Tag Archives for Surgery

My Reluctant Surgeon Keeps Bursting My Bubbles

Yesterday I had an appointment with my reluctant surgeon to follow-up my consultation with the second opinion surgeon. She does not agree with his assessment. She said that she and the second opinion surgeon have “binary opinions” about how to proceed. She still does not believe there will be any positive outcomes to the surgery that has been identified as necessary to remove the growth in my pelvis and restore my health. While he believes the only way to improve my situation is to undergo that risky surgery.

As it usually goes, I walked into my appointment feeling hopeful and I walked out feeling deflated. The only time, since my first meeting with her, that I felt any hope is when she suggested that I meet with the second opinion surgeon to get more guidance about my condition and options for how to treat it. I see now that she expected him to support her position. She wanted him to say that I shouldn’t have the surgery because it would be too risky and could considerably reduce my quality of life. She wanted him to take responsibility for making the decision. She had even told me that he might decide to take over my case after reviewing my charts and meeting me and have her assist during surgery.

But the second opinion surgeon didn’t say or do any of that. So yesterday she offered up the possibility of getting a third opinion. She said I shouldn’t view it as a “tie breaker” – because this next doctor’s opinion would clearly fall on either side – but it would make sure that all perspectives had been considered. How many perspectives are there in a case like mine? I can either have the necessary surgery with good outcomes or I can’t. What more is there to investigate? And what happens if this third opinion surgeon’s views land on the same side as the second opinion surgeon? Will my reluctant surgeon still be reluctant to do surgery? Will she continue to seek out other opinions until she gets the support she wants? Had she even considered that she was sending me to see a doctor at the hospital where I was misdiagnosed to get this third opinion?

When I questioned the rationale behind seeking a third opinion, she offered up the option to move forward with another exploratory procedure. This time it would be a laparoscopy. I mentioned that the second opinion surgeon asked if I had had one. The laparoscopy would be done to take a look into my pelvis to see if the structure growing there could be seen with more clarity than from all the imaging and other procedures I’ve had over the last 21 months (countless abdominal and trans-vaginal ultrasounds, two CT scans, an MRI, a colonoscopy, and two failed fine needle aspirations), and to confirm the growths exact origin. The structure and the origin of this growth have been debated since I first became ill and I was under the impression, until yesterday, that these issues had been resolved. But clearly not, and now instead of moving forward to completely remove it from my body she wants to take another small diagnostic/exploratory step.

Although, I should make something clear. She wants me to consent to this small step – the laparoscopy – with the understanding that depending on what she sees she may go ahead with the more complicated resection. I cannot consent to that. I cannot consent to that because my pain specialists have developed a detailed pain management plan for during and after the resection, which if not followed could leave me even more f****d than I am now. The pain plan must be started before surgery for a successful outcome. So the thought of allowing my reluctant surgeon to do something that would put me at risk of having more pain than I have now scares me beyond words.

After the appointment, when I got home, I contacted my doctor that referred me to my reluctant surgeon. Even though he is not my family doctor/general practitioner – he’s the gynecologist I was sent to because of my misdiagnosis – he has managed all my referrals. He’s the only one I trust to help me make the right decisions about this situation. I’ve requested an appointment to see him within the next few weeks. Whatever he says I’m sure will be better than my reluctant surgeon telling me that if I was her sister she wouldn’t recommend I have the surgery, which amounts to I shouldn’t have anything done at all and continue living with this unbearable pain and taking the mountains of pain medication that barely make a dent. Or worse, that I should make the decisions and absolve her from her responsibilities as a surgeon because she might put on her best, god-like performance in the operating room and fail.

This morning a light went on. My reluctant surgeon is not reluctant. She just does not want to do my surgery. She has not only burst my bubbles she has become the fly in my ointment.

 

Miley Cyrus – The Climb

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)