Ok here we go....
Day 1 =
I must say i was pretty relaxed before going in...although i was anxious to get going. Catching up w/my sista, wallowing in the flora and fauna of sunnyvale california a couple of days prior, (they have their own brewd of mexican green parrots calling sunnyvale home) must have relaxed me somewhat.
My MRI/MRV's (brain, neck, spine) was scheduled for 12:00 but i got a call early that morning saying something is wrong w/my insurance. My SSDI is an HMO and prior approval w/ the HMO had to be reconciled before doing anything. I talked w/ the finance dept and she was working up cost for the MRI's and procedures. each mri was 5/K+ change and the procedure w/o doc fees would be 82/K + change....whoa but for some reason i was not upset. i just
knew that everything was going to be all right. ( i also was in possesion of a credit card with up to 30K credit limit from my past life income).
Remeber folks we will need to pay our 20% if you do not have an extra ins. supplement 
Well wouldn't you know that Dr. D personally went to the finance lady and bargained for me so atleast i can get the dx from MRI's. I was to receive only a pic of my neck at a discount fee. So at 3:30pm I was scheduled and met w/ Dr D afterward for consult.
Well...the pics showed my left jug with about 5cm of stenonis No flow
and the right jug with a small section narrowing. hence the double jug dx.
This is important we all know this. during the consult, we brought up zambonis results and he had questions regarding them. He explained that Dr.Z only used doppler and sonogram technolgy and was missing images ear level of the head. so some people may not be dx'd and those supposed "normal healthy" people may have venous issues.
Day 2
Now what do we do? does surgery commence? Well the finance lady must have been influenced somehow w/o HMO approval (keeping the faith) ...because i was to only pay the 20% of the procedure fee. So off I go to surgery later that day. Was in surgery from 12:00 ish to about 4:00ish.
Surgery comments -
Thankfully i did not eat/drink past 12:00pm so i could get surgery if approved. Normal pre-surgery prep...IV salene solution, a valium 5mg, and a child asprin. no super pain killers. Wheeled in to op room where a handful of people were mulling around. Dr. D and one of his resident staff dr. so and so and a few nurses. All of whom were very attentive and gracious. Another IV bag that was an abx to catch any post surgery infection. one nurse said she was going to give me some painkiller through IV...the name began with an F...then the swabbing of my abdomen and the incision was made on my right femoral vein. It was no big deal, due to pain killer? I can't remember when Heparin was introduced, during, before or after the op.
Blood tests were also part of pre op to compare INS and D-Dimmer? we have to ask marie what this is. her doc did this before she left and when she got home and there was a significant difference between the two.
When wheeled in, one is laying over a special camera which is horse shoe shaped. It is called a floroscope. (sp?) It can be electronically moved around for different views. it projects upon flat screens infront of the docs and can be scene while laying there. I was witnessing the op/my body in realtime. first stop was the left jug. It seemed uneventful... saw some collateral veins and the vein looked short. once the stent was put in place i could see it lengthen and collateral veins disappear. Sensations during placement of stent weren't too bad. one can feel it move in your body and for me my ears popped like adjusting to the pressure of an airplane ride. Dr D preformed before and after pressure readings...dang it I forget what they were. All the time this was going on Dr D was explaining everything and directing people to perform certain tasks. Dr. so and so was involved atleast partially in the procedures.
Next stop Right Jug...they are fishing around and could not find the small area that was supposed to be a narrowing of that vein. So Dr D went hunting for my azygous... WOW Dr D said... When i looked at the screen to what was supposed to be my azygous, it looked like something out of greek mythology. There were so many collateral veins looking like snakes on medusa's head. Also a portion near the stomach was collasped and need to be stented. Once stented, all snakes deflated
During the Azygous procedure Dr D was very excited and was saying to all in the room that this is real intervention. Dr D told me later that he wants follow ups to be w/him. He also told me that i was the worst person yet that he has seen. is that good or bad?
I was wheeled to recovery, was given a turkey sandwhich. my neck hurt to move, felt like a really bad sprain. my chest, breast bone wsa sore too. My headache was much like a sinus headache, mute pain above the left eye and left rear skull behind the ear. i had no nausea. today is much better with just a little sore neck left. i will post progress in regime forum with the rest.
Getting PCP on board and referal experience - Dr Dake emailed me last night stating:
I spoke to Dr. Rxxxxx yesterday and also dictated a letter to him regarding your follow-up care, blood tests, meds, etc. He seemed a bit taken back that you had been here and was asking who referred you, etc., type questions. So, I felt it necessary to tell him the headache, swelling while visiting “my sister” version, which he seemed to understand. Any way, I hope he is understanding and sensitive to your condition
And I gave my PCP a packet...guess he read thru it carefully
Remeber I have an HMO SS advantage program where the headache scenario may need to be played out as last minute approval...PPO folks - pre approval may not be necessary and go w/o a glitch but...if you have an on board PCP or Nuero things should go well. but if you are working w/old school drs. you may have to use the "While visiting my sister...routine.
Meanwhile I have a plavix and warfarin rx for the next two mos. Dr Dake said do not change your habits (eating, supplemetns etc.) even though eating spinache may scew blood thinning results, it would be worse if you do and slip up and your results will fluctuate grossly and one can risk to high or too low amts. Ofcourse we know not to take aspirin and one can take aleve or motrin if needed.
What do you guys think? Holly
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no headache sore neck and sore schest area...yeah..azygous you should have heard dr dake...he was going nust exclaming to his staff saying this is real intervention 
