So Chief Justice John Roberts wrote for the majority in Obamacare supporting the health care reform. This is a big deal because Roberts was nominated by the evil George Bush. This rocked. But many of us lay people still didn’t totally get what Obamacare was until I read the following, which is below.

Obamacare
Okay, explained like you’re a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:

What people call “Obamacare” is actually the Patient Protection and Affordable Care Act. However, people were calling it “Obamacare” before everyone even hammered out what it would be. It’s a term mostly used by people who don’t like the PPACA, and it’s become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn’t have to.
So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
(Note: Page numbers listed in citations are the page numbers within the actual document, not the page numbers of the PDF file)
Already in effect:
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )
It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 216, sec. 2501 )
It establishes a non-profit group, that the government doesn’t directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181 )
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )
It makes a “high-risk pool” for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of “pre-existing conditions” altogether. For now, people who already have health issues that would be considered “pre-existing conditions” can still get insurance, but at different rates than people without them. ( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec. 2702 )
It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 47, sec. 2705 )
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )
It says that health insurance companies can no longer tell customers that they won’t get any more coverage because they have hit a “lifetime limit”. Basically, if someone has paid for health insurance, that company can’t tell that person that he’s used that insurance too much throughout his life so they won’t cover him any more. They can’t do this for lifetime spending, and they’re limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )
Kids can continue to be covered by their parents’ health insurance until they’re 26. ( Citation: Page 15, sec. 2714 )
No more “pre-existing conditions” for kids under the age of 19. ( Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )
Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 47, sec. 2794 )
People in a “Medicare Gap” get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 379, sec. 3301 )
Insurers can’t just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )
Insurers have to tell customers what they’re spending money on. (Instead of just “administrative fee”, they have to be more specific).
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they’re turned down. ( Citation: Page 23, sec. 2719 )
Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 699, sec. 6402 )
Medicare extends to smaller hospitals. ( Citation: Starting on page 344, the entire section “Part II” seems to deal with this )
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 492, sec. 4202 )
A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ). ( Citation: Page 36, sec. 1103 )
A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note – this program was temporary. It already ended) ( Citation: Page 830, sec. 9023 )
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they’re not price-gouging customers. ( Citation: Page 22, sec. 1101 )
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn’t paying for the Aspirin you bought for that hangover. ( Citation: Page 800, sec. 9003 )
Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 800, sec. 9002 )
Any new health plans must provide preventive care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 14, sec. 2713 )
1/1/2013
If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word “tiny”, a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we’re talking about people in the top 5% of earners. ( Citation: Page 818, sec. 9015 )
1/1/2014
This is when a lot of the really big changes happen.
No more “pre-existing conditions”. At all. People will be charged the same regardless of their medical history. ( Citation: Page 45, sec. 2704, Page 46, sec. 2701, and Page 57, sec. 1255 )
If you can afford insurance but do not get it, you will be charged a fee. This is the “mandate” that people are talking about. Basically, it’s a trade-off for the “pre-existing conditions” bit, saying that since insurers now have to cover you regardless of what you have, you can’t just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you’ll have to pay the fee instead, unless of course you’re not buying insurance because you just can’t afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it’s considered a tax on the uninsured and not a penalty for not buying insurance… nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 145, sec. 5000A, and here is the actual court ruling for those who wish to read it. )
Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can’t afford?
Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you’re worried about it. You can see it here.
Okay, have we got that settled? Okay, moving on…
Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance) ( Citation: Page 179, sec. 2001 )
Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 138, sec. 1421 )
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
Insurers now can’t do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )
Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 62, sec. 1302 )
Cut some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 801, sec. 9005 )
Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. ( Citation: Page 88, sec. 1311 )
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won’t be footing their health care bills any more than any other American citizen. ( Citation: Page 81, sec. 1312 )
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they’ll get taxed.
The amount you can deduct from your taxes for medical expenses increases.
1/1/2015
Doctors’ pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you’re looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.
1/1/2017
If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )
2018
All health care plans must now cover preventive care (not just the new ones).
A new tax on “Cadillac” health care plans (more expensive plans for rich people who want fancier coverage).
2020
