AVR and DOUBLE BYPASS

[bigsidster]

Hello all.
I just got the call that my open heart surgery to replace my aortic valve and double bypass is scheduled for 1 Pm Monday Nov 22 at London Health and Science center.I have been waiting since Oct 18 when i found out from angiogram.I feel pretty good with the upcoming surgery after reading all the posts here.Wish me luck.

 

[escargome]

Best Wishes for your surgery on Monday. I hope all goes well and your recovery is swift and bump free. Try to get someone to keep us posted if you can.

 

[Duffey]

Best wishes for a successful replacement and bypass. I've put your surgery on the calendar so you're good to go with us. We'll be waiting for an update, and we will keep you in our thoughts and prayers until we receive word that all went well.

 

[Bina]

Mr. Big, you will do great !
You may want to get a haircut, trim your toenails, and pack your bag.

 

[buncle]

Wishing you all the best! Let us know how you are as soon as you can.Good luck-you will do fine!

 

[Jkm7]

Sending you very best wishes for successful surgery and bump free recovery.


There's something I've wondered aboout and hope you don't mind my asking......

Did you select which hospital and surgeon to use or is it assigned?

Thanks anyone from Ontario, Canada who can answer. I've never quite been able to figure out which. (Is it the same policy in all Provinces?)

 

[normofthenorth]

Good luck on the surgery -- I'm right behind you (9 days behind)!

jkm7, in Ontario we can all choose our PCPs (GPs), some of whom are in group practice, some not. All the doctors are "private", though the bills are paid by OHIP, the Ontario Health Insurance Plan. (I've never lived in another Canadian province, so I'm reasonably ignorant about that. The Canada Health Act sets limits, but there's some flexibility for individual provinces.)

I don't think anybody can walk into any specialist's office (like a Cardiologist, or a Cardiac Surgeon) without a referral from their PCP. Usually that's an easy hurdle, even for a ref to a Sports-Med clinic or Physio, etc. In my case, my PCP referred me to a Cardiologist, and the Cardiologist referred me to a Cardiac Surgeon. All the specialists are attached to a hospital, and I doubt that many deal with more than one hospital, so choosing a specialist means choosing a hospital. Almost 100% of the hospitals are publicly owned, with the big money coming from OHIP, but other big money coming from individual and corporate donations. (My surgery will be done in the Monk Cardiac Centre, for which Mr. Monk presumably paid big bucks.)

I think any patient is pretty free to get second opinions and maybe thirds, though I haven't done much of that.

When I was facing hernia surgery a while back, my PCP/GP asked me if I wanted to have it done at the hospital she's associated with (Mt. Sinai, IIRC), or at the (rare) private Shouldice Clinic, which specializes in hernias. I chose Shouldice this time. My first hernia, on the other side, was very successfully repaired at Mt. Sinai hospital, a decade or so earlier. In hindsight, I prefer the repair at Mt. Sinai, though the rest of the experience at Shouldice is wonderful -- no sick people, every surgeon is super-experienced at this particular repair, and all your neighbors are "classmates" who've had exactly the same surgery you just had! (I'll let you know in a few weeks if I get that same feeling at the Monk Cardiac Centre!)

 

[ottagal]

My very best wishes and positive vibes for a successful surgery and smooth recovery. Hopefully, someone will be able to post to let us know how you are doing.

 

[Jkm7]

Thank you, normofthenorth.
So, in effect, your PCP chooses which surgeon and hospital by virtue of whichever that surgeon is attached to.

If you said to your PCP you heard 'good things' about a different surgeon, would they be apt to say "Fine, go to him/her" and here is the referral you need?

I mean absolutely nothing about these questions except an interest in learning about various systems.
Thank you.

 

[Lionheart]

Hey Big Sid,

Best wishes on your surgery. We'll look forward to hearing from you soon.

John

 

[Johan]

Positive thoughts, prayers and healing vibes on the way for you Big Sid for Monday!!

 

[normofthenorth]

KJM7, I think that's exactly how it would probably work. In this case, it's a smidge more involved, because my Cardiologist is situated "in-between" my PCP and my surgeon. PCPs refer patients to Cardiologists, and Cardiologists refer them to Surgeons. So I don't think my PCP would be keen to refer me directly to a surgeon I'd heard good things about. And of course, everybody's used to dealing with the people and institution they're used to dealing with, quite apart from the role of Government as the Insurer. But the ultimate choices are usually the patient's, in theory and in my experience.

