Tag Archives for congenital condition

The Second Opinion Surgeon Has Spoken: Two Years Is Too Long

I recently had my appointment with the second opinion surgeon. My reluctant surgeon sent me to him for a final opinion on what should be done to treat my condition. Before I get to the outcome of the consultation I want to say a few things about this doctor because I believe that who he is and how he dealt with meeting me should be described.

First, he wasn’t just any surgeon. He is THE SURGEON. More than thirty years ago, he graduated from one of the oldest and best medical schools in the country that today “teaches scientific excellence and humanity in medicine, facilitates leading health research, and influences social and health policy.” He then trained in General Surgery and followed that with a specialty in Colon and Rectal Surgery at another historied and world-class university – it was founded before our country was even a country. He completed is training in a prestigious Colon and Rectal Surgery Resident Training Program in Boston.

Since completing his training, the second opinion surgeon has amassed countless accolades. First, he returned to practice medicine at the medical school from which he graduated and within a few short years took on the role of Program Director of the General Surgery Residency Program – imagine the level of talent you would have to possess to have that role entrusted to you so early in your career. Within a few years he was back at his surgical alma mater to fulfill the role of the Program Director of a larger General Surgery Residency Program while simultaneously working as Head, Division of General Surgery – at the hospital where I am now being treated – for a decade. Within that same period he also became Program Director Residency Program in Colon and Rectal Surgery and still holds that role today.

The second opinion surgeon is a Member of the Board of Directors of the American Board of Colon and Rectal Surgery and is an Examiner for the American Board. He has served as an Associate Editor of Diseases of the Colon and Rectum and an Associate Editor of the Canadian Journal of Surgery. He has served as the President of the Canadian Society of Colon and Rectal Surgeons and as the Chair of the Royal College of Canada Specialty Committee for Colon and Rectal Surgery.

If these years of experience and knowledge as a surgeon and professor of medicine doesn’t put him at the top of his profession, then I don’t know what will. Nonetheless, with all of this backing him, he was unassuming and very human. He bounded into the examination room followed by four residents. I’ll confess that this was the part of the consultation that unnerved me: four extra sets of eyes and ears acting as witnesses to the history of my illness, all its wonderful symptoms, the side effects of medications, all the results from diagnostic tests and scans, and failed procedures. But neither they nor the second opinion surgeon were fazed by anything I reported about my likely rare congenital condition.

At the end of the Q&A, the second opinion surgeon made a number of declarations. First, two years is too long for me to live as I have with so much pain and such low quality of life. Second, it isn’t feasible for me to continue taking all the medications I need to manage the pain long-term. Next, my reluctant surgeon has taken a conservative approach to treating me by exploring all non-surgical options, but “the time for conservatism is over”. And finally, the thing in my pelvis that is the source of my pain has to come out. He looked up from his note-taking and asked if I agreed with his list of assertions. Of course I said yes. Truthfully, at that moment he could have told me the earth is flat and I would have agreed.

There you have it. The second opinion surgeon has spoken. I will have surgery. The thing living in my pelvis must be removed – regardless of the risks. My reluctant surgeon educated me about the known and warned of possible unknown risks and he agrees there are significant risks inherent to a resection, but leaving me as I am is not an option. Besides, there are risks with every major surgery. The hope is that removing this interloping growth will end my pain. The fear is that it won’t. Whatever the outcome, at least once it’s out they will finally be able to say with certainty what it is.

 

David Bowie – Changes

Second Opinion Surgeon

My Reluctant Surgeon continues to do things to gain my trust and confidence.

She has come through – a lot faster than I expected – with an appointment for me to be assessed by a more senior surgeon for a second opinion. I received a call from her office with a date to see the Second Opinion Surgeon in the next four weeks. My Reluctant Surgeon is sending me to him because she has significant concerns that the surgery I need might harm me more than it will help me.

