Definetly send the note and pic, and maybe include your cardio? I am much closer to my cardio tahn the surgeon (you only see the surgeon a couple of times), but I do see my surgeon at times as I volunteer in the hospital where he works.
SO, my first completed marathon post op was New York in 2008...the last 5 miles were terrible....I kept saying to myself: finish this race so you can give your finishers medal to Dr. Caputo (my cardio)...my mantra got me to the finish line. A week later, I set it up with the hospital to have a tv crew there, had them set up a meeting with my cardio...and surprised him on camera with my NY finishers medal. He has a still shot of it, with my medal, hanging in the waiting room....