My Next Great Adventure

[MisterSnoop]

Good luck with the surgery

 

[57Rambler]

I'm not going to dismiss the "quiting" perspective, but we are all adults and should be able to make such decisions on our own. Refusing medical services to someone just because they smoke, especially when the condition is not directly related, seems unwarranted in my opinion.

When I questioned the doctor regarding the smoking he told me that the success rate for this particular surgery, without any reoccurrence, for non-smokers is 97% and drops to 82% for smokers.

Considering the impact the hernia is having on my lifestyle and physical activity (lack thereof), I'll take the 82% chances anytime. That decision should be mine, not the doctor's or the insurance companies.

I seriously doubt whether they would even test you for nicotine. Even so, a saliva test would only detect usage in the last few days, they would need to do a follicle test to catch usage further out.

 

[2black1s]

I seriously doubt whether they would even test you for nicotine. Even so, a saliva test would only detect usage in the last few days, they would need to do a follicle test to catch usage further out.

I asked that question too.

"What if I just tell you I quit"?

The doctored replied that they will be testing for tobacco usage prior to performing the surgery... I think he mentioned a urine analysis but I'm not certain.

I know that smoking is becoming less and less socially acceptable these days, but the medical bureaucracy responsible for this policy is way out-of-bounds in my opinion.

 

[2black1s]

Ok... I've implemented Plan B.

After this morning's video visit with the surgeon, I have to admit I was a bit frustrated, so I kicked back in my recliner for an hour or so to collect my thoughts and recalibrate my logic before proceeding.

Plan B...

I sent an email to my primary care physician in regards to the issues (COVID and smoking) brought up by the surgeon and asked if she had any suggestions for my path forward. In that email I also brought up my concern over waiting so long for the surgery and how that would impact my overall physical condition/health due to the fact that my physical activities are severely hampered/limited by my current condition. I don't want to turn into a bowl of jello while I'm sitting around waiting for months.

I then called and filed a complaint with the Members Services organization of my health provider (Medicare Advantage through Kaiser Permanente). This complaint includes the same topics, i.e., waiting time due to COVID, their failure to provide a necessary service due to the fact that I smoke, and my physical conditioning/health concerns as a result of waiting/physical inactivity.

Now I just have to give them a little time to respond. We'll see where this goes.

 

[PaulMys]

Ok... I've implemented Plan B.

After this morning's video visit with the surgeon, I have to admit I was a bit frustrated, so I kicked back in my recliner for an hour or so to collect my thoughts and recalibrate my logic before proceeding.

Plan B...

I sent an email to my primary care physician in regards to the issues (COVID and smoking) brought up by the surgeon and asked if she had any suggestions for my path forward. In that email I also brought up my concern over waiting so long for the surgery and how that would impact my overall physical condition/health due to the fact that my physical activities are severely hampered/limited by my current condition. I don't want to turn into a bowl of jello while I'm sitting around waiting for months.

I then called and filed a complaint with the Members Services organization of my health provider (Medicare Advantage through Kaiser Permanente). This complaint includes the same topics, i.e., waiting time due to COVID, their failure to provide a necessary service due to the fact that I smoke, and my physical conditioning/health concerns as a result of waiting/physical inactivity.

Now I just have to give them a little time to respond. We'll see where this goes.

Excellent thought process. And I agree.

 

[2black1s]

Excellent thought process. And I agree.

That's why I relaxed in the recliner for an hour LOL. I definitely needed a little time to settle and clear my mind.

My initial inclinations were not as concise, or civil.

 

[2black1s]

Just received a call from Kaiser following up on my complaint filed yesterday.

My concerns of postponing the surgery due to COVID, and their outright refusal to perform the surgery due to my smoking, are being forwarded to their "Expedited Review" function.

The rep assured me that a decision would be reached and I will be informed of such decision by Friday.

That's a reasonable response at this point. Obviously I'd like the process to be faster but I also realize that "stuff" takes time.

 

[PaulMys]

Tell them you are an illegal (oh wait....... "undocumented") immigrant.

You'll be on the OR table in the morning.


Rant over.:bolt:

 

[2black1s]

Sitting around is making me anxious so I went out to the garage to do a little more polishing of my bike. I did the front fairing and the front fender. I still have the tank and the two lower front fairings to do.

Doing the fairing wasn't all that bad as I was primarily on my feet.

