Final problem before surgery

[Paleowoman]

I wrote this in another thread but that meant that other thread was rather highjacked by me so I paste what I wrote here:

I just came back from a cooling off six mile walk with hubby - had a big stress this morning - I discovered that the cardiac surgeon's secretary had given me the wrong insurance procedure code so I had to deal with that. I really don't think I should have to clear up people's mistakes about this at this point in time so I was pretty upset. I was practically crying on the phone to the insurance company - they will pay up and everything no problem, but it meant the authorisation code etc had to be changed - and you know, I spotted the error - why do I have to deal with this type of thing ? The surgeon and her secretary are in my bad books - they were even before this - I'm even considering not having the follow up at six weeks with the surgeon if everything is going well - I would much rather see my cardiologist (the only reason I am employing this surgeon is because on paper she appears the best technically). I have some very good doctors so I don't need to see other doctors whom it's not necessary to see...but that's assuming it all goes well which there's no reason to doubt....apart from when I get home and have problems with the stairs, my futon on the floor and my son who has autistic spectrum disorder. Next time when I have the re-do I will make sure that I have everything organised with much more time so that I don't keep having to clear up mistakes - this isn't the first ! At least I am still as fit as ever as that long walk showed. And (Tiger's thread) has inspired me

You should see a surgeon for your closeout. They take a chest XRay to see how your sternum has knit, how the wires are, etc. In the US, a post-surgery closeout meeting is included in the price and there is no extra charge, nor savings if you do not go. In my closeout, my surgeon suggested my INR range be changed from 2-3 to 2-2.5 due to his knowledge of the heart valve; my cardio's INR expert later agreed to the narrower range. From what I understand, a cardiologist is not the only specialist to judge the complete success of the operation; it's a partnership between the cardio with their echo and the surgeon with their Xray.

Hi Tom - I won't have to pay for the six week post-op follow up, it's just that unless there is a problem I see it as a waste of time me seeing a doctor who has caused me a lot of extra anxieties and frankly has annoyed me. With the luxury of more time I would have gone further afield to find a surgeon who would be not just technically good, like the one I am having, but who would also answer my questions and not be irritated by them, and who would not rush in her irritation. My husband came to the consultation that I had with the surgeon and he was rather put out by her attitude too. I'm having a tissue valve so no worries about INR as far as I know...and anyway I have many other health problems which she has made errors of judgement on - she's a surgeon and not a physician ! Still maybe she will be a changed woman when I see her on Sunday evening.......I am a very forgiving person ! And if my cardiologist advises me to see her, well I probably will.

 

[clay_from_nj]

Paleogirl - It looks like you got the opposite deal that I did. My surgeon is warm and friendly and extremely helpful ("call or come by any time") and even, according to my mother, very good looking. My cardiologist, on the other hand, has absolutely NO bedside manner (no personality according to some of his coworkers). I'd probably consider another cardio if he weren't as competent or if I had to see more of him (as with a GP).

 

[big_L]

I didn't see my surgeon again. This is common for those of us who travel for the surgery. Your GP or cardio can do the follow-up.

I too wasn't that fond of my surgeon. I think he's very technically proficient, but not the easiest to deal with. Having to straighten out their mess yourself is unbelievable. It's a sad example of the state of our health care system, but I'll spare you the rant on that subject.

 

[Paleowoman]

I didn't see my surgeon again. This is common for those of us who travel for the surgery. Your GP or cardio can do the follow-up.

I too wasn't that fond of my surgeon. I think he's very technically proficient, but not the easiest to deal with. Having to straighten out their mess yourself is unbelievable. It's a sad example of the state of our health care system, but I'll spare you the rant on that subject.

My health care system is the UK NHS but I have private medical insurance on top of that which is paid for by my hubby's work. Indeed I shouldn't have to straighten out the mess though - it's inefficiency, pure and simple

Good to know that not everyone sees their surgeon at the six week mark but can get follow up from GP or cardio. Both my cardio and GP are exceptionally good

 

[Jkm7]

It's been my impression many cardios encourage discharge from surgeon and 'handover' to cardio for continuing care. My cardio saw me post op several times prior to my being discharged by my surgeon but I think 'technically speaking' my surgeon was the lead physician in charge of my care until he released me. Others here please weigh in on this if you wish.

I might suggest you set up the surgeon follow up appointment post op and get your cardios opinion about whether (s)he really wants you to be released by surgeon or if they think it fine you not return. Why get caught in the middle of a tangle if it is unavoidable.

Your cardio well may say they are fine with you transferring back immediately to their care.

 

[Paleowoman]

I'll play it by ear and see how it goes in hospital and talk to my cardio about it. Of course I'd see the surgeon if there were a problem that only she could deal with, but if my cardio can deal with it…..but I'm having a tissue valve so I know I'll be under the cardio for follow ups anyway.

I'm off to the hospital tomorrow afternoon. I would much rather go in Monday morning since my surgery is scheduled for the afternoon, but that seems to be how they do things here - I wonder what they'll do for nearly 24 hours with me !

I'll report in when I'm back online

 

[Jkm7]

I have tissue valve and my surgeon ordered a brief course of coumadin until my own tissue grew over the seat of the valve. He wanted three months but as it turned out, my body required a very high dose of coumadin and I never actually reached his prescribed range before he told me to stop it at 2 1/2 months. He didn't like my taking so big a daily dose. Lucky for me I opted for a tissue valve as there was no way for me/my surgeon to know this in advance. Some surgeons want this brief course of coumadin post op with tissue valve and some do not. It might have made a difference my problem valve is mitral. One would think if your surgeon wanted it, (s)he would have said so by now. Mine told me in advance.

All best wishes to you. There is every reason to think you'll do absolutely fine. Of course, we'll be eager to hear from you as soon as you are comfortable posting.

 

[Bina]

I'll play it by ear and see how it goes in hospital and talk to my cardio about it. Of course I'd see the surgeon if there were a problem that only she could deal with, but if my cardio can deal with it…..but I'm having a tissue valve so I know I'll be under the cardio for follow ups anyway.

I'm off to the hospital tomorrow afternoon. I would much rather go in Monday morning since my surgery is scheduled for the afternoon, but that seems to be how they do things here - I wonder what they'll do for nearly 24 hours with me !

I'll report in when I'm back online

In Montreal, Canada, I saw my surgeon twice before surgery and immediately afterwards. Since I stayed in for 16 days I saw him a few times for my INR readings.
After that I went home and at the next post op visit it was my cardio that I saw. In between I was in contact with my general doc for basic concerns.

My admission to hospital was also the day before and my husband stayed with me until late night when i fell asleep.
The next time that I woke up was a day or so later and all was done
Best wishes !