choosing a surgeon?

[bethanne]

I have really been confused by the conflicting approaches to the bi-cuspid aortic valve issue of surgery before progression or surgery once changes to heart have taken place.

It makes sense that this conflict comes from cardiologist versus cardiology surgeon (is that the right terminology?)

How do you suggest finding a surgeon? When I peruse the methodist hospital website it is unclear which of the surgeons perform the valve replacement procedure. How did y'all go about finding a surgeon? Should I just wait and ask my card on March 3rd who he would recommend. I have to admit that I feel timid telling the cardiologist that I am interested in a second opinion from a surgeon's perspective. This seems so ridiculous that I feel this way, after all it is my life we are talking about here...

Does anyone know anything about the surgeons at Methodist Hospital. I did notice one doctor on their list of Cardio Surgeons that attended med school at the Cleveland Clinic...

Any suggestions?

 

[MarkU]

By the time I noticed my symptoms I had already had some enlargement of my left ventricle and my cardiologist suggested surgery within 3-6 months to avoid any permanent damage.
My cardiologist recommended my surgeon - they both concurred on the diagnosis and the need for my AVR. I was comfortable with both of them from the start and never felt the need for a second opinion.
During my surgery they found my valve was in much worse condition than they thought and the decision for my surgery was very appropriate.
I feel very lucky about my situation - that I had doctors that I trusted completely. If I would have had any doubts or questions I would certainly have sought second opinions.
I was also very fortunate to have some close friends on the surgical staff at the hospital who were able to give me some "unofficial" opinions about the doctors I was working with.
AVR is a life-changing event and you need to have absolute confidence in the people who are treating you.
Good luck,
Mark

 

[tommy]

Bethanne,

I used internet searches and word of mouth to find a surgeon. I had my echo, and was going back to the cardio to confirm that surgery was required. I basically turned the conversation from him "telling", to me asking for his opinion about the surgeons on my list. He rolled with that very well, and turned into my consultant. He validated each one and gave me a brief baground on their specialties and locations. He told me to do my research, come to a decision, and don't look back.

As for the search, I keyed in every word I could find for surgeons in the Dallas area, I felt like Dallas is a big enough place that I didn't need to go to Houston or Cleveland. I looked for surgeons that were staying up-to date in their craft - minimally invasive, etc. I felt like these are folks that really care to improve and use the latest available skills to help their patients. I was not looking for grand standing, but confidence is good. I had a short list and was looking for something definative that might help me choose.

Then I talked to people, a lot. Who do you know? What have your heard? What about this guy? What about this hospital? What about travelling - should I just pick the place closest to home?

Some friends at church have worked in the medical field in Dallas for some time. They suggested several hospitals that have great reputations for heart patients. I also got a personal recommendation for the surgeon at the top of my list - his kids' school teacher - my neighbor.

For me, all roads led to the same place. I was very fortunate in that regard. It was a difficult time, but surgery selection turned out to be simple after a short time.

My wife and I went to visit Dr. Mack. We went to get to know him and to get our second opinion about the surgery. We looked for things that might make us uncomfortable enough to seek a third opinion, or go elsewhere. We were impressed with him in all respects. The decision was made. Tears of relief confirmed it.

As I look back, I feel that anyone of the surgeons on my short list probably would have done fine job. Lots of people get wheeled straight from ER to OR wihtout any choice of surgeons, and they do fine.

I think that part of the process of research and study is coming to terms with the reality of heart surgery. Part of it is providing an outlet to have some "control" of the process. Of course, part of it is having the confidence that you are doing the right thing.

The important thing is that I have absolutely no regrets. I wish the same for you.

Houston is a great place for heart surgeries. I hear great hings about Methodist and Texas Heart Institute, although no personal experience. You should have no trouble finding a great surgeon that is a great fit you you.

All the best.

 

[epstns]

Bethanne - I can't help with choosing a surgeon, as I'm still too far pre-surgical for that. I can tell you, though, that any of the doc's I've ever seen were very comfortable with my seeking second opinions. They were confident enough that they felt that another opinion would validate their advice to me. It did -- although if the two opinions differred I would have had to make a choice. . .

 

[ALCapshaw2]

Re: Choosing a surgeon.

Many hospitals have a 'Doctor referal' service.
Call your local hospitals and ask if they do
heart surgeryes and who performs them.

Check the hospital ratings (by procedure)
on www.HealthGrades.com

You should be able to find a listing of
Cardiothorasic Surgeons in the telephone
books for major cities. Call those offices
and ask who specializes in Valve Surgery.
The one you mentioned who trained at
the Cleveland Clinic would be a good
place to start.

Once you have found some hospitals,
you may want to visit the Heart Surgery
floor and talk with the nurses there,
preferably when they are in a position
to 'talk freely'.

Good luck in your search.

'AL'

 

[bethanne]

I looked up methodist hospital for valve replacement the rating was a * which translates poor...

I am beginning to get a little jealous of those of you who live close enough to have your procedures done at the cleveland clinic

am i remembering correctly that some of you have flown after your surgery? But how do you handle follow up care?