But the front fender - that's a different story. Crawling around on the ground, from side-to-side, for the 45 minutes or so that it took has done me in for a while.

Now I need to rest and allow the pain to subside a bit, then repeat the cycle. Probably tomorrow.

I hope no one here thinks I'm looking for sympathy - I'm not. I have had worse pains before. And I'm pretty good at dealing with whatever comes my way.

I just simply have extra time on my hands because my physical activity is somewhat limited. Documenting my journey here seems like a reasonable way to spend some of that time.

View attachment 72372 View attachment 72373

 

[2black1s]

Finished my bike today in three separate sessions with pain relief rest periods in between. Did the tank first and then each of the lower front fairings.

Looks GOOD!!!

Hopefully I'll feel up for a ride this weekend.

View attachment 72392 View attachment 72393 View attachment 72394 View attachment 72395 View attachment 72396

Oh yeah, on a little side note, I have a video appointment with another surgeon tomorrow afternoon.

 

[Jacob Harrod AUTOCLEAN]

Sorry to hear that brother. Please be sure to keep us updated.

Sent from my SM-G975U using Autogeekonline mobile app

 

[2black1s]

Dealing with Kaiser is in the early stages of what looks like it's going to be an ongoing struggle.

Their response to my complaint was to offer a second surgical opinion. I'm not questioning the need of the surgery, contrary, I want it done ASAP. Basically, their response to my complaint did not address my complaint at all. Just like a politician answering a question they don't really want to answer.

They are giving me a surgery date of June 25th and are sticking to the "quit smoking" requirement. Essentially zero progress since this all started.

Monday I have an in-office visit with a second surgeon, whom I had a phone visit with today and suggested that I come in for a real-live examination. I figure I'll get that second opinion, for absolute certainty in my mind, and then decide on what I can do next (if anything, beyond being a squeaky wheel) to speed things along.

Regardless of what happens with the second opinion and the timing, the smoking part of the equation is going to be really tough. I don't think they're going to budge on that requirement.

 

[2black1s]

Got out for a 130-mile ride this morning.

Breakfast in Camarillo, onto Santa Paula Airport, then to Pacific Coast Highway through Ventura and Malibu, Encinal Canyon, Mulholland Hwy, and then back home.

Felt ok during the ride, not perfect, but ok. I'd have to think pretty hard before embarking on my annual summer cross-country motorcycle trip in my current condition. Not sure I'll be up for that before getting this hernia issue resolved.

Last year was only the third time since 2003 that I missed my annual trip and that was due to COVID. I had no intention of missing it again this year, COVID or not. Now we'll have to see.

 

[PaulMys]

Dealing with Kaiser is in the early stages of what looks like it's going to be an ongoing struggle.

Their response to my complaint was to offer a second surgical opinion. I'm not questioning the need of the surgery, contrary, I want it done ASAP. Basically, their response to my complaint did not address my complaint at all. Just like a politician answering a question they don't really want to answer.

They are giving me a surgery date of June 25th and are sticking to the "quit smoking" requirement. Essentially zero progress since this all started.

Monday I have an in-office visit with a second surgeon, whom I had a phone visit with today and suggested that I come in for a real-live examination. I figure I'll get that second opinion, for absolute certainty in my mind, and then decide on what I can do next (if anything, beyond being a squeaky wheel) to speed things along.

Regardless of what happens with the second opinion and the timing, the smoking part of the equation is going to be really tough. I don't think they're going to budge on that requirement.

Incredibly stupid.

Say you suffered a heart attack? Would they delay surgery because you smoke?

When the liability of the insurance companies trumps the welfare of the patient, we have a problem. Oh wait.......... What am I saying? The interests of the big insurance companies ALWAYS trump the needs of the people.

 

[2black1s]

Incredibly stupid.

Say you suffered a heart attack? Would they delay surgery because you smoke?

When the liability of the insurance companies trumps the welfare of the patient, we have a problem. Oh wait.......... What am I saying? The interests of the big insurance companies ALWAYS trump the needs of the people.

I tend to agree...

 

[2black1s]

In preparation for my Monday morning appointment with the second surgeon (Dr. Park), I prepared a document with several important points that I want to be sure to discuss. I hope to convince them of my perspective. We'll see what my chances are.

Any opinions regarding my sharing of the following with the doctor(s) are welcome...


