Questions for Surgeon

[ALCapshaw2]

The more I learn about my situation (3rd surgery, radiation damage), the more questions come to mind.

Here is my latest list. My S.O. thinks it goes too far. What do you folks think?

1. How many Right Thorocotomys (R. side entry) have you performed each year beginning with CY 2000?

2. Which of these were for Mitral Valve Replacement?

3. Which of these were on patients already on Warfarin anti-coagulation for any reason?

4. Which (if any) of these patients suffered from Radiation Damage to the Chest?

5. Were there any complications resulting from any of these surgeries?

6. If so, what kinds of complications and how did you deal with them?

7. Were any of the patients permanently disabled (stroke or ??) or did anyone die from the surgery?


My S.O. thinks it goes too far. What do you folks think?

On a related note, how many of you had more than one meeting and/or Q/A session with your surgeon before setting a date?

As I look back, I am shocked at how little I knew about my surgeons before agreeing to let them operate.

'AL Capshaw'

 

[Phyllis]

I think they are all valid questions and any surgeon "worth his salt" would not be offended.

 

[ruth]

I had 1 meeting with my surgeon, it is amazing how little we know about the folks who open us up.

I like your list. One that we added was 'Are you the best surgeon in your practice to perform this particular surgery?' Our answer was 'I'm the only one in the practice that does the thorocotomy incision.'

Look at their hands, are they small? Someone with huge hands and/or fat fingers may have a harder time with this incision.

I would also ask whether the bypass machine will be in the same incision or will you have a second incision in your leg (or elsewhere) because they used the femeral (sp?) artery. I was just surprised to wake up to 2 cuts, not one. Not sure it matters to me really, both healed fine.

You're a man so I don't know how this applies or if it does. My right breast stayed numb for like 2 months. I think it would be fair to ask if you'll have numbness in your chest. You guys are lucky, nothing in the way....

Wishing you all the best.

Ruth

 

[ALCapshaw2]

Interesting point about numbness in the breast / chest Ruth. Thanks for your input.

One of my Bypass Grafts used one of the mamary arteries and that side of my chest was semi-numb for some time afterwards with a 'rubbery' kind of feel to it. It eventually returned to normal but I don't remember how long it took.

'AL Capshaw'

 

[MaryC]

Al,
Here's a few other questions I asked at my consultation:

Do you work with the same anesthesiologist? (Can get specific name of who he works with.)
Will there be residents in the OR?
Can surgery end up going traditional instead of port access and why? (I didn't ask but can ask for a percentage of how many of his/her surgeries go traditional...)
What tests are needed to do prior to surgery, such as CT angio, or heart catheter?
What are the risks/complications?

Another question you might want to ask is does anyone else do any of the surgery besides the surgeon (ex: Pa's)?

 

[Susan BAV]

Al -

I think your questions are good and I like Mary's too especially because the anesthesiologist plays a critical role in the surgery. Something that was particularly importatant to me was that I did not want a blood transfusion. That may or not matter to you but if it does, you would probably want to address that also.

But remember, the delivery of the questions is extremely important also. Could that be what your "significant other" is concerned about?

I had excellent word-of-mouth recommendation of my surgeon and consulted with him once pre-op but my husband and I immediately liked him. And he had small, sensitive but strong, hands that Ruth mentioned also.

Hope all goes well with your consultation. Keep us posted!

 

[bvdr]

Al, I think asking for specific numbers goes too far. I think we all already know that he has encountered complications so how about phrasing that a little more like what kind of complications has he run into and what were the most common ones and how often have these complications been significant enough to leave permanent damage or even be fatal.

Maybe also ask why he feels he is the best choice of surgeon for your case. He might be more apt to open up and then your other questions will be introduced more naturally into the conversation.

Tell him how you know that you are a higher risk patient and ask what special concerns that he, as a surgeon, has.

I guess what I am saying is try not to make it sound like an inquisition but rather part of your over-all preparation for surgery. I haven't been on the boards much lately so I'm not sure how close you are to having this all done. Do know that I wish the very best for you and that you will be in my prayers.

 

[brd]

Hi Al, I agree with Betty's points and would add the following. As you know I am post-radiation too and looking forward to AVR and possibly MVR so I spend and have spent a lot of time researching and talking to people about all this. The biggest thing on my mind is finding a surgeon who has significant experience with post radiation patients. According to all the medical folks I have spoken with that is essential. Secondly of course you want someone who has done this specific procedure many times. I don't think the exact number is necessary.

The other thing is the infection rate.....more specifically what is the hospital's current infection rate and has he had infections recently. I plan on ending with the suggestion that we work together on the latter and do everything possible to avoid it. Kim's recent experience really highlights this for me.

Al, when is this happening for you? I think I told you before that during my consult at Mass General with Gus Vlahakes he said that if he replaced the aortic now and I needed the mitral later he would do exactly the procedure you are having. He has experience with post radiation patients and I know several people on this forum have had their surgeries done by him.

That's all I know. Take care, Barbara