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What ?s should surgeons be asking their patients?
Thanks for the reply’s. What concerns me is a multiple of issues in my long hernia journey. My case should have been I think pretty straight forward, if I had been given a Surgeon according to my very specific requests. I was told by the person who set up my initial appointment that he was a highly trained hernia specialist that performed hernia surgeries all of the time. I just found out that he had performed 0 in the 18 months leading up to my presurgical consult and that it was known that this quote world renowned hospital had a known 25 to 30 percent 1 year post surgery pain rate. Here is some background. My hernia occurred during a bad coughing spell at the site of the surgery for aN open appendicitis operation about 30 years ago. I will use this from another post ” It is just right of midline between my belly button and pubic bone”. My GP’s PA did the initial diagnosis and said it was a inguinal hernia. The quote expert hernia GS did two separate inguinal exams on different dates both lying down and standing and could not find anything and asked where is the bulge and I pointed to the spot described above. In his notes there is no mention of this, his findings or diagram of the hernia location. A couple on months later it was getting slightly worse for protruding and pain, plus when driving the top of the lap belt ran across it. So I decided to go ahead and have it fixed. So here is were this leads to in this post.
I was told by every staff member of this Doctor by phone or during consults which there were three, how great of surgeon, his current training and knowledge, that he performs them all the time and excellent outcomes at this clinic at 8% or less total problems and/or complication. So after the surgeon and his staff went thru what to expect and was given the little booklet here are my questions to the doctor which I asked.
When I left the first consult watchful waiting and open surgery.
This is what I asked to his PA and what I was told. second consult for surgery work up
How many has he done – performs them all the time since coming to the hospital about 18 months.
Will he perform the entire surgery – we do not have techs so a resident will only assist. She also stated that the resident would be the only non licensed person in OR. It would only be the surgeons highly trained and experienced team in the OR.
Gave the name of a class mate that is anesthesiologist that I would not be comfortable with doing the gas – Agreed but not noted in notes plus told the that it would be a highly experienced general anesthesiologist doing the gas.
Asked about metal-no metal to be used – absolvable sutures were to be used.
What is there are complications or pain post surgery – we have a world renowned specialist on staff for post pain to resolve the issue.
Surgery changed to Lap.Second consult with surgeon 3rd total. Changed back to open surgery. When I asked why no reason given. But again this is supposedly one of the best hospitals in the nation and being told constantly how great my surgeon is I except this.
Questions I ask the surgeon.
How many times have you done this type of surgery – well over 1,000
Are you going to perform the entire surgery – yes according to their residents exit survey the residents might perform up to 90% of the surgeries at this hospital.
What about current training – I am up on all current techniques for open hernia surgery
What or how do you deal with the three main nerves – We agreed he would locate and preserve. When asked after the surgery about why no note in post op about two of the nerves were not reported I was told not in the surgical field of vision.
What type of mesh to be used – We agreed on lightweight mesh. Heavyweight(PMII) was used and he could not answer why but another PA stated he performed so few since coming to this hospital that he might not have known approved types available.
Time of recovery – 6-8 weeks to be fully recovered.
Can I travel by plane in 10 day s- no problem
Side effects and complications – listed seroma, hematoma and infection as the three main ones. The writer of a study that found they had a 25% post pain issue was in the consult room at the time and said nothing. Also I had two previous surgeries in the general area and never mentioned a possible loss of testicle. Less than a week after the surgery the doctor stated he inserted the mesh a tight as possible
Pure tissue surgery – no can not be done that way.I now know that I forgot to ask two important questions-Why are you recommending open over lap and if doing it open why are you recommending a general over local.
I think I asked the right questions and was given the answers they wanted me to hear, that led me to consenting but after my surgery and reviewing my history plus what I have found I believe I was intentional missed informed.
That is why I stated this and Dr. Goodyears forum along with the book unaccountable should be required by consent it obtained.
Doctor Towfigh if you or the other mediators would like to review my history I would be more than happy to forward them to you.
Thanks again for all of your time and help you provide to this group