financially?

I had heard about major medical insurance, that old option no longer offered that covered catastrophic illnesses or accidents. This made sense to me, as I take care of myself and would rather pay for only major coverage rather than pay for a hangnail or cold to be treated by an insurance.

I’ve always compared health insurance to auto insurance. I didn’t understand why health insurance covered the day to day small things which drive the cost up, when it would be much more affordable if the insurance was used for catastrophic events only just like an auto policy. Auto insurance doesn’t pay for my regular oil changes and tire rotations or car washes, but it does protect me if I get in an accident or someone steals my car.

So, I began to look into my options for coverage that would protect me from accidents or catastrophic illness and then options for my day to day health. Here’s a break down of what I found to be most helpful and comforting for coverage and financial protection:

  • Opt to maintain a healthy living style
    • Gym Membership – $10 per month
    • Healthy Food – cost ranges
    • Cooking at home – less expensive than eating out!
    • Yoga membership – Free App or $12 per class with instructor = Stress Relief
    • Using holistic treatments in lieu of prescription drugs when reasonable
  • Good RX – simple free app
    • discounts on perscriptions
    • transparency on cost based on where you get your prescription filled
  • Primary Care Physician Membership (concierge doctor) – $50 per month
    • Local physicians that offer memberships for a small group of paitents
    • You have 1 doctor
    • They get to know you
    • They take the time to know all about you
    • Includes a yearly physical with blood work and some even include female yearly exam
    • Same day appointments, call backs and/or Perscriptions
    • Typically these memberships have pharmacy arrangements for discounts
  • Accident Insurance – ~$50 per month
    • pays out cash directly to me
    • accidents including slip and fall, car accident, tripping over a dog bone and twisting an ankle, etc.
    • amount paid based on treatment, diagnostics needed and such
  • Cancer Insurance – ~ $50 per month
    • pays out cash directly to me
    • amount paid based on type of cancer diagnosis, treatments, and other variations
  • Medical Payment option within Auto Insurance
    • added coverage within auto policy for insured persons medical expenses from car accident (whether or not your at fault doesn’t matter)
    • can go up to $10,000 in coverage

 

Please share any other findings you as my readers may have found. I am always in search of new alternatives and options. This is an evolving industry and this blog is to bring together options for all.