Back from surgical consult - I have a date...

[buffhughes]

Just got back from the HUP and surgical consult with Dr. Pochettino. We drove from home to Philly on Wednesday - normally a 4.5 hour ride on a good day. Wednesday wasnt a good day... we started with about a foot of snow overnight and so the roads here were a mess. Further south in PA it was just sloppy and then just rain with some snow...it took us about 6hours to get to our hotel; we stayed about an hour outside Philly.

Drove into Philly on Thursday am for a 9:30 appointment at the Perelman Center with Dr. Pochettino. I have to say that the place is HUGE and extremely busy - it can be intimidating at first blush. The staff there took very good care of us and had us in an exam room 15 minutes early; they came in took my medical records and test CD's and said they would look them over be back. About 45 min later Dr. Moser came in to talk about his impressions of the studies and what the recommendation would be.

He basically said that it was time to go with a valve area of 0.6 and 50mmHg mean gradient. He also said that they would do a double bypass at the same time. He asked a few more questions and said that the surgeon (Dr. Pochettino) would be by shortly. Dr. Pochettino came in and very patiently went through all the pros and cons of tissue vs mechanical valves and said that he recommended a mechanical valve for me. I told him that part of why we selected him was that he implants the On-X valve and he said that he does many On-X valves and that I would be very happy with it. He said that for the bypass portion of the surgery that they would attempt to use an artery from the arm instead of saphenous vein from the leg. He said that studies show that arteries do better long term than veins but that the only arteries available are in the arm - some folks can do without them, others not. He answered our questions about surgical issues - opening, closing, blood, anesthesia, recovery...a lot of which we were well prepared for.

We scheduled for 18APR - this give me time to settle issues at work and my wife time to get her schoolwork and childcare worked out for the time we are gone. Since the surgery is less than a month out, the clinic staff sent me for all the pre-admission testing - chest xray, bloodwork, urine and an ultrasound of the arm.

We stayed in the Reading area Thursday night and discovered on our way out that the Philly traffic at 5pm is terrible. Will definitely have to find a place closer for DW for the surgery. Drove home today with a tiny stop at Cabelas for gifts for the kids (BIG and small)

 

[Lynlw]

Sounds like things went well and you seem much more happy after meeting the HUP doctors than the doctors you were talking to after your cath.
How did you end up choosing a hotel so far away? There are lots of places much closer, especially since HUP is part of the U of Penn campus, I'd definately stay in philly

 

[buffhughes]

Hi Lyn: We ended up in Reading basically because I'm cheap and I just couldnt see spending $500 for 2 nights in the city. Reading is about an hour out, not too bad and for a day trip I can put up with the hassle. I am much happier with Dr. Pochettino and the HUP experience. Not that our local system was bad, just that they didnt offer the valve I wanted and they assumed too much without asking. It didnt help that the surgeon we thought we might use didnt bother to even talk to me even though we asked for her and she was just 3 beds away. No hello, no recognition that we existed. Not a good way to get started.
DW is already looking in to getting a room in the city for the surgery..too much traffic and too many things to go wrong staying so far out.

 

[Lynlw]

Hi Lyn: We ended up in Reading basically because I'm cheap and I just couldnt see spending $500 for 2 nights in the city. Reading is about an hour out, not too bad and for a day trip I can put up with the hassle. I am much happier with Dr. Pochettino and the HUP experience. Not that our local system was bad, just that they didnt offer the valve I wanted and they assumed too much without asking. It didnt help that the surgeon we thought we might use didnt bother to even talk to me even though we asked for her and she was just 3 beds away. No hello, no recognition that we existed. Not a good way to get started.
DW is already looking in to getting a room in the city for the surgery..too much traffic and too many things to go wrong staying so far out.

Did you check into the discount hospital rates? I'm pretty sure even with out the discount there are a few hotels in walking distance much less than 250 a night- closer to 100-125 ,IF the HUP site doesn't offer enough details about closer hotels, be sure to check CHOPs site they list how many blocks from the hospital their located

 

[Greg a]

Larry, you are on the VR calendar

 

[epstns]

Larry - I'm not sure of your bypass needs, but did your surgeon mention the possibility of using the left interior mammary artery (LIMA)? This artery is entirely within the chest cavity and there is no secondary wound site. There is a second interior mammary artery on the right side, if you need more. I'm surprised they didn't mention this possibility, unless there are technical/medical/surgical reasons why not to use the mammary arteries. My bypass was done this way, and so far (4 weeks out) the only negative fallout from the bypass is some numbness of the skin on my upper chest, which usually goes away in a few months.

 

[buffhughes]

Hi Steve: He didnt mention the LIMA or RIMA(?), just that arteries do better than veins long term. Guess I will have to ask why the preference for the arm vs internal arteries.