The elimination of the “Medicare gap”
.
Aaaaand that’s it right there.
The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it’s not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.
Plus, as previously mentioned, it’s necessary if you’re doing away with “pre-existing conditions” because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.
Of course, because so many people are arguing about it, and some of the people arguing about it don’t really care whether or not what they’re saying is true, there are a lot of things people think the bill does that just aren’t true. Here’s a few of them:
Obamacare has death panels!: That sounds so cartoonishly evil it must be true, right? Well, no. No part of the bill says anything about appointing people to decide whether or not someone dies. The decision over whether or not your claim is approved is still in the hands of your insurer. However, now there’s an appeals process so if your claim gets turned down, you can challenge that. And the government watches that appeals process to make sure it’s not being unfair to customers. So if anything the PPACA is trying to stop the death panels. ( Citation: Page 23, sec. 2719 )
Obamacare gives free insurance to illegal immigrants!: Actually, there are multiple parts of the bill that specifically state that the recipient of tax credits and other good stuff must be a legal resident of the United States. And while the bill doesn’t specifically forbid illegals from buying insurance or getting treated at hospitals, neither did the laws in the US before the PPACA. So even at worst, illegals still have just as much trouble getting medical care as they used to. ( Citations: Page 122, sec. 1402, Page 123, sec. 1411, Page 125, sec. 1411, Page 132, sec. 1412 )
Obamacare uses taxpayer money for abortions!: One part of the bill says, essentially, that the folks who wrote this bill aren’t touching that issue with a ten foot pole. It basically passes the buck on to the states, who can choose to allow insurance plans that cover abortions, or they can choose to not allow them. Obama may be pro-choice, but that is not reflected in the PPACA. ( Citation: Page 64, sec. 1303 )
Obamacare won’t let me keep the insurance I have!: The PPACA actually very specifically says you can keep the insurance you have if you want. ( Citation: Page 55, sec. 1251 )
Obamacare will make the government get between me and my doctor!: The PPACA very specifically says that the Secretary of Health and Human Services (who is in charge of much of the bill), is absolutely not to promote any regulation that hinders a patient’s ability to get health care, to speak with their doctor, or have access to a full range of treatment options. ( Citation: Page 165, sec. 1554 )
Obamacare has a public option! That makes it bad!: The public option (which would give people the option of getting insurance from a government-run insurer, thus the name), whether you like it or not, was taken out of the bill before it was passed. You can still see where it used to be, though. ( Citation: Page 92, sec. 1323 (the first one) )
Obamacare will cost trillions and put us in massive debt!: The PPACA will cost a lot of money… at first. $1.7 Trillion. Yikes, right? But that’s just to get the ball rolling. You see, amongst the things built into the bill are new taxes – on insurers, pharmaceutical companies, tanning salons, and a slight increase in taxes on people who make over $200K (an increase of less than 1%). Additionally, the bill cuts some stuff from Medicare that’s not really working, and generally tries to make everything work more efficiently. Also, the increased focus on preventative care (making sure people don’t get sick in the first place), should help to save money the government already spends on emergency care for these same people. Basically, by catching illnesses early, we’re not spending as much on emergency room visits. According to the Congressional Budget Office, who studies these things, the ultimate result is that this bill will reduce the yearly deficit by $210 billion. By the year 2021, the bill will actually have paid itself and started bringing in more money than it cost.
Obamacare is twice as long as War and Peace!: War and Peace is 587,287 words long. The Patient Protection and Affordable Care Act, depending on which version you’re referring to, is between 300,000-400,000 words long. Don’t get me wrong, it’s still very long, but it’s not as long as War and Peace. Also, it bears mention that bills are often long. In 2005, Republicans passed the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users, 2005, which was almost as long as the PPACA, and no one raised a stink about it.
The people who passed Obamacare didn’t even read it!: Are you kidding? They had been reading it over and over for a half a year. This thing was being tossed around in debates for ages. And it went through numerous revisions, but every time it was revised, it was just adding, removing, or changing small parts of it, not rewriting the whole thing. And every time it was revised, the new version of the bill was published online for everyone to see. The final time it was edited, there may not have been time to re-read the entire thing before voting on it, but there wasn’t a need to, because everyone had already read it all. The only thing people needed to read was the revision, which there was plenty of time to do.
Pelosi said something like, “we’ll have to pass the bill before reading it”!: The actual quote is “we have to pass the bill so that you can find out what is in it, away from the fog of controversy”, and she’s talking about all the lies and false rumors that were spreading about it. Things had gotten so absurd that by this point many had given up on trying to have an honest dialogue about it, since people kept worrying about things that had no basis in reality. Pelosi was simply trying to say that once the bill is finalized and passed, then everyone can look at it and see, without question, what is actually in the thing (as opposed to some new amendment you heard on the radio that they were going to put in).

Remember when your mother shrieks from the other room, “Did you WASH YOUR HANDS???!!!” And you called back that you had but really didn’t? Remember when you’d splash some water on them so they’d be moist in case she felt them? Remember how most of the time she’d know you were lying, and you never understood the big deal. Well, I’ve got a story for you.

