Check out Christophers segment in the Great American Motorcycle Tour with Dr. David Kibbe (his interview starts around 11 min 30 sec.)!

The tweets (messages on twitter) was so popular last time, I did it again for the follow up laser ablation surgery done on the back of my legs for varicose veins. You can catch the first installment here if you missed it.  And once again, I went through the trouble of reverse flowing the tweets so they go in order as you read down. For the record, I saw Dr. Roger Bonau at The Surgical Clinic in Nashville.

The discomfort this time may be a little bit more apparent from the posts. But the post op has been better. Luck of the draw, I guess.

The award for best tweet to me during the surgery comes from good friend and health care law blogger, Bob Coffield (catch his tweets @bobcoffield on twitter):

@robert_hendrick another twitter use. Monitor real time malpractice. Going to start including tweet requests in discovery

@bobcoffield doc found no humor in tweets in discovery. I did though.

@Robert_Hendrick did you tell him that I am on the defense side?

Enjoy!

Live from surgery part 2. Tweeting my surgery starting around 9am

Sooo. Valium $2.63 last time. $2.29 this time at same kroger. Must be on sale. Purely for research. Going drug free.

Uh oh. The staff at the doc’s office is following me on twitter now.

Getting quick ultrasound on previous surgery spot. Healing nicely.

Smearing betadine on my legs now. COLD.

Waiting for the rock star doc to show for surg. Country music playing in operating room. I love Nashville.

Doc walked in “what the hell are we listening to?”

First stick. No big deal. Still feel the flush and warmth in my body. Nerves.

Man I’m sweating. Stress of recent days ha heightened my apprehension over this. Doc in canulating (trying to get needle in vein)

Dr. Bonau says of the canulating “This is a bit tortuous.” Mmmmhmmmm.

Doc jinxed us when he said “this will be easier than first one.” Getting more lydocaine right now.

Wondering where the health content 08 tweets are. Not seeing any.

@dian_luffman the adrenaline rush has abated. Still on leg #1. Searching…searching…searching

Left leg canulated. FINALLY! Going for other leg and planning to laser both at one time.

@bobcoffield thanks for the distraction.

Doc is giving me his entire educational background. Been at tulane, NY, sloan kettering, st thomas, vandy…

No more pain than the first time. Far more tedious. “Worst is over.”

Firing up the laser…

Lydocaine going in around laser site. Flattens the vein a bit by putting pressure protectsthe vein from the heat.

Ooooooooow. Bad stick. Bad bad stick. Ow ow ow ow ow

Taste of burnt blood in the back of my throat from laser

Right leg hurt like shit up in the hammy. Left leg done and no pain at all.

Oh so glad to be done. Cleanup to ensue. More COLD stuff on my legs to clean.

So doc goes in at calf. Runs catheter up leg about 12″ and then lasers 12″ of vein shut.

Only getting compression wrap on calves. w00t! No behind the knee wrap.

@bobcoffield doc found no humor in tweets in discovery. I did though.

And done. Thanks to everyone!

8 hours after the surgery, the lydocaine has worn off.

Ah. Now I’m getting the feeling of little bee stings up the back of my left leg. This is fun (sarcasm noted).

Just had a great interview with some allies in the battle to bring transparency to the healthcare system. I spoke with Kristy Williams of Alijor and for those not familiar with them, the concept is interesting. On Alijor, patients can connect with providers to address their specific need(s). Simply opening a line of communication between provider and patient is a huge need.Alijor facilitates just that and more.

Right now, there is a lot of effort going into the effort to bring transparency to healthcare, and we’ve met a lot of them in the past two years of doing this. We’re going to meet more in the coming years, but it’s nice to find friends in among the fray who are thinking outside of the box and who share our goals.

We need all of the friends we can get. Thanks guys!

change:healthcare CEO Christopher Parks is this months “You Ask It” expert on SHOUTAmerica.

What is “You Ask It”??  Well it’s an online interactive forum where you can submit questions to leading healthcare experts.

So if you are confused about your health insurance, curious about the changing face of the health care industry, wondering about consumer directed health plan and transparency… Christopher has the answer.

Unleash his knowledge at http://www.shoutamerica.com/content/get-involved/you-ask-it and get involved in the discussion!

First off, thanks for all of the concern and support from so many people over the past few days WRT my surgery. It seems I’m telling people things and repeating myself and I hate to bore anyone, so I’m putting this together to give folks the details and use my own experience as a personal example of why change:healthcare does what it does.

Why change:healthcare Does What It Does:

The business end of things…My doc will bill my insurer somewhere around $6,124. However, the allowed amount with my insurer is $2,904. Per the FANTASTIC staff at Dr. Bonau’s office, “double check with [insurer] to be sure and I don’t even know if they will tell you an exact number but you can try… The procedure codes are 36478/36479″

They also pointed me to the insurer’s financial counselor complete with the phone number.

