Albemarle / Nelson County, VA
To say I dodged a bullet would be accurate. For several years I’ve needed to get a nagging hernia repaired. Essentially that’s a torn lower abdominal muscle. It wasn’t big, wasn’t really showing (only really found on ultrasound) and rarely caused any noticeable pain. Most that know me, know I’ve gotten into fitness over the past several years. In August I ran more and more topping 50 miles in a month. For me that was significant. This past summer the hernia would bother me more and more after runs and just the normal lifting and labor I do here on the farm. Then a physical exam in the early fall found I had actually developed another one on the other side. I was likely overcompensating for the torn muscle. The decision was eventually made to fix them both.
For a year or two I’d been researching how to have the hernia surgery done without having mesh put in as a means of fixing it. Few places do it and almost no surgeons locally do. But I managed to find Dr. William McKibben in Fishersville that would consider it. If possible. Though, after lots of discussion, he and I eventually decided mesh would be the best. As active as I am and as much heavy lifting as I do, not to mention recovery from the surgery, it would be the way to go. It was minimally invasive, it would be done laparoscopically. That’s where small incisions are made and tools can be introduced to make the repairs and then the small cuts are sewn up. Recovery is far less than typical surgery where they cut you open. The next question is where to have the surgery. Generally, all of my healthcare has been through Sentara Martha Jefferson Hospital system. But my own search for a “mesh-less” surgeon led me elsewhere. Dr. McKibben was on staff at Augusta Medical Center and also on staff at Monticello Surgery Center in Charlottesville. I was frankly, being frugal as well, since we end up having to pay lots of the costs out of pocket due to the current state of healthcare over the past several years. I’d had surgery in Augusta a decade before and they are a fine facility. No question. But when I went to ask about exact costs for the procedures I couldn’t get an answer. They would not furnish me with the costs of what I was having done. That coupled with knowing that a surgery center would be far less, and they gave me exact costs, led me there.
I want to say up front, Monticello Surgery Center was very professional. These are seasoned nurses, surgeons, etc. You never feel that your care is less than top notch. My surgery was same day in around 12:15 PM for the surgery and on way home by 5 or so that afternoon after recovery. The surgery went flawlessly. One detail in surgery is what set me on the path you are about to read. Since I was on the table for about 2.5 hours, it was decided to place what’s called a foley catheter in my bladder. Yeah, it’s not glamourous. It’s pushed in through the end of your business and up into the bladder. But since you are having IV fluids dripping the entire time the pee has to go somewhere! Thankfully the entrance into said business and for the pull out of said business, I was already put to sleep. A good thing! I was released with a painkiller prescription and sent home to recover. My wife had it filled, and off we went an hour away back to the farm to settle into recovery for the coming days.
I had typical post surgical pain, and initially some pain when peeing. But I thought, “Hey they just shoved a hose up my junk, it’s probably gonna be sore.” By the next day it was better and so was the surgery, I was less sore and didn’t require any painkillers about 48 hours out on Friday. I was mobile and things were improving. Until they weren’t …..
Just after we’d finished supper on Friday night and were mini-celebrating a good day, began having some burning in my urinary track. By the hour it worsened, greatly. By 10 to 11 PM it unbearable and I began having severe chills. (Rigors) Something wasn’t right. My wife had briefly nodded off while I was frantically trying to locate an emergency after hours phone number for my surgeon. The one listed on my discharge form from the surgery center was his office. There was no after hours answering service. I left a message, which ironically wasn’t heard until “normal business hours” on Monday. I called the surgery center for emergency info. Nothing there, if it’s an emergency with your surgery call the number your surgeon gave you. Yeah, really? I even tried to reach the anesthesiologist that put me to sleep. Her number was listed but the voice mailbox was full and hadn’t been checked in days. By now my wife was up again and saw what I was doing. I said you know, my surgeon is also on staff at Augusta Health, they didn’t do this surgery but maybe they have a way to reach him. Eventually their own on call surgeon did call us, and really didn’t offer much. It wasn’t his case and it didn’t take place at that hospital. He did say my surgeon would be on call later in the morning and he’d pass the message along. “Thanks.”