 

[tommy]

Lies, damn lies, and statistics

Lies, damn lies, and statistics

Bethanne,

Your post surprised the heck out of me, because Houston is supposed to be one of the absulotely best places to go. Were you investigating on Healthgrade.com? I saw the one star * rating mortality for valve replacements at Methodist Hospital.

I dug a bit for the fine print and found that their data is gathered primarily from Medicare patients. They indicate that Medicare patients comprise 55-60% of the cardiac patients. Patient data for those under the age of 65 is specifically excluded.

http://www.healthgrades.com/public/index.cfm?fuseaction=mod&modtype=Content&modact=Hrc_Methodology&MeTy=MortComp

Also the one star * rating compares mortality rates with expectation. I don't know where they get their expectations, but the mortality rates are comparable to *** ratings for Dallas hospitals, just the Dallas expectation was an easier threshold (oh lucky me).

The raw data is incomplete and the start ratings are both bogus. So much for Internet research.

Find your surgeon. If the place is Methodist or St Lukes (Texas Heart Intitute), you can't go wrong - my opinion.

 

[Granbonny]

After my Heart Cath in Atlanta..my Cardiologist brought down a surgeon to my post-op Cath room and told my family..this is the surgeon that I would want to do my OHS... Had it done3 days later..No pain..No remembering ICU (vent, ect) and a pretty scar. And a great recovery.. I am so lucky..that Cardiologist came to my hometown..30 miles away to be chief cardiologist at a new Heart Wing..I see him every 6 months. Will be 2 years post-op March 25th...and he has the sweetest nurse. She just called me 5 minutes ago about my calling in my INR this morning. 3.2..Have been stable almost 21 months now. (INR) She always says. Keep doing whatever it is..you are doing. It is so good to have your Cardiologist nearby..if you need anything. You only see your surgeon one time after OHS..3 weeks later. Bonnie

 

[KathyH]

The way I chose the cardiac surgeon I saw was kind of the same way Tom did. I checked out the US news ratings for hospitals and saw that Brigham & Womens was rated #3. Since it is on 1 1/2 hours from where I live, I though why not go to the best. I checked out the hospital site and found out the names of the Dr. I remembered mamsram (one of VR members)had surgery there so I checked out his threads to find out the Dr he used. A friend of mine has a sister in law who worked at the hospital and she talked to nurses that worked in the unit. I was told they were all excellent.
KathyH

 

[Bryan B]

I noticed that list compared expected results to actual results. I would look at the actual mortality rate and factor in your age since the stats are taken from medicare patients. Another thing you need to consider is the type of cases the hospital you're looking at takes. For instance, teaching hospitals tend to take more critical cases than some of the others, therefore their mortality rate may naturally be higher. One thing that was important to me was the ratio of nurses to patients (higher ratio meaning you will have the staff to give you the care you need). And finally, I would ask around to find out how others who have been patients in the hospital would rate their stay.

 

[Granbonny]

Bryan

Bryan

It was only after my OHS..that I found out..St. Joseph's in Atlanta had a 5 star rating for their Heart nurses...Now I see. why I had no pain. No remembering ICU..ect.. They sat outside my room in a cubicle..while I was in my private room. watching me like a hawk I would walk and they would keep me on their monitor..They would just smile when I walked by..Bonnie

 

[bethanne]

thanks tom for the following:

"I dug a bit for the fine print and found that their data is gathered primarily from Medicare patients. They indicate that Medicare patients comprise 55-60% of the cardiac patients. Patient data for those under the age of 65 is specifically excluded. "

Boy that is a relief, my heart was certainly racing at that one.

Methodist has such a good reputation, I could hardly believe it when I saw the statistics...

any suggestions for researching online the surgeons listed on the methodist website?

i had posted an update on Jumpin in regarding my appt with my pa so i won't recount that appt. here .... i am feeling better being on the antibiotic but i am definately pursuing being prepared with having a surgeon in mind. and as soon as i get my echo done on the 26th and appt on March 3rd with card, get a second with the surgeon.

thanks alot y'all. I can't even talk to my husband about any of this it really flips him out... he keeps making these comments about me obsessing about all of this. I really appreciate the good information I have found here. knowledge is a powerful thing.


I have been holding my anxieties and fears inside, being able to express my fears and concerns on this site is very comforting...

 

[bethanne]

I think you coined it well with this Tom...

I think that part of the process of research and study is coming to terms with the reality of heart surgery. Part of it is providing an outlet to have some "control" of the process. Of course, part of it is having the confidence that you are doing the right thing.

Control is such an illusion.

bye the way happy valentines day everyone...

 

[tommy]

Bethanne,

As I titled the reply, there are "lies, damn lies, and statistics". In searching for surgeons, I guess I ignored the statistics and looked for the specialites, experience, continuous learning, and reputations. The cream rose to the top pretty quickly.

Healthgrade.com has some doctor searches that you have to pay (nominal) for. For my search, I just started keying in all the related words that I could come up with in a yahoo search ...... heart surgeon dallas ..... etc.

Glad you are doing better. Sorry your husband seems to be having a rough time with this. Perhaps his comments are because he's scared, or impatient - pretty natural reactions. Perhaps he's one of those that would just as soon let the cardio refer the surgeon and skip the research. Give him a couple of extra hugs for valetine's day.