I had intended to finish cleaning my apartment today, but a badly timed accident involving a knife and my thumb, the day before surgery no less, has thrown a wrench into all my plans. Naturally. So instead, I’m making myself write this.

My brain and spine surgeon submitted his written appeal the day after the peer-to-peer resulted in a denial, starting the 45-day countdown to Aetna’s final verdict, which will undoubtedly be a formal, indisputable denial. I recently had a follow-up appointment with the interventional neurologist who started the process of diagnosing my IJVC, CCI, and TOS, and while he reassured me that he has backup plans to get this surgery done for me with someone (if not this elite god-tier surgeon) and keep me alive, he also agreed that November remains my death date unless we do something stat.

So when I was greenlit for bilateral thoracic outlet syndrome (TOS) decompression surgeries—a four-part surgery (two procedures per side) involving rib-sparing scalenectomy, pec minor release, and removal of scar tissue and other compressive structures, with a follow-up balloon venoplasty—I decided to go ahead with it. According to my doctors, opening these constrictions at least buys me more time.

Tomorrow I go in for the left upper extremity decompression. It’s a major surgery but (I was told) an outpatient procedure since it spares the rib; however, I was also told by the clinical team that there’s a chance it might turn into an overnight stay if my pain isn’t controlled or I need monitoring. I’ve also read about how uneven and potentially excruciating the recovery process is.

Meanwhile, it’s been mishap after mishap, like the gods don’t want me to live: the 11th hour open wound; a random scrape on my ankle that happened on Friday; flare-up on top of flare-up from having to madly clean most of my apartment and from general stress.

Can’t say I’m not anxious for how this procedure will go, particularly because I’d vastly prefer to recuperate at home (and worry about what insurance will cover if I end up with a hospital stay) and the anecdotes about the first two weeks of recovery are mostly horrific… but also I look forward to hopefully feeling a little less like every day spells my death.