With no other options I then called for my own primary care physician at Martha Jefferson. I didn’t actually expect to get my doc but knew I’d get somebody. I did and when I described what was happening he said, do not screw around with this. “Get to the ER. “These things have a way of spiraling out of control very quickly just after surgery.” He was so very right. With roughly an hour drive ahead of us my wife loaded me into the truck and headed toward Martha Jefferson ER from here in Nelson County.
We arrived around 1:30 AM give or take an hour, I can’t remember. I was taken back within 10 minutes and the staff there immediately jumped on this. Once Dr. Erin Talman of the staff there saw what was up, she said,, “I don’t like your heart rate, and I don’t like your blood.” Mind you I am an active runner with a resting heart rate of 50-55 BPM and resting in the ER I was at 110 BPM. She didn’t like the initial lab work and suspected I had an aggressive infection in the urinary tract that had begun migrating to the blood stream. In fact it had as later tests confirmed. I was admitted. I later learned that my physical fitness probably helped me over this rather than becoming more serious.
Once I settled in at the hospital on the floor at 3rd Cornell I was placed into the care of the staff physician there. Dr. Nicholas Brandt was a true professional with the bedside manner of any nice relative you might have. He personally called often to check on me, made sure every question and need was met. The nurses there were spectacular. There was Brittany the first fully day, then Susan at night. Marcie and Candi came in on the final day I was. I’ve never had such great care before.
Eventually Dr. Brandt and the entire staff at MJH got the infection under control enough to send me home and finish up on pills by mouth. I was tested to see if I could take one I was mildly allergic to years before and it didn’t show any signs there. I was released!
From here we picked up prescriptions and headed out on the 45 mile drive back to the farm. But, by Tuesday I was starting to have an allergic reaction to my oral antibiotic. The on call doc for MJH said stop it now. I already had a followup appointment with my own MJH doctor the next day. By the time I got to Dr. Steve Schmitz’s office that Wednesday afternoon the bacterial infection was already regaining some of it’s foothold from being off of antibiotics. “Dr. Steve” as we all call him jumped right in as he always does and figured a plan of action. He knew the bacteria was sensitive to the antibiotics I was getting in the hospital, so he needed to duplicate that in the field in his office. Otherwise I was headed back to the hospital. He was able to mix an injectable form of the antibiotic and hit me in my butt to kickstart the treatment. Then we needed to find an oral form of that antibiotic as closely matched as we could.
Knowing he would, Dr. Steve found a good match. We got the prescription filled and headed back home, this time just a few minutes away, not an hour. Friends of mine had been praying for my recovery. I was humbled and honestly mentally broken. I’d had very little sleep in a week and the close call earlier in the week had wiped me out.
Over the next few days my condition improved dramatically. It was night and day. My energy returned there was zero pain from surgery and my mobility was back. Other than finishing out a few more days of oral antibiotics, I should be ok and fully recovered.
In the beginning I mentioned a lesson learned. Remember, this is my experience. That doesn’t mean there aren’t just as many great experiences. As a matter of fact, I’d give my surgeon and the surgery itself 5 stars on the procedure. I’d give him a F on followthrough. Ditto the surgery center.
When you have major surgery, you should be able to reach your surgeon when you have a an issue after hours. Being given an office number with an answering machine that isn’t monitored doesn’t cut it. Though the surgery center did make a routine call to check on me the next day, that was it, and it felt more of a formality than anything else. So they could check the box. As far as I know my surgeon never reached out to the docs at MJH to even confer with them about my situation even once he actually knew. Unacceptable. Conversely, the staff, all of them at MJH, were top notch. On top of it from the time I hit the ER to the time I have been at home.
What have I learned from all of this? Next time I have surgery, especially one that’s major, I’ll be having it done at the hospital. While I initially saved money by using a surgery center, that will probably end up costing me thousands more vs just having it done in a hospital outpatient setting. The continuity of care just isn’t there. Had this all been done under the roof at say either Augusta or MJH, there wouldn’t be this question of who was in charge, or where did this happen, it would be theirs to figure out. Period.
My hat is off to the people of Martha Jefferson Hospital in Charlottesville and all of their affiliate staff and doctors. Well done, well done and thank you for getting me back to my family and what matters most!