Claire’s Papa had been scheduling a surprise visit to Arizona for her birthday the first week of April, and he was to arrive Monday, April 4th. Well Sunday afternoon Claire began to feel a little under the weather and was not enjoying her time with a friend who was visiting. She was a little warm and we both were a little concerned since Papa flew in 24 hours later and hoped to help her ride her bike, swim with her at our local pool, play games, take walks, etc… Of course Papa knew she would attend school every single day he was here, and he could see her afterward (Boy, was I wrong!).

By Monday’s end, Claire wouldn’t play with her friends at kid’s express and just sat there after school. By the time Donna picked her up and got her home, Claire only wanted to go to bed. I was picking Papa up at the airport, and we planned this whole unveiling that was quickly forgotten. Later Monday night she woke once and was confused but happy Papa was there. By now her temp was between 101-103 for a day, and she was not attending school Tuesday. Tuesday she also went to the pediatrician who believed it was viral as were a lot of cases they’d seen recently. She was regularly vomiting and having diarrhea by this time. She stayed home Tuesday and Wednesday, but by Wednesday she didn’t want to get out of bed at all and refused to eat or drink anything at all. Back to the pediatrician’s office we went Thursday morning. She was down a pound and our regular pediatrician told Donna and her father to take Claire to the ER immediately for fluids.

I met them Thursday afternoon at the ER, and Claire already looked better. The fluids perked her up but they took blood and stool to check just in case. After a few hours, Claire came home and was back to “normal”. She was not permitted to attend school on Friday, her birthday, but she was doing well. Now she had a good excuse to spend her entire birthday with Papa! I came home at noon Friday, April 8th, to spend time with her and make sure she was ok, and she looked great. Friday we went to the pediatrician’s again, and the doc said it definitely must’ve been viral (which I had a really hard time believing by this point!) and Claire looked great. Friday we celebrated. Saturday she and her friend spent part of the day together for her birthday, and then she and Papa spent the evening together. Sunday we took Papa to the airport and said our good byes. Even though Claire was on the couch a lot sick, they did get a lot of time together.

Before going to the airport, the ER called. They said a test came back abnormal and she had to go back in. Donna and I decided that would happen after the airport. We felt it was routine so I went about my own pre-planned event for the afternoon while the three of them headed to the airport. I told Donna to email me at my event if there were any issues or if they wanted me to headed to the hospital after my event if they were still sitting (as people do often in ER waiting rooms).

Around 4:00pm Sunday, Donna texted me and it read: “Salmonella. Sending home on antibiotics.” My reaction was “yuck”, but who the heck gets salmonella? This is something your mother threatened so you would take a bath before bed, or your Mimi threatened you with because you would not get out from under her feet while she cooked a nice chicken dinner.

I told my wife I’d meet them at home, and then I kept doing my thing. Someone at my event talked my ear off for half an hour, and then I got in my car to head home. I glanced back at my phone almost an hour after the last text. This one said “Infectious Disease not letting her leave. Being admitted. IV antibiotics.”

My response is not appropriate for a PG-13 blog post.

I channeled Mario Andretti while frantically trying to call my wife’s mobile and/or my mother, the nurse. Donna’s response (almost always calmer than my own) was to go home and get together a list of stuff she and Claire would need, and then grab dinner before heading to the hospital. That made sense to me but I was a little strung out. I was worried about what we needed and when we’d go home and why was she even in the hospital in the first place. She was fine. She looked fine. She felt fine. She was sick last week, not now. This did not compute.

I arrived at the hospital Sunday evening three hours after she arrived, and she was still in an ER room. Neither of us was too happy and expressed our concerns to the nurses outside of the room before Claire was finally taken upstairs. Now this isn’t a bad hospital and overall we’re happy with them. Donna even picked this hospital in the first place was because it’s the new “children’s hospital” five minutes from our house.

That evening it was assumed Claire would be at the hospital for 48 hours while we waited for the test results. The goal was that by Tuesday the results would be negative and she could leave. This would pretty much mean that any salmonella in her streams was transient and we would worry less. In the mean time the CDC wanted her on aggressive IV antibiotics, and the doctors prescribed more fluids since she was still a little “dry”.

Her spirits were good, and her new room was more like a suite with a pull out bed for Mama and a TV with tons of kid’s movies, games, and even the internet on the TV. We determined I would work the first half of each day and then relieve Mama who went to work from the afternoon into early evening before going home to get work clothes for the next day before settling into the hospital at night. Donna’s college is across the street from the hospital, so this worked out for everyone.

