Surgery Tips

I wanted to document everything that I had to do in order to get myself ready for the surgery.  Due to a fast turn around, everything was completed in the last minute and I wish I knew these information before my surgery.  Hopefully it is helpful.

1)  Insurance: Be sure this is covered by your insurance.  During my research, it was mentioned that a lot of insurance companies consider this procedure to be "Experimental and Investigational," and won't cover the cost.  Normally I read that the Dr's office will call your insurance company and ensure that it would be covered, but I was not provided with firm answer from the Dr's office, despite booking a surgery date and completing blood work / physical.  I realized that even if it is covered, it won't tell me the whole picture of my cost as the hospital & anesthesiologist would bill me separately anyway, so I had to take a matter into my own hands.   I have a Blue Shield of CA and I called and ensured that the surgery (Surgery # 28585) would be covered.  I gave Dr. Katz's name and office address, and also gave information on Corona Regional Medical Center.  All are in-network and will be covered (I'm under 80% / 20% plan).  Some people have mentioned that only their "First Surgery" was covered, so I also ensured that both surgeries will be covered.  After getting a confirmation, I asked for representative's name and a reference # to our conversation and documented it in excel chart.  After it was taken care of, I called Corona Regional Medical Center and asked for contracted anesthesiologist's information.  I was given the number to 3rd party company which does billings for hospital, and I again confirm that my anesthesiologist is also "in-network" and will be covered by insurance!  (Note: Hospital told me that since 09/30/2017, new law has passed which won't allow hospitals to bill outrageous "out of network" anesthesiologist cost to patients - this is great news!) Now I had a peace of mind knowing that everything is in-network.  

2)  Blood Work / Physical: I was initially told that Dr's office will provide me with documents which I can take to the urgent care center, but I was never provided one.  I explained to the urgent care doctor that I was going for the surgery which will require general anesthesia, and they gave me a standard tests they usually perform.  This was enough for my purposes and I signed the release form which will allow them to send my information to Dr. Katz's office.  Dr's office is supposed to send it to hospital, but I was never given a confirmation that it was enough or complete, so I asked urgent care to send me the results which I printed out and brought it with me to the hospital (I didn't have to use it, thankfully).  The result of my blood work came out within a day, so it was very fast.  However, you also need to ensure that the urgent care send Dr's office both your Blood work AND Physical, as I called urgent care and they told me they only faxed over my blood work, not the physical.  

3)  Get Pre-Op Instructions:  The day of my surgery was Wednesday, but I was not given any instructions as of Monday.  I didn't know what time my surgery was, or what I had to do to prepare for the surgery.  I called Dr's office and they believed they sent me the information to my email, but I have not received anything.  They re-sent the information and that is how I learned that my surgery will be at 7:30 AM.  Since I had to arrange my rides and also request time-off from work, this information was crucial.  Don't wait - ask Dr's office ahead of time for this information. 

4) Register with Hospital:  The pre-op instruction will give you a number you can call to register with a hospital (they advise you do this at least a week before, but I did it 2 days before and had no issues), so call and give them your information (who is going to pick you up, insurance information, emergency contact, etc).  Hospital will call you a day or two before your surgery to confirm & go over last minute instructions.

5) Things you might want to buy:  

 a) Crutches: This is what I got

I was told that crutches might not be needed, but I do not see how this is possible since you can't put ANY weight on your foot for at least a couple of days.  I absolutely needed the help of crutches

b) Waterproof Boot: This is what I got

You will need this to take a shower without getting your bandages wet.  You can't get any water into the wounds for the next 2 weeks, so you will be using this a lot for both of your feet

c) Ice Wrap: This is what I got

Since your feet will be heavily swollen, you will need to ice it like it is a religion.  This wrap covers entire feet & my ankle, and air pressure will also compress it to targeted area.  I honestly think this is a part of a reason why my recovery was pretty quick

d) Air Cast: This is what I got

Once you graduate the boots, you can start to put more weight on your foot and wear regular shoes.  But that doesn't mean you are 100% good to go.  I would put air cast on after the boot, to ensure that you are getting the support you need.

E) Leg Pillow: This is what I got
You will have to put your leg above your heart for at least full 24-hour period and as much as you can until you are completely recovered.  Many people stack pillows on top of each other, but this is unstable and won't work well when you go to bed.  Even without surgery, I heard that it is generally a good idea to keep your legs up to improve circulation, so this could be a good long-term investment.

6) Cost: As stated above, I have Blue Shield of CA (PPO - 80/20 plan).  If you have HMO, it is more complicated as you will need approval before the surgery.

Here is a break-down of my cost:

a) Hospital: Billed: $22,845.00 (WOW!) My Responsibility: $1,041.58

b) Prescription of Pain Killer: I was prescribed with Hydrocodone / Acetaminophen, which costed me $2.5 after insurance

c) Surgery: Doctor's bill for surgery #28585: $1,200, My Responsibility: $145.3

d) Anesthesia: I'll update this upon getting a bill

e) Ride: I had to arrange a pick up and this has costed me $140 including tips (round trip)

f) Bloodwork: Billed $194.38, My Responsibility: $8.07

g) Post-Surgery Follow-Up: My Responsibility: about $60 for 2 visits

Also, I already met my yearly deductible before this surgery so didn't have to pay additional $750, but that is something you might want to consider to your cost.

Excluding a ride and pre-surgery visits, my cost per foot was: $1,041.58 + 2.5 + 145.3 + 8.07 + 60 = $1,257.45.  This is before adding in anesthesia and other necessary costs (crutches, waterproof boots, etc). So I'm expecting around $1,700 per foot.  Considering that most people without coverage pays about $5,000 per foot, I would think this is highly reasonable. 

7) Find Your Doctor: http://www.hyprocure.com/hyprocure-doctor/
Try to find a doctor with "Master Surgeon" qualification in your area.  I think it is worth it to get the procedure from the most experienced, since it can contribute to fast recovery with minimal down-time.