Day #151: Surgery at the VA, a runthrough
Now that I’m somewhat out of my anesthesia sickness (seriously not fun), I figured I would give a rundown on what having surgery through the VA looks like and some of the things you have to do pre-surgery to get ready. Since I’ve never had a surgery outside of the VA, it would be interesting to see how much of this applies to other hospitals, but I suspect that the answer would be not much.
In this scenario you’re a service connected veteran who needs a surgery, why service connected? Well unless you retired or are service connected you don’t get health benefits (fun fact, right?) furthermore if you aren’t 100% disabled you don’t get dental benefits through the VA either, which makes absolutely no sense unless you’re the VA and want to screw people over (which let me spoil the answer for you, they do).
Okay you’re service connected, but you may have a copay if you 1. don’t have outside insurance or 2. are not disabled enough (seriously, what the fuck, right??). Since I’m totally and permanently disabled, this means that I am 100% or more disabled and am not expected by the VA to ever have substantial improvement or improvement in my conditions that would lower my rating, I don’t get a bill, this is nice, but I hate that other vets do.
Now, you see your PCP (primary care provider), get a referral to the specialist that would do the surgery (ENT, plastics, neuro, etc). After a few months, they will see you (yes, months, this is the VA) and give you a consult. Here they will order any tests needed, for this latest surgery I needed an CT with contrast, so a few weeks later I had that done. Then they have a follow up appointment and you schedule the surgery (hopefully). This will be about a month or more out, most likely more unless it’s life or death, in which case you’re better off going to the ER (emergency room).
Now you have the day you’re counting down to, mine was 6 weeks from the agreement that I needed surgery and what kind of surgery they would perform, joy! But this is the VA so you’re not done yet! Every VA is a little different, in my case I had one more appointment with the doctor who would be doing the surgery to go over everything yet again (that was 2 weeks ago roughly?) and then I get a scavenger hunt of tests to do.
Not every VA does this, my old VA certainly did NOT! However, this VA requires you to have an EKG (to check your heart), some bloodwork (to make sure everything is normal), a chest X-ray (for the anesthesiologist), and to see the pre-OP nurse so that they can give you the pre-surgical prep that you are responsible for the night before and the day of surgery.
Well you made it, you did all of the tests prior to surgery and now you’re ready right? Wrong. You don’t have a time for surgery, just a date. The VA will call you the day before to schedule your time, this is extremely anxiety inducing, but hey why not. The best part is that if they don’t call you by 8pm you need to call them to get your time, but wait there’s more. Should you wait too long, they close and you will not get your time, so watch the clock!
It’s the night before surgery, time to crack open your pre-surgical washing kit! This kit will depend on your VA (again) my last VA liked handing out chlorhexidine body wash that you would use half the night before and half the day of in the shower. This VA likes handing out little kits. You shower, air dry, then apply the sticky chlorhexidine soaked towels, they come in packs of 2 and you get 3 packs the day before and 3 for the day of and let me say it is nasty. It leaves you nice and sticky and I hate it. So you have 6 chlorhexidine towels and you apply them to different body parts per the instructions, you also get a handy mouthwash to use, that isn’t so bad.
Side note, becuase this is the VA sometimes they give you nothing to use pre-surgery and I had this happen, becuase they gave me nothing I was told to use antibacterial soap and wish upon a star that I wouldn’t get an infection in surgery. True story, well except for that last bit, but they gave me nothing for prep and were not very sympathetic to my, “I don’t want an infection” plea. Luckily I survived infection free, so there’s that. Now back to the surgery!
The day of looks a lot like the night before, you have all the same steps, minus the shower. You apply the second set of wipes (all 6 of them) to the body in the order the paperwork tells you and you get your fancy mouthwash that tastes like nasty feet smell. You also get a fun iodine nose applicator! Basically a q-tip you dip into iodine and rub inside the nose. Now you’re clean (you dirty, dirty animal) and are ready for surgery.
You arrive at the VA 2 hours earlier than your surgery is scheduled, why? Well it’s the VA and they want to be efficient, should you cancel they need to work around you. They couldn’t call anyone else in to replace you (See the surgical prep steps) so I have no idea why they need two hours, but that’s the rule.
Next, you sit inside the waiting room until your surgical time. Then you wait some more. Then you wait even longer. Yep, they are almost always running late, so much so they have a permanent sign hanging, but at least they are thanking us for our service Eyeroll I would prefer if they just told us to fuck off. At least it would be more honest. Finally, a few hours (again most likely, but not always) after your supposed surgery time you will get called back, changed into the gown and wait. Seriously, more waiting, but hey why not?
Once they are ALMOST ready for you, you get moved to another staging area, they run an IV into your hand and miss the nice veins you have, this will happen a few times. In fact the guy doing mine this last time stabbed me twice and wiggled for like 10 minutes before getting the vein. For the record no one has ever had trouble hitting a vein in my veiny hands, but the VA seems to find a way. Anywho, here you wait for ~30-45 minutes before it is finally, FINALLY your turn.
Post surgery they scream at you to wake you up (Seriously) even though all you want to do is sleep because you’ve been sedated. This doesn’t always happen, my old VA let me sleep it off, but this VA likes to torture you. You’re then placed in a waiting area for the anesthesia to wear off. Once more, every VA is different, my old one didn’t do this, but they do. Once that happens the nurses argue with the schedulers because you already have a post-op appointment scheduled. That happened this time, I had to wait an extra ~2.5 hours before they took me back to the last staging area because the nurse said it wasn’t her job to do the scheduling and I already had an appointment scheduled anyway!
Once you’re back in the main room (for this VA it is the same room they start you out in), you have one final task before you can go home. You have to pee. No, seriously the anesthesia has that effect on people where you have trouble peeing so they want to make sure you can before they let you go. This time around I puked a few times, I don’t know if it was the pain meds they gave me or what, but I usually don’t have this problem so that was fun. It also took me forever to finally pee, but then I was let go. Once more, not every VA is like this, my old VA just let me go without having to pee and I would’ve never thought about how complicated it was to pee post surgery if it wasn’t for this new VA.
There you have it, start to finish. I also threw up a bunch when I got home, but I passed out shortly after, woke up about midnight feeling better and had my first meal in over 24 hours, then went back to bed and now this morning I’m feeling sore, but good.
My binder for surgery showed up the day before (lol) I was super anxious about it. It doesn’t fit very well, it’s supposed to be somewhat compressive (hence why I call it a binder), but it doesn’t feel that way, maybe I was expecting something more. It looks like a crop top (seriously) and is supposed to support my shoulders, but doesn’t feel like it’s doing much, too late to complain about it now I guess, I was fitted for it 2 weeks before surgery, so who knows they order in S, M, L, XL, so maybe I was at the lower end of the size they ordered.
In any case, despite their best efforts, I’m alive and healing. I’m actually going into the lab today to follow up with my experiment this afternoon. We had a morning experiment, but I definately could not make that one. So yeah, back to work for me, but hey it’s by choice at least. My Co-PI told me to take as long as I needed, but I really want to be there.