Monday, October 05, 2009


One day about 5 years ago, while playing golf, I experienced severe left hip pain. I immediately abandoned the game and returned to hospital, where an X- ray showed that I had developed severe osteoarthritis probably from avascular necrosis of the head of my left femur. Initially the pain was easily bearable. I decided to bear with the pain and continue my work, while waiting for the technology to improve and also planning to have the prosthesis ( it is essentially spare parts replacement ) to outlast me. I suspected that the left head of femur avascular necrosis is probably the result of radiation from my wrk as an interventional cardiologist. I remember in the good old days of 1990s the interventional devices and accessories were bulky ( nothing compared to present day ) and procedures were long, as we struggled sometimes for hours doing three vessel diseases. Flouo times were often in the hours. The hip is in that position where there is a slit in our lead apron, and some radiation may have escaped in.
Anyway, about the beginning of this year, the pain was getting unbearable and I had difficulty performing my duties in my teaching programs and patientcare. I decided that it was time to get my left hip replaced. The titanium metal-metal hip prosthesis should last me 15-20 years at least and that should bring me to 73-78yrs old ( God willing ). I have always been in consultation and supervision of Dr Teo Wee Sin, consultant orthopedic surgeon at Sunway Medical Center. In late August, we planned to have the surgery on the 30th Sept 2009 ( his operations day in Sunway ). Dr Teo chose Dr Tan Yit, as the anaethesist. Dr Teo is my classmate. ( Weare both from MU, the medical class of 1970-75 ).
I checked my self into Sunway Medical Center on the afternoon of the 29th Sept 2009, having done my pre-admission procedure, especially insurance clearance on the 23rd Sept 2009. The surgery on the 30th Sept went well. It was practically painless. The night before, I had some sedation. On the morning of, I had skin preparations at about 6.30am and was wheeled into OT ( operations theatre ) at about 7.45am. I felt a smal needle prick in my left hand and thereafter, I slept through the whole surgery and was awoken in CCU at about 2pm, having been brought back from OT at about 11am. Well of course I cannot say that it was a pleasant experience ( afterall it is major surgery ), but it is fair to say that it was not too unpleasant. I had thoughts of pains and scary experiences pre-op. The whole surgery was done under Epidural anaesthesia with heavy sedation. I still had an epidural cathether when I returned to CCU and the wards. From the op onwards, it was just boredom and inconveniece as I recover. I could not get out of bed till third post-op day, which means that I could not wash up, pass motion ( not use to doing on bedpan ), or walk around. It was just boring. On the second post-op day, I had my first physio ( passive exercises in bed ). On the third post-op day, the epidural catheter and the drains came off, and also the urinary cathether. That evening, the physio allowed me to get out of bed to walk with a walking frame. I was also taught how to get up and down the staircase with a walking clutch. ( my bedoom at home was upstairs ). I was discharged on the fourth post-op day. It took me 2 hours to await insurance clearance before I was allowed to leave the hospital. This was despite my having obtained insurance clearance before my surgey and also having my insurance agent ( a personal friend ) involved tp make sure things are according to insurance procedures.
Throughout this whole adventure, I learned a few lessons to share with you all :-
1. That anaesthesia and orthopedic surgery have come along way, and you could have major surgery done under regional anaesthesia, with minimal pain. The team was good
2. That the biggest challenge post-op was lack of freedom, to do the things that you wish. All your usual routines are upset, and you have to accomodate and get use to new way of doing things. Staring at the ceiling, repeatedly being interrupted with nursing procedures, watching the TV showing reruns, is a real challenge. Visitors break the monotony every now and then.
3. Insurance can be a pain. Up till now, I have not seen my hospital bill. Taking hours to clear me, despite all the pre-admission documentations, is not reasonable. With the attending physician's statement preop, and with his postop report, the bills should have no problem being cleared. My advice to all of you, is to have a good friendly relationship with your agent, who can help much to expedite the whole billing process. Without her help, I do not know who long more it would have taken. The medical insurance claims procedure surely needs a revamp.

I need much more physio before I can walk normally and know how successful the operation have been. I hope that the rest of the recovery will be as smooth, as the operations.
Well at least now you know why I did not blog on Friday.

1 comment:

msforty5 said...

now you know how it feels like to be a patient and usually insurance company are a pain in the neck, dissapearing act when you need them the most, with or without a reliable insurance agent.