We quickly got into a pattern of me getting my sub and heading up in the late mornings, and Donna showering in the hospital room’s bathroom. Even though Claire was definitely in good spirits and utterly asymptomatic, by Tuesday we were done with this hospital thing. We wanted to go back to our normally schedule lives. (Remember by then Claire had not been at school in 7 school days).

But it was not meant to be. Claire’s test came back positive. Two more days in the hospital, Mr. Groundhog. So we continued. The days meshed into each other, and I was in the hospital by noon each day and didn’t see fresh air again until after dark. Dante, the dog, was spooked because our home felt so empty since it was just me from about 9pm-6am each day. People sent well wishes and hoped she felt better soon, and I had to remind them that she felt totally fine… that we just needed to kill the salmonella swimming in her blood before anything really bad happened. Donna worked later and later, trying to fit 8 hours of work into 4, and we waited.

We knew that when they reran the blood tests Tuesday that there was no way we’d be home until Thursday at the earliest, and when the Infectious Disease doc came into the room, I got him to tell us that outright so we could plan our week.

We also asked him how she got sick and what it really meant. He said that it’s not uncommon for people to get Salmonella in Arizona (one strain is even named after the state!), but many people who get it are adults. Many times they don’t even noticed it. He said it could come from reptiles or amphibians. He said it could be found in unfiltered water. He said it is in nature. He even said it could be found in peanut butter!

My response was “what if Claire was recently playing in a creek, in the forest, down stream from a cattle ranch, eating peanut butter filled pretzels and playing with crayfish far from a sink where she could wash her hands?” He looked at me and said “that’d be the perfect storm.” Little did he realize that over break, while camping, Claire did exactly that. Even the incubation period matched with when she became symptomatic.

All the while, each day, we’d email Claire’s teacher, principal, kid express’ teacher and attendance officer. She received several nice emails back, a wonderful gift from Donna’s colleague, a beautiful card from my student’s mother, and even a personal call from her principal. We got homework done, played games, and watched television. By Tuesday the fluids were done, so she was not tethered to a machine 24/7. (Better for us all as she kept moving around the room, and we were worried she’d yank the IV out of her arm.)

By the time I arrived at the hospital on Wednesday, the preliminary culture was still negative. The doctor said after 12 hours of negative growth, the chances of the culture staying negative increases with each passing hour. We were pretty happy about that. If by Thursday the culture was positive, we need to start examining her for bone disease or Meningitis (in other words, we did NOT want the test to turn positive!).

By the time Donna returned Wednesday night, we felt really good about Thursday. We had so many well wishes via texts, Facebook, Twitter, and phone calls to us or Claire in the room. The thoughts and prayers were flowing in, and Donna packed up most of our belongings in the hospital room for me to bring home. Each night Donna had picked what Claire would have for dinner, and I’d order it each afternoon. That night as Claire had her dinner, we began laughing out loud! Donna had ordered her Salmon without thinking. It was hilariously coincidental!

Thursday morning, it was a matter of waiting. I had my own drama to deal with at work, so I didn’t stick by my phone much until 10:30 am when I had a new email that simply said “We’re Outta Here!”

It’s Thursday afternoon now, Donna’s back at work, I’m at home with Claire for the remainder of the day, and Claire’s excited to get back to school tomorrow just in time for her first kindergarten field trip and a relaxing weekend. She even had a gift waiting for her. Mimi ordered Claire stuffed bacteria. This company makes these stuffed animals that aren’t really animals. They come in the shape of bacterium or viruses but they’re plush and magnified by 10,000,000. (They’re about 4″ long and 2″ wide.) Guess which one Claire got in the mail? Salmonella. Three of them living in a petri dish. Very funny.

Hi everyone. It’s been a few days since I wrote. Tomorrow will mark the 2 week anniversary of my surgery and while I’m not perfect, let me talk to you about the last few days.

By this past weekend I was doing “ok”. Friday night I came in the house and Donna had made a scrumptious beef veggie soup that was mostly corn, kidney beans, green beans and small chunks of beef. I grabbed and small bowl and said what the hell. I sat down and ate very slowly and chewed everything. It tasted like heaven. There were a few times when the left side where the incision pulled open more than the right bugged me, but I ate a two small bowls. It was bliss.

As I mentioned last time, I had two conference presentations this weekend. Friday’s was ok and I had to stop a few times for Lisa (my co-presenter) to take over while I had a drink. By Saturday I had to present myself and I did just fine. After my presentation Saturday, it was lunch time. I just shrugged and got in the lunch line. I took a few slices of lunch meat, some cheese, and a small spinach salad. I sat down with some friends and began to eat. I made sure to stay on the right side of my mouth and actually did well. I was please with myself and by Saturday night I had a light dinner of shredded pork, chicken, and several sorts of beans for protein. I’ve not been hungry really yet, which is great, and I kept the portions small.

