My surgery is scheduled for one week from today (6/20). I scrambled to make sure I got all of the required testing done last week so the results could get to my orthopedist before the 6/17 deadline. I
had my PCP run the bloodwork, chest X-ray, and EKG to send to my cardiologist because I knew it would be faster than trying to have my cardiologist schedule them (PCP has all of that in house and my cardiologist only has EKG in her office). They had all of the results by Thursday and sent them over. I received a call from my cardiologist that day asking me for more details about the surgery so she could figure out I’d I have to come off my anticoagulants beforehand or not. The problem is, she doesn’t have a lot of patients on warfarin and to be honest, I really manage my own. She didn’t feel confident in deciding how to proceed, so she asked me to get in touch with my electrophysiologist, who has operated on me many times and knows the protocols better. Honestly, she should have called him herself. I’m not completely certain why she didn’t, but I agreed to find out. I sent a message through the patient portal and a nurse responded, asking me to have the orthopedist to send the clearance request to them. Which isn’t what I was asking for at all. So I tried again, saying I just needed his recommendation for managing my medication before/after. I got a reply saying they couldn’t help me because they aren’t the prescribing doctor. 🙄 At this point I decided to try calling. Maybe I wasn’t making myself clear. But the person I talked to said I needed to talk to my cardiologist. I said “That’s who told me to call you!” She refused to help or get a message to try doctor.
So I took it to the next level. Years ago, when my health was much worse and his office staff was bad about not getting messages to him, my EP gave me his personal cell number. He said he knew I wouldn’t abuse it. I hate using it. But I felt like I had no choice. So I texted him Friday afternoon. About 20 minutes after my text I got a response saying “He’s finishing a procedure and will call you shortly.”
I never heard from him. I gave it the weekend, but was pretty sure he’d gotten busy and forgotten all about my text, if he’d actually seen it at all. I debated what I should do. Should I try texting again? Call my cardiologist and tell her to call him? Ask the orthopedist to call?
At 7:30 this morning I decided to send him a quick message. “Did you forget about me?”
Seconds later, my phone was ringing. He said “Forget is a strong word. Misplaced maybe?” We then discussed the situation and he asked me for the orthopedist’s number so he could talk directly to him. Finally! He then asked me how my family and I were doing (he’s been my doctor for 18 years or so and my husband used to work with him all the time as a nurse in his hospital). And this is why I stay with him. Because once I get past the gatekeepers, I have a fantastic relationship with him. We tease each other and he really listens. His office staff will always be a nightmare, but he’s worth the hassle.
Around noon I got a call from the nurse at the orthopedist saying she’d talked to my EP and was working to connect him to the orthopedist. She asked about my cardiologist clearance and I told her that she had just been waiting on the EP’s recommendation before sending the clearance and I would let her know he was in contact with them so she could send her letter. I sent an email as soon as I got off the phone.
Later, I got another call from her asking if I’d gotten my CT scan done. I had and told her where I’d gone. I guess they hadn’t sent it yet, but I just had it done Thursday morning.
I got a text from my EP that he’d finally talked to the orthopedist and he told me the plan for my warfarin. Stop 4 days before, bridging with lovenox injections (no lovenox the night before surgery). Restart warfarin the night of surgery. No lovenox after. This is typically what I’ve done for ICD surgery, so I’m not surprised. Now I need to know who will be prescribing the lovenox so I can have that before Thursday, which is when I will need to start it.
I just got a call from my cardiologist’s office asking if I just needed the letter of clearance or if they needed her to outline the warfarin protocol and I told her that I assume that the fact that the EP and Orthopedist talked to each other, they just need the clearance. Hopefully that means it will get faxed tonight and they’ll have it in the morning. I will call and find out if the orthopedist is calling in the lovenox prescription. It makes the most sense for them to do so.
This whole process has been super stressful and I hope it all works out. While being so crunched for time is probably adding to the stress, I’m glad it will be over soon. One of the reasons I scheduled it this quickly was because I know from experience that waiting can be more stressful than the surgery itself for me. Also, I know I’ll be having defibrillator surgery (simple device change) this year and would like to be recovered from this before that happens. As nice as it would be to try to coordinate them so that I only had to come off warfarin once, the defibrillator surgery is dependent on how long my battery lasts and it’s impossible to predict exactly when that will be. It’s not possible to do it early because insurance won’t cover it until it reaches a certain battery level.
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