Back Surgery Update

In order for my back surgery to proceed, my orthopedist required me to get clearances from A.) my nephrologist – because as per my records I have been shown to be close to having kidney disease because earlier tests showed I only had 30% of my right kidney functioning (90% – 80% would be normal for my age), and B.) a cardiologist, which is normal since one always asks these for advice before any surgery.

To understand why I have a nephrologist, it’s apt to go back a bit in my medical history. Back in 2010 I blogged about discovering I had diabetes. I ate healthy and worked out and my blood numbers improved. A year or two I got worse again, then I got back on the wagon and improved again. Yes it’s crazy.So anyway, at the latter part of 2015 I threw my back out and experienced back pain a little less similar to what I had a week ago. I went to the Ortho doctor., the same one I have now, and as per my MRI the situation with my lower disc was still ok. He recommended rest and pain killers, which I did, and I was up and about a month after.

A few months later though I started to feel a little lump at the ball of my right foot. It was only painful if I stepped on it, but it felt weird, and I couldn’t run, so I wanted to have my Ortho take a look at it. But before I did that I thought it would be prudent if I first check if diabetes had anything to do with it.

Happily at this point it coincided with a time I had a HMO card that my wife had as part of her benefits where she used to work. So since it was ‘free’, I went to a clinic to get myself worked up, blood and all.

Now the process of getting checked out is long because before a lab actually gets to work on you they’ll need a doctor to give them a go ahead first. This serves as a guide for the lab technicians and also as a way for the HMO to figure out whether they’ll shoulder the cost or not. Fortunately the clinic had in house doctors too, which is great, except you’ll have to figure out and adjust to their schedules. Then you fall in line (not surprisingly there’s always a lot of people that need to consult in house clinic Drs.), and after you get the results of the consultation you then go to the lab, who will then set another schedule for you to go there and get it done. Of course it’s possible the lab will do it right away, but in my case, for a fasting blood sugar (FBS) test, you’ll need to not eat for 8-10 hours then go there for them to take your blood, and do any other required tests.

So ok, after getting the tests, I wait a day or two till I can pick up the results, after which I go back to the in house doctor so she can figure out whether there’s anything wrong with me and what, which means another check with the doctors’ sched, go there, fall in line again, and so on.

So finally the doctor checks my lab results and she says my FBS is ok, meaning my diabetes is controlled (which is kind of a miracle since I had not been taking any maintenance medicine for it whatsoever, but lets talk about that later), however, I had a creatinine levels, and she wanted me to talk to a specialist, a nephrologist, about this. She gives me a piece of paper asking a nearby hospital where she works asking their HMO office to set me up with one, preferably who can be paid via my HMO card, which is nice.

So I do this. I get his name, find out his sched, then I go to that hospital. I meet him, he frowns at my lab results, and decides he wants to figure out whether the reason my creatinine is high is because of my diabetes. He’s curious though if I really do have diabetes, because as per lab results my blood sugar is ok (an FBS result is very hard to cheat or dispute). He recommends an eye exam via an ophtalmologist, which is a sure – fire way, he says, to find out if I have it or not, as well as a bunch of other exams that have to do with my urine (and another blood test(?) I’m not sure).

Since the hospital does not yet have an in house opthalmology clinic, their HMO office is kind enough to help me track down one, who will accept my HMO card, in another hospital a jeepney ride away.

So I figure out the Optha’s schedule, and this requires another day or two of wait.

In the meantime, the reason why I’m doing this to begin with, which is to check out the weird lump at the bottom of my foot, has yet to be looked at by the orthopedist. Three weeks or so has passed since.

I finally meet the opthalmologist, she checks me out, and fortunately declares right there and then that the state of my eyes are excellent. I say fortunately because I didn’t have to wait and come back for the results as is usually the case. However, she is careful to explain to me that this does not necessarily mean I do not have diabetes. It only means that if I do it has not affected my eyes.

So she writes this up, I gather the other lab result exams the nephrologist asked me to get, and I go again and show these to him.

Now I would guess this nephrologist is very smart at the technical aspects of his job, because if his lack of communication skills is any indication, he’s probably a genius. He reminds me of the nerdiest programmers I know who are great at what they do and can program the hell out of anything, but has an awful time explaining the simplest things to people. What I do gather from him is that he is not happy with the results, and even more so that I am not doing anything about it, as indicated by my not taking and diabetes medicines.