Had I been uninsured, the amount would have been $6,124. On a different insurance, the cost would most assuredly been something OTHER THAN $2,904. And had my surgery not been Medically Necessary, and I had simply done self-pay without submitting a claim, I may have been expected to pay $6,124. Keep your eye on the peanut, now which shell is it under?

change:healthcare helps people sort through all of that.

My Status:

I’m doing well. 48 hours out of surgery the wrap is off, I have to wear a support sleeve on the leg, but I got on my bicycle on the stand in my home office. Rode for an hour at a moderate pace on an easy gear. Felt great to move again. Doing well.

So well in fact that I failed to take the prescribed ibuprofen today (day 2 post surgery). Should have taken some on waking up at 6 AM. After lunch, I started to feel it a bit, and finally got the anti-inflammatory into my system at around 2PM (Kids, do NOT try this at home).

The Procedure:

The procedure I had is called laser ablation or a phlebectomy. It beats the living crap out of the other option which is the traditional vein stripping I had done 25 years ago (I describe the traditional method below).

With laser ablation, they do a local anesthesia and then they insert a catheter into the leg near the vein. they run a fiber optic cable into the vein and use a laser to cauterize the vein closed. I literally stood up from the procedure and walked out the door. The other method would have left me bed ridden for several days and as much as 6 weeks from any significant physical activity (Boooooooooo).

The degree of discomfort during the procedure was less than that of getting some ink. Post-op, the discomfort is minimal and far less than the discomfort that I used to live with on a day to day basis. I did not realize how much pain I was living with day in and day out.

History:

I have a long-running history of varicose veins. My first surgery was at age 16 on both legs. Had a second surgery at 18 on the right leg. That would have been 1983-85 time frame. There was no ultrasound in those days to see what was going on inside, so they did what they thought was best, but in fact it turned out to create future problems. So here I am today some 25 years later dealing with it again.

I went to Doctor N., Head of Vascular Surgery at a large academic hospital which shall remain nameless. I told him the procedure I wanted – laser ablation. He told me the veins were not big enough and that the method would be the traditional vein stripping.

In vein stripping, they put you under general anesthesia and make numerous small (1-2 inch) incisions all down your legs, tie off the veins at those spots, cut them and pull them out. Bad news. Long recovery times (6 weeks) and severe bruising of the legs all along the path of the veins. That’s what Doc N. wanted to do to me. I declined.

A good friend of mine I ride bikes with had the same condition and recommended Dr. Bonau instead. My buddy told me that he did not realize how much pain he was living with until after surgery. Pre and post, the relief is hard to believe. I am ever so grateful to my fellow cyclist.

Had a bit of outpatient surgery done on my legs today. Laser ablation on my legs to eliminate varicose veins. Basically they numb the site, locate the vein using ultrasound, insert a fiber optic cable and cauterize the veins closed at the faulty junction. I was awake and on no drugs for the whole procedure. Opted out of the Valium to calm my nerves. And I “tweeted” (used twitter) the entire experience in real-time. Some of those who follow me suggested I post the tweets. So here they are. For the twitter-savvy, the order is in chron order – went thru the trouble so it would read from top to bottom.

Alrighty now. Get ready for live tweets from surgery. Getting laser ablation on my legs this am.

Got some great paper shorts. Then they french cut them up the side. Gr8!

Pre-op ultrasound.

I’ve got 10mg valium just in case I get nervous. So far no drugs.

Betadine on the legs. Damn this room is cold.

Ah, the joys of medicine. All dignity is sacrificed

Enter the rockstar…erm…doc

Oh crap. The ultrasound is running thru a laptop running windows platform.

To clarify. Having laser ablation to remove varicose veins.

First stick. Little bit o lidocaine. No biggee. Laser in.

2 lasers in top part of left leg. Little bit of sting not bad. Getting a tattoo is worse.

Doc explaining procedure and pointing out what’s going on on the screen.

Looking at ultrasound, doc says,”That’s the sheath and this is the laser” blown up to several times actual size this looks painful. But its not.

Lydocain and sodium bi-carb going in around site for laser. Provides better contact and numbs. Extreme laser heat next.

Head down to make vein smaller. First shot of laser stings a bit. Getting more numbing med.

Getting a bit of a burning taste in the back of my throat. Normal perdoc. No pain now from laser.

2 veins down. 2 to go. 1 lower left leg. 1 lower right leg. Top left leg done.

FYI there will not be pix of this one. Will bring cam next time. Back of the legs in a couple of weeks.

“Lower leg harder to anethesize” yeah thanks doc. Noticing that.

And lasering the lower left. Much quicker set up.

Dr. Bonau rocks! Gr8 sense of humor about all of this. He’s not sure what twitter is but he’s indulging me.

Feels like a bad windows program – searching…searching…searching. Looking for something on left leg. Left is all in back so will get it in 2 weeks. Done.

Now its time for cleanup. Wiping down the betadine from my freshly shaved legs. Maybe I’ll b faster on the bike now.

@bobcoffield @matt_mueller @georgesibble and others. Thanks for all of the support. @caparks. Thanks for the ride.

Leg wrapped tight. Stays bandaged for 48 hrs. No bath. Hmmmm.