I have a rare congenital condition that is detected by a single symptom: debilitating pain. It can only be treated by one thing: invasive abdominal surgery. My diagnosis was confirmed when my condition was very advanced and I had already been categorized as a chronic pain patient. The advanced stage and chronic pain are what make my Reluctant Surgeon so reluctant. She does not believe the surgery will eliminate my pain. At this point she and the pain specialists believe I have nerve damage, which may cause me to have greater pain after the surgery. And to top it off, I have a complicated form of this rare congenital condition. This exponentially increases the odds of me developing every known post-operative complication associated with abdominal surgery, and my Reluctant Surgeon is concerned that there may be unknowns that fall outside the scope of her experience.

So it will be up to the Second Opinion Surgeon to decide if I should have the invasive abdominal surgery. His additional years of experience are being counted on to find a surgical path to successfully remove the encroaching mass – that suddenly disrupted my life 18 months ago – without further harming my body. And, I’m hoping, those same skills will lessen my pain.

But I have to try not to get ahead of myself the way I did with my Reluctant Surgeon. Before my first appointment with her I had convinced myself that my condition was temporary – even with the knowledge of the known risks of the abdominal surgery. I was devastated when she told me surgery might not be an option for me and I might continue to be in pain for the rest of my life. Going into this appointment with the Second Opinion Surgeon, I want to be grounded in the reality that I could hear the same opinions. Although, a big part of me is preparing for the possibility that I will have to take a huge leap of faith toward and hope for the best.

 

George Michael – Faith (US Version)

Recall of Toradol Pain Medication

There is currently a voluntary recall of the pain medication I have grown to rely on – Toradol (ketorolac tromethamine) – when I go to the emergency room to get a bit of relief when I can no longer bear a pain flare up. Toradol only helps me when I get it by IV or direct injection combined with an opiate pain medication. And for me ‘help’ means it gets my pain back to what I now characterize as ‘normal’ levels, or on a general pain measurement scale down to about a four.

If you have never heard of it before, Toradol is a nonsteroidal anti-inflammatory drug (NSAID). It is used for the short-term treatment of moderate to severe pain. It works by reducing the production of hormones that cause inflammation. This helps to decrease swelling, pain, or fever. Unfortunately for me, the pill form does very little to reduce my pain but causes me significant stomach irritation so a trip to the emergency room to get an IV drip of Toradol has become my proxy happy place.

If you rely on Toradol injection for pain relief I hope this recall does not affect you. That being said, here’s the press release that was posted by the FDA

Hospira, Inc., (NYSE: HSP) has announced a voluntary recall of ketorolac tromethamine injection, USP in the United States and Singapore due to potential particulate. The presence of particulate has been confirmed through a customer report of visible, floating particulate identified in glass fliptop vials. The particulate was identified as calcium-ketorolac crystals. Multiple lots are impacted by this recall; refer to the addendum for product list and lot information.

…lots were distributed from February 2013 to December 2014 in the United States and from January 2014 to July 2014 in Singapore. Hospira has not received reports of any adverse events associated with this issue for these lots to date. Hospira has initiated an investigation to determine the root cause and corrective and preventive actions.

Anyone with an existing inventory of the recalled lots should stop use and distribution, and quarantine the product immediately. This recall is being carried out to the medical facility/retail level. Customers who have further distributed the recalled product should notify any accounts or additional locations which may have received the recalled product and instruct them if they have redistributed the product to notify their accounts, locations or facilities to the medical facility/retail level. Hospira has notified its direct customers via a recall letter and is arranging for impacted product to be returned to Stericycle in the United States. For additional assistance, call Stericycle at 1-888-345-4680 between the hours of 8am to 5pm ET, Monday through Friday. Customers outside the United States should work with their local Hospira offices to return the product per the local recall notification

Read the complete release: http://www.fda.gov/Safety/Recalls/ucm433857.htm

 

Lisa Fischer – How Can I Ease The Pain – Music Video (1991)