Today’s been good. I won’t lie. My throat’s still feeling a little odd. The stitches (which should dissolve anytime now) feel like threads tickling the back of my mouth. Today I left the house for two hours without my water bottle and barely needed it. I also keep taking my painkillers until everything is A-OK.

Tomorrow I return to work bright and early. I think all will be well, but you never know. There’s always that scary idea of bleeding out, and all but I think I am over and out. I even plan to camp in the woods by Friday, carrying heavy stuff, and not worrying about anything except starting a fire. Thank you for sharing this journey with me, and if I don’t write again about this, then all is well. I see the ENT in two weeks, and I have a sleep test in two months. I plan to report back on those, and I hope anything who reads this thread in the future is mollified. If I can do it, and I am feeling great, then you can to. It’s way better than dying early in life with heart attacks and strokes.

Well here I am. Back again. I will begin by saying that all will be well. Claire and I went to the ENT today and I had my list of questions for him. He asked how I’ve been doing and I had my spreadsheet with the schedule for the last week including meds, consumption or food (can you call it that?) and water, and other fun stuff. He began by checking my nose, and I told him about seeing the intubation tube coming out and how my right nostril has bothered me. He pulled out a large pair of tweezers that he stuck into my nostril. He slowly pulled out what looked like a 4 inch long skinny earth worm covered in snotty goo. It felt like he pulled it from my stomach. It was so cool! My nostril felt so much better. He said it was mucous build up from the tubal irritation and that I should use some saline spray until it feels all better.

Next we discussed my throat. I told him day 3-5 were pretty good but then after that I was sorer than usual. He said this was all typical and not to worry. He next looked into my throat and asked me where I was having most of the pain. Was it on the sides, he asked? Yes, I said. He said I had dehiscence, which means that the incision spacing between my sutures are pulling apart a little. He said this is typical in 30-40% of the cases, and there’s nothing I did or didn’t do that caused this. He said it won’t affect the healing but it will delay it by about a week. Sucks.
I am still restricted in terms of carrying (nothing over 10lb.), which includes lifting my daughter into or out of a car seat or buggy. Ugh. He said talking won’t hurt anything so do as much as I feel comfortable with. He continued my painkiller script, but I forgot to ask for anything topical, which was a thought of mine earlier. Much of the healing process I am going through is typical but the dehiscence does put me back a little.

Some other updates. Diet. I am surprised by how not hungry I’ve been. Literally. Every now and then I will catch a smell and my stomach will rumble a bit, but seriously I’m not hungry and if my stomach shrinks some then that’ll be good. Of course, my mentality is still of someone who loves food. It’s the psychology of consumption that still needs to change. I’ve felt as active as ever, and I do not feel unhealthy in any other way. Some things I do enjoy eating include cold Jellos, some pureed soups, lots of water, some pudding occasionally, sorbet, and ice cream. I use to have a large range before the dehiscence because now certain things burn the back of my mouth like some sorbets, orange Jello, and Gatorade. Those are off my diet now. Doctor and nurse suggested finding ways to increase the fiber and protein in my diet, so I may be experimenting with some liquid drinks that include protein powders and/or Metamucil. I do know my pre-op weigh but the ENT does not have a scale so I can’t check my current weight until I return to the high school on Monday.

Yes, and as for Monday and high school. I am planning my week out so I can talk as least as possible. If I have lecture materials I need covered, I am going to video tape them this week so I can just play them. What I can write, I will write out. I will also talk to my classes about my needs, as well.

My attitude is great, and all will be very well.

Well I ain’t gonna lie. I was feeling so well Saturday and even went out (eating carefully of course) that by Sunday morning I was in so much pain. When I took my painkillers in mid-day my pain level was 9. I had tears in my eyes. I was sitting around a 5-6 most of the week until then. Sunday I spent a bit of time resting and trying to not talk (Saturday was more talking, too) and Monday was much of the same. I went from trying to eat Mac & Cheese back to jello, but for some reason now the acidic nature of the jello is burning my sutures, too. Every four hours like clockwork I am taking painkillers and Amoxicillin three times a day. I do not think I damaged anything and there still is no blood (Thank God) but I won’t speculate on anything until after my formerly schedule post-op appointment with my ENT on Tuesday morning at 10AM. I have two separate workshop conferences this weekend on Friday and Saturday where I am currently scheduled to speak 60 minutes for each of them. I also have to return to my full time teaching highschool gig in seven days. Wish me luck.