Here is the part I admit my fault because I had not been following up with my diabetes doctor, since our last consult approximately two years ago. This is partly because as per our last meeting my blood numbers at the time were terrific, and she even congratulated me for it, and secondly because of cost. The maintenance medicine cost is ok, but the machine I use to check my blood sugar daily also had some cost, and it required time to go to a pharmacy, buy the stuff, then do the thing everyday, only to find out my blood sugar remained normal for weeks on end. Plus each consult with the doctor is p600 a pop, which I am careful to say I do not begrudge them, they certainly deserve more if they can get more, and yes I know it’s for my own good, but it’s a lot per se, that’s all I’m saying.

In other words, I stopped going to my diabetes doctor because I got complacent from my blood sugar level numbers, which were consistently ok.

In any case nerdy nephrologist guy insists I consult once again with my diabetes doctor, whom he happens to know and  is conveniently holding clinic within the same hospital anyway, and who can be paid via my HMO card as well, which is great.

So a week or two passed after that, since needless to say, I get busy with other things as well. In fact all throughout my recollection of above I neglect to mention I am busy with other stuff, such as trying to earn a living. Finding time to do this stuff takes time and effort to pull me away from earning projects. The fact that this is all funded by an HMO card is probably 80% of the reason I’m finally doing it, so I find myself thanking I have that HMO card at every step, and even more so after what’s about to happen.

Because at this stage what happens is what I described at my last blog post.

We go on a trip to Subic, and my back hurts a little bit when we get back, but nothing big. I experience an arthritis episode on my right foot, which I assume would pass after a day or two, but as I throw myself (not even ‘throw’, just jump a little) back into bed after a trip to the bathroom I experience 10/10 pain in my lower back, practically paralyzing my hips and back because the smallest amount of movement was equal to a (manly) scream of intense pain.

Which lead to the ambulance and hospital stay, super pain killers and hours of rest and sleep, and I finally get to meet my orthopedic guy doctor, and who gets me to go to Makati Med on an ambulance at 11pm to get an MRI (it only takes 20 minutes from Sucat to Makati Med on a wailing ambulance at night).

After this MRI, he decides I need surgery. And to get this surgery, I need the above mentioned clearances, and to get these clearances, I am having to chase doctors, go 2 or 3 times to laboratories to get my blood drawn, a 2d echo (today) and gather results from said drawn blood, and so on. By Saturday we are hoping to finally find a cardiologist who would then recommend we go again to a lab so he can have my heart checked, which again will require another schedule to go there and pick up the results, then another trip to show this to the cardiologist who will give a thumbs up or down re if I can get my surgery.

So that’s where I’m at right now. It’s been 3 days since getting out the hospital and I can walk ‘normally’ with a cane now, albeit limping, and not very long since my back tends to ache again. Although it may seem deceiving that I am getting better, and that it might only take some time before I can do normal stuff again, the fact that my right foot kind of drags along and that I want a cane to always help me is reminder that something deeper is wrong, so I am anxious to get that surgery going.

Addendum:

  1. I feel it prudent to list my meds at this time:
    Lyrica (Pregabalin) – 150mg 1x a day before sleep. Probably one of the strongest drugs one can take for this sort of thing. It’s an anti – convulsant, which helps when one’s back occasionally ‘spasms’, which is what essentially happened to me. It’s also the most expensive at P85.00 a pop. Oddly enough the side effect is suicidal thoughts, which is weird. I think it manifests in me via the fact I’ve started to want to listen to jazz a lot.
  2. Algesia (Tramadol Hydrochloride + Paracetamol) – 37.5mg / 325mg, 3x a day. This stuff plus the Lyrica makes you woozy, and is a pretty strong pain killer. Over time my pain decreased so I had occasionally skipped one or two. I really don’t want to be taking pain killers when I don’t have much pain. I’m going to request a decrease of this dosage when I next meet my doctor.
  3. Sodium Bicarbonate – 650mg daily. Something to do with my kidney something or other.
  4. Irbesartan – 150mg daily. Anti diabetic maintenance stuff.
  5. Atenurix – 40mg daily. Uric acid control.

That’s it for the moment, at least until after surgery where I expect this to change of course.

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