Hernia Surgery and Smoking – A Patient’s Perspective

Re:
Prior conversations with Hernia Surgery Specialists; Gregory M. Heitmann MD, M.D. and Cheryl Lin Park MD, M.D., each individually, from the Kaiser Permanente Woodland Hills Surgery Center

During the referenced conversations, I was informed by both Dr. Heitmann and Dr. Park that my pending hernia repair surgery could not be performed unless, and until, I stopped smoking for a minimum of 30-days prior to the surgery. I was additionally informed that any nicotine-containing smoking cessation aids are prohibited during the same timeframe; and that urine samples would be necessary at 2-weeks prior, and 2-days prior, to the subject surgery to confirm compliance.

While I understand the data driving this prerequisite at a high level as presented to me by Dr. Heitmann, and Dr. Park, and from my own online research, that suggests a higher level of risk for complications and/or hernia recurrence in smokers, I do not understand how this policy can be applied unilaterally in all cases, while still serving the patient’s best interests.

In my case, the data provided me by Dr. Heitmann, and reaffirmed by Dr. Park, indicates that due to my smoking I will have a six-fold increase in the likelihood of complications and/or recurrence should the surgery be performed. 3% vs. 18%. I look at that as 97% vs. 82% likelihood of success. Some of my own online research indicates studies where the data is not so clear-cut. I bring that up only as a point of reference, not as any discrediting of the information provided.

Regardless of the actual numbers, I agree by simple logic that I should quit smoking to improve my “odds”. But I also have to ask myself, “are the odds good enough”?

Given my hernial condition and the acute effects it is having on my activities and general quality of life, I do not see the reduction in success likelihood associated with smoking, as rising to the level of a single-determinant factor. Other factors such as; general health, exercise and physical conditioning regimen, body type, psychological perspective and attitude; Don’t these play a role and possibly negate some of the “smoking” risks? I would think yes, to some degree.

In a perfect world none of this would matter because it would simply not apply. But in our imperfect real-world, one can lose sight of the greater good while chasing perfection. I know this as well as anyone, as I am both blessed, and cursed, with a streak of perfectionism in my own personality. As noble a goal as any, please don’t let the “chasing of perfection” preclude me the real-world “greater good”.

Please ask yourself…
Is my need for hernia repair surgery any less than that of a non-smoker?
Is the risk for complication so great that surgery must be precluded?
Is the risk of recurrence so high that performing the surgery is an exercise in futility?
Do the answers to any of these questions rise to the level that surgery cannot be justified?
My answer to each is “no”.

 

[sunday joe]

Good time to catch up on your reading. Public Library will be glad to help you.
Make lemonade out of lemons. Enough clichés ?

 

[2black1s]

Good time to catch up on your reading. Public Library will be glad to help you.
Make lemonade out of lemons. Enough clichés ?

It's Sunday. Is that a coincidence? Or are you really just "sunday joe"?

I haven't seen you here before and found your screen name on this Sunday a little coincidental.

Thanks for the message. I'm doing my best with the lemonade reference.

 

[sunday joe]

I apologize for my poor reply. I hope they take good care of you and that you are able to quit the smoking addiction.
Re sunday joe user name: About 10 yrs. ago when I began lurking on the Maguires forum, A member commented that he considered a full time detailer to be call a Detailer and someone who just just washed and waxed their car weekly or whenever was a Joe Sunday. I thought I fitted into that category and used the name. I quit smoking June 18th 1950 when a friend refused me a cigarette. I vowed that would never happen again. I was very lucky I had no withdrawal problems ever. He never knew what a great favour he did for me. I'm turning 90 in a few weeks and that may have helped.
Again, best wished for you in the coming months.

 

[2black1s]

I apologize for my poor reply. I hope they take good care of you and that you are able to quit the smoking addiction.
Re sunday joe user name: About 10 yrs. ago when I began lurking on the Maguires forum, A member commented that he considered a full time detailer to be call a Detailer and someone who just just washed and waxed their car weekly or whenever was a Joe Sunday. I thought I fitted into that category and used the name. I quit smoking June 18th 1950 when a friend refused me a cigarette. I vowed that would never happen again. I was very lucky I had no withdrawal problems ever. He never knew what a great favour he did for me. I'm turning 90 in a few weeks and that may have helped.
Again, best wished for you in the coming months.

No apologies necessary... There was nothing wrong with your initial reply.

And the Sunday Joe explanation makes sense. I guess I'm somewhere in-between. Not a full-time detailer but a little more than simply a Joe Sunday.