Today I sort of pushed myself. Donna woke me half an hour before Claire’s karate lesson and I dove into the shower. I’d not been in public since before surgery so this was a new test for me. I was still in glasses at this point (no contacts for surgery) but was able to get cleaned. Donna drove to karate, obviously.

I had woken with a pretty sore throat and need to remember to put on the humidifiers tonight. Grab my meds before running out the door to class and a coupe of people talked to me through class. I did my best and mostly they didn’t let on they knew anything was funny with my speech patterns.

After karate, we hit a few garage sales and then headed home for lunch. I was a little eager to get out a little more and knew SwimKidsUSA was open until 2pm. I asked Claire if she wanted to head up there to practice her strokes and she readily agreed. In hindsight I should’ve taken my suit and relaxed in the heavily humid pool. That might’ve been nice. Claire swam for almost an hour and then I showered her. We ran over to the local bookstore so I could pick up her Peter Yarrow tickets, and she spent a bit of time reading and playing.

I talked briefly to some employees while looking for a book of my own, and I saw a friend who knew I’d gone under the knife. After an hour, I was tired and wanted to go home, though. But it was nice to get out into the real world again.

Our friend was having her 30th birthday tonight, so we laid low until it was time for dinner. This was first real test eating out of the house. I introduced myself at the dinner party and briefly explained my situation to those who didn’t know me. When I took the menu, I knew I needed something soft and bland. We were at a Mexican place, and I found something that was a fancy mac & cheese. I figured it was safe. I ordered that and “luke warm tap water with absolutely no ice”. The guy gave me a look but followed my order.

While eating a meal I could’ve devoured in under 10 minutes pre-surgery, I took small bites and chewed twice as long. Many time my throat wanted to swallow but I forced it to wait a few more chews. After an hour and people asking me if I wanted a box twice, I gave up. I had eaten about half and it was really good. I got the box and ordered some vanilla ice cream for desert. My throat is definitely a little sorer between eating and also talking, which I did a lot of at dinner with these two new couples we’d not met before.

The driving didn’t bother me today and even though I will be the first to not recommend driving on painkillers (it’s actually like DUI), that didn’t bother me at all. I know Tuesday I have to drive to the ENT office downtown, so that will be the real journey. Beyond that, nice day. More beautiful weather and have been really active mentally.

Working now after a relatively fitful night sleep and remembered the nurse in the hospital joking about painkiller dreams. Hydrocodone has been my painkiller of choice over the years, but I sure did have some odd dreams last night. I wasn’t in a ton of pain or anything and I slept pretty well from midnight until 9:30AM. As with every morning so far I woke with a pretty sore throat. Nothing meds and water couldn’t help. This morning I also decided to try teeth brushing. Nothing fancy, just cool water without paste. Front of my palette felt fine and my tongue felt ok, too. I do feel like I have a few of those sores you sometimes get on your tongue but I can deal with them. The brush didn’t bother my tongue or palette too much, but I also made sure I didn’t go back too far either. I took my Amoxicillin and painkillers and moved to the couch. After about two hours of lounging around there, I had to do something. Anything.

I grabbed my laptop and textbooks and made myself a work area out back on the porch. A soft top poker table worked perfectly and the temperature today has been wonderfully perfect. Claire’s spent some time out here playing and working on planting some green beans, too.

It’s about 1530 now, and I’ve not taken more meds (sorta seeing how my throat feels without them). I also was able to get a ton of grading done, commiserate with the other millions of people who still don’t have a Google Wave invite, and go through a 32oz Gatorade and some puddings. Not that you care, but I also successfully used the toilet today; I know the ENT will be happy about that since it’s been 5 days now.

Ok, more tomorrow then. Going to grade more this evening and probably move inside when the wife gets home from the day job. Tomorrow is the new test: leaving the house.

Hey hey, it’s Thursday. Actually, that’s what people tell me, anyway. I can’t even begin to tell you where my watch is, and by the tone of this post, you can see I am feeling better. Donna and I stayed up way too late last night watching random shows on the television, and I think I crashed around midnight. I don’t remember much between then and 8:30AM today, but when I woke up my throat was relatively raw and I needed a drink. I could tell I’ve been breathing through my mouth, and I am going to have to check with the ENT next week about that.