Kroger pharmacy – healthcare consumer shout of the day! They have $4 generics but 3x 10mg valium generic only $2.63.

@jenmccabegorman I’m sure its even cheaper in the netherlands.

@bobcoffield had this done at ages 16 and 18. Now at 41. Have watched options evolve. Laser ablation is best imho.

@georgesibble Yep. Normal routine. Movement is good for circulation in lower leg. No heavy lifting. Ibuprofen o’ plenty.

Transparency: Dr. Bonau has performed this surgery 2500 times. 2 cases w complications. Both successfully resolved.

Robert was featured on The Doctors October 15th!!  Congrats Robert!

Check out his segment below… you may get some ideas on how to reduce your health care costs.

Monday (10/6) at SHOUTAmerica’s first leadership conference I had the pleasure of hearing Senator Corker brief the audience on his recent accomplishments in bi-partisan healthcare activities.

Here are his four opening points:
1.    Congress does little communicating across party lines – this needs to change
2.    30% of healthcare delivered is wasted, i.e. it does not actually help people get well/healthy
a.)  That directly translates to 5% of our GDP wasted
3.    800,000 Tennesseans and more than 45 million across the country do not have health insurance coverage
4.    Healthcare is not a right, rather a moral obligation
a.)  Everyone deserves access to affordable private healthcare

He was cautious to make the distinction between what Republicans are striving for (preservation of choice) and what Democrats are striving for (universal coverage).  Corker wants the best of both worlds.  He wants  to preserve choice while finding a way to cover everyone.

Throughout the hour and a half speech/discussion I had several points of contention/questions.

1. Is choice our number one priority when we have 45 million uninsured Americans, 9 million of which are children?
2. Should we be providing tax credits as an incentive to purchase health insurance coverage?
3. Should the federal government mandate health insurance coverage?
4. Should all health insurance be community rated?
5. Should we separate health insurance benefits from the employer?

Choice should never be our number one priority (should I never say never?).  We need to focus on increasing access, coverage, and quality, while simultaneously reducing costs.  Choice isn’t even in my top 3 priorities for healthcare reform.

The American government has used the tax-credit concept for years with respect to financial saving.  Despite the tax incentives, Americans still fail to reasonably save the money they earn.  Why would the concept be any different applied to healthcare?  Just because a $5000 per family tax-credit is issued does not mean people will purchase a policy costing $14,000.  That’s still $9000 left for a family to cover.

I still haven’t figured out all the reasons why health insurance coverage has not been mandated by the government. Obviously cost is one (look at the difference between auto insurance and health insurance, we are talking thousands of dollars).  But what are some other reasons, and possibly coverage should be mandated and subsidized by the government up to a certain % of the poverty level.

Community rating all health insurance would mean that risk would be spread equally over large groups of people.  If you have high blood pressure and high cholesterol you would pay the same as the same price as a healthy individual your age.  This could be a good thing if the price groups change/account for age, smoking, family size and location.  It certainly provides a way to increase coverage and reduce costs for high-risk groups.

Health insurance benefits have been linked to our employers for years.  Is this practice too entrenched in our culture to separate it?  No.  However, I think the idea has its pros and cons.

Pros:

1. Makes healthcare portable.  Individuals will no longer feel tied to their dreaded job due to health benefits.  Their coverage and chosen plan could be taken with them to any place of employment.
2. Leads to more individual responsibility.  An individual will have to better understand what they are purchasing.

Cons:

1. Less guidance on aggregating large numbers of people to spread insurance risk.
2. Decoupled benefits will reduce competitive advantages between employers. Not that this directly is a bad thing – but will we see employers giving employees the money in their pockets that they used to see by way of health benefits?

All and all I still haven’t figured out the details of my proposal for healthcare reform.  Fortunately Senator Corker seemed to have a solid “moderate” stance on the issue!

Ran across this neat concept that has started here in Nashville as an offshoot of St. Thomas Hospital. The idea is that those who are in need of prescriptions but are unable to afford them should still have access. The Dispensary of Hope accomplishes this by partnering with pharma to collect unused samples and drugs as they near the end of their shelf-life. Instead of allowing these drugs to run to their end and not be utilized, they distribute them out to the less fortunate. It’s a noble cause and one well worth taking a look at.

Consumerism, just like transparency, is a current industry buzz word.  It is thrown around like everyone knows exactly what “healthcare consumerism” means.  However, consumerism often refers to the “derogatory” idea of society being preoccupied with the acquisition of consumer goods. Since healthcare consumerism is intended to represent a more positive movement, I am going to lay it all out on the table.

Consumerism, in relation to healthcare, is about moving past the perception that someone else is responsible to make decisions for us. We need to shift our thinking to be more actively engaged in our health and healthcare decisions.

Think about it – active participation and education prior to decision-making occurs in almost every other industry and consumer purchase… e.g. automobiles, electronics, home buying. Why are we so inclined to remain a bystander when it comes to healthcare? We need to move past the era of the passive patient.

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