Local vs Out of State

[puckparent]

I am in the Chicago suburbs and have a meeting with Dr. Malaisrie at Northwestern Aug. 30th. I was going to set up a meeting with Dr. Schaff at Mayo, too, but am now torn about going out of state for my aortic valve replacement. I was told by someone (and confirmed by my cardiologist) that if there are complications after returning home from out of state that no local surgeon would touch another surgeon's work. Now I am really worried about that and don't know what to do. Even though my cardiologist keeps telling me that this is a routine heart surgery I am still worried and scared and want the best person and best hospital working on me. I welcome any opinions from those of you who went out of state or chose to stay home instead. My cardiologist said that if I don't like Dr. Malaisrie there is still time to set up meetings with other surgeons as I am looking at having the surgery either the end of October or beginning of November.

 

[hetmarie]

You have to be comfortable with who your surgeon is. It's a big decision. Have you researched Dr. Malaisrie and his/her clinic? Is there a reason you are having reservations about going to Northwestern? I was fortunate enough to be set up with the best of the best surgeon at the UW Madison. I liked Dr. Edwards immediately upon meeting him. He was very blunt and to the point with a touch of sarcasm which was a perfect fit for me. I live an hour away from the UW Hospital and had to have lots of follow up visits because my incision didn't close properly. I also had to go see him two days after being let out of the hospital because my shoulder incision had filled with fluid. (That was a very unpleasant car ride.) At one point I was going every week to see the surgeon. I work in Madison so one would think the hour long drive to see the doctor wouldn't be a huge issue but I have to say after that major of a surgery, it wiped me out so much and I dreaded having to go all that way so often. Just food for thought when deciding on how far you want to travel for your surgeon.

On a side note, my dad who lives in Florida has had numerous surgeries thanks to our tissue disorder (He's having surgery Aug 9 on his 8th aneurysm). He had to go four hours away because no one would touch him in his area. It was a real pain for him to have to travel that far for pre-op appointments and then post-op. I was worried for him because what happens if something happened to him once he got all the way home? Do we just pray that he has four hours to get to the hospital?

 

[Debbrn]

I live in Alabama and flew to Boston for my surgery. I needed another pulmonary valve replacement which was my fourth heart surgery. I thought that if I did not want the local hospital to do the surgery than I did not want them to handle any immediate post-op problems. I stayed in Boston for 2 weeks after discharge. I spent the first week in a hotel with my sister than luckily I had friends in Boston and stayed with them another week. I then flew home by myself with my parents picking me up at the airport. I actually had a wonderful time in Boston recuperating. I figured that the majority of surgical problems would happen in the first 2 weeks. I had a follow-up clinic appointment the day before I flew home. If I had lived in town I would have been back in 6 months. I actually waited a year. The main reason I waited is that 6 months was in December and I told her that I did not do snow. My cardio consented. My 1 year follow-up was good and I do not need to follow-up for 2 years. I have a local cardio that can do echos. I can call my Boston cardio if I feel that is needed.

Debbie

 

[Mentu]

Like many others, before my AVR I wondered about this same thing. In the end, I chose to have my surgery here in Tulsa. The facility was fairly new but already developing a good reputation and my surgeon and surgical team were very skilled. What I learned about my surgeon left me confident that I would not get better care elsewhere. As it turned out, my care after surgery was excellent and I was home in five days and walking in my own neighborhood. It was important to me that my surgeon, cardiologist and family doctor were nearby should I need them. Throughout the experience of preparation, surgery and recovery, my family doctor monitored my condition and care. If I had gone out of state, that would have been more difficult.

There is also the issue of my out of pocket cost. My insurance would cover less of the cost out of state than in state. I also learned that out of state, the hospital could choose to bill me for that portion of the cost above what my insurance paid; this was not the case in state. Financially, I would have experienced more exposure and possibly much more out of state. It is a good idea to ask some pointed questions of your health insurance company before making these decisions.

I would say that if you have any special issues relating to your surgery that you should look for someone skilled in dealing with those problems where ever they may be. If your surgery is relatively uncomplicated, then you have a lot more options to consider.

Larry

 

[New Guy]

Puckparent,

I live in Chicago area and went to Mayo for my AVR. Now I have 2 Cardios, my guy here and my guy there. I have benefited from that experience because both have helped me a great deal.

Mayo is only a 5 hour drive and I've been there 3 times. Once for my initial consult, once for the surgery and last time for a 6 month follow up. My other visits have been to my local guy. If you end up with a problem that needs immediate surgery you likely wont be seeing your original surgeon anyway. If it's not an emergency Mayo is only 5 hours away, and the Docs have been to me very accessible, much more so than my local Doc. I even have the email for my Mayo surgeon and Cardio and both have answered my q's the same day I emailed them. I could also schedule an appt with them sooner than I could my local guy.

The 5 hr drive home 5 days after surgery wasn't a problem for me. I had a great experience at Mayo but I'm sure NWestern is great too.

Doug

 

[puckparent]

Thanks everyone. A lot of interesting points for me to consider! I will see how I feel about the local doctor after I meet him and then I guess I will decide if I still want to go to Mayo.

 

[Marcia58]

Have you considered anywhere else in the Chicago area besides Northwestern? I'm in Indiana, but I went to the U of Chicago Hospital. My surgeon was Dr. Jeevanandam (Dr. Jeeves), Chief of Cardio-Thoracic Surgery. I've been very happy with the outcome.