I dragged myself out of bed, got some meeds, and said goodbye to Donna who was running off for the day. Claire and I hunkered down in the living room for the day, and she watched way too much Dora and Diego, which I popped Mysteries of Pittsburgh into my MacBook Pro’s dvd player. I cannot even begin to tell you how terrible this film was. I had read the book circa 1998 and really enjoyed the characterization. I loved Phlox and found Jane the perfect description of heroine. It didn’t bother me that there we two characters with the same name, and the homosexual under tones didn’t bother me at all. Flash forward a decade and the film’s been made with Sienna Miler (as Jane), Peter Skaarsgaard as Cleveland. I’d been asking Donna to watch it with me for a month or two now, but she’s always had an excuse. I wish I had an excuse, too. Oh my God, it was terrible. Phlox was completely flattened as a character, Jane became boring, one of the Arthurs was cut completely from the film. The only thing I liked about this film was that it was filmed in Pittsburgh. Please skip this movie.

Anyway, back to the healing. I was able to eat cool orange jello and chocolate pudding. I also got about 32 oz of cool water down. Ice water is not a good idea yet, though. When I took the early afternoon painkiller and Amoxicillin does, Claire asked for a nap. I knew that if I laid down then I could also nap. We headed into my bedroom and crawled under the blankets. She was out for three hours and I was out another 90 minutes while she colored and made herself a peanut butter & jelly sandwich.

Around dinner time I woke up to make us some soup. I am ready to move up in the world to other challenges so I pulled out Red Lentil puree soup. Claire stuck her finger into her bowl before I microwaved it. She said “yum!” and I asked if she wanted it cold. She nodded vigorously and grabbed a spoon. I warmed mine and even though it was a little spicy I ate it all. At this point, I just need to remember to make small bites and lift my head when I swallow.

Later in the evening I felt well enough to vacuum and do dishes. Claire helped me clean up and we had sorbet for desert before she went to bed. We both brushed teeth tonight, which was something I was sort of scared to do beforehand.

If you’re reading this, and getting anything out of it, let me know. If you want to know more about pain or such, let me know. More about eating, etc… Let me know. I plan to update this until I return to work. This is Oct 22nd. We will see how that goes.

Well sleeping was a bit of a test. Somewhere along the line Donna and I began watching The Postman, and before I knew it she was in bed, it was midnight, and I had an hour left before the film was over. I was feeling just ok, and knew if I waited until 1AM I could take another dose of painkillers before bed.

When I went into the bedroom Donna had my pillows all propped up for me. The ENT wanted m to sleep with my head raised, which annoys me because I am such a flat sleeper usually. By about 2AM I was able to fall asleep relatively soundly. I did wake up every so often to try to swallow, so it wasn’t all fun and games but I sure did make it all night.

Around dawn I woke up to realized two things. 1) I forgot to put on my humidifier, & 2) it was time for more painkillers and I sure could use it. I wasn’t screaming out in pain, but I sure was a little uncomfortable. I crawled out of bed, took my meeds, had a little water and went back to sleep. I remember Donna saying something about lying too flat on my back (even though I know I had way more pillows under me than usual), and then I heard Claire shrieking. This was about 945AM and after checking on her, I fell back into bed until Donna called to make sure I was not still in bed at 10AM.

So it was time to transfer myself to the couch and take more meds. Got some painkillers and antibiotics, and Claire brought me orange jello. We mostly just sat around all afternoon. She wanted to color on the dry erase board with me, so I convinced her to put it across our laps. I also realized how many of her dry erase markers were dried out. She and I spent an hour drawing before she moved onto a show. She was looking forward to some Dora so I popped Forgetting Sarah Marshall into my laptop with my earphones. I don’t know if it was the painkillers or what but the movie was utterly terrible.

I moved onto some Pomegranate Sorbet and it tasted pretty good but since I’d just taken my meeds, it had an odd taste. I was still spitting a lot of gook but there’s still no blood, which is really good. In the late afternoon Donna picked Claire up to go to Karate, and Donna suggested I take a nap. I headed into the bedroom and was able to put together about an hour of fitful sleep.

When Donna and Claire came home, I was ready for the next test. Hot fluids. Donna had purchased several pureed soups, including a smooth corn soup. When she brought the bowl over, it was really warm, which concerned me. I let it sit until it was lukewarm (as I would rather warm it up again than to drink it too hot), and then I began to sip it with a teaspoon. It was very tasty and went down surprisingly well. I did have to warm it up once and I ended up eating most of a bowl full.

The only concerns I see right now is that occasionally it does feel like some of the fluids do go up into my nose a little bit. I know this can be a concern and a side affect that may never go away. I sure don’t want this to be permanent, and it is definitely one of the things I need to talk to the ENT about next week.