I've also occasionally had one specialist refer me to a "competitor" specialist (e.g., one sports-medicine clinic referred me to another, when they didn't have a spare Ortho Surgeon and I had a torn Achilles), without my having to go back to my PCP.

Like anywhere, I have more choices in Toronto than I'd have far from a big city, but I've never felt that the system that pays the bills was restricting my choices, except in relatively minor cases. Here's one: Kryptonite glue hasn't been incorporated into "the book" for sternum closure yet . (It's already approved for skull closure.) So unless I became part of a formal trial, I can't get it. Period.

In the US, even if my insurer refused to cover it, I could presumably put the extra $500-ish cost on my VISA and get glued together, even if that use of the glue were "off-label". Here, having a patient get "special treatment" because they paid extra is Beyond the Pale, a fundamental threat to the much-prized universality of the system, and illegal. (My surgeon says he's not sold on Kryptonite yet, either, but that's another issue.)

Interestingly, even though access to health care is totally universal, I'm pretty sure that wealth is still a stronger statistical determinant of life expectancy here than smoking! (Doctors, eat your hearts out!)

I'm a big fan of the Canadian system, in general, as are most of my neighbours -- though I personally wish that patients got to see the itemized bills (of the expenses we don't have to pay a nickel of). As it is, I have NO IDEA what kind of money is changing hands for treatments I hope I'm actually getting. After each of my past hospitalizations (3 non-cardiac surgeries), I usually got charged for a phone, or a pair of crutches, and that was the closest I got to seeing a full accounting.

 

[carolyn]

Very best wishes to you for a successful surgery and uneventful recovery.

 

[Greg a]

Just a couple of points that have been missed .....we have more choice than is often recognised both within the system of OHIP and outside of it ....private caregivers are becoming more common in every province with a "pay and play" type service and our health care system a good example is mot far from where Norm's surgery is the Cleveland Clinic on Bay St http://my.clevelandclinic.org/canada/default.aspx

Also I am on my second Cardiologist and third Endocronologist .....my GP had refered me back to cardio rehab three times due to the unusal nature of my situation my enpcronologist has refered me to the diabetic clinic four times to help bet my blood sugars in line

My point is that all too often we are sheep and don't even ask about change IT IS AVAILABLE we have more choice than we think BUT the big factor is to be comfortable with your GP (my second as my first left the country) I am comfortable with mine and he is the one that has schooled me on choice suggesting referals and when needed home care by RNs

My health care team is incredible I currently see 11 different doctors and the Lord only knows how many specialtists such as kiniseologists, Nurse Practitioners etc by the way my cost for this is CHOCOLATES a few times a year:biggrin2:

 

[Greg a]

Gee I got so wrapped up I forgot to say we are with you at London Health Sciences ....hmm another of my haunts ....my implantation of of my ICD was there !!!!

And that brings to mind cost of hardware ....if my GP feels I need a prostetic or health device of any type it is covere by OHIP otherwise all my drugs (26 pills six injections/day) are covere by my wife's (I have not been able to work since May of 2007) employer paid health plan and that is why we pay more for goods and services generally as the payroll burden carried by most retailers alone runs to 15% of cost of goods (nothing is really free) but thanks to Tommy Douglas I think we have a great health care system



; )

 

[Jkm7]

Thanks, Norm and Greg. Very helpful responses.

Best wishes, Norm. Hoping all goes smoothly for you....(and you, too, Greg).

 

[Greg a]

Thanks, Norm and Greg. Very helpful responses.

Best wishes, Norm. Hoping all goes smoothly for you....(and you, too, Greg).

I can only wish it had

If you want to know more about choice and options here is a secret government web site

dont tell okay? (we dont have to mention the extensive TV campaign on riight now as the Ontarion Gov woke up to the fact that the provinces population does not know there are options

http://www.health.gov.on.ca/en/public/programs/hco/default.aspx

 

[nngbwh]

Wishing you a very successful surgery on Monday. Keep us posted.

 

[bigsidster]

I am from Windsor Ontario and the cardio doctor who did the angiogram sends his recomendations down to London health and Science center.There is a director there that looks at the surgeons schedules and then schedules you a doctor.I had a doctor Quantz who I did not know so I called and asked for Doc Myers who had just done my sister in law and her results were terrific.Doc Myers is a woman with small hands.

 

[Bina]

Mr.Big should be in surgery this afternoon.......waiting for good news!