After the soup, I felt well enough to help Claire with her bath. I kept upright as much as possible, I am talking a little more, and I am feeling pretty ok right now. I had a little sorbet this evening after the soup, and the ENT is correct that citrus isn’t the best thing since it’s lemon flavored and a little sore.

My attitude’s been good, and Donna and I both expected me to be more out of it still. For example, I think we both expected me to be unconscious all evening last night and in bed much of today. I’ve been laying low, and I want to thank all of the people who’ve messaged me their well wishes.

Well Monday rolled around quickly, and Donna and I took Claire to daycare early in the morning before driving to Banner Good Samaritan Hospital in Phoenix. We checked in around 7:30AM, paid my 20%, and eventually got called back to pre-op. The nurse asked all the normal questions, had me strip down to my boxers, and had me put all my belongings away. Even though the signs all said no mobile phones, I still hung onto mind to tweet ’til the last minute. After I was all set up and had my IV, they let Donna come back.

After a bit Dr Orozco (ENT) & Dr Whooley (anesthesiologist) came in to answer questions. Donna and I wrote them all down and took a couple last minute photos before the nurse wheeled me down to the operating room. (Donna was to wait in the waiting room until I was done). As they wheeled me into the OR, I had this sense of overwhelming dread at the last second. It was the anxious feeling of passing the point of no return. As soon as they got me on the table, Whooley administered Versed, which is a relaxing drug they’ve used on me before. While he did that, he told the nurse to get a nasal intubation tube. I know enough about medical procedures to know I did NOT want to be awake when they intubated me!

Well, guess what? The next thing I knew was hearing Donna’s voice. She said something about the nasal tube, and then I opened my eyes. Right when I opened my eyes, I watched the RN swiftly pull what looked like a 6″ curved, bloody tube from my right nostril. Donna gasped because she didn’t realize how far into my body that tube would go. I did. It hurt a little but not really that much since I was still completely out of it. By this point, Donna has later told me that I’d been out of surgery for 90 minutes.

Once a bed opened, they moved me upstairs. There are holes throughout my afternoon that she could probably fill in, but as I said before, I am writing this for people who will have these surgeries more for me. Through out the afternoon I was surprised at how sore I wasn’t. Yes, not that sore. The ENT had said I would feel like I have the worse sore throat ever, but that’s not true for me. I’ve had a sore throat where I felt like I was swallowing glass all the time. This isn’t that bad. But you know what they didn’t tell me that has bothered me? The gook. Now, I haven’t seen any blood but have you ever had a mouth full of really thick spit that you just needed to get out of your throat? Well, that’s what I’ve been feeling completely for 24 hours now. I’ve been either spitting into tissues and tossing them or trying to swallow. It takes 2-3 times for me to swallow when trying, and most of the time i don’t completely succeed. The ENT said all of this is normal for now.

The evening after surgery I was in and out of consciousness all night long. One time I woke up to a meal sitting in front of me. It was all liquid sort of food, and one thing there was chicken soup that was pureed. I decided to try it, and some of it was going back up my nose, which was sort of scary because I sure don’t want that to permanent part of my eating abilities from now on. I gave up on soup and then had some pudding. It was lemon flavored and he said no citrus but it felt ok to me.

By 2AM Donna reminded me that I had my noise cancellation headphones with me, and since my roommate was way too loud, I popped those on, and fell asleep for 4-5 hours. Tuesday morning was a lot of waiting around to be released. Over night I realized the nurse had been giving me double doses of my painkillers, which was good news for me. After the nurse split the dose to the correct dosage, it still was doing it’s job just fine.

As for talking, it sure isn’t something I want to be doing but I’ve had to talk a little here and there and it’s been ok. It doesn’t really hurt, but I am just not that interested in talking too much. Of course, Claire doesn’t quite understand but she will be ok.

By about 1PM I was allowed to go home. Donna drove me home and I’ve been mostly on the couch since. I’ve slept a bit and watched TV, and the only reason I can post this is because I am 3 1/2 hours out from painkillers so I am relatively lucid right now.

I am sort of surprised by my lack of appetite. I thought I would be terribly hungry and my family even had a great dinner here near me, but so far it’s not bothered me at all. I’ve been sipping on a Gatorade all day and forced down a chocolate pudding. I know what my weight was pre-surgery, so I can more about that after this journey. As for the bathroom, I know I need to be urinating. When you have something like this and don’t urinate then it’s definitely an issue, which could lead to dehydration and fluids in the ER. Yuck. So I am keeping track of my toilet habits, too. As for bowel movements, if it don’t go in, then it won’t come out. ’nuff said. ok, moving on…

I think bed